Western Psychiatric Institute Research Articles

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Physical Activity Monitoring Preferences in Adults With Bipolar Disorder.

This report investigated physical activity (PA) monitoring preferences and problems among adults with bipolar disorder (BD).Methods: PARC2 study was conducted at the Western Psychiatric Institute and Clinic at the University of Pittsburgh. This secondary data analysis assessed three PA monitors; Body Media SW Pro Armband, Actigraph AM-7164, and Pedometer Omron HJ-720IT. PA monitors were worn simultaneously for 1 week. Participants reported preferences and problems (irritating, cumbersome, movement of the activity monitor, technical difficulties, and impaired functioning) encountered with each activity monitor.Results: Approximately 70% of the participants (n = 66) were middle-aged Caucasian women with a diagnosis of BD I and overweight. Sixty-six adults with BD wore all 3 monitors simultaneously. Twelve (18%) participants had no PA monitoring preference, 28 (42%) preferred the armband, 17 (26%) preferred the pedometer and 9 (14%) preferred the Actigraph. Activity monitoring preferences did not statistically differ by age, gender, race, BMI, diagnosis, or depressive and mania symptoms (p > 0.25). Two-thirds of the participants (64%) had at least one problem with at least one activity monitor. As far as problem categories, more than a quarter of participants reported irritation with the Armband (26%, n = 17) and movement of the pedometer (32%, n = 21). No statistically significant association was observed between activity monitoring preferences and problems (p = 0.72).Discussion: Adults with BD were willing to wear activity monitors even though problems were reported. Preference of physical activity monitors, in descending order, was the armband, pedometer, and Actigraph. One fifth of the adults with BD reported no preferences in activity monitors. The activity monitors selected for investigation included the “gold standard” in activity monitoring (Actigraph) worn at the waist as well as a research grade pedometer that is considerably more affordable, provides activity feedback in real-time, and may be a more feasible option for large scale studies.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions

Editorial introductions

Editorial introductions

Editorial introductions

Severity and Variability of Depression Symptoms Predicting Suicide Attempt in High-Risk Individuals

Predicting suicidal behavior continues to be among the most challenging tasks in psychiatry. To examine the trajectories of clinical predictors of suicide attempt (specifically, depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability) for their ability to predict suicide attempt and to compute a risk score for suicide attempts. This is a longitudinal study of the offspring of parents (or probands) with mood disorders who were recruited from inpatient units at Western Psychiatric Institute and Clinic (Pittsburgh) and New York State Psychiatric Institute. Participants were recruited from July 15, 1997, to September 6, 2005, and were followed up through January 21, 2014. Probands and offspring (n = 663) were interviewed at baseline and at yearly follow-ups for 12 years. Lifetime and current psychiatric disorders were assessed, and self-reported questionnaires were administered. Model evaluation used 10-fold cross-validation, which split the entire data set into 10 equal parts, fit the model to 90% of the data (training set), and assessed it on the remaining 10% (test set) and repeated that process 10 times. Preliminary analyses were performed from July 20, 2015, to October 5, 2016. Additional analyses were conducted from July 26, 2017, to July 24, 2018. The broad definition of suicide attempt included actual, interrupted, and aborted attempts as well as suicidal ideation that prompted emergency referrals during the study. The narrow definition referred to actual attempt only. The sample of offspring (n = 663) was almost equally distributed by sex (316 female [47.7%]) and had a mean (SD) age of 23.8 (8.5) years at the time of censored observations. Among the 663 offspring, 71 (10.7%) had suicide attempts over the course of the study. The trajectory of depression symptoms with the highest mean scores and variability over time was the only trajectory to predict suicide attempt (odds ratio [OR], 4.72; 95% CI, 1.47-15.21; P = .01). In addition, we identified the following predictors: younger age (OR, 0.82; 95% CI, 0.74-0.90; P < .001), lifetime history of unipolar disorder (OR, 4.71; 95% CI, 1.63-13.58; P = .004), lifetime history of bipolar disorder (OR, 3.4; 95% CI, 0.96-12.04; P = .06), history of childhood abuse (OR, 2.98; 95% CI, 1.40-6.38; P = .01), and proband actual attempt (OR, 2.24; 95% CI, 1.06-4.75; P = .04). Endorsing a score of 3 or higher on the risk score tool resulted in high sensitivity (87.3%) and moderate specificity (63%; area under the curve = 0.80). The specific predictors of suicide attempt identified are those that clinicians already assess during routine psychiatric evaluations; monitoring and treating depression symptoms to reduce their severity and fluctuation may attenuate the risk for suicidal behavior.

