Acta psychiatrica Scandinavica
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Acta Psychiatr Scand · Jun 2015
Randomized Controlled TrialMaintained superiority of chronotherapeutics vs. exercise in a 20-week randomized follow-up trial in major depression.
To investigate the long-term antidepressant effect of a chronotherapeutic intervention. ⋯ In this clinical study patients continued to improve in the follow-up phase and obtained very high remission rates. This is the first study to show adjunct short-term wake therapy and long-term bright light therapy as an effective and feasible method to attain and maintain remission.
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Acta Psychiatr Scand · May 2015
Randomized Controlled TrialCommunity treatment orders: clinical and social outcomes, and a subgroup analysis from the OCTET RCT.
Despite widespread use internationally, there is no convincing evidence that community treatment orders (CTO) (legal regimes making out-patient treatment compulsory), reduce readmission rates or have wider patient benefit. The primary and secondary outcomes of the Oxford Community Treatment Order Evaluation Trial (OCTET) (hospitalisation) showed no benefit. This article will, first, test the effect of community compulsion on wider clinical and social outcomes and on patients' experiences of services and the use of treatment pressure and second, explore differential effects in different groups of patients. ⋯ CTOs do not have benefit on any of the tested outcomes, or for any subgroup of patients. Their continued use should be carefully reconsidered.
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Acta Psychiatr Scand · Apr 2015
Randomized Controlled Trial Multicenter StudyNeurocognitive impairment in a large sample of homeless adults with mental illness.
This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. ⋯ Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population.
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Acta Psychiatr Scand · Sep 2006
Randomized Controlled Trial Multicenter StudyUnderstanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) trial.
To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions. ⋯ Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or 'psychotic' origin.
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Acta Psychiatr Scand · Feb 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialDouble-blind study of the efficacy and safety of milnacipran and imipramine in elderly patients with major depressive episode.
The novel antidepressant agent milnacipran is a dual and equipotent serotonin and noradrenaline reuptake inhibitor. The aim of this double-blind study was to compare the efficacy and safety of milnacipran (50 mg twice daily) with that of imipramine (50 mg twice daily) in elderly patients with major depressive episode. ⋯ A significantly greater number of side-effects, particularly anticholinergic effects, was observed in the imipramine group. Milnacipran may be preferable to imipramine in elderly depressed patients, as it provides the same antidepressant activity as imipramine with a lower incidence of side-effects, and does not impair cognitive ability.