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CNS Spectrums

Massimo C Mauri, Giovanna Cirnigliaro, Chiara Di Pace, Silvia Paletta, Alessandra Reggiori, Carlo A Altamura, Bernardo Dell'Osso
OBJECTIVE: Psychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion. METHOD: The Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI)...
February 4, 2019: CNS Spectrums
Célia Fourrier, Gaurav Singhal, Bernhard T Baune
Cognitive impairments reported across psychiatric conditions (ie, major depressive disorder, bipolar disorder, schizophrenia, and posttraumatic stress disorder) strongly impair the quality of life of patients and the recovery of those conditions. There is therefore a great need for consideration for cognitive dysfunction in the management of psychiatric disorders. The redundant pattern of cognitive impairments across such conditions suggests possible shared mechanisms potentially leading to their development...
February 4, 2019: CNS Spectrums
Philippe Fossati
Major depression is a multidimensional disorder producing emotional dysregulation, cognitive impairment, and neuro-vegetative symptoms. A pathophysiological model of depression needs to explain how these dimensions interact to produce specific clinical phenotypes and how these interactions may predict remission to specific treatments. It is unlikely that major depression results from discrete brain lesions. Here we propose to define major depression as a disorder of neural networks. We review evidence suggesting that the dynamics of neural networks involved in allocation of attention resources to the internal and external world contribute to cognitive impairment, increased self-focus, and dysfunctional saliency detection in depression...
January 30, 2019: CNS Spectrums
Julie L Ji, David J Kavanagh, Emily A Holmes, Colin MacLeod, Martina Di Simplicio
Mental imagery refers to the experience of perception in the absence of external sensory input. Deficits in the ability to generate mental imagery or to distinguish it from actual sensory perception are linked to neurocognitive conditions such as dementia and schizophrenia, respectively. However, the importance of mental imagery to psychiatry extends beyond neurocognitive impairment. Mental imagery has a stronger link to emotion than verbal-linguistic cognition, serving to maintain and amplify emotional states, with downstream impacts on motivation and behavior...
January 28, 2019: CNS Spectrums
Juliet Silberstein, Philip D Harvey
A growing body of research has shown that two domains of cognition, neurocognition and social cognition, predict different domains of real-world outcomes in people with schizophrenia. Social cognition has been shown to predict social outcomes but not non-social outcomes (e.g. living independently), and neurocognition provides minimal prediction of social outcomes (e.g. interpersonal relationships). The differing predictive value of neurocognition and social cognition has led to an exploration of potential factors that interact with cognition to influence everyday outcomes...
January 26, 2019: CNS Spectrums
Nicole D Anderson
Mild cognitive impairment (MCI) represents a transitional stage between healthy aging and dementia, and affects 10-15% of the population over the age of 65. The failure of drug trials in Alzheimer's disease (AD) treatment has shifted researchers' focus toward delaying progression from MCI to dementia, which would reduce the prevalence and costs of dementia profoundly. Diagnostic criteria for MCI increasingly emphasize the need for positive biomarkers to detect preclinical AD. The phenomenology of MCI comprises lower quality-of-life, greater symptoms of depression, and avoidant coping strategies including withdrawal from social engagement...
January 17, 2019: CNS Spectrums
Priyanka Panchal, Alexander Kaltenboeck, Catherine J Harmer
While impairments in cognitive emotional processing are key to the experience of mood disorders, little is understood of their shared and distinct features across major depressive disorder (MDD) and bipolar disorder (BD). In this review, we discuss the similarities and differences in abnormal emotional processing associated with mood disorders across the cognitive domains of perception, attention, memory, and reward processing, with a particular focus on how these impairments relate to the clinical profile of the disorders...