Long-acting risperidone injections in a pregnant patient with bipolar disorder.

Bipolar DisordersVolume 19, Issue 7 p. 606-607 CONUNDRUM Long-acting risperidone injections in a pregnant patient with bipolar disorder Kimberly Clinebell, Corresponding Author Kimberly Clinebell clinebellkd@upmc.edu Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Correspondence Kimberly Clinebell, Clinical Assistant Professor Psychiatry, Western Psychiatric Institute and Clinic of UPMC, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA, USA. Email: clinebellkd@upmc.eduSearch for more papers by this authorJessica Gannon, Jessica Gannon Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this authorSarah Debrunner, Sarah Debrunner Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this authorK. N. Roy Chengappa, K. N. Roy Chengappa Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this author Kimberly Clinebell, Corresponding Author Kimberly Clinebell clinebellkd@upmc.edu Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Correspondence Kimberly Clinebell, Clinical Assistant Professor Psychiatry, Western Psychiatric Institute and Clinic of UPMC, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA, USA. Email: clinebellkd@upmc.eduSearch for more papers by this authorJessica Gannon, Jessica Gannon Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this authorSarah Debrunner, Sarah Debrunner Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this authorK. N. Roy Chengappa, K. N. Roy Chengappa Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA University of Pittsburgh School of Medicine, Pittsburgh, PA, USASearch for more papers by this author First published: 09 November 2017 https://doi.org/10.1111/bdi.12572Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume19, Issue7November 2017Pages 606-607 RelatedInformation

Assessing Career Outcomes of a Resident Academic Administrator, Clinician Educator Track: A Seven-Year Follow-up.

This study reports the academic outcomes, including scholarly productivity, of the graduates of one residency training track for future clinician educators and academic administrators. Since its implementation in 2008, the Academic Administrator, Clinician Educator (AACE) track at Western Psychiatric Institute and Clinic - UPMC has grown in popularity with reports of participants achieving post-graduate academic success; however, there has been no prior assessment of outcomes. In 2015 all graduates of the track were surveyed using an anonymous, web-based survey. Twenty-nine total graduates were surveyed RESULTS: Twenty-four graduates responded to the survey (83% response rate). The graduates are very active in academic psychiatry with 23 (96%) holding an academic appointment with different administrative roles, medical director (50%) and training director (17%) being the most frequent. Participants have also been active in pursuing scholarship with 80% presenting their scholarly projects at local and national conferences and producing post-graduate, peer-reviewed articles (50%). This study underscores the benefits of a clinician educator track and suggests areas for future growth.

Brain morphometric biomarkers distinguishing unipolar and bipolar depression. A voxel-based morphometry-pattern classification approach.

The structural abnormalities in the brain that accurately differentiate unipolar depression (UD) and bipolar depression (BD) remain unidentified. First, to investigate and compare morphometric changes in UD and BD, and to replicate the findings at 2 independent neuroimaging sites; second, to differentiate UD and BD using multivariate pattern classification techniques. In a 2-center cross-sectional study, structural gray matter data were obtained at 2 independent sites (Pittsburgh, Pennsylvania, and Münster, Germany) using 3-T magnetic resonance imaging. Voxel-based morphometry was used to compare local gray and white matter volumes, and a novel pattern classification approach was used to discriminate between UD and BD, while training the classifier at one imaging site and testing in an independent sample at the other site. The Pittsburgh sample of participants was recruited from the Western Psychiatric Institute and Clinic at the University of Pittsburgh from 2008 to 2012. The Münster sample was recruited from the Department of Psychiatry at the University of Münster from 2010 to 2012. Equally divided between the 2 sites were 58 currently depressed patients with bipolar I disorder, 58 age- and sex-matched unipolar depressed patients, and 58 matched healthy controls. Magnetic resonance imaging was used to detect structural differences between groups. Morphometric analyses were applied using voxel-based morphometry. Pattern classification techniques were used for a multivariate approach. At both sites, individuals with BD showed reduced gray matter volumes in the hippocampal formation and the amygdala relative to individuals with UD (Montreal Neurological Institute coordinates x = -22, y = -1, z = 20; k = 1938 voxels; t = 4.75), whereas individuals with UD showed reduced gray matter volumes in the anterior cingulate gyrus compared with individuals with BD (Montreal Neurological Institute coordinates x = -8, y = 32, z = 3; k = 979 voxels; t = 6.37; all corrected P < .05). Reductions in white matter volume within the cerebellum and hippocampus were found in individuals with BD. Pattern classification yielded up to 79.3% accuracy (P < .001) by differentiating the 2 depressed groups, training and testing the classifier at one site, and up to 69.0% accuracy (P < .001), training the classifier at one imaging site (Pittsburgh) and testing it at the other independent sample (Münster). Medication load did not alter the pattern of results. Individuals with UD and those with BD are differentiated by structural abnormalities in neural regions supporting emotion processing. Neuroimaging and multivariate pattern classification techniques are promising tools to differentiate UD from BD and show promise as future diagnostic aids.

