Dennis McCarty, Christina Bougatsos, Brian Chan, Kim A Hoffman, Kelsey C Priest, Sara Grusing, Roger Chou
OBJECTIVE: The authors conducted a scoping review to survey the evidence landscape for studies that assessed outcomes of treating patients with opioid use disorder with methadone in office-based settings. METHODS: Ovid MEDLINE and the Cochrane Database of Systematic Reviews were searched, and reference lists were reviewed to identify additional studies. Studies were eligible if they focused on methadone treatment in office-based settings conducted in the United States or other highly developed countries and reported outcomes (e...
July 28, 2021: American Journal of Psychiatry
Christine Merrild Posselt, Nikolai Albert, Merete Nordentoft, Carsten Hjorthøj
OBJECTIVE: The Danish OPUS trial showed significant efficacy of early intervention services for first-episode schizophrenia spectrum disorders compared with standard treatment, leading to implementation of the OPUS intervention in clinical practice. The authors sought to determine whether the effectiveness of OPUS treatment in real-world clinical practice is comparable to the efficacy seen in the trial. METHODS: The study compared patients who received OPUS treatment as part of the original randomized trial to those who received standard treatment in the trial (the control group) and those who received OPUS treatment after it was implemented in Denmark...
July 28, 2021: American Journal of Psychiatry
Brian A Fallon, Trine Madsen, Annette Erlangsen, Michael E Benros
OBJECTIVE: Lyme borreliosis is a tick-borne infectious disease that may confer an increased risk of mental disorders, but previous studies have been hampered by methodological limitations, including small sample sizes. The authors used a nationwide retrospective cohort study design to examine rates of mental disorders following Lyme borreliosis. METHODS: Using Denmark's National Patient Register and the Psychiatric Central Research Register, and including all persons living in Denmark from 1994 through 2016 (N=6,945,837), the authors assessed the risk of mental disorders and suicidal behaviors among all individuals diagnosed with Lyme borreliosis in inpatient and outpatient hospital contacts (N=12,156)...
July 28, 2021: American Journal of Psychiatry
Alexis C Edwards, Henrik Ohlsson, Eve Mościcki, Casey Crump, Jan Sundquist, Paul Lichtenstein, Kenneth S Kendler, Kristina Sundquist
OBJECTIVE: The authors examined the extent to which the genetic and environmental etiology of suicide attempt and suicide death is shared or unique. METHODS: The authors used Swedish national registry data for a large cohort of twins, full siblings, and half siblings (N=1,314,990) born between 1960 and 1990 and followed through 2015. They conducted twin-family modeling of suicide attempt and suicide death to estimate heritability for each outcome, along with genetic and environmental correlations between them...
July 14, 2021: American Journal of Psychiatry
James J Prisciandaro, Michaela Hoffman, Truman R Brown, Konstantin Voronin, Sarah Book, Emily Bristol, Raymond F Anton
OBJECTIVE: Although gabapentin has demonstrated efficacy in mitigating alcohol withdrawal symptoms and preventing relapse drinking in individuals with alcohol use disorder (AUD), the neurobiological mechanisms of action underlying these therapeutic effects remain unknown. The present study evaluated changes in GABA and glutamate levels in the dorsal anterior cingulate cortex (dACC) as candidate mechanisms of action. METHODS: In a 16-week randomized clinical trial, 68 adults with AUD, including a history of alcohol withdrawal syndrome, received 1,200 mg/day of gabapentin (N=37) or placebo (N=31) and nine medical management visits after ≥72 hours of abstinence...
July 14, 2021: American Journal of Psychiatry
Mark Weiser, John M Davis, Clayton H Brown, Eric P Slade, Li Juan Fang, Deborah R Medoff, Robert W Buchanan, Linda Levi, Michael Davidson, Julie Kreyenbuhl
OBJECTIVE: Effectiveness of antipsychotic drugs is inferred from relatively small randomized clinical trials conducted with carefully selected and monitored participants. This evidence is not necessarily generalizable to individuals treated in daily clinical practice. The authors compared the clinical effectiveness between all oral and long-acting injectable (LAI) antipsychotic medications used in the treatment of schizophrenia in the U.S. Department of Veterans Affairs (VA) health care system...
July 14, 2021: American Journal of Psychiatry
Marco Solmi, Jess Fiedorowicz, Laura Poddighe, Marco Delogu, Alessandro Miola, Anne Høye, Ina H Heiberg, Brendon Stubbs, Lee Smith, Henrik Larsson, Rubina Attar, René E Nielsen, Samuele Cortese, Jae Il Shin, Paolo Fusar-Poli, Joseph Firth, Lakshmi N Yatham, Andre F Carvalho, David J Castle, Mary V Seeman, Christoph U Correll
OBJECTIVE: This study used meta-analysis to assess disparities in cardiovascular disease (CVD) screening and treatment in people with mental disorders, a group that has elevated CVD incidence and mortality. METHODS: The authors searched PubMed and PsycInfo through July 31, 2020, and conducted a random-effect meta-analysis of observational studies comparing CVD screening and treatment in people with and without mental disorders. The primary outcome was odds ratios for CVD screening and treatment...
