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January 2011



Recent Posts


 The Dark Reality

U.S suicide trends and online screening interventions

Psychiatry Weekly 2009 Sep 21; 4(21)

Gebbia R.

Executive Director,
American Foundation for Suicide Prevention, New York


Only about half of Americans who die by suicide had been receiving treatment for a previously diagnosed psychiatric disorder at the time of their death, according to Robert Gebbia, whose organization funds suicide prevention research.

There are many people suffering from underlying psychiatric disorders that put them at risk for suicide, but who are not in treatment,” says Gebbia. “While there are strategies to identify them and get them into treatment, research indicates that 90% of those who die by suicide have a diagnosable psychiatric disorder at the time of their death, most often unrecognized or untreated depression. Unfortunately, people don’t realize that these disorders can be fatal.


© 2009 Psychiatry Weekly, LLC

Experts excited about Servier’s antidepressant Valdoxan

France’s Servier has unveiled more promising data on its first-in-class antidepressant Valdoxan, this time showing superior efficacy over Prozac.

The data, presented at the European Congress of Neuropsychopharmacology in Istanbul, involved a 515-patient trial which revealed that the antidepressant efficacy of Valdoxan (agomelatine) was significantly superior to that of Eli Lilly’s Prozac (fluoxetine).


© 2009 PharmaTimes

[UK] Study denies GPs are over prescribing anti-depressants

Medical researchers from the University of Aberdeen say doctors may even be under-prescribing the drugs.

A new study refutes the claim that GPs are handing out antidepressants too readily.

Medical researchers from the University of Aberdeen say doctors may even be under-prescribing the drugs.

Antidepressant prescriptions have more than trebled in Scotland in the last decade – and with no evidence to explain the rise, it has been suggested GPs have been over-prescribing them.


© stv.tv 2009

Treatment guidelines issued on depression during pregnancy

For women with serious conditions, medication may be the best route, but ‘talk therapy’ may alleviate suffering for others, according to a document prepared by two national physicians groups.

By Melissa Healy

For the nearly one in four women who experience symptoms of depression during pregnancy, physicians on the front lines have long had little more than a prescription for antidepressants and a massive dose of uncertainty to offer.


Copyright 2009 Los Angeles Times

Managing depression in pregnancy

Gretchyn Bailey

A new report from the American Psychiatric Association (APA) and the American College of Obstetricians and Gynecologists, published in the September-October 2009 issue of General Hospital Psychiatry, explores the management of pregnancy and depression.

Depression is not uncommon in pregnant women. Between 14 and 23 percent of pregnant women will experience a depressive disorder while pregnant. In 2003, approximately 13 percent of pregnant women took an antidepressant at some point during their pregnancy. This rate has doubled since 1999. Many women go untreated due to concerns regarding the safety of treating pregnant women.

The report describes results from an unusual collaboration of authors from the American Psychiatric Association and American College of Obstetricians and Gynecologists, as well as a consulting developmental pediatrician. These authors reviewed the world’s English-language literature and reported results describing the association of depressive symptoms and antidepressant treatment on fetal and neonatal outcomes.

Both depressive symptoms and antidepressant exposure were found to be associated with fetal growth changes and shorter gestations. Short-term neonatal irritability and neuro behavioral changes were also linked with both maternal depression and antidepressant treatment. Some, but not all, studies reported low rates of fetal malformations with first trimester exposure, but there was no specific pattern of defects for individual medications or class of agents.

This timely article by Yonkers and colleagues reviews the data on the potential effects of both antidepressant medications and depressive symptoms on birth and fetal outcomes,” said Wayne J. Katon, MD, Editor-in-Chief of General Hospital Psychiatry.

Yonkers KA, Wisner KL, Stewart DE, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry. 2009 Sep-Oct;31(5):403-13   [Abstract]

Artificial neural networks pinpoint methods for predicting postpartum depression

Plataforma SINC

Worldwide, 13% of women who give birth suffer from postnatal depression, which causes a significant deterioration in a mother’s quality of life and her ability to care for her baby. Now, Spanish researchers have developed a model to diagnose this illness with a predictive power of 80% – the best result to date for this kind of depression.

Early diagnosis of postnatal depression would make it possible to intervene to prevent it from developing among women at risk,” says Salvador Tortajada, lead author of the study and a researcher at the Polytechnic University of Valencia (UPV).

The experts studied data on 1,397 Spanish women who gave birth between December 2003 and October 2004 in seven hospitals in Spain, and devised various models that can predict – with an 80% success rate – which mothers run the risk of developing depression during the first weeks after giving birth.

This study, published recently in the journal Methods of Information in Medicine, reports the best results to date in terms of predicting this illness. “Now it needs clinical evaluation, and for psychiatrists to start to test it directly on patients in order to study the true potential of these tools,” says Tortajada.

The researchers used artificial neuronal networks and extracted a series of risk factors highlighted in previous studies – the extent of social support for the mother, prior psychiatric problems in the family, emotional changes during the birth, neuroticism and polymorphisms in the serotonin transporter gene (genes with high levels of expression lead to an increased risk of developing the illness).

They also discovered two protection factors that reduce the risk of depression – age (the older the woman the lower her chance of depression), and whether or not a woman has worked during pregnancy (which reduces the risk). The researcher points out that: “it can be seen that these factors are relevant in the neuronal networks, but not by using other statistical methods.” The path is now clear for future studies to corroborate these findings.

However, many studies have shown that between 10 and 15% of women who give birth suffer from depression, normally between the second and third month after having given birth. This illness affects the patient’s emotional and cognitive functions (in extreme cases leading to suicidal tendencies), and may have serious knock-on effects on the child’s future development.

Tortajada S, Garcia-Gomez JM, Vicente J, et al. Prediction of Postpartum Depression Using Multilayer Perceptrons and Pruning. Methods Inf Med. 2009;48(3):291-8   [Abstract]


Possible breakthrough in understanding the molecular basis of major depression

Psychiatry Weekly 2009 Sep 21;4(21)

Sussman N.

Editor, Primary Psychiatry and Psychiatry Weekly,
Professor of Psychiatry, Interim Chairman, Department of Psychiatry,
New York University


One of the more frustrating aspects of treating depressive illness is our inability to predict the risk of developing the disorder or to confirm the diagnosis with any objective test-some form of imaging or blood test, for example. This may soon change.


© 2009 Psychiatry Weekly, LLC

Unintended consequences of FDA antidepressant warnings

Primary Psychiatry. 2009;16(9):14

Sussman N.

Dr Sussman is editor of Primary Psychiatry as well as professor of psychiatry and interim chairman in the Department of Psychiatry at the New York University School of Medicine in New York City.

By now, most readers of Primary Psychiatry are familiar with the October 2003 alert by the Food and Drug Administration Public Health Advisory citing the risk of suicidality for pediatric patients taking antidepressants. In February 2005, the FDA went further, asking that antidepressant product information contain a black box warning to that effect. In May 2007, the warning was extended to young adults 18-24 years of age.


© 2009 Primary Psychiatry a Publication of MBL Communications

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