APA Offers Online Course Focusing on Recovery

Back to table of contents Previous article Next article Association NewsFull AccessAPA Offers Online Course Focusing on RecoveryVabren WattsVabren WattsSearch for more papers by this authorPublished Online:15 Sep 2014https://doi.org/10.1176/appi.pn.2014.9b3AbstractThe new Recovery to Practice course is designed to help psychiatrists and mental health professionals foster a deeper relationship with patients, say the course developers.In August, APA launched the website of Recovery to Practice (RTP), an online continuing medical education course centered on recovery-oriented care.“There has been a push for transformation of our behavioral health care system to become a more person-centered kind of care,” commented Wesley Sowers, M.D., director of the Center for Public Service Psychiatry at Western Psychiatric Institute and Clinic in Pittsburgh and a member of the RTP curriculum advisory committee. “This new project,” he explained to Psychiatric News, “will allow patients to take control of their lives and have a directive roll in recovery.”The course was co-developed by APA and the American Association of Community Psychiatrists to equip psychiatrists and other mental health care providers with the “knowledge and tools to provide care in a manner that respects the person, engages them as an active participant in decision making, and engenders hope in achieving their goals,” according the course description.The RTP consists of nine modules, each ranging from 20 to 40 minutes, that address specific aspects of recovery-oriented practice via narrated slides, video clips from experts, and case vignettes. APA designates a maximum of 1 AMA PRA Category 1 credit per module. These are the module:Introduction to Recovery-Oriented Care Engagement and Welcoming Environment Person-Centered Planning and Shared Decision MakingPeer Supports in RecoveryThe Role of MedicationHealth- and Wellness-Focused CareDeveloping Living Skills and Natural SupportsCulturally Appropriate CareTrauma-Informed CareThough there has been much focus on the biological and technical aspects of treatment for mental disorders over the past decade, Sowers said that once implemented in practice, the principles learned from the RTP course will show that the “human” aspects of treatment are just as important in healing as treatments that may be considered more “advanced.”The course can help psychiatrists develop “better and deeper relationships” with patients, Sowers stressed. “By engaging with [patients] in a humanistic way, we will recognize their potential for growth and getting back to a satisfying and productive life.”Funding for the course was provided by the Substance Abuse and Mental Health Services Administration’s Recovery to Practice Initiative, which awarded five-year contracts, each valued at $350,000, to six national mental health organizations “to develop and implement training curricula that promote greater awareness, acceptance, and adoption of mental health recovery principles and practices among mental health providers.” ■The Recovery-Oriented Care in Psychiatry course can be accessed here. Enroll now in 9 part series to provide psychiatrists with a basic understanding of recovery from mental illness and substance use disorders. ISSUES NewArchived