January 15, 2019: CNS Spectrums
Roger S McIntyre, Nicole Anderson, Bernhard T Baune, Elisa Brietzke, Katherine Burdick, Phillipe Fossati, Philip Gorwood, Catherine Harmer, John Harrison, Philip Harvey, Rodrigo B Mansur, Alice Medalia, Kamilla Miskowiak, Tanya Ramey, Carola Rong, Joshua D Rosenblat, Allan Young, Stephen M Stahl
During the past two decades, it has been amply documented that neuropsychiatric disorders (NPDs) disproportionately account for burden of illness attributable to chronic non-communicable medical disorders globally. It is also likely that human capital costs attributable to NPDs will disproportionately increase as a consequence of population aging and beneficial risk factor modification of other common and chronic medical disorders (e.g., cardiovascular disease). Notwithstanding the availability of multiple modalities of antidepressant treatment, relatively few studies in psychiatry have primarily sought to determine whether improving cognitive function in MDD improves patient reported outcomes (PROs) and/or is cost effective...
January 15, 2019: CNS Spectrums
Astrid Müller, Matthias Brand, Laurence Claes, Zsolt Demetrovics, Martina de Zwaan, Fernando Fernández-Aranda, Randy O Frost, Susana Jimenez-Murcia, Michael Lejoyeux, Sabine Steins-Loeber, James E Mitchell, Richard Moulding, Maja Nedeljkovic, Patrick Trotzke, Aviv Weinstein, Michael Kyrios
The phenomenon of buying-shopping disorder (BSD) was described over 100 years ago. Definitions of BSD refer to extreme preoccupation with shopping and buying, to impulses to purchase that are experienced as irresistible, and to recurrent maladaptive buying excesses that lead to distress and impairments. Efforts to stop BSD episodes are unsuccessful, despite the awareness of repeated break-downs in self-regulation, experiences of post-purchase guilt and regret, comorbid psychiatric disorders, reduced quality of life, familial discord, work impairment, financial problems, and other negative consequences...
January 3, 2019: CNS Spectrums
Mao-Hsuan Huang, Mu-Hong Chen, Kai-Lin Huang, Ju-Wei Hsu, Ya-Mei Bai, Chih-Ming Cheng, Tung-Ping Su, Cheng-Ta Li, Shih-Jen Tsai, Wei-Chen Lin, Albert C Yang, Tzeng-Ji Chen
BACKGROUND: Research suggests an association between metabolic disorders, such as type 2 diabetes mellitus (T2DM), and schizophrenia. However, the risk of metabolic disorders in the unaffected siblings of patients with schizophrenia remains unclear. METHODS: Using the Taiwan National Health Insurance Research Database, 3135 unaffected siblings of schizophrenia probands and 12,540 age-/sex-matched control subjects were included and followed up to the end of 2011...
January 3, 2019: CNS Spectrums
Jagannadha Avasarala
Pharmacotherapy of multiple sclerosis (MS) is evolving rapidly. Despite impressive gains over the past 2 decades in the approval of multiple drugs for MS, lack of recruitment of minorities with MS in phase 3 clinical studies is a persistent concern and skews efficacy and disability data.
January 3, 2019: CNS Spectrums
Julie R Larsen, Camilla K Svensson, Louise Vedtofte, Mathilde Lund Jakobsen, Hans Søe Jespersen, Michelle I Jakobsen, Kamuran Koyuncu, Ole Schjerning, Jimmi Nielsen, Claus T Ekstrøm, Jens J Holst, Christoph U Correll, Tina Vilsbøll, Anders Fink-Jensen
OBJECTIVE: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. METHODS: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance...
December 31, 2018: CNS Spectrums
Tatiana Ramey, Paul S Regier
Cognitive impairments in substance use disorders have been extensively researched, especially since the advent of cognitive and computational neuroscience and neuroimaging methods in the last 20 years. Conceptually, altered cognitive function can be viewed as a hallmark feature of substance use disorders, with documented alterations in the well-known "executive" domains of attention, inhibition/regulation, working memory, and decision-making. Poor cognitive (sometimes referred to as "top-down") regulation of downstream motivational processes-whether appetitive (reward, incentive salience) or aversive (stress, negative affect)-is recognized as a fundamental impairment in addiction and a potentially important target for intervention...
