Fineberg NA, et al. – The current study investigated the neurocognitive profile in a nonclinical community–based sample of people fulfilling diagnostic criteria for obsessive compulsive personality disorder (OCPD) in the absence of major psychiatric comorbidity. Nonclinical cases of OCPD showed significant cognitive inflexibility coupled with executive planning deficits, whereas decision–making remained intact. This profile of impairment overlaps with that of OCD and implies that common neuropsychological changes affect individuals with these disorders. Pharmacological management of persistent hostility and
aggression in persons with schizophrenia spectrum disorders: A
The Journal of Neuropsychiatry & Clinical Neurosciences, 02/10/15
Victoroff J, et al. – The authors undertook a systematic review of
the English language literature to determine the efficacy of
neuropharmacological agents for the management of hostility and
aggression among persons with SSDs. Paliperidone–extended release
currently appears to be the agent for the management of hostility among
inpatients with SSDs for which there is the strongest evidence of
The search combined findings from the Medline, EMBASE, and PsycINFO databases.
Ninety-two full text articles were identified that reported relevant findings.
The American Academy of Neurology criteria were used to determine levels of evidence.
Paliperidone-extended release is probably effective for the
management of hostility among inpatients with SSDs who have not been
preselected for aggression (Level B).
Clozapine is possibly more effective than haloperidol for the
management of overt aggression and possibly more effective than
chlorpromazine for the management of hostility among inpatients with
SSDs who have not been preselected for aggression (Level C).
Clozapine is also possibly more effective than olanzapine or
haloperidol for reducing aggression among selected physically assaultive
inpatients (Level C).
Adjunctive propranolol, valproic acid, and famotidine are possibly
effective for reducing some aspects of hostility or aggression among
inpatients with SSDs (Level C).
They searched Pubmed (October 29, 2014) for randomized controlled
trials (RCTs) that examined switching the drug in nonresponders to
They described important methodological choices of the OPTiMiSE trial.
They found 10 RCTs on switching antipsychotic drugs.
No trial was conclusive and none was concerned with first-episode schizophrenia.
In OPTiMiSE, 500 first episode patients are treated with
amisulpride for 4 weeks, followed by a 6-week double-blind RCT comparing
continuation of amisulpride with switching to olanzapine and ultimately
a 12-week clozapine treatment in nonremitters.
A subsequent 1-year RCT validates psychosocial interventions to enhance adherence.
Escitalopram in the prevention of posttraumatic stress disorder: A pilot randomized controlled trial
BMC Psychiatry, 02/27/15
Suliman S, et al. – The data are consistent with other recent work
indicating that the SSRIs may not be efficacious in the prevention of
PTSD. Nevertheless, the small sample size and baseline differences
between groups limit the explanatory power of the study. Although a
consideration of the possibility of medication prophylaxis in PTSD
remains important, both from conceptual and clinical perspectives,
caution is needed with regards to the use of SSRIs until their efficacy
can be proven. Methods
24 week, double-blind placebo controlled study.
31 participants presenting immediately after trauma, and meeting
diagnostic criteria for full or partial acute stress disorder were
randomized to treatment with 10–20 mg of escitalopram or placebo daily
for 24 weeks.
2 participants were excluded from the analysis due to early drop
out, leaving 29 participants (escitalopram = 12, placebo = 17) for
inclusion in an intent- to- treat analysis.
Participants were followed up until 56 weeks, and assessed with the Clinician Administered PTSD Scale (CAPS).
A mixed model repeated measures analysis of variance (RMANOVA) was
undertaken to determine the efficacy of the intervention on the CAPS
There was a significant reduction in CAPS score over the course of
treatment (F(7, 142) = 41. 58, p < 0.001) in both the escitalopram
and placebo groups, with a greater reduction in CAPS score in the
placebo group F(7, 142) = 2.12, p = 0.045.
There were improvements on all secondary measures, including the
Clinical Global Impressions scale, and scales assessing depression,
anxiety and disability.
Only functional disability outcomes (F(7, 141) = 2.13, p = .04),
were significantly different between treatment and placebo groups.
In the sample as a whole, improvement in scores were maintained at the 52 week follow-up.
Istoric In Romania, in vremea comunismului, pshiatrii au fost incadrati in APR, ramura a celorlalte ramuri medicale.Dupa 1989 APR si-a coninuat prezenta, fiind in continuare condusa de urmasii lui Predescu, Gorgos, Angheluta & co. APR se face vinovat in fata istoriei printr-o selectie mafiotica care a coborit psihiatria romaneasca la un instrument de persecutie a regimului fata deorice aspiratie de innoire,de respingerea a numeroase valori care n-au incaput in breasla si au trebuit sa emigreze sau sa fie marginalizati, perspectiveneavind decit cei hiperadaptati la teroarea raului. Persecutiile fata de psihiatrii si chiar fata de unii bolnavi sunt cunoscute. Text integral