Reis’s Pieces: Love, Loss, and Schizophrenia

Back to table of contents Previous article Next article Book ReviewsFull AccessReis’s Pieces: Love, Loss, and SchizophreniaJeffrey L. Geller, M.D., M.P.H., , and Wesley Sowers, M.D.Jeffrey L. GellerSearch for more papers by this author, M.D., M.P.H., Editor, and Wesley SowersSearch for more papers by this author, M.D.Published Online:1 Mar 2014https://doi.org/10.1176/appi.ps.650316AboutSectionsView articlePDFView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleby Winters SchwartzKaren; Norwood, New Jersey, Goodman Beck Publishing, 2012, 290 pagesThis is the second novel by Karen Winters Schwartz, an active member of the National Alliance on Mental Illness and a long-time advocate for mental health awareness. In it she tells the story of a man whose life is altered by the late onset of psychotic illness. As the subtitle implies, it recounts the losses that preceded it and those that resulted from it and, yes, an unlikely love story.Reis Welling is a somewhat precocious professor of botany at Cornell University. He has always been a lover of nature and absorbed by his studies, which have allowed him to advance rapidly in the academic world but have also kept him from developing a very broad social life. Through one of his colleagues, he is introduced to and subsequently falls in love with a less brilliant, but more extroverted young woman on the faculty of another department, who shares his love of nature and hiking. So things are looking pretty good for him until he begins to experience psychotic symptoms, which are worsened by the unexpected death of his father, with whom Reis was quite close. Reis’ fiancé does not understand his grief and is unable to endure his changes and begins to separate from him.Following a suicide attempt, Reis is hospitalized, stabilized, and returned to his hometown community, where he struggles to find a new life. He takes a low-level job in a local library and reluctantly ingests the pills his psychiatrist urges upon him. He feels alienated and observes the community clandestinely, often perching in one of the trees of the public park. One day he startles a young woman and her dog when she encounters him in such a position and has a brief, awkward conversation with her before they part. Although this woman is nearly engaged to a man who is successful and handsome, if somewhat preoccupied with himself, she becomes slightly obsessed with Reis and seeks him out at the library where he works. Thus begins a relationship that endures despite various tribulations faced over the next year and for which she abandons her previous partner. Notwithstanding periods of symptomatic relapse, self-doubt, self-punishment, and suicidal obsessions, the book ends happily.Critics may find fault with the authenticity and plausibility of certain aspects of the plot and the characters, as well as the portrayal of the illness with which Reis is afflicted and the psychiatrist who treats him. They would probably be justified in doing so, but admirers of the book would counter that the author’s underlying objective is a consideration of the stigma, both internal and external, that accompanies psychotic illness and the portrayal of one man who learns to overcome it and reestablish a satisfying and full life. The author portrays the hope of redemption despite overwhelming challenges. Some psychiatrists will enjoy this book, and persons affected by mental illnesses and their family members will likely appreciate it more.Dr. Sowers is director of the Center for Public Service Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh. FiguresReferencesCited byDetailsCited ByNone Volume 65Issue 3 March 2014Pages e07-e07 Metrics PDF download History Published online 1 March 2014 Published in print 1 March 2014

Reunion

Back to table of contents Previous article Next article Book ReviewsFull AccessReunionJeffrey L. Geller, M.D., M.P.H., , and Nubia Lluberes, M.D.Jeffrey L. GellerSearch for more papers by this author, M.D., M.P.H., Editor, and Nubia LluberesSearch for more papers by this author, M.D.Published Online:1 Mar 2014https://doi.org/10.1176/appi.ps.650313AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail by James Kennedy George, Jr.; Bloomington, Indiana, AuthorHouse, 2012, 312 pagesThe book Reunion is the first novel of James Kennedy George, Jr., after his retirement from a successful corporate career. The author sets the stage with an initial phone call inviting him to the 45th high school reunion of graduates from Princeton High School in West Virginia, and while delivering stories about those wonderful years, he manages to touch many important aspects of life.The characters are not superheroes, and there are no intricate thoughts delivered in a subliminal way. Instead, the characters come across as real people, similar to those with whom I shared my high school years: the happy types and the risk takers, the more formal and the class clowns, and the “other kids”—those who occasionally would antagonize others. They are characters much like those most readers will remember from their high school experience. Drawing parallels with one’s own school years is easy and irresistible—so easy that it makes the novel feel very real.In the story, Jimmy, the main character, reflects on his experiences: “More vivid memories, etched-in-stone experiences, remain about my classmates than about my own parents.” This is a phrase that many readers can identify with. He describes the struggles to reconcile ambivalent feelings toward parental figures and their flaws. The emotions during those important dialogues are distilled from the book to our psyche.The period of the book is the 1960s, which brings other important themes to the reader’s attention: segregation-desegregation struggles and the contrasting views of parents versus teens. The author conveys a time when young minds were so open to break away from preconceived ideas and yet youths were respectful of their parents’ views.On the down side, I found some chapters to be somewhat slow, but I could not help but think that the information that appears somewhat irrelevant to me may have an important emotional meaning to the author, maybe even for other readers. At times it appeared to me that there was no ultimate goal or end point until I realized, much like life, the book’s teaching points have been given all along.Dr. Lluberes is a general psychiatrist with Fairmont General Hospital, Fairmont, West Virginia, and community psychiatry fellow at the Center for Public Service Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh. FiguresReferencesCited byDetailsCited ByNone Volume 65Issue 3 March 2014Pages e11-e11 Metrics PDF download History Published online 1 March 2014 Published in print 1 March 2014