December 28, 2018: CNS Spectrums
Christoph U Correll, Jennifer Kern Sliwa, Dean M Najarian, Stephen R Saklad
With more long-acting injectable (LAI) antipsychotics available for treating schizophrenia, each with variable durations of action (2 weeks to 3 months), it is important to have clear management strategies for patients developing breakthrough psychotic symptoms or experiencing symptomatic worsening on LAIs. However, no treatment guidelines or clinical practice pathways exist; health-care providers must rely on their own clinical judgment to manage these patients. This article provides practical recommendations-based on a framework of clinical, pharmacokinetic, and dosing considerations-to guide clinicians' decisions regarding management of breakthrough psychotic symptoms...
December 27, 2018: CNS Spectrums
Bashkim Kadriu, Wen Gu, Panagiota Korenis, Jeffrey M Levine
BACKGROUND: Numerous studies shown that structural hippocampal alterations are present in subjects at high risk of developing psychosis or schizophrenia. These findings indicate that in a subset of patients undergoing first-psychosis episode (FPE), hippocampal volume alterations are accompanied by associated cognitive and neuropsychological deficits. The combination of psychological deficits and neuroanatomical alterations, in turn, appears to increase treatment complexity and worsen clinical outcomes...
December 3, 2018: CNS Spectrums
Marie-Laure Cléry-Melin, Fabrice Jollant, Philip Gorwood
A lack of motivation and anhedonia represent frequent and pervasive symptoms in depression, although with poor specificity. Historically described as a response bias, reward-related impairments in depression may account for the important aspects of the cognitive impairments associated with diagnosis of major depressive disorder. Reward processing is a broad psychological construct that can be parsed into 3 distinct components known as "reinforcement learning" (learning), "reward responsiveness" (liking), and "motivation to obtain a reward" (wanting)...
November 26, 2018: CNS Spectrums
Zihang Pan, Caroline Park, Elisa Brietzke, Hannah Zuckerman, Carola Rong, Rodrigo B Mansur, Dominika Fus, Mehala Subramaniapillai, Yena Lee, Roger S McIntyre
Cognitive dysfunction is a symptomatic domain identified across many mental disorders. Cognitive deficits in individuals with major depressive disorder (MDD) contribute significantly to occupational and functional disability. Notably, cognitive subdomains such as learning and memory, executive functioning, processing speed, and attention and concentration are significantly impaired during, and between, episodes in individuals with MDD. Most antidepressants have not been developed and/or evaluated for their ability to directly and independently ameliorate cognitive deficits...
November 23, 2018: CNS Spectrums
Marco Solmi, Michele Fornaro, Kuniyoshi Toyoshima, Andrè F Carvalho, Cristiano A Köhler, Nicola Veronese, Brendon Stubbs, Andrea de Bartolomeis, Christoph U Correll
OBJECTIVE: Our aim was to summarize the efficacy and safety of atomoxetine, amphetamines, and methylphenidate in schizophrenia. METHODS: We undertook a systematic review, searching PubMed/Scopus/ for double-blind, randomized, placebo-controlled studies of psychostimulants or atomoxetine in schizophrenia published up to 1 January 2017. A meta-analysis of outcomes reported in two or more studies is presented. RESULTS: We included 22 studies investigating therapeutic effects of stimulants (k=14) or measuring symptomatic worsening/relapse prediction after stimulant challenge (k=6)...
November 21, 2018: CNS Spectrums
Richard Skaff
No abstract text is available yet for this article.
November 21, 2018: CNS Spectrums
Jeggan Tiego, Sanne Oostermeijer, Luisa Prochazkova, Linden Parkes, Andrew Dawson, George Youssef, Erin Oldenhof, Adrian Carter, Rebecca A Segrave, Leonardo F Fontenelle, Murat Yücel
OBJECTIVE: Impulsivity and compulsivity have been implicated as important transdiagnostic dimensional phenotypes with potential relevance to addiction. We aimed to develop a model that conceptualizes these constructs as overlapping dimensional phenotypes and test whether different components of this model explain the co-occurrence of addictive and related behaviors. METHODS: A large sample of adults (N=487) was recruited through Amazon's Mechanical Turk and completed self-report questionnaires measuring impulsivity, intolerance of uncertainty, obsessive beliefs, and the severity of 6 addictive and related behaviors...
November 21, 2018: CNS Spectrums
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