July 14, 2021: American Journal of Psychiatry
Edward V Nunes, Jennifer M Scodes, Martina Pavlicova, Joshua D Lee, Patricia Novo, Aimee N C Campbell, John Rotrosen
OBJECTIVE: Sublingual buprenorphine-naloxone and extended-release injection naltrexone are effective treatments, with distinct mechanisms, for opioid use disorder. The authors examined whether patients' demographic and clinical characteristics were associated with better response to one medication or the other. METHODS: In a multisite 24-week randomized comparative-effectiveness trial of assignment to buprenorphine-naloxone (N=287) compared with extended-release naltrexone (N=283) comprising inpatients planning to initiate medication treatment for opioid use disorder, 50 demographic and clinical characteristics were examined as moderators of the effect of medication assignment on relapse to regular opioid use and failure to initiate medication...
June 25, 2021: American Journal of Psychiatry
Isabell Brikell, Theresa Wimberley, Clara Albiñana, Emil Michael Pedersen, Bjarni Jóhann Vilhjálmsson, Esben Agerbo, Ditte Demontis, Anders D Børglum, Andrew J Schork, Sonja LaBianca, Thomas Werge, Ole Mors, David M Hougaard, Anita Thapar, Preben Bo Mortensen, Søren Dalsgaard
OBJECTIVE: Stimulant medications are effective for treating attention deficit hyperactivity disorder (ADHD), yet discontinuation and switch to nonstimulant ADHD medications are common. This study aimed to identify genetic, clinical, and sociodemographic factors influencing stimulant treatment initiation, discontinuation, and switch to nonstimulants in individuals with ADHD. METHODS: The authors obtained genetic and national register data for 9,133 individuals with ADHD from the Danish iPSYCH2012 sample and defined stimulant treatment initiation, discontinuation, and switch from prescriptions...
June 22, 2021: American Journal of Psychiatry
B Timothy Walsh, Tianchen Xu, Yuanjia Wang, Evelyn Attia, Allan S Kaplan
OBJECTIVE: There is long-standing interest in how best to define stages of illness for anorexia nervosa, including remission and recovery. The authors used data from a previously published study to examine the time course of relapse over the year following full weight restoration. METHODS: Following weight restoration in an acute care setting, 93 women with anorexia nervosa were randomly assigned to receive fluoxetine or placebo and were discharged to outpatient care, where they also received cognitive-behavioral therapy for up to 1 year...
June 22, 2021: American Journal of Psychiatry
Camilla L Nord, Rebecca P Lawson, Tim Dalgleish
OBJECTIVE: Maintenance of bodily homeostasis relies on interoceptive mechanisms in the brain to predict and regulate bodily state. While altered neural activation during interoception in specific psychiatric disorders has been reported in many studies, it is unclear whether a common neural locus underpins transdiagnostic interoceptive differences. METHODS: The authors conducted a meta-analysis of neuroimaging studies comparing patients with psychiatric disorders with healthy control subjects to identify brain regions exhibiting convergent disrupted activation during interoception...
June 22, 2021: American Journal of Psychiatry
Luke J Norman, Gustavo Sudre, Marine Bouyssi-Kobar, Wendy Sharp, Philip Shaw
OBJECTIVE: Psychostimulants are first-line pharmacological treatments for attention deficit hyperactivity disorder (ADHD), although symptom reduction varies widely between patients and these individual differences in treatment response are poorly understood. The authors sought to examine whether the resting-state functional connectivity within and between cingulo-opercular, striato-thalamic, and default mode networks was associated with treatment response to psychostimulant medication, and whether this relationship changed with development...
June 4, 2021: American Journal of Psychiatry
Adrienne Grzenda, Nina V Kraguljac, William M McDonald, Charles Nemeroff, John Torous, Jonathan E Alpert, Carolyn I Rodriguez, Alik S Widge
"Mr. A," a 24-year-old man, presents for evaluation of worsening depression. He describes a history of depression since adolescence, although he notes that he suffered a troubled childhood, including emotional neglect. He believes a recent breakup and having been denied a promotion precipitated this episode. "I'm sleeping all the time, and my body feels heavy," he adds. He also reports increased appetite, weight gain, and "urges to cut, which I have not done in years." However, he remains social and actively involved in several hobbies...
