Martin B Keller

..Future studies should emphasize the role of preventive pharmacotherapy to improve the long-term course of anxiety and to reduce its associated suffering, suicide, and occupational and social impairment...

..Additional well-designed studies addressing these issues are urgently needed...

..The significantly higher remission rates attained with venlafaxine treatment as compared with some SSRIs warrant further studies of SNRIs for the long-term treatment of depression...

..Because treatment-seeking behavior is known to be associated with a worse prognosis, 23 weeks probably represents a lower-limit approximation of the median duration of an untreated depressive episode...

..To report second-year results from the 2-year maintenance phase of a long-term study to evaluate the efficacy and safety of venlafaxine extended release (ER) in preventing recurrence of depression...

..This study examined psychosocial functioning as a predictor of recovery from episodes of unipolar major depression...

..The main purpose of this study was to examine whether NA and AS will also predict the clinical course of PD...

..e., full and partial PTSD). This study suggests that, in a primary care setting, PTSD is a persistent illness, and that many subjects who have recovered from PTSD continue to suffer from subthreshold symptoms of PTSD...

..However, limited attention has been paid to how SLEs might affect the severity of panic symptoms in individuals with PD/PDA. In this study, we examined the relationship between SLEs and panic symptom severity in adults with PD/PDA...

..Whereas, the relapse rate, once recovery is achieved, is 34% during this 10-year follow-up. Treatment is underutilized in patients with SAD, and a long-term treatment approach may be needed to improve the likelihood of recovery from SAD...

..This study describes recurrence of major depression despite maintenance pharmacotherapy, termed tachyphylaxis...

..The goal of this study was to develop and validate a brief instrument to screen for bipolar disorder in patients actively ill with major depression...

..To date, few researchers have examined the natural course of SP in primary care. We examined the natural course and predictors of recovery in a large sample of primary-care patients...

..This study evaluated risperidone as an augmenting agent for patients who failed or only partially responded to an adequate trial of an antidepressant medication...

..Although this was not a prevalence study, results indicate a very low occurrence of MAD across 15 primary care settings. Further, they indicate that this diagnosis may not be stable across time and raise doubts about its utility...

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..Our purpose was to describe the characteristics of mental health treatment received by primary care patients diagnosed with PTSD...

..This study examined psychiatric treatment received by primary care patients with anxiety disorders and compared treatment received from primary care physicians and from psychiatrists...

..In patients who have recovered from an episode of major depression, the presence of psychosocial impairment may help identify who is at increased risk of recurrence...

..Overall, the LSAS performed similarly in our African American sample as in previous European American samples. Exploratory factor analyses are warranted to determine whether a better factor structure exists for African Americans...

..The current study extends previous research by showing that different anxiety disorders and comorbid conditions may be associated with impairment in specific domains of HR-QoL...

..Because the degree to which anxiety impacts patients with bipolar disorder is not fully known, more information is needed about the relationship between bipolar disorder and anxiety...

..Electroconvulsive therapy and psychotherapy offer additional treatment strategies. New nonpharmacologic therapies are under investigation. Remission is the goal of treatment...

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..The authors examined how the use of psychotropic drugs has shifted over the course of 10 years to determine if prescribing patterns have changed to reflect these revised treatment guidelines...

..The findings suggest that sleep disturbance in PTSD may have prognostic significance and may be important to address in clinical interventions...

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..The theoretical implications of these findings for future evaluations of anxiety sensitivity are discussed...

..Much remains unknown about the phenomenology of bipolar I disorder...

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..To describe the duration of bipolar I major and minor depressive episodes and factors associated with time to recovery...

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..14 over the 8 years. In conclusion, among individuals ascertained for anxiety disorders, the probability of recovering from BDD was relatively high and probability of BDD recurrence was low...

..We evaluated the comparative efficacy and safety of venlafaxine extended release (ER) and fluoxetine in the acute and continuation phases of treatment...

..These findings suggest that the presence of comorbid SUD may not explain the level of social and health difficulties associated with the dual diagnosis of PTSD and SUD...

..In conclusion, gepirone ER at a dose range of 40 to 80 mg/d is effective for relapse prevention in patients with recurrent major depression. It is well tolerated during long-term treatment for up to approximately one year...

..This dynamic is reinforced via the integration of current best therapeutic thinking in research settings, leading to clinical trials that more closely approximate an ideal, remission-focused treatment regimen...

..Physicians can help improve adherence by selecting medications with simple dosage regimens and educating patients and families about the disorder and what to expect from medications...

