ABSTRACT
This study examined the efficacy of mindfulness based cognitive therapy on children (MBCT-C) with anxiety. Two hundred and forty children were screened, of which 52 (25 boys and 27 girls) with anxiety were randomly allocated to either MBCT-C or group therapy (GT including cognitive behavioral principles). Both groups were rated on the Spence Children's Anxiety Scale and Emotion Regulation Questionnaire-Child and Adolescent, pre- and 12 weeks post-interventions. MBCT-C was found to be more effective than GT in improving anxiety among children (between-group effect size Cohen's d 1.05) and as effective as GT in reducing emotion suppression for effective emotion regulation. This study provides support for MBCT-C as an effective group intervention for children with anxiety.
Subject(s)
Cognitive Behavioral Therapy , Mindfulness , Psychotherapy, Group , Adolescent , Anxiety/therapy , Anxiety Disorders/therapy , Female , Humans , MaleABSTRACT
Brief and repetitive episodes of perceptual changes, termed paroxysmal perceptual alteration (PPA), have been described in association with antipsychotic treatment. We report a case of paranoid schizophrenia who had such perceptual changes akin to PPA for 15 years, which was not related to antipsychotic treatment. There was a rapid resolution of PPA after treatment with low-dose clonazepam.
Subject(s)
Clonazepam/therapeutic use , GABA Modulators/therapeutic use , Perceptual Distortion/drug effects , Schizophrenia, Paranoid/drug therapy , Schizophrenia, Paranoid/psychology , Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Clozapine/adverse effects , Clozapine/therapeutic use , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To conduct a systematic review and meta-analysis of randomized placebo-controlled trials of mirtazapine for the treatment of antipsychotic-induced acute akathisia (AIAA). METHODS: Studies were identified using online searches of PUBMED/MEDLINE and Cochrane database (CENTRAL), along with websites recording trial information such as www.clinicaltrials.gov, www.controlled-trials.com, and www.clinicalstudyresults.org. The study eligibility criteria were randomized, double-blind clinical trials comparing mirtazapine with placebo for AIAA with standardized rating for akathisia as outcome measure. The methodological quality of included trials was assessed using the Jadad Scale. Separate meta-analyses were undertaken for each outcome (response rate and complete remission) and treatment effects were expressed as Mantel-Haenszel risk ratio (RR). Fixed-effect meta-analysis was performed as heterogeneity was not significant. Number need to treat (NNT) as a measure of relative treatment effectiveness was calculated. RESULTS: A systematic review of the literature revealed six studies that had assessed mirtazapine for the treatment of AIAA. Of these, two studies (n = 86) met the review inclusion criteria and were included in the final analysis. A meta-analysis was performed to see the effect size of response rate and complete remission. For response rate, RR was 6.67 [95% confidence interval (CI) 2.14-20.78], favoring mirtazapine compared with placebo, and the overall effect was significant (p = 0.001, NNT 4, 95% CI 2.6-8.6). For complete remission, RR was 6.20 (95% CI 1.74-22.08), favoring mirtazapine compared with placebo, and the overall effect was significant (p = 0.005, NNT 5, 95% CI 2.9-11.6). CONCLUSIONS: Although limited to only two studies and small sample, existing data support the efficacy of mirtazapine for the treatment of AIAA, with one in four patients showing partial response and one in five patients showing complete remission.
ABSTRACT
OBJECTIVE: The objective was to study the outcome of mood stabilizer discontinuation on recurrence in patients with bipolar disorder after at least 5 years of euthymia. METHODS: Twenty-three patients diagnosed with bipolar affective disorder according to the International Classification of Diseases, 10th Revision Diagnostic Criteria for Research, receiving mood stabilizer prophylaxis for at least 5 years, had undergone planned discontinuation, and the rates and time to recurrence were studied. RESULTS: Twenty (87%) of 23 patients had recurrence, and all of the episodes were manic. Kaplan-Meier survival analysis showed median time to recurrence following discontinuation of mood stabilizer prophylaxis was 10 months (SE, 6.06 months; 95% confidence interval, 0 to 21.89 months). CONCLUSION: Four fifths of our patients had recurrence following discontinuation of mood stabilizer prophylaxis within 10 months.
Subject(s)
Antipsychotic Agents/administration & dosage , Bipolar Disorder/diagnosis , Bipolar Disorder/drug therapy , Withholding Treatment/trends , Adult , Aged , Bipolar Disorder/psychology , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Recurrence , Time Factors , Treatment Outcome , Young AdultABSTRACT
Bupropion is a norepinephrine dopamine-reuptake inhibitor that has been found to be effective in the treatment of nicotine dependence. Although well tolerated, seizures and psychosis have been described to occur with bupropion as severe adverse effects. We report the precipitation of acute psychosis with bupropion prescribed for smoking cessation in an elderly patient.
Subject(s)
Bupropion/adverse effects , Dopamine Uptake Inhibitors/adverse effects , Psychoses, Substance-Induced/etiology , Acute Disease , Bupropion/therapeutic use , Dopamine Uptake Inhibitors/therapeutic use , Humans , Male , Middle Aged , Smoking Cessation/methodsABSTRACT
Usher syndrome (or Hallgren syndrome) is an autosomal recessive genetic disorder characterized by sensorineural deafness, retinitis pigmentosa, and variable vestibular deficit; Usher syndrome type II is the most common form. Various neuropsychiatric disorders have been reported to occur in those with Usher syndrome, including schizophrenia-like disorder, atypical psychosis, recurrent depressive illness, neurotic disorder, and mental retardation; however, bipolar disorder is not common in those with Usher syndrome. Herein we describe a 30-year-old male with Usher syndrome type II that developed features indicative of a probable manic episode. The patient had complete remission of symptoms in response to treatment with olanzapine 20 mg d-1. In persons with dual sensory impairment there are inherent problems with assessment and diagnosis is difficult due to their limited communication abilities. The diagnosis of Usher syndrome depends heavily on behavioral observation and disturbances in vegetative functions.
Subject(s)
Antipsychotic Agents/administration & dosage , Benzodiazepines/administration & dosage , Bipolar Disorder/psychology , Usher Syndromes/psychology , Adult , Bipolar Disorder/complications , Bipolar Disorder/drug therapy , Diagnosis, Differential , Humans , Male , Olanzapine , Usher Syndromes/complications , Usher Syndromes/drug therapyABSTRACT
Inhalant abuse such as kerosene, petrol, gasoline, and typewriter correction fluid has been reported from India. Naphthalene or mothballs, a commonly used substance in households and freely available in the market is an uncommon form of inhalant abuse which may lead to severe medical complications. We report an adolescent with addiction to naphthalene balls who developed severe anemia.