Three Candidates Vie to Become APA’s Next President-Elect

Back to table of contents Next article Association NewsFull AccessThree Candidates Vie to Become APA’s Next President-ElectKen HausmanKen HausmanSearch for more papers by this authorPublished Online:6 Dec 2013https://doi.org/10.1176/appi.pn.2013.12a26AbstractElection season is under way at APA as the names of candidates who will be running for several Board of Trustees positions are announced. Two Areas will be choosing their representatives as well.Renee Binder, M.D., James Nininger, M.D., and Mark Rapaport, M.D..APA members will be able to choose among three president-elect candidates in the upcoming APA election who specialize in different areas of psychiatry but share extensive involvement in APA—Renȳe Binder, M.D., James Nininger, M.D., and Mark Rapaport, M.D.Binder is professor and director of the Psychiatry and the Law Program at the University of California, San Francisco, and associate dean for academic affairs for the School of Medicine and former interim chair of psychiatry. She is chair of the APA Committee on Advocacy and Litigation Funding and a former trustee at large and Area 6 representative.Nininger is a clinical associate professor of psychiatry at Weill/Cornell Medical College and in private practice with a subspecialty in geriatrics. He is APA’s Area 2 Trustee, on the American Psychiatric Foundation Board, vice-chair of the APA Steering Committee on Practice Guidelines, a past speaker of the Assembly, and served on the DSM-5 Clinical and Public Health Committee.Rapaport is the Reunette W. Harris Chair of Psychiatry and the Behavioral Sciences at Emory University School of Medicine and chief of psychiatric services for Emory Healthcare System. He is the founding co-editor in chief of the APA journal Focus: The Journal of Lifelong Learning in Psychiatry and a member of the Council on Medical Education and Lifelong Learning.The treasurer’s post, which is for a three-year term, is also up for election, and in that race Frank Brown, M.D., of Atlanta will face James Greene, M.D., of Memphis.One of the Board’s trustee-at-large positions will also be contested in this election cycle, with Anita Everett, M.D., vying with Stephen McLeod-Bryant, M.D. Everett is from Glenwood, Md., and McLeod-Bryant is from Old Hickory, Tenn. At-large trustees also serve three-year terms.Two of APA’s seven Areas will vote for trustees in the next election. In elections for Area trustee, the Area Council rather than the APA Nominating Committee chooses the candidates.Facing off for Area 2 trustee are Jack Drescher, M.D., and Vivian Pender, M.D. Area 2 includes all of the district branches in New York state. Area 5—which includes the Southern states, Puerto Rico, and the military district branch—will also be electing a trustee. The candidates in that race are R. Scott Benson, M.D., of Pensacola, Fla., and Gary Weinstein, M.D., of Louisville, Ky.Members-in-training (MITs) will also have three candidates from whom to choose as they vote for the Board position of member-in-training trustee-elect. Competing for that position are Vittoria DeLucia, M.D., a resident at the University of Maryland/Sheppard Pratt Program; Heather Liebherr, D.O., a resident at the University of Pittsburgh Western Psychiatric Institute and Clinic; and Ravi Shah, M.D., a resident at Columbia University - New York State Psychiatric Institute.APA announced the slate of candidates November 1, and while it is considered public, it is not official until the Board approves it at its meeting this month.All members for whom APA has a valid e-mail address on file will receive an electronic ballot. Other members will receive a paper ballot along with instructions on how to vote online if they so choose. All candidates and their supporters should review APA’s updated Election Guidelines. ■Election information is posted on APA’s website at http://www.psych.org/network/board-of-trustees/apa-national-elections. The election guidelines are posted at http://psychnews.psychiatryonline.org/newsarticle.aspx?articleID=1754317. ISSUES NewArchived

Randomized Placebo-Controlled Adjunctive Study of an Extract ofWithania somniferafor Cognitive Dysfunction in Bipolar Disorder

