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This Week in Psychiatry — 6/13/11

June 8, 2011

Vilazodone: Safe and Effective for MDD

In the latest Journal of Clinical Psychiatry, researchers evaluated the safety and efficacy of vilazodone in adults with MDD. The 481 patients in this 8-week study received either vilazodone 40 mg/day or placebo. At endpoint, patients receiving vilazodone had a significantly greater improvement in their MADRS scores, as well as significantly higher MADRS response rates, compared to patients receiving placebo (44% vs. 30%, P=.002). However, MADRS remission rates for both populations were similar (27.3% vs. 20.3%, P=.066). The vilazodone patients also had greater improvements in HAM-D17, HAM-D21, HARS, and CGI-I scores. The researchers therefore believe that vilazodone is both safe and effective in adults with MDD.

An “Integrative” Recovery Style May Predict Remission in Psychosis 

A Dutch study, published in the Journal of Nervous & Mental Disease, explored the concept of recovery style and whether it is tied to 1-year outcomes in patients with psychotic disorders. The researchers evaluated recovery style (“sealing over” versus “integrating”), insight, and symptoms in 103 patients with a psychotic disorder. Follow-up assessments occurred at 6 and 12 months. Higher levels of an integrative recovery style were associated with a 1.84-fold improved odds of remission, but insight and therapeutic alliance were not. The only baseline criterion associated with 1-year outcome was presence of positive symptoms, which is independent of recovery style.

Good Outcomes or Old Habits: What Motivates Compulsions in OCD?

What lies between the OCD patient’s compulsions and simultaneous recognition of the pathological nature of said compulsions? The authors of a paper in The American Journal of Psychiatry compared 21 OCD patients to 30 healthy controls in tasks designed to assess goal-directed behavior versus control of habitual behaviors. After exposure to structured stimuli with the objective of winning rewarding outcomes, subjects completed questionnaires to give feedback on the test’s link between stimuli and reward. OCD patients were able to express appropriate responses to the stimuli during feedback, but their conception of its embedded outcomes and rewards was poor, compared to controls. Also, OCD patients were more likely to respond habitually to stimuli, rather than responding in a goal- and outcomedirected manner.

This Week in Psychiatry” is written Christopher Naccari and Lonnie Stoltzfoos


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