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Psychiatric Care During Pregnancy and Postpartum: Part II Management of Anxiety, Psychosis, and Lactation 妊娠和产后的精神护理:第二部分焦虑、精神病和哺乳期的管理
Pub Date : 2013-04-01 DOI: 10.1097/01.PSYPHR.0000429900.76636.70
M. McKean
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引用次数: 1
Psychiatric Care During Pregnancy and Postpartum: Part I: Diagnosis and Management of Mood Disorders 怀孕和产后的精神护理:第一部分:情绪障碍的诊断和管理
Pub Date : 2013-03-01 DOI: 10.1097/01.PSYPHR.0000428766.86387.F4
M. McKean
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引用次数: 1
Transcranial Magnetic Stimulation in the Treatment Of Anxiety Disorders 经颅磁刺激治疗焦虑症
Pub Date : 2013-02-01 DOI: 10.1097/01.PSYPHR.0000427461.48450.93
M. Dokucu, A. Denunzio, E. Esen
Lippincott Continuing Medical Education Institute, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article(s) and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 80% of the quiz questions correctly. This activity expires on January 31, 2014. Anxiety disorders are more common than depression in the United States, with an overall lifetime prevalence of 29%, and a 12-month prevalence of 18%. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), lists (from most to least prevalent): specific phobia (lifetime 12.5%, 12-month 8.7%); social anxiety disorder (SAD) (12.1%, 6.8%); posttraumatic stress disorder (PTSD) (6.8%, 3.5%); generalized anxiety disorder (GAD) (5.7%, 3.1%); panic disorder (PD) (4.7%, 2.7%); and obsessive-compulsive disorder (OCD) (1.6%, 1.0%). The DSM-V revisions proposed for these disorders involve minor changes in criteria while maintaining the current subclassification. The level of functional impairment for most people with anxiety disorders is significant, and related estiAfter participating in this CME activity, the psychiatrist should be better able to:
利平科特继续医学教育学院是由继续医学教育认证委员会认可的,为医生提供继续医学教育。Lippincott继续医学教育研究所有限公司指定这种持久材料为最多1个AMA PRA 1类信用tm。医生只应要求与他们参与活动的程度相称的荣誉。要获得CME学分,您必须阅读CME文章并完成随附表格上的测验和评估评估调查,正确回答至少80%的测验问题。此活动截止至2014年1月31日。在美国,焦虑症比抑郁症更常见,其总体终生患病率为29%,12个月患病率为18%。精神疾病诊断与统计手册,第四版,文本修订版(DSM-IV-TR),列出了(从最常见到最不常见的):特定恐惧症(终生12.5%,12个月8.7%);社交焦虑障碍(SAD) (12.1%, 6.8%);创伤后应激障碍(PTSD) (6.8%, 3.5%);广泛性焦虑障碍(GAD) (5.7%, 3.1%);惊恐障碍(PD) (4.7%, 2.7%);以及强迫症(OCD)(1.6%, 1.0%)。针对这些疾病提出的DSM-V修订版在维持当前亚分类的同时,对标准进行了细微的修改。大多数焦虑症患者的功能损害程度是显著的,相关的评估在参加了这种持续CME活动后,精神科医生应该能够更好地:
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引用次数: 1
The Effect of Antidepressant Therapy on Blood Pressure and Heart Rate Variability: A Review 抗抑郁治疗对血压和心率变异性的影响:综述
Pub Date : 2013-01-01 DOI: 10.1097/01.PSYPHR.0000425505.76789.f1
Alyson K. Myers, M. Trivedi
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引用次数: 1
Agomelatine: A Novel Antidepressant Therapy 阿戈美拉汀:一种新型抗抑郁药物
Pub Date : 2012-12-01 DOI: 10.1097/01.PSYPHR.0000423006.73274.e7
Ma Commodore
States was estimated to be 9%. Major depression can lead to deleterious effects on the medical, social, and vocational lives of sufferers in addition to costing the economy more than $50 billion per year as a result of treatment costs and lost productivity. Despite a steady increase in the size of the antidepressant armamentarium, no randomized clinical trial has demonstrated at least a 50% response for major depression (much less for the more significant endpoint of remission). Furthermore, all available antidepressants trace their mechanisms of action back to the biogenic amine hypothesis, raising the question of whether other avenues might produce more effective treatments. To that end, we examine the data for the efficacy, safety, and comparative effectiveness of agomelatine, a novel antidepressant. Disruptions of the sleep-wake cycle are key features of mood disorders, and residual symptoms, including sleep disturbances, are well-known risk factors for relapse. Furthermore, various manipulations of circadian rhythm (eg, rapid eye movement [REM] sleep deprivation, phase advancement) may produce antidepressant activity. Thus, influencing circadian rhythm patterns could be a potential antidepressant strategy. The core biological clock is located in the suprachiasmatic nucleus (SCN) in the anterior hypothalamus. The rhythms generated by the SCN are continuously synchronized by photic and nonphotic signals (Figure 1). The primary nonphotic inputs to the SCN originate in the median raphe nucleus, a major site of serotonergic neurons. The SCN projects to the pineal gland, stimulating the synthesis of melatonin, which provides negative feedback onto the pineal gland. Although it is neither a pacemaker nor does it function independently as an antidepressant, its main function is to set the endogenous clock’s sensitivity to light. Melatonin also acts to set the onset and duration of darkness by producing phase shifts in the signal patterns of the SCN. Data from rodent and primate studies indicate that the serotonergic projections onto the SCN serve to modulate After participating in this CME activity, the psychiatrist should be better able to: • Evaluate the pharmacologic profile of agomelatine and its potential mechanism of action. • Interpret the trial data supporting the efficacy of agomelatine in the treatment of major depression. • Compare the adverse-effect profile of agomelatine with that of other commonly used antidepressants.