Cognitive impairments contribute significantly to inadequate functional recovery following illness episodes in bipolar disorder, yet data on treatment interventions are sparse. We assessed the cognitive effects of a standardized extract of the medicinal herb Withania somnifera (WSE) in bipolar disorder. Sixty euthymic subjects with DSM-IV bipolar disorder were enrolled in an 8-week, double-blind, placebo-controlled, randomized study of WSE (500 mg/d) as a procognitive agent added adjunctively to the medications being used as maintenance treatment for bipolar disorder. Study enrollment and data analyses were completed between December 2008 and September 2012. Cognitive testing at baseline and 8 weeks assessed primary efficacy outcomes. Psychopathology and adverse events were monitored at scheduled visits. Fifty-three patients completed the study (WSE, n = 24; placebo, n = 29), and the 2 groups were matched in terms of demographic, illness, and treatment characteristics. Compared to placebo, WSE provided significant benefits for 3 cognitive tasks: digit span backward (P = .035), Flanker neutral response time (P = .033), and the social cognition response rating of the Penn Emotional Acuity Test (P = .045). The size of the WSE treatment effect for digit span backward was in the medium range (Cohen d = 0.51; 95% CI, 0.25-0.77). None of the other cognitive tasks showed significant between-group differences. Mood and anxiety scale scores remained stable, and adverse events were minor. Although results are preliminary, WSE appears to improve auditory-verbal working memory (digit span backward), a measure of reaction time, and a measure of social cognition in bipolar disorder. Given the paucity of data for improving cognitive capacity in bipolar disorder, WSE offers promise, appears to have a benign side-effects profile, and merits further study. ClinicalTrials.gov identifier: NCT00761761.

Taking Disruptive Mood Dysregulation Disorder Out for a Test Drive

Taking Disruptive Mood Dysregulation Disorder Out for a Test Drive

A new ‘face’ forBipolar Disorders?

Bipolar DisordersVolume 14, Issue 7 p. 681-683 Editorial A new ‘face’ for Bipolar Disorders? Samuel Gershon, Samuel Gershon University of Pittsburgh School of MedicineSearch for more papers by this authorK. N. Roy Chengappa, K. N. Roy Chengappa Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USASearch for more papers by this authorGin S. Malhi, Gin S. Malhi Discipline of Psychiatry, Sydney Medical School, University of Sydney CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, AustraliaSearch for more papers by this author Samuel Gershon, Samuel Gershon University of Pittsburgh School of MedicineSearch for more papers by this authorK. N. Roy Chengappa, K. N. Roy Chengappa Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USASearch for more papers by this authorGin S. Malhi, Gin S. Malhi Discipline of Psychiatry, Sydney Medical School, University of Sydney CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, AustraliaSearch for more papers by this author First published: 29 October 2012 https://doi.org/10.1111/bdi.12012Citations: 1 Corresponding author: Samuel Gershon, M.D. Editorial Office Bipolar Disorders4601 Baum Boulevard Pittsburgh, PA 15213 USA E-mail: samuelgershon258@gmail.com Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume14, Issue7November 2012Pages 681-683 RelatedInformation

Diagnosis of Depression in Adolescents Following Traumatic Fracture

To assess how frequently adolescents are clinically diagnosed with depression following hospitalization for traumatic fracture, with the assumption that a retrospective approach would yield lower rates of depression compared to those reported previously in prospective studies. We hypothesized that depression would be less common among adolescents whose injuries were primarily limited to fractures of the appendicular skeleton, vertebral column, and/or thoracic cage compared to those sustaining concomitant spinal cord and/or brain injuries and those suffering from facial/skull fractures. A patient population of 1,121 adolescents, aged 12 to 19 years, who were hospitalized overnight at the University of Virginia (UVA) Health System, Charlottesville, for fractures between 2000 and 2009, was generated using the health system's Clinical Data Repository. The number of these adolescents who received a new diagnosis of depression (per ICD-9 codes) at the UVA Health System within the first year following their injury was determined. By the end of the first year, 37 of 913 adolescents (4.1%) who had at least 1 follow-up visit after their fracture were diagnosed with depression. When patients with a concomitant spinal cord injury and those with a facial/skull fracture with or without an associated brain injury were excluded, this percentage dropped to 3.2% and 1.1%, respectively. The results support our initial hypothesis that the percentage of adolescents diagnosed with depression following a traumatic fracture determined retrospectively would be lower than the percentages previously reported in related prospective studies. This finding adds to the growing concern that depression in youth is underdiagnosed, even among youth who have contact with health care providers. When compared to our own retrospectively determined data, the much higher rates of depression reported in several prospective studies indicate that more proactive, routine implementation of depression screening tools in the postinjury period is likely to improve identification of at-risk youth.