International Journal of Psychiatry in Clinical Practice, 2010; 14: 235
Int J Psych Clin Pract Downloaded from informahealthcare.com by Universitaet Zuerich on 12/28/14 For personal use only.
EDITORIAL Two review articles, one on body shape and psychiatric diagnosis and the other on anxiety disorders as a risk factor for subsequent depression, open this issue. Pailhez and Bulbena summarize the literature based on Medline and PsycInfo databases up to 2009. The colleagues conclude that the topic was studied throughout the centuries. Among their diagnostic distribution, schizophrenic as well as mood disorder patients tend to oppose to body shapes. Further research and more empirically objective criteria to grasp these physical signs are encouraged. The review of Horn and Wuyek concludes that the presence of anxiety disorder is associated with high rates of developing subsequent major depression. The highest rates of subsequent depression have been found in generalized anxiety disorder, followed by panic disorder and social anxiety disorder. Sansone and colleagues surveying 80 patients addressed the relationship of childhood trauma and pain medication prescription in adulthood. It was evident that the number of different types of childhood abuses correlated with the prescription of NSAIDS or other pain medications as well as with the total number of pain medication prescribed. This seldomly addressed clinical topic deserves further research. A Taiwanese group, spearheaded by Tang, investigated the longterm effectiveness of aripiprazole in 28 adolescents and young adults with bipolar disorder. Although aripiprazole lead to a clinically meaningful improvement of global symptoms of mania, the treatment discontinuation rate within these first 6 months was high. Interestingly, patients experiencing a mixed episode discontinued aripiprazole therapy significantly earlier than those with manic or depressive episodes. Aslan and colleagues studied the dopamine type 2-receptor gene polymorphism in schizophrenic patients and healthy controls. They could not find any association in a Turkish sample. The authors correctly emphasized that larger sample sizes are needed to substantiate the role of the dopamine 2 polymorphism involved in the pathophysiology of schizophrenia. The Iran group of Semnani et al. investigated the bilirubin level in schizophrenia. A total of 162 schizophrenic and 165 bipolar disorder patients were compared to 95 patients admitted to a coronary care unit. Although the mean bilirubin levels were within the normal range at admission, they were higher in the group of schizophrenic patients and bipolar patients than compared those of the control group. There were also significantly higher degrees in the schizophrenia group. The possible common pathway between bilirubin metabolism and schizophrenia is discussed in this paper. Salivary α-amylase and cortisol levels were studied in unremitted and remitted depressed patients by the Japanese group of Ishitobi et al. Both salivary α-amylase ISSN 1365-1501 print/ISSN 1471-1788 online © 2010 Informa Healthcare DOI: 10.3109/13651501.2010.525357
and cortisol levels were significantly increased in unremitted depressed patients. Additionally to the wellknown fact of cortisol, salivary α-amylase can be considered as a state-dependent marker of depressive disorder. The pathophysiological consequences are discussed in the paper. A telephone-based nursing strategy to improve adherence to antipsychotic treatment in clinically stable outpatients with schizophrenia has been studied by Montes and colleagues from Spain. At week 16, a significantly higher percentage of patients who received a telephone-based follow-up were classified as adherent as compared to the control group. This research indicates that adherence to a medication can be modified by, for example, this easy-to-administer telephone approach. Smoking is still a problem in a large number of psychiatric hospitals worldwide. Takeuchi and colleagues studied the validity of self-reported smoking status in 158 schizophrenic patients and demonstrated that this is a reliable method for evaluating the smoking status. Ivarsson et al. examined the self-assessment Global Quality of Life scale, which could demonstrate, based on the statistical procedure, that it has acceptable psychometric properties and is valid for seriously mentally ill persons. Its use as an easy-to-use instrument for screening of perceived global quality of life is one of its obvious benefits. Malyszczak et al. studied mixed anxiety and depressive disorder before and after psychodynamic group psychotherapy, which was followed up after 1 year. It could be demonstrated that mixed anxiety and depressive disorder are a quite stable diagnosis, even after 12 months, and it therefore can also be diagnosed during and after psychotherapy. Two short reports conclude this issue, one on antidepressant monotherapy and combination of antidepressants in the treatment of resistant depression, the other one on bright light therapy. The group of Bares identified 81 patients, who benefited from a combination therapy with antidepressants and provided therefore “real world” data, which can be viewed as complementary to results of randomized controlled trials. The effect of bright light therapy (BLT) was studied with a new device in 20 healthy controls. It was apparent that the illumination of 5000 lux was well tolerated, specifically no headache was reported. The light cabin, that is how the authors call this device, can therefore be recommended for further studies based on these preliminary data. We hope that this issue is helpful for clinical practice and stimulates further research. Siegfried Kasper and David Baldwin