估计是9%。重度抑郁症会对患者的医疗、社会和职业生活造成有害影响,除此之外,由于治疗费用和生产力损失,每年还会造成超过500亿美元的经济损失。尽管抗抑郁药物的规模稳步增加,但没有随机临床试验证明对重度抑郁症至少有50%的疗效(更重要的缓解终点更少)。此外,所有可用的抗抑郁药的作用机制都可以追溯到生物胺假说,这就提出了其他途径是否可以产生更有效治疗的问题。为此,我们检查了阿戈美拉汀(一种新型抗抑郁药)的有效性、安全性和相对有效性的数据。睡眠-觉醒周期的中断是情绪障碍的主要特征,而包括睡眠障碍在内的残留症状是众所周知的复发危险因素。此外,对昼夜节律的各种操纵(例如,快速眼动[REM]睡眠剥夺,阶段推进)可能产生抗抑郁活性。因此,影响昼夜节律模式可能是一种潜在的抗抑郁策略。核心生物钟位于下丘脑前部的视交叉上核(SCN)。SCN产生的节律由光和非光信号持续同步(图1)。SCN的主要非光输入源自中缝核,这是5 -羟色胺能神经元的主要部位。SCN投射到松果体,刺激褪黑激素的合成,褪黑激素向松果体提供负反馈。虽然它既不是起搏器,也不是独立的抗抑郁药,但它的主要功能是调节内源性时钟对光的敏感性。褪黑素还通过在SCN的信号模式中产生相移来设定黑暗的开始和持续时间。来自啮齿动物和灵长类动物的研究数据表明,在参与这种CME活动后,精神科医生应该能够更好地评估阿戈美拉汀的药理学特征及其潜在的作用机制。•解释支持阿戈美拉汀治疗重度抑郁症疗效的试验数据。•比较阿戈美拉汀与其他常用抗抑郁药的不良反应。
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引用次数: 0
Monoamine Oxidase Inhibitors: An Important but Underutilized Treatment Part II: Safety and Tolerability 单胺氧化酶抑制剂:一种重要但未充分利用的治疗方法。第二部分:安全性和耐受性
Pub Date : 2012-11-01 DOI: 10.1097/01.psyphr.0000422135.23603.07
Maria J. Julios Costa, M. Moyer, J. O'reardon
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引用次数: 0
Monoamine Oxidase Inhibitors: An Important but Underutilized Treatment Part I Efficacy 单胺氧化酶抑制剂:一种重要但未充分利用的治疗方法
Pub Date : 2012-10-01 DOI: 10.1097/01.PSYPHR.0000421537.96374.a0
Maria J. Julios Costa, M. Moyer, J. O'reardon
HISTORY AND BACKGROUND Monoamine oxidase (MAO) is an enzyme that converts biogenic amines to their corresponding aldehydes. In the brain, its primary substrates are epinephrine (EPI), norepinephrine (NE), dopamine (DA), and serotonin (5-HT). Tyramine is also catabolized by MAO after being absorbed from the gastrointestinal tract or after being generated by bacterial metabolic transformations. Johnston first demonstrated the existence of 2 forms of MAO in the brain, type A (MAO-A) and type B (MAO-B), which differ in their substrate affinities and inhibitor sensitivities. During the late 1940s, isoniazid and related compounds were used to treat tuberculosis but also produced unanticipated mood elevation. Later, it was determined that these drugs shared an ability to inhibit the MAO enzyme and increase the levels of 5-HT, NE, and DA in the brain. Hence, (MAOIs were the first class of antidepressant drugs to be identified and have long been recognized as efficacious for the treatment of depression. However, because of reports of acute hypertension after the ingestion of dietary tyramine After participating in this CME activity, the psychiatrist should be better able to:
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引用次数: 2
Psychopharmacologic Treatment of Acute Agitation: Part II 急性躁动的精神药理学治疗:第二部分
Pub Date : 2012-09-01 DOI: 10.1097/01.PSYPHR.0000419187.87926.2d
C. M. Gould
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引用次数: 0
Recent Second-Generation Antipsychotics: Implications for Treating Elderly Patients With Schizophrenia 最新的第二代抗精神病药物:对老年精神分裂症患者的治疗意义
Pub Date : 2012-08-01 DOI: 10.1097/01.PSYPHR.0000416597.69455.1e
P. Janicak, Jeffrey Rado
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引用次数: 0
Psychopharmacologic Treatment of Acute Agitation: Part I 急性躁动的精神药理学治疗:第1部分
Pub Date : 2012-07-01 DOI: 10.1097/01.PSYPHR.0000415883.88497.AC
C. M. Gould
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引用次数: 1
期刊
Psychopharm review : timely reports in psychopharmacology and device-based therapies
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