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This Week in Psychiatry — 11/1/10

October 29, 2010

Postsurgical Morbidity: Worsened by Psychiatric Comorbidity?

A retrospective analysis, published recently in Archives of Surgery, examined the potential effect of psychiatric comorbidity on postsurgical morbidity. The researchers identified 8,922 surgical patients who had 12-month outpatient prevalence of depression, anxiety, PTSD, bipolar disorder, or schizophrenia. Adjusted 30-day mortality rates were higher for patients with psychiatric comorbidity, compared to no psychiatric comorbidity (odds ratio, 1.21; 95% CI, 1.07-1.37; P=.003). Unadjusted 30-day mortality rates were, however, similar between both groups (3.8% vs 4.0%, P=.56). Out of the 5 psychiatric comorbidities examined, anxiety or depression comorbidity was associated with the highest 30-day mortality rates (P=.01 and P=.02).

How Might A Smoke-Free Policy Affect A Large Psychiatric Hospital?

The staff of a large Canadian psychiatric hospital completed surveys regarding implementation of a smoke-free hospital policy. The anonymous survey, published in General Hospital Psychiatry, asked staff members about their opinions of the policy, and about any perceived changes in patient behavior, 2–7 months and 31–33 months following implementation of the policy. More staff supported the policy post-implementation compared to pre-implementation (89.1% vs 82.6%). High support remained at 2 years (90.1%). The incidence of patient aggression codes did not increase post-implementation.

FDA Approves Botox for Prophylactic Treatment of Chronic Migraine in Adults

Approval was based on two double-blind, placebo-controlled trials with 1,384 adults. When used as a treatment for chronic migraine, 31 Botox injections are administered into 7 sites on the head and neck. In both studies, patients who received Botox had significantly fewer headache days at 24 weeks than at baseline (7.8 and 9.2 fewer days), compared to placebo (6.4 and 6.9 fewer days).

Adverse events included headache, migraine and facial paresis, eyelid ptosis, bronchitis, and musculoskeletal stiff and pain.

Full safety and prescribing information are available at — Lonnie Stoltzfoos

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