Wednesday, May 25, 2005

Cognitive-Behavioural Therapy for Severe Mental Disorders  Guest editorial in the Canadian Journal of Psychiatry - "Over 4 decades, ago Aaron T Beck presented the basic theoretical and treatment approach of cognitive-behavioural therapy (CBT). Since then, hundreds of randomized controlled clinical trials (RCTs) have demonstrated the efficacy of CBT for the broad range of psychiatric conditions, including severe mental disorders such as bipolar disorder, refractory obsessive–compulsive disorder (OCD), substance abuse, suicide, personality disorders, and schizophrenia. Increasingly, we see the integration of CBT with biological psychiatry resulting in optimized treatment outcomes. This may be no better illustrated than in the recent efforts to develop and test cognitive and behavioural interventions for patients experiencing persistent symptoms of psychosis with only partial response to pharmacologic interventions. Although it has been noted that, as late as the 1980s, schizophrenia was the “forgotten child of behaviour therapy”, significant developments in the use of CBT for medication- resistant symptoms in schizophrenia have occurred over the past 15 years..."  
  

Is This Clinical Trial Fully Registered? A statement from the International Committee of Medical Journal Editors in the Journal of the American Medical Association - "In September 2004, the members of the International Committee of Medical Journal Editors (ICMJE) published a joint editorial aimed at promoting registration of all clinical trials.1 We stated that we will consider a trial for publication only if it has been registered before the enrollment of the first patient. This policy applies to trials that start recruiting on or after July 1, 2005. Because many ongoing trials were not registered at inception, we will consider for publication ongoing trials that are registered before September 13, 2005. Our goal then and now is to foster a comprehensive, publicly available database of clinical trials. A complete registry of trials would be a fitting way to thank the thousands of participants who have placed themselves at risk by volunteering for clinical trials. They deserve to know that the information that accrues from their altruism is part of the public record, where it is available to guide decisions about patient care, and deserve to know that decisions about their care rest on all of the evidence, not just the trials that authors decided to report and that journal editors decided to publish. We are not alone in pursuing this goal. The World Health Organization (WHO), through meetings in New York, Mexico City, and Geneva, has brought us close to the goal of a single worldwide standard for the information that trial authors must disclose..."  
  

Little change in suicidal thoughts, plans or attempts in US Press release from the Journal of the American Medical Association - "Despite a substantial increase in treatment for suicide attempts, no significant decrease occurred in the number of persons reporting suicide-related behaviors in the U.S. in the 1990s, according to a study in the May 25 issue of JAMA. Suicide is one of the leading causes of death worldwide, according to background information in the article. As a result, the World Health Organization and the U.S. surgeon general have highlighted the need for more comprehensive data on the occurrence of suicidal thoughts and attempts, with the assumption that such data would be useful for planning national health care policy, as well as for evaluating efforts to reduce suicide and suicide-related behaviors." An abstract of the study, "Trends in Suicide Ideation, Plans, Gestures, and Attempts in the United States, 1990-1992 to 2001-2003 ,"is available online from JAMA at no charge.  
  

New Seroquel data support benefits in bipolar disorder Shire Health International press release - "New data presented today at the American Psychiatry Association (APA) meeting in Atlanta, USA, demonstrate that the atypical antipsychotic SEROQUEL (Quetiapine) is effective in reducing suicidal thinking in patients suffering from bipolar depression, and also improves quality of life and adherence to treatment in patients with bipolar disorder. 'Unfortunately bipolar depression is associated with high suicide rates, with 25% to 50% of people with the illness attempting suicide,' commented Professor Joseph Calabrese, Co-Director of the Bipolar Research Center at University Hospitals of Cleveland and Case Western Reserve University School of Medicine. 'These data suggest a brighter future for patients with bipolar disorder as they illustrate that those treated with SEROQUEL benefit from a strong efficacy profile, combined with improved compliance and quality of life – three factors in antipsychotic treatment that are intrinsically linked. The fact that this strong efficacy profile includes an ability to reduce suicidal thinking is a significant benefit and is encouraging news for clinicians who are striving to deliver meaningful results for their patients.' "  
  

Integrated schizophrenia and substance abuse therapy improves outcomes Story at Psychiatry Matters - "Integrated dual disorders treatment appears to result in a good outcome for the majority of patients with schizophrenia and coexisting substance use disorders, report researchers from Dartmouth Medical School in Lebanon, New Hampshire, USA. 'Because patients with schizophrenia and substance abuse present a complex set of interwoven problems and treatment needs, a consensus has developed in favor of combining mental health and substance abuse treatment, which is termed integrated treatment,' note Haiyi Xie and team."