http://www.primarypsychiatry.com/The Largest Peer Reviewed Phychiatric Journal in the Nation60Seventy percent to 90% of women of childbearing age experience premenstrual symptoms; 20% to ~40% of suffer these symptoms to a level which bothers their quality of life and have become labeled as premenstrual syndrome; and 3% to 8% have severe symptoms sufficient to be classified as premenstrual dysphoric disorder (PMDD). The affected women have been estimated to experience ~3,000 days of severe symptoms during reproductive age resulting in a heavy life burden and functional impairment. A variety of complex mood and somatic symptoms have been reported to characterize the PMDD. However, the underlying mechanism of irritability and behavior characteristics has not been comprehensively evaluated.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3606Ju-Yu Yen, MD, Cheng-Chung Chen, MD, PhD, Shun-Jen Chang, PhD, Chih-Hung Ko, MD, PhD, Cheng-Sheng Chen, MD, and Cheng-Fang Yen, MD, PhDFri, 16 Sep 2011 10:02:24 -05Major depressive disorder (MDD), often referred to as the “common cold of psychiatry,” has a lifetime prevalence of nearly 20% in the general population. Approximately 7% of American adults will be affected with this disease during a given 12-month period. While data indicate that MDD is frequently encountered in clinical practice, it is often undertreated, resulting in increased mortality for some patients. Additionally, the American Foundation for Suicide Prevention reports that >60% of people who die by suicide suffer from “major depression.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3605James W. Jefferson, MDThu, 15 Sep 2011 16:31:44 -05Obsessive-compulsive disorder (OCD) is classically considered to consist of two major syndromes: obsessions, which are intrusive unwanted thoughts, fears or images; and compulsions, which are ritualized behaviors or mental acts, generally performed to relieve the anxiety and/or distress caused by the obsessions. It has a lifetime prevalence of 2% to 3% and it is the fourth most common mental disorder, frequently accompanied by dysfunctions in several areas: family, social, school, and occupation. Some efforts of attempting to find OCD subgroups were conducted, including aspects such as: the age of obsessive-compulsive symptoms (OCS) onset; subjective experiences preceding OCS (sensory phenomena); comorbidity patterns; and clinical course. The results of those several approaches have led the researchers to consider OCD as a clinical and genetically heterogeneous disorder.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3604Igor Marcanti dos Santos, MD; Leandro Ciulla, MD; Daniela Braga, MD; Keila Maria Ceresér, PharmD, PhD; Clarissa Severino Gama, MD, PhD; Flávio Kapczinski, MD, PhD; and Ygor Arzeno Ferrão, MD, PhDWed, 7 Sep 2011 11:57:55 -05There is considerable interest and debate concerning the place of generic substitution, especially relating to antiepileptic drugs (AEDs). One of the causes of the ongoing debate is sadly confusion, often fueled intentionally by the pharmaceutical industry, among health professionals and patients regarding the regulatory definition of bioequivalence. It is often erroneously stated, and was unfortunately perpetuated by Sankar and colleagues, that to be considered bioequivalent there is an allowed difference in the extent and rate of absorption of 80% to 125% between a generic drug product and the branded standard. This is false and implies there is a wide leniency allowed, with varying clinical outcomes probable. Readers deserve better than an industry-sponsored publication promoting this myth in the cause of preventing the generic substitution of AEDs. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3603Gregory M. Peterson PhD, MBA, FSHP, FACP, AACPAMon, 1 Aug 2011 14:23:21 -05Priapism might be caused by medical treatment provided from a clinical practice. There are some case reports about antipsychotic-related priapism.1,2 However, there are few reports about aripiprazole-induced priapism. We present a case of a patient who developed priapism during treatment with aripiprazole.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3598Wen-Yu Hsu, MD, Nan-Ying Chiu, MD, Chieh-Hui Wang, MD, and Cheng-Yeh Lin, MDMon, 27 Jun 2011 13:43:23 -05We report the clinical and fMRI characteristics of a schizophrenia patient who developed auditory hallucinations with musical content and obsessive in form. We suggest that “obsessive musical hallucinations”, that integrate both psychotic and OCD-related features, may be mediated by the brain networks believed to be involved in OCD and in auditory musical hallucinations. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3597Maya Bleich-Cohen, PhD, Talma Hendler, MD, PhD, Artashes Pashinian, MD, Sarit Faragian, PhD, and Michael Poyurovsky, MD, PhDTue, 31 May 2011 10:37:06 -05There is a robust body of evidence supporting the association between inflammatory mediators and MDD. Polymorphisms in genes encoding different immunological mediators have been associated with susceptibility to MDD. Some of these inflammation-related proteins may suffer an influence of environmental factors (for example, trauma and childhood maltreatment), modulating the vulnerability to MDD. In addition, imbalance of certain cytokines has been recently demonstrated to be associated with specific characteristics in MDD, such as suicidal behavior, and with prediction of responsiveness to antidepressive therapy. In bipolar disorder, the findings are not abundant but are nonetheless consistent and will be the focus of this review.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3596Elisa Brietzke, MD, PhD, Raquel Stabellini, PhD, Rodrigo Grassi-Oliveira, MD, PhD, and Beny Lafer, MD, PhDMon, 16 May 2011 14:08:26 -05Although prior studies have documented poor work functioning in individuals with psychiatric and medical disorders, there are only a few studies that provide normative information about work functioning in individuals without such disorders. Without such normative information in healthy people, studies about work functioning in individuals with psychiatric or medical conditions are limited in their ability to interpret rates of absenteeism or quality of work functioning. Thus, norms for healthy individuals are needed for interpreting rates of absenteeism and quality of work performance both for individuals as well as groups. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3595Thilo Deckersbach, PhD, Jonathan P. Stange, BA, and Andrew A. Nierenberg, MDTue, 10 May 2011 10:36:17 -05We describe the case of a Treatment-resistant major depression patient whose depression did not respond to aggressive pharmacotherapy, psychotherapy, bilateral anterior cingulotomy, or electroconvulsive therapy, but which remitted when treated with vagus nerve stimulation in combination with electroconvulsive therapy.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3594Charles R. Conway, MD, Mehret D. Gebretsadik MD, and Richard D. Bucholz, MDMon, 9 May 2011 09:50:40 -05We aimed to determine the influence of ethnicity on the age at onset (AAO) and further understand the significance of AAO as a clinical marker of bipolar and schizoaffective disorders. Both populations were studied together to encompass a broader spectrum of mood-related illnesses. We applied admixture analysis to identify sub-groups characterized by differences in AAO, evaluated differences in the clinical presentation of these sub-groups, and conducted statistical comparisons with previous studies.http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=3593Naima Javaid, BSc, James L. Kennedy, MD, and Vincenzo De Luca, MD, PhD Mon, 9 May 2011 09:42:02 -05