Adult ADHD is not the same as childhood ADHD. Most people with adult ADHD never had childhood ADHD and most people with childhood ADHD never will have adult ADHD. This past year what was long thought to be known about adult ADHD turned out not to be true. Indeed, up until DSM-V adult ADHD could not be diagnosed unless someone …
Lurasidone for Depression with Mixed Features
Lurasidone (Latuda) May Treat Depression with Mixed Features A recently published clinical trial suggests that lurasidone, which is an atypical antipsychotic with strong evidence for efficacy in treating bipolar depression, may be associated with response in patients who, according to DSM5, do not meet criteria for bipolar disorder, but do have evidence of mixed features. The study points to the importance …
Another Blood Test for Depression
We ran across a recent article that promised a “blood test for depression” and thought how strange it was that this article was being republished in the Journal of Clinical Psychiatry. After all we wrote about a blood test for depression based on an article that appeared in translational psychiatry just a few months ago. Imagine my surprise when I …
Brain Morphometry Separates Bipolar vs Unipolar
Brain Morphometry refers to a technique for comparing the sizes of different structures in the brain. A new study suggests that using MRI scans of brains it is possible to distinguish between bipolar and unipolar depression with some degree of accuracy (70 – 80% accuracy). The study looked at two separate groups of patients, one from Munster, Germany and one …
Bipolar or Unipolar Depression?
Bipolar or unipolar depression: How to distinguish between these two conditions, which can have very different treatment response remains a difficult question without really satisfying answers. As noted in the picture to the right, misdiagnosis is common and can have serious consequences. An article in European Psychiatry adds to the literature pointing to certain features that increase the odds that someone …
Blood Test for Depression
How many times has a new patient in the clinic asked, “isn’t there a blood test for depression?” Always in the past we had to say that there were no reliable tests that could identify depression. There was some evidence that functional brain imaging could do so but the technique was expensive and experimental. In an article published in the …
Predicting Bipolar Disorder
Predicting bipolar disorder might allow early intervention that could change the course of the condition, or prevent at risk adults or adolescents from developing severe mood swings. But is predicting bipolar disorder a reasonable goal? What is the science behind this effort? The August 2014 issue of Bipolar Disorders (the official journal of the International Society for Bipolar Disorders) has …
Genetic Testing Guides Treatment for Bipolar or Depression
We have been using a relatively new assay from a company called Genomind (the Genecept test) in some of our patients with bipolar and/or depression. The test involves a saliva sample which is analyzed for ten gene variants that may be useful in guiding treatment. So far we find that in about half of the patients with treatment resistant depression …
Treatment of Fatigue in Patients with Depression or Bipolar
Treatment of depression in patients with depression or bipolar is often complicated. If medications are prescribed, will they make mood symptoms worse, or have other significant adverse effects? And yet fatigue is common in people with a history of depression (it occurs in up to 10% of the general population and is much more common in women, who have a …
RDOCS and DSM 5: Diagnosis and Psychiatry
Tom Insel, the Director of the National Institute for Mental Health, to celebrate the release of DSM5 in May of 2013, famously announced that the manual was already irrelevant to psychiatric research. This quote from Psychology Today captures the moment fairly well. Just two weeks before DSM-5 is due to appear, the National Institute of Mental Health, the world’s largest funding agency …
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