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Home » Topics » General Psychiatry

General Psychiatry
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Using the PHQ-9 in Psychiatric Practice

October 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
The PHQ-9 is the Patient Health Questionnaire-9. It was adapted from an instrument originally funded by Pfizer, the PRIME-MD, which was developed as a tool for primary care doctors to screen their patients for psychiatric disorders.
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Little guidance provided for second- step antidepressant selection

October 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
The most recent findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial provided little help regarding which medication to prescribe if an initial SSRI trial failed to result in remission of depressive symptoms.
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Viagra reduces SSRI-induced sexual side effects in women

October 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
Sildefanil (Viagra) has been shown helpful in treating antidepressant-induced sexual dysfunction (AISD) in men, but no controlled trials had tested its effectiveness in women. In this trial, 98 women with SSRI associated sexual dysfunction were randomly assigned to either sildefanil or placebo; all participants continued their SSRI, and their sexual functioning was assessed at multiple times.
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Psychiatrists providing less psychotherapy

October 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
In a nationally representative sample of office-based psychiatrists, the percentage of patient visits involving at least 30 minutes of psychotherapy dropped from 44% in 1996-1997 to 29% in 2004-2005.
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Learning Objectives, Improving Psychiatric Practice, TCPR, October 2008

October 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
After reading these articles, you should be able to…
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CLINICAL UPDATE

Topics in Personality Disorders

September 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD
Are you diagnosing a personality disorder (PD) in half of your patients? If not, you probably are not asking enough questions.
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CLINICAL UPDATE

Medications for Borderline Personality Disorder

September 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD
Most authorities in the world of borderline personality disorder (BPD) say that psychotherapy is the mainstay of treatment and that medications should only be used adjunctively to treat symptoms as they arise. Nevertheless, medications are used relatively frequently for this disorder.
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Gabitril fails to improve GAD symptoms in three controlled trials

September 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
Cephalon’s selective GABA reuptake inhibitor, the antiepileptic drug tiagabine (Gabitril), was assessed for the treatment of generalized anxiety disorder in adults in three large 10-week placebo-controlled studies.
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Vanda’s antipsychotic candidate iloperidone rejected by FDA

September 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
The FDA issued a Not Approvable letter regarding Vanda Pharmaceutical’s antipsychotic medication iloperidone (Fanapta). The agency based its decision on iloperidone’s question able efficacy results versus risperidone.
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Placebo response is usually long-lasting

September 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD
Based on data from eight randomized double-blind, placebo-controlled trials, researchers found that 79% of patients who responded to placebo in the initial phase of the trial maintained their response while continuing to take placebo during the continuation phase of the trial.
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