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This Week in Psychiatry — 1/24/11

January 21, 2011

Cognitive Function, Awareness, and Illness Insight in Schizophrenia

Schizophrenia Bulletin published a study in which the authors examined awareness and insight in schizophrenia in 31 patients with mostly chronic schizophrenia. The authors assessed the independence or overlap of multiple domains of function and how those dimensions relate to neuropsychological function, clinical, demographic, and mood variables. Insight into cognitive deficits was greater than insight into symptoms. Self-certainty and self-reflexivity were more highly indicative of cognitive insight than neuropsychological factors.

Early Menarche Associated with Greater Depression in Young Girls

A recent study from the British Journal of Psychiatry found a correlation between early onset of menstruation in girls and higher depression symptoms throughout adolescence. Using data from a longitudinal parent and child study, the researchers took into account age at onset of menstruation and depressive symptoms at ages 10.5, 13, and 14 years in 2,184 girls. Girls with an early onset of menstruation (<11.5 years of age) had higher levels of depression at ages 13 (P=.007) and 14 (P<.001) years compared to girls with a normal onset of menstruation, at age 13.5 years. These findings could support selective early intervention for depressive symptoms, the authors say.

Comparative Opioid Safety Findings

Opioids are commonly used to control non-malignant pain in adults. An Archives of Internal Medicine study evaluated the comparative safety of these drugs in 6,275 subjects over nearly 10 years. Cancer, hospice care, and nursing care patients were excluded. Cardiovascular events at 30 days were similar among the 5 opioid groups, but codeine had the highest rate of cardiovascular events after 180 days of use. Propoxyphene and tramadol had a lower risk of fracture compared to hydrocodone. Compared to hydrocodone, oxycodone and codeine had higher all-cause mortality rates after 30 days. Gastrointestinal events did not vary across all 5 opioid groups.

“This Week in Psychiatry” is written by Lonnie Stoltzfoos

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