Psychiatry 2006 - ISSN: 1550-5952 - Volume 3 - Issue 4 - April 2006
Feature Article:
Major Depression with ADHD in Children and Adolescents
by ATILLA TURGAY, MD; RUBABA ANSARI, MA

KEYWORDS: Chilld and Adolescent, Depression, Attention Deficit/Hyperactivity Disorder, ADHD Abstract: The objective of this paper is to review recent studies on comorbidity and treatment of major depression (MD) and attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Both ADHD and MD are commonly associated with other DSM-IV Axis I psychiatric disorders. ADHD is more commonly associated with oppositional defiant disorder and conduct disorder in children and adolescents. The literature on comorbidities of MD and ADHD suggests that when these two disorders occur together, they bring their own unique profiles, often including a number of other psychiatric disorders and severe symptoms. The guidelines for the use of first-line ADHD medications (psychostimulants and atomoxetine) and the use of antidepressants in patients with MD comorbid with ADHD (with and without psychostimulants) will also be reviewed. Recommendations for the sequencing of these medications i
Atypical Depression
by Tanvir Singh, MD; Kristi Williams,MD

The authors conducted Pubmed searches to examine the epidemiological characteristics, symptoms, association with bipolar disorder, personality and temperament features, biology, and pharmacotherapy response of atypical depression and significance of current knowledge about this subtype of depression in treatment planning. Atypical depression has a high prevalence rate, starts early in life, tends to last longer, is more likely to occur in people with bipolar disorder, has high comorbidity of anxiety disorders, carries more risk of suicidal behavior, and has distinct personality psychopathology and biological traits. Atypical depression is an important specifier with significance in terms of predicting clinical course of depression, and hence in treatment planning and service use. Key Words: Atypical depression, epidemiology, pharmacotherapy
Acute Akathisia with Suicidal Ideation Associated with Low Dose Aripiprazole
by Tanveer Padder, MD; Kenneth Skodnek, MD; Seema Hashmi, MD; majid Samad, MD; Aparna Udyawar, MD; Nouman Azhar, MD; and Kamil Jaghab, MD

abstract Akathisia is a relatively common and disturbing side effect of neuroleptic agents. It is widely assumed that the atypical antipsychotic agents are much less likely to produce movement disorders than the conventional antipsychotic agents. Still, there have been reports of akathisia associated with all of the atypical antipsychotic agents. Like other atypical antipsychotics, aripiprazole has a low risk of producing extrapyramidal symptoms compared with the conventional antipsychotics. Aripriprazole is generally well tolerated relative to other antipsychