Professional Documents
Culture Documents
Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain
tissue loss in schizophrenia: a progressive longitudinal MRI study. Am J Psychiatry 2013;
170:609-615
Important study finding antipsychotics cause brain shrinkage rather than relapses, and
suggest using the lowest doses possible
Demjaha A, Murray RM, McGuire PK, Kapur S, Howes OD. Dopamine synthesis capacity in
patients with treatment-resistant schizophrenia. Am J Psychiatry 2012; 169:1203-1210
This paper shows that dopamine dysregulation is not found in those with treatment resistant
schizophrenia and thus dopamine antagonists are worthless in these patients
Fletcher PC, Frith CD. Perceiving is believing: a Bayesian approach to explaining the positive
symptoms of schizophrenia. Nat Rev Neurosci 2009; 10:48-58
An extremely clever model uniting Schneiders first rank symptoms as theory of mind deficits
in context of other biological and neuropsychological findings in schizophrenia
Honer WG, Thornton AE, Chen EYH et al. Clozapine alone versus clozapine and risperidone
with refractory schizophrenia. N Engl J Med 2006; 354: 472-482
CARE study showed adding risperidone to clozapine no more effective than clozapine alone
Jones PB, Barnes TR, Davies L et al. Randomized controlled trial of the effect on quality of life of
second- vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest
antipsychotic drugs in schizophrenia study (CUtLASS 1) Arch Gen Psychiatry 2006; 63:1079-87
CUtLASS study was British equivalent of the CATIE using more of the typical antipsychotics
and confirming the new drugs cost more and have no additional benefit on quality of life
Kahn RS, Fleischhacker WW, Boter H et al. Effectiveness of antipsychotic drugs in first-episode
schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 2008;
371:1085-97
EUFEST study found that first-episode psychosis like chronic schizophrenia responds just as
well to the older drugs as the newer drugs
Kane J, Hongfeld G, Singer J, Meltzer H and the Clozaril Collaborative Study Group. Clozapine
for the treatment resistant schizophrenic: a double-blind comparison with
chlorpromazine. Arch Gen Psychiatry 1988; 45:789-796
Classic study demonstrating clozapines superiority to chlorpromazine in treatment-resistant
schizophrenia that led to re-discovery of clozapine in clinical practice
Lieberman JA, Stroup TS, McEvoy JP et al. Effectiveness of Antipsychotic Drugs in Patients with
Chronic Schizophrenia. N Engl J Med 2005; 353:1209-1223
CATIE study showed olanzapine was more effective than other atypical antipsychotics and
ziprasidone less effective, with no difference between typical and atypical antipsychotics
Wunderink L, Nieboer RM, Wiersma D, Sytema S, Nienhuis FJ. Recovery in remitted firstepisode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or
maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical
trial. JAMA Psychiatry 2013; 70:913-920
Controversial study that confirms older data that continued antipsychotic use leads to poorer
functional outcomes with better symptom control than discontinuation/early dose reduction
Depressive Disorders
Beck AT. The evolution of the cognitive model of depression and its neurobiological
correlates. Am J Psychiatry 2008; 165:969-977
Very readable overview of the cognitive model of depression in a biopsychosocial perspective
from the founder of cognitive therapy itself
Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 newgeneration antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373:747-758
Mirtazapine and venlafaxine are the most efficacious, duloxetine and reboxetine dont work,
and sertraline or citalopram are probably the best first-line agents for depression
Fava GA. Can long-term treatment with antidepressant drugs worsen the course of
depression? J Clin Psychiatry 2003; 64:123-133
This paper suggests that antidepressants may be contributing to the poor prognosis for
depression!
