Arch Gen Psychiat
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Randomized Controlled Trial Comparative Study Clinical Trial
Cost-effectiveness of evidence-based pharmacotherapy or cognitive behavior therapy compared with community referral for major depression in predominantly low-income minority women.
Few clinical trials have evaluated interventions for major depressive disorder in samples of low-income minority women, and little is known about the cost-effectiveness of depression interventions for this population. ⋯ Effective treatment for depression in low-income minority women reduces depressive symptoms but increases costs compared with community referral. The pharmacotherapy and CBT interventions were cost-effective relative to community referral for the health care system.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction.
Depression after myocardial infarction (MI) is associated with higher morbidity and mortality. Although antidepressants are effective in reducing depression, their use in patients with cardiovascular disease remains controversial. ⋯ Use of selective serotonin reuptake inhibitors in depressed patients who experience an acute MI might reduce subsequent cardiovascular morbidity and mortality. A controlled trial is needed to examine this important issue.
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Comparative Study
Alcohol misuse and mood disorders following traumatic brain injury.
Alcohol abuse and/or dependence (AA/D) and mood disturbance are co-occurring conditions among patients who have had a traumatic brain injury (TBI). However, the relationship between these disorders has not been extensively studied. ⋯ Previous alcohol abuse increases the risk of developing mood disorders after TBI, and emotional disturbance, in turn, increases the risk of alcohol abuse relapse. Alcohol's neurotoxic effects and TBI likely interact to produce greater disruption of the neural circuits that modulate reward, mood, and executive function. Patients with a history of AA/D who also developed mood disorders following TBI had major difficulties resuming a productive life.
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Comparative Study
White matter abnormalities in obsessive-compulsive disorder: a diffusion tensor imaging study.
Several neurobiological models of obsessive-compulsive disorder (OCD) posit a primary role for dysfunction of the anterior cingulate gyrus. Both functional and structural neuroimaging studies have implicated anterior cingulate gray matter abnormalities in the pathophysiology of OCD, but there has been little investigation of the anterior cingulate white matter in this disorder. ⋯ These preliminary findings provide evidence of an abnormality that involves the anterior cingulate white matter in the pathogenesis of OCD and are consistent with neurobiological models that posit a defect in connectivity in the anterior cingulate basal ganglia-thalamocortical circuit. White matter abnormalities in other brain regions may also be implicated in the neurobiology of OCD.
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Comparative Study
Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication.
Dramatic changes have occurred in mental health treatments during the past decade. Data on recent treatment patterns are needed to estimate the unmet need for services. ⋯ Most people with mental disorders in the United States remain either untreated or poorly treated. Interventions are needed to enhance treatment initiation and quality.