..Thus, it is critical to stay up to date with the best therapeutic approach, while remaining flexible as new therapies are developed...

..It is also well tolerated over prolonged periods. It should therefore prove suitable for use as maintenance treatment in depressed patients...

..The authors examined the relationship between posttraumatic stress disorder (PTSD), trauma, and self-reported nonpsychiatric medical conditions in a sample of 502 primary care patients with one or more anxiety disorders...

..Until then, remission should continue to be based on the descriptive and experiential phenomena of symptoms and psychosocial functioning...

..Personality disorders may be characterized by stable trait constellations that fluctuate in degree of maladaptive expression...

..Thus, although panic symptoms during remission may indicate an increased risk of subsequent relapse, the absence of symptoms during remission does not indicate that relapse is unlikely...

..Studies on the course of major depressive disorder (MDD) among elderly persons are limited to short periods of follow-up, seldom provide comparisons with younger cohorts, and raise other methodological concerns...

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..These results and the consistency of similar results over time point to the dire need for patient and provider education regarding the signs and symptoms of depression and its treatment...

..We set out to examine the prevalence and correlates of substance use disorders (SUD) in a large sample of adolescents with bipolar disorder (BP)...

..It may be that sex differences in the clinical course of anxiety disorders hold prognostic implications for patients with these illnesses...

..Few studies, though, have systematically examined the clinical correlates of Axis II personality disorder comorbidity or its effect on treatment response or time to response...

..This observational study examined the effectiveness of somatic antidepressant treatments as administered in the community...

..Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment...

..Longitudinally, BP-II is expressed as a dimensional illness involving the full severity range of depressive and hypomanic symptoms. Hypomania of long or short duration in BP-II seems to be part of the same disease process...

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..As nefazodone-mediated blockade of serotonin-2 receptors may directly relieve insomnia associated with depression, we examined the more specific effects of CBASP and nefazodone, singly and in combination, on sleep disturbances...

..Symptom severity levels fluctuate, often within the same patient over time. Bipolar I disorder is expressed as a dimensional illness featuring the full range (spectrum) of affective symptom severity and polarity...

..Among patients with a concurrent anxiety disorder, nefazodone. either alone or in combination with CBASP, improves anxiety symptoms faster than CBASP alone, independent of depressive symptom reduction...

..This investigation assessed the effect of personality disorders (PersDs) on time to remission in patients with generalized anxiety disorder, social phobia, or panic disorder...

..8%). Somnolence was significantly greater among the patients taking active medication (15.4%), compared with placebo (4.6%). CONCLUSIONS: Nefazodone is well-tolerated and is an effective maintenance therapy for chronic forms of MDD...

..Difficulties in the implementation of treatment guidelines are discussed...

..Earlier research showed that the use of benzodiazepines was not significantly associated with the presence or absence of a history of an AUD over the first year of follow-up. This report extends that investigation...

..Evidence of psychosocial disability in bipolar disorder is based primarily on bipolar I disorder (BP-I) and does not relate disability to affective symptom severity and polarity or to bipolar II disorder (BP-II)...

..Global patient ratings such as the PGI-I, as opposed to specific item-based ratings, provide less valid findings...

..The Journal of Nervous and Mental Disease, 188, 805-812], and suggest that increased psychosocial impairment may be a risk factor for relapse...

..These results underscore that GAD is a chronic and persistent illness in primary care patients...

..A continuation study of an extract of St. John's wort (Hypericum perforatum) for depression was performed in follow-up to an acute study that found no significant difference between St. John's wort extract and placebo...

..2001). Implications of these results for both the mental health and primary care fields are also discussed...

..The low relapse rate for patients with an acute placebo pattern switched to placebo suggests specific drug effect played a smaller role in their initial improvement...

..The authors suggest that chronic depression should be viewed as a single, broad condition that can assume a variety of clinical course configurations...

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..To test the long-term efficacy and safety of venlafaxine extended-release (ER) in preventing recurrence in patients with major depression...

..Patients receiving combination treatment reported stronger alliances with their psychotherapists than patients receiving CBASP alone. However, the impact of the alliance on outcome was similar for both treatment conditions...

..Our results suggest that psychotherapy may be an essential element in the treatment of patients with chronic forms of major depression and a history of childhood trauma...

..CONCLUSIONS: Women with more severe pathology have higher treatment utilization rates. This pattern may explain the seeming lack of treatment efficacy for eating disorders outside of randomized controlled studies...