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This Week in Psychiatry — 11/8/10

November 5, 2010

Early Pubertal Onset Linked to More Social Problems in Adolescence

A large, prospective longitudinal study (N=1,420), reported by The American Journal of Psychiatry, examined outcomes of early pubertal timing in girls aged 9, 11, and 13 years at study onset. Onset of puberty was defined by self-report criteria and age of menarche. Outcome measures included social and family functioning, crime, substance use, sexual behavior, and mental health in adolescence (ages 13–16); and crime, socioeconomic status, and sexual behavior in young adulthood (ages 19–21). Although girls with relatively early pubertal onset reported higher levels of criminal behavior, sexual activity, substance use, and mental health problems during adolescence, their functioning in many areas resembled that of normal- and late-developing girls by young adulthood. Early maturing girls were, however, overall more likely to be depressed in young adulthood, and to have more sexual partners.

http://ajp.psychiatryonline.org/cgi/content/abstract/167/10/1218

Profiles of Neuropathic Pain in Malingerers

A recent report from The Journal of Neuropsychiatry & Clinical Neurosciences evaluated 237 patients reporting chronic pain categorized as neuropathic pain. Through surveillance, 16 patients were identified as malingerers and received neurological examination. In all 16 patients identified as malingerers, no symptoms could be explained objectively, and they had all received the label of complex regional pain syndrome (CPRS). The profiles of CPRS I and CPRS II, the authors say, might allow for the possibility of recognizable feigning behavior, as well as legitimate nervous injury.

http://neuro.psychiatryonline.org/cgi/content/abstract/22/3/278

FDA Approves Naltrexone Extended-Release Injectable for Prevention of Opioid Relapse

pproval was based on a 6-month, multi-center, randomized phase III study. According to intent-to-treat analysis, patients who received extended-release injectable naltrexone had significantly higher rates of opioid-free urine screens compared with placebo (P<.0002). The most commonly reported adverse events included hepatic enzyme elevations, nasopharyngitis, and insomnia. Please review additional safety and prescribing information at www.vivitrol.com — Lonnie Stoltzfoos

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