Fava M, Rush AJ. Current status of augmentation and combination treatments for major
depressive disorder: a literature review and a proposal for a novel approach to improve
Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive
neuropsychological model of antidepressant drug action. Br J Psychiatry 2009; 195:102-108
An attempt at explaining antidepressant action in cognitive neuropsychological terms
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and
antidepressant benefits: a meta-analysis of data submitted to the Food and Drug
Adminstration. PLOS Med 2008; 5:e45 doi:10.1371/journal.pmed.0050045
The best known study to report from unpublished data that antidepressants are no better than
placebo except in the most severe depressive episodes
McGrath PJ, Steward JW, Fava M et al. Tranylcypromine versus venlafaxine plus mirtazapine
following three failed antidepressant medication trials for depression: a STAR*D report. Am J
Psychiatry 2006; 163:1531-1541
STAR*D report finds response rate after three failed antidepressants is about 14% and that
combo of venlafaxine and mirtazapine is easier to use and better tolerated than
tranylcypromine
Rush AJ, Trivedi MH, Wisniewski SR et al. Bupropion-SR, Sertraline, or Venlafaxine-XR after
failure of SSRIs for Depression. N Engl J Med 2005; 354:1231-1242
STAR*D trial finds only 20% remit after one failed antidepressant, and bupropion, sertraline
and venlafaxine are just as bad as each other
Trivedi MH, Fava M, Wisniewski SR et al. Medication augmentation after the failure of SSRIs
for depression. N Engl J Med 2006; 354:1243-1252
STAR*D trials finds augmentation strategies all as bad as each other and no better than
Trivedi MH, Rush AJ, Wisniewski SR et al. Evaluation of outcomes with citalopram for
depression using measurement-based care in STAR*D: implications for clinical practice. Am J
Psychiatry 2006; 163: 28-40
STAR*D study finds remission rates only 30% for first trial of citalopram and that it takes
about 6-8 weeks to note remission, longer than previously claimed
West ED, Dally PJ. Effects of iproniazid in depressive syndromes. Br Med J 1959; 1:1491-1494
One of the first papers to report MAOIs are effective especially in atypical depressions
Bipolar Disorders
Cade JF. Lithium salts in the treatment of psychotic excitement. Med J Aust 1949; 2:349-352
Classic paper that first used lithium to treat mania, absolute must read.
Cipriani A, Barbui C, Salanti G et al. Comparative efficacy and acceptability of antimanic drugs
in acute mania: a multiple-treatments meta-analysis. Lancet 2011; 378:1306-1315
This meta-analysis finds that antipsychotics are the best treatment for acute mania rather
than lithium or mood stabilizers.
Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood
disorders: updated systematic review and meta-analysis. BMJ 2013; 346:f3646
Updated meta-analysis finds lithium still appears to have anti-suicidal properties
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet 2013; 381:1672-1682
Reviews the evidence for pharmacological and psychological treatments in bipolar disorder
Janowsky DS, Epstein RS. Playing the manic game interpersonal maneuvers of the acutely
manic patient. Arch Gen Psychiatry 1970; 22:252-26
Describes the frustrating and destructive maneuvers manic patients catch clinicians in.
Possibly more relevant to borderline patients, I find this slightly outmoded and offensive, but
seems well-loved by more seasoned psychiatrists of all stripes
McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile:
a systematic review and meta-analysis. Lancet 2012; 379:721-728
Toxicity of lithium has been overblown with ESRD being a rare complication. Li also causes
hyperparathyroidism and checking Ca periodically is recommended
Miklowitz DJ, Otto MW, Frank E et al. Psychosocial treatments for bipolar depression: a 1-year
randomized trial from the Systematic Treatment Enhanced Program. Arch Gen
Psychiatry 2007; 64:419-426
Shows family focused therapy, IPSRT and CBT as useful therapies in treatment of bipolar
depression
Geddes, JR, Goodwin GM, Rendell K et al. Lithium plus valproate combination therapy versus
monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomized open-label
trial. Lancet 2010; 375:385-395
Lithium is better than valproate, and there benefit of combining the two isnt clear
Yonkers KA. Management of bipolar disorder during pregnancy and the postpartum period. Am
J Psychiatry 2004; 161:608-620
Nice review of management of bipolar disorder in women
Suicide
Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J
Psychiatry 1997; 170:205-228
Meta-analysis finds mental disorders except for mental retardation and dementia increase
risk of suicide
Rosen DH. Suicide survivors. A follow-up study of persons who survived jumping from the
Golden Gate and San Francisco-Oakland Bay Bridges. West J Med 1975; 122:289-294
Classic study interviewing survivors of the Golden Gate Bridge attempted suicides argues for
suicide barriers. Must read.
Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res
Therapy 2000; 38:319-345
An insightful and extremely useful model for understanding chronic PTSD from the cognitive
perspective
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in
U.S. soldiers returning from Iraq. N Engl J Med 2008; 31:453-463
mTBI is common in OIF Veterans and often highly comorbid with PTSD symptoms
Roy-Byrne PP, Craske MG, Stein MB. Panic disorder. Lancet 2006; 368:1023-1032
Concise overview of panic and its treatment
Summerfield D. The invention of posttraumatic stress disorder and the social usefulness of a
psychiatric category. Br Med J 2001; 322:95-98
Provocative discussion of PTSD as a sociopolitical construct
Personality Disorders
Groves JE. Taking care of the hateful patient. N Engl J Med 1978; 299:883-887
Classic paper describes 4 hateful patients in the medical setting
Vaillant GE. The beginning of wisdom is never calling a patient a borderline; or, the clinical
management of immature defenses in the treatment of individuals with personality disorders. J
Psychother Pract Res 1992; 1:117-134
Classic, extremely well written and useful discussion of managing different defenses in
difficult patients
Eating Disorders
Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010; 375:583-93
Nice overview on biology of eating disorders and review of evidence for different therapies
Arsenault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence
and risk for adult psychosis: longitudinal prospective study. BMJ 2002; 325:1212-1213
First prospective longitudinal study to establish adolescent cannabis use as a risk factor for
psychosis
Koston TR, OConnor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;
348:1786-1795
Comprehensive overview of withdrawal syndromes and their management
McKetin R, Lubman DI, Baker AL, Dawe S, Ali RL. Dose-related psychotic symptoms in chronic
methamphetamine users: evidence from a prospective longitudinal study. JAMA
Psychiatry 2013; 70:319-324
First prospective longitudinal study to establish causal relationship and dose-dependence
between methamphetamine use and psychosis
Van Winkel R, Kahn Rs, Linszen DH et al. Family-based analysis of genetic variation underlying
psychosis-inducing effects of cannabis: sibling analysis and proband follow-up. Arch Gen
Psychiatry 2011; 68:148-57
Shows gene-environment interaction between SNPS in AKT1 and cannabis use in increasing
risk of psychosis which has been replicated, unlikely previous studies involving SNPs of COMT
Volkow ND, Swanson JM. Clinical practice: adult attention deficit-hyperactivity disorder. N
Engl J Med 2013
Up-to-date review of adult ADD
Bowlby J. The making and breaking of affectional bonds. I. Aetiology and psychopathology in
the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered
before the Royal College of Psychiatrist, 19 November 1976. Br J Psychiatry 1977; 130:201-210
Very readable paper summarizes key findings of attachment theory and its relevance to
psychopathology throughout the lifespan
Jensen PS, Arnold LD, Swanson JM et al. 3-year follow-up of the NIMH MTA Study. J Am Acad
Child Adolesc Psychiatry 2007; 56:989-1002
Important ADHD study showed benefits of stimulant treatment did not persist after initial
Sikich L, Frazier JA, McClellan J et al. Double-blind comparison of first- and second-generation
antipsychotics in early-onset schizophrenia and schizoaffective disorder: findings from the
treatment of early-onset schizophrenia spectrum disorders (TEOSS) study. Am J
Psychiatry 2008; 165:1420-31
TEOSS study finds molindone (now defunct) is just as good as the newer drugs in early onset
psychotic disorders
Geriatric Psychiatry
Burns A, Jacoby R, Levy R. Psychiatric phenomena in Alzheimers disease. IV: Disorders of
behavior. Br J Psychiatry 1990; 157:86-94
Outlines the most common behavioral disturbances in Alzheimers from a sample of 178
patients, and finds features of Kluver-Bucy syndrome occur more commonly than is realized
Howard RJ, Juszszak E, Ballard CG t al. Donepezil for the treatment of agitation in Alzheimers
Disease. N Engl J Med 2007; 357: 1382-1392