June 3, 2021: American Journal of Psychiatry
Lara A Ray, ReJoyce Green, Craig Enders, Adam M Leventhal, Erica N Grodin, Gang Li, Aaron Lim, Emily Hartwell, Alex Venegas, Lindsay Meredith, Steven J Nieto, Steven Shoptaw, Diana Ho, Karen Miotto
OBJECTIVE: Pharmacological treatments that can concomitantly address cigarette smoking and heavy drinking stand to improve health care delivery for these highly prevalent co-occurring conditions. This superiority trial compared the combination of varenicline and naltrexone against varenicline alone for smoking cessation and drinking reduction among heavy-drinking smokers. METHODS: This was a phase 2 randomized double-blind clinical trial. Participants (N=165) who were daily smokers and drank heavily received either 2 mg/day of varenicline plus 50 mg/day of naltrexone or 2 mg/day of varenicline plus matched placebo pills for 12 weeks...
June 3, 2021: American Journal of Psychiatry
Daniel S Pine, Steven P Wise, Elisabeth A Murray
Although rodent research provides important insights into neural correlates of human psychology, new cortical areas, connections, and cognitive abilities emerged during primate evolution, including human evolution. Comparison of human brains with those of nonhuman primates reveals two aspects of human brain evolution particularly relevant to emotional disorders: expansion of homotypical association areas and expansion of the hippocampus. Two uniquely human cognitive capacities link these phylogenetic developments with emotion: a subjective sense of participating in and reexperiencing remembered events and a limitless capacity to imagine details of future events...
June 3, 2021: American Journal of Psychiatry
Travis T Mallard, Jeanne E Savage, Emma C Johnson, Yuye Huang, Alexis C Edwards, Jouke J Hottenga, Andrew D Grotzinger, Daniel E Gustavson, Mariela V Jennings, Andrey Anokhin, Danielle M Dick, Howard J Edenberg, John R Kramer, Dongbing Lai, Jacquelyn L Meyers, Ashwini K Pandey, Kathryn Paige Harden, Michel G Nivard, Eco J C de Geus, Dorret I Boomsma, Arpana Agrawal, Lea K Davis, Toni-Kim Clarke, Abraham A Palmer, Sandra Sanchez-Roige
OBJECTIVE: Genome-wide association studies (GWASs) of the Alcohol Use Disorders Identification Test (AUDIT), a 10-item screen for alcohol use disorder (AUD), have elucidated novel loci for alcohol consumption and misuse. However, these studies also revealed that GWASs can be influenced by numerous biases (e.g., measurement error, selection bias), which may have led to inconsistent genetic correlations between alcohol involvement and AUD, as well as paradoxically negative genetic correlations between alcohol involvement and psychiatric disorders and/or medical conditions...
May 14, 2021: American Journal of Psychiatry
Maria C Pitharouli, Saskia P Hagenaars, Kylie P Glanville, Jonathan R I Coleman, Matthew Hotopf, Cathryn M Lewis, Carmine M Pariante
OBJECTIVE: The authors investigated the pathways (genetic, environmental, lifestyle, medical) leading to inflammation in major depressive disorder using C-reactive protein (CRP), genetic, and phenotypic data from the UK Biobank. METHODS: This was a case-control study of 26,894 participants with a lifetime diagnosis of major depressive disorder from the Composite International Diagnostic Interview and 59,001 control subjects who reported no mental disorder and had not reported taking any antidepressant medication...
May 14, 2021: American Journal of Psychiatry
Yash B Joshi, Michael L Thomas, David L Braff, Michael F Green, Ruben C Gur, Raquel E Gur, Keith H Nuechterlein, William S Stone, Tiffany A Greenwood, Laura C Lazzeroni, Laura R MacDonald, Juan L Molina, John A Nungaray, Allen D Radant, Jeremy M Silverman, Joyce Sprock, Catherine A Sugar, Debby W Tsuang, Ming T Tsuang, Bruce I Turetsky, Neal R Swerdlow, Gregory A Light
OBJECTIVE: Many psychotropic medications used to treat schizophrenia have significant anticholinergic properties, which are linked to cognitive impairment and dementia risk in healthy subjects. Clarifying the impact of cognitive impairment attributable to anticholinergic medication burden may help optimize cognitive outcomes in schizophrenia. The aim of this study was to comprehensively characterize how this burden affects functioning across multiple cognitive domains in schizophrenia outpatients...
May 14, 2021: American Journal of Psychiatry
Deidre M Anglin, Sabrina Ereshefsky, Mallory J Klaunig, Miranda A Bridgwater, Tara A Niendam, Lauren M Ellman, Jordan DeVylder, Griffin Thayer, Khalima Bolden, Christie W Musket, Rebecca E Grattan, Sarah Hope Lincoln, Jason Schiffman, Emily Lipner, Peter Bachman, Cheryl M Corcoran, Natália B Mota, Els van der Ven
The authors examine U.S.-based evidence that connects characteristics of the social environment with outcomes across the psychosis continuum, from psychotic experiences to schizophrenia. The notion that inequitable social and economic systems of society significantly influence psychosis risk through proxies, such as racial minority and immigrant statuses, has been studied more extensively in European countries. While there are existing international reviews of social determinants of psychosis, none to the authors' knowledge focus on factors in the U...
May 3, 2021: American Journal of Psychiatry
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July 2021: American Journal of Psychiatry
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