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Current Psychiatry Reviews
ISSN: 1573-4 005
Current Psychiatry Reviews
Volume 5, Number 3, August 2009
Contents
Anhedonia and Increased Stress Sensitivity: Two Promising
Endophenotypes for Major Depression Pp. 143-152
Elske Vrieze and Stephan J. Claes
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Article]
First Episode Psychosis, Substance
Abuse and Prognosis: A Systematic Review Pp. 153-163
Suzanne Archie and Katalin Gyömörey
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Article]
A Review of Modern Antidepressants’ Effects
on Neurocognitive Function Pp. 164-174
Eva Biringer, Arvid Rongve and Anders Lund
[Abstract] [Purchase
Article]
Obesity, Binge Eating, and Psychological Distress:
The Moderating Role of Self-Concept Disturbance Pp.
175-181
Bruce E. Blaine
[Abstract] [Purchase
Article]
Eating Disorders in Ethnic Minority Women: A Review
of the Emerging Literature Pp. 182-193
Fary M. Cachelin, Faith-Anne Dohm and Melanie
Brown
[Abstract] [Purchase
Article]
Managing Sleep Disturbance in Bipolar Disorder
Pp. 194-201
Allison G. Harvey and Descartes Li
[Abstract] [Purchase
Article]
Bifrontal ECT: A Systematic Review and Meta-Analysis
of Efficacy and Cognitive Impact Pp. 202-217
Chris Plakiotis and Daniel W. O'Connor
[Abstract] [Purchase
Article]
Parkinson’s Disease Dementia Pp. 218-225
Bradley J. Robottom and William J. Weiner
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Article]
Abstracts
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Anhedonia and
Increased Stress Sensitivity: Two Promising Endophenotypes
for Major Depression
Elske Vrieze and Stephan J. Claes
An endophenotypic approach in the research of major depression
(MDD) has the potential to enlarge our understanding of the
neurobiology and genetics of this complex disease. It has
been suggested that anhedonia and increased stress sensitivity
are two of the most promising endophenotypes for MDD. The
aim of this article is to evaluate the validity of this hypothesis,
based on the criteria necessary for the identification and
validation of endophenotypes: specificity, heritability, state-independence,
cosegregation, familial association and biological and clinical
plausibility. We conducted a review of the most current findings
of anhedonia and increased stress sensitivity in MDD, using
a survey of clinical, neurobiological, and genetic studies.
Both anhedonia and increased stress sensitivity seem to fulfil
the criteria for a valid endophenotype in the discussed literature.
However, increased stress sensitivity is less specific for
MDD and might influence MDD more indirectly, for example via
personality or early life events. Recent findings suggest
an interaction between the two endophenotypes, hypothesizing
that the anhedonia trait combined with stressful life events
may result in a vulnerability to MDD.
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First Episode Psychosis, Substance Abuse and Prognosis:
A Systematic Review
Suzanne Archie and Katalin Gyömörey
Objective: To determine whether first episode psychosis
(FEP) patients who meet criteria for substance abuse have
worse outcomes than FEP patients who do not abuse substances.
Method: A systematic literature search was conducted
using MEDLINE, PSYCHInfo, Cochrane controlled trial register,
and other databases to find prospective studies comparing
outcomes for FEP patients with and without substance abuse.
Both schizophrenia spectrum and affective spectrum patients
were included in the review. Outcomes included positive and
negative symptoms, risk of relapse, re-hospitalization, treatment
compliance and psychosocial variables.
Results: Twelve studies met inclusion criteria. Compared
to FEP patients without substance abuse, patients with substance
abuse experienced increased positive symptoms in five out
of seven studies; increased risk of relapse in two out of
two studies; and increased risk of poor treatment compliance
in three out of five studies. Only one of six studies examining
negative symptoms found a significant association with substance
abuse and only one out of eight studies found any associations
between psychosocial outcomes and substance abuse.
Conclusions: FEP patients with co-morbid substance
abuse may experience increased risk of relapse, increased
positive symptoms and poor compliance, but negative symptoms
and psychosocial variables may not be affected.
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A Review of Modern Antidepressants’
Effects on Neurocognitive Function
Eva Biringer, Arvid Rongve and Anders Lund
The present paper reviews the current literature
on modern antidepressants’ effects on neurocognitive
function. Today, it seems justified to state that SSRIs in
general do not affect cognitive function. However, there exists
some evidence that paroxetine is associated with a somewhat
lower performance on neurocognitive tests than other sub-groups
of SSRIs. Further, studies have consistently found sertraline
to be better with regard to cognitive function compared to
other SSRIs. There is a lack of studies assessing effects
of RIMAs and α2-receptor
antagonists on cognitive function. Some evidence suggests
that the latter may have negative effects on cognitive function.
Other studies suggest that reboxetine, bupropion and SNRIs
may be more beneficial with regard to cognitive function than
other antidepressants. However, the question whether these
medications may actually improve cognitive function to a higher
level than expected from improvement in depressive symptomatology,
remains unclear. Clinical, social and emotional factors are
important for cognitive function and these factors should
always be taken into consideration when assessing effects
of modern antidepressant therapy on cognitive function.
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Obesity, Binge Eating, and Psychological
Distress: The Moderating Role of Self-Concept Disturbance
Bruce E. Blaine
Obesity and binge eating disorder are common
comorbid conditions. Research documents that obese individuals
who binge eat have more psychopathology than do obese people
who do not binge eat, but theoretical explanations for this
relationship are scarce. A model is proposed that integrates
the robust self-concept differences between obese people with
and without binge eating disorder into our understanding of
the relationships between obesity, binge eating, and psychopathology.
The model characterizes binge eating as one of an array of
behavioral responses, which also include weight loss, dieting,
and social withdrawal, that help buffer psychological distress.
Some clinical implications of the model are discussed.
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Eating Disorders in Ethnic Minority
Women: A Review of the Emerging Literature
Fary M. Cachelin, Faith-Anne Dohm and Melanie
Brown
This paper presents recent research on ethnic
and cultural differences and similarities in disordered eating
in diverse groups of women. Eating disorders present a significant
problem among adolescent and young women in many Westernized
countries and are associated with numerous physical and psychiatric
problems. A common misconception has been that eating disorders
are a disease of middle- or upper-class White females. However,
a growing body of literature asserts that girls and women
from ethnic minority populations are not immune to developing
eating disorder symptoms or syndromes, although there are
indications that prevalence estimates vary depending on the
particular eating disorder symptom or syndrome under investigation
and depending on the population being studied. Studies provide
an initial indication that cultural factors may play a role
in the etiology of eating disorders. We first review what
currently is known about eating disturbances among diverse
groups of women and then present research examining the role
of culture and ethnicity in the detection and treatment of
eating disorders. We conclude with a summary of avenues for
future research and intervention.
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Managing Sleep Disturbance in Bipolar
Disorder
Allison G. Harvey and Descartes Li
Bipolar disorder is a severe and chronic disorder,
ranked in the top 10 leading causes of disability worldwide.
While there have been important advances in treatments, a
significant proportion of patients continue to experience
disabling symptoms between episodes and the risk of relapse
into an episode of depression or mania remains high. Three
lines of evidence suggest that sleep disturbances are strongly
coupled with interepisode dysfunction and symptom worsening
in bipolar disorder: (1) sleep disturbance is a core symptom
of bipolar disorder, (2) experimental studies suggest that
sleep deprivation can trigger manic relapse and (3) there
is evidence that sleep deprivation can adversely affect emotion
regulation the following day. The clinical management of the
sleep disturbances experienced by bipolar patients, including
insomnia and hypersomnia, may include medication approaches,
psychological interventions, light therapies and sleep deprivation.
The advantages of the psychological interventions include
that they are low in side effects, may be preferred by patients,
are durable and have no abuse potential. There is a critical
need to develop and test specific interventions for the sleep
problems experienced by patients with bipolar disorder.
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Bifrontal ECT: A Systematic Review
and Meta-Analysis of Efficacy and Cognitive Impact
Chris Plakiotis and Daniel W. O'Connor
The aim of this paper is to review the literature
regarding bifrontal electroconvulsive therapy (ECT) and provide
recommendations for future research in this area. Original
publications were retrieved using PubMeD, EMBASE, PsycINFO,
and Google Scholar. A systematic review and meta-analysis
of randomised clinical trials examining efficacy and/or cognitive
effects of bifrontal ECT for the treatment of depression is
the centrepiece of this paper. The literature regarding bifrontal
ECT is limited, with small patient numbers and treatment variation
across studies complicating result interpretation. However,
our findings suggest that while bifrontal and bitemporal ECT
may have similar efficacy, bifrontal ECT is associated with
less cognitive impairment immediately after a treatment course.
Bifrontal ECT may have greater efficacy than low-dose right
unilateral ECT but less efficacy than high-dose right unilateral
ECT. Conversely, bifrontal ECT may affect cognition more adversely
than low-dose right unilateral ECT, but less so than high-dose
right unilateral ECT. To further investigate the likely favourable
benefit to cognitive risk profile of bifrontal ECT, detailed
cognitive testing should be undertaken as part of any future,
large scale studies comparing the efficacy of adequately-dosed
bifrontal, bitemporal and right unilateral ECT.
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Parkinson’s Disease Dementia
Bradley J. Robottom and William J. Weiner
Parkinson’s disease (PD) is the second most common
neurodegenerative illness diagnosed in the United States.
Dementia is recognized to be common in PD, occurring in 19-78%
of patients depending upon the definition used. The cognitive
syndrome of Parkinson’s disease dementia is predominantly
one of executive dysfunction, and it has a profile that is
distinct from Alzheimer’s dementia. Neuropsychiatric
problems frequently accompany Parkinson’s disease dementia
and lead to considerable therapeutic challenges. This review
focuses on the epidemiology, clinical characteristics, pathology,
neuroimaging, diagnosis, and treatment of Parkinson’s
disease dementia.
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