Donepezil doesnt help agitation in context of Alzheimers disease
Howard RJ, McShane R, Lindesay J et al. Donepezil and memantine for moderate-to-severe
Alzheimers Disease. N Engl J Med 2012; 366:893-903
There is a small functional benefit to donepezil or memantine in moderate-to-severe
Alzheimers with no difference between the two and no additional benefit of the combination
Inouye SK. Delirium in older persons. N Engl J Med 2006; 354:1157-1165
Barsky AJ, Saintford R, Rogers MP, Borus JF. Nonspecific medication side-effects and the
nocebo phenomenon. JAMA 2002; 287:622-627
Describes the nocebo effect as a common occurrence in anxious patients, and a cognitive
model for understanding its development
Beach SR, Celano CM, Noseworthy PA, Januzzi JL, Huffman JC. QTc prolongation, Torsades de
pointes, and psychotropic medications. Psychosomatics 2013; 54:1-13
Comprehensive up-to-date review on QTc prolongation and psychotropic drugs. Turns out we
vastly overestimate the significance of cardiac risk of drugs.
Block SD. Psychological issues in end-of-life care. J Palliat Med 2006; 9:751-772
Comprehensive review of psychological problems and psychiatric disorders at the end-of-life
Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005; 352:1112-1120
Comprehensive review of serotonin syndrome comparing it to other differentials
Groves JE. Management of the borderline patient on a medical or surgical ward: the psychiatric
consultants role. Int J Psychiatry Med 1975; 6:337-48
Practical suggestions on how to manage difficult patients in the medical setting
McDermott BE, Feldman MD. Malingering in the medical setting. Psychiatr Clin N Am 2007;
30:645-662
Detailed review of malingering and its detection
Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and
diagnosis. J Neurol Neurosurg Psychiatry 2005; 76(Suppl I): i2-i12
Strawn JR, Keck Jr PE, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry 2007;
164:870-876
Up to date review of neuroleptic malignant syndrome
Electroconvulsive Therapy
Anjala AV, Smetana GW. Medical evaluation of patients undergoing electroconvulsive
therapy. N Engl J Med 2009; 360:1437-1444
Discusses the medical workup and preparation of patients for ECT
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders:
a systematic review and meta-analysis. Lancet 2003; 361:799-808
The most comprehensive meta-analysis of ECT for depression showing its efficacy in
depressive states
Psychiatric Diagnosis
Kendell RE, Cooper JE, Gourlay AJ, Copeland JRM, Sharpe L, Gurland BJ. Diagnostic criteria of
American and British psychiatrists. Arch Gen Psychiatry 1971; 25: 123-130
The UK-US diagnostic study showed American Psychiatrists diagnosed more schizophrenia
than their British counterparts in every case, including cases of depression, manic-depressive
illness and even personality disorder, establishing importance of reliability in psychiatric
diagnosis
Murphy JM. Psychiatric labeling in cross-cultural perspective. Science 1976; 191:1019-1028
This paper describes the concept of madness or mental illness existing across cultures
dispelling mental illness as the result of simply labeling deviance or a convenient myth
Rosenhan DL. On being sane in insane places. Science 1973: 179:250-258
This classic study questioned the validity of psychiatric diagnosis by having pseudopatients
get admitted to psychiatric hospital who then remained there despite no further reports of
symptoms of mental illness!
Conceptual issues in psychiatry
Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;
196:129-36
This classic paper popularizes the biopsychosocial model and the application of general
systems theory to medicine.
Kandel ER. A New intellectual framework for psychiatry. Am J Psychiatry 1998; 155:457-469
Kandel suggests firmly rooting medicine of the mind in the biology of the brain
Kendler KS. Explanatory models for psychiatric illness. Am J Psychiatry 2008; 165:695-702
Kendler proposes psychiatric disorders are understood best pluralistically with multiple levels
of explanation and biological understanding will not supplant more macro level
understanding of disorders but enhance it