Tuesday, March 22, 2005

Early Detection of Schizophrenia Story in Current Opinion in Psychiatry at Medscape - "This article will evaluate the rationale and feasibility of detecting psychosis and schizophrenia earlier than is currently the case. ... Schizophrenia incidence may vary more than has been believed previously. Early detection studies fall into two groups. Firstly, operational criteria now exist for prodromal or at risk mental states which predict transition to psychosis of 20-40% over 1 year. The first randomized trials of antipsychotic drug and psychological interventions aimed at reducing this transition rate have shown promising results. Secondly, duration of untreated psychosis in the first episode seems genuinely to be associated with clinical outcome but how much of the association is truly causal remains disputed." [Viewing Medscape resources requires registration, which is free].  
  

Strategies to Enhance Patient Adherence: Making It Simple Medscape General Medicine article - "The problem of poor patient adherence has been extensively researched, but the rates of nonadherence have not changed much in the past 3 decades. Healthcare providers play a unique and important role in assisting patients' healthy behavior changes. We conducted a narrative review of the current literature to help providers become more familiar with proven interventions that can enhance patient adherence. We then grouped the interventions into categories that can be remembered by the mnemonic "SIMPLE": 1. Simplifying regimen characteristics; 2. Imparting knowledge; 3. Modifying patient beliefs; 4. Patient communication; 5. Leaving the bias; and 6. Evaluating adherence..." [Viewing Medscape resources requires registration, which is free].  
  

Adjunctive risperidone benefits chronic PTSD patients Story at Psychiatry Matters - "Risperidone appears to be an effective adjunctive treatment for chronic combat-related post-traumatic stress disorder (PTSD), say researchers in findings that suggest atypical antipsychotic medications may have a wide therapeutic spectrum. 'In this severely ill and probably treatment-resistant group of patients, risperidone was superior to placebo in reducing PTSD as well as other symptom clusters such as anxiety, psychosis, and possible depression over the 4-month study period,' George Bartzokis (University of California School of Medicine, Los Angeles, USA) and colleagues report. For the study, 65 men with chronic combat-related PTSD were referred to a 5-week residential treatment program followed by a 3-month patient follow-up. After the first week, the participants were randomly assigned to receive either risperidone or placebo in addition to ongoing psychotropic medication."  
  

Study: Depression can be treated in seniors Intense treatment can forestall dependency USA Today story reprinted at PsycPORT - "Successful treatment of depression in frail older people may help slow their physical decline, which could help keep them living independently as long as possible, a new study says. The findings suggest that doctors more aggressively identify and treat seniors with depression, an illness that puts people, especially the elderly, at risk of suicide. Many doctors mistakenly believe that treatment doesn't help older people suffering from depression. Not so, says Christopher Callahan, a geriatric researcher at the Indiana University School of Medicine in Indianapolis. Depression can be harder to treat in seniors, but this study and others suggest that treatment does work for many people. And when the fog of depression lifts, they find they're better able to perform routine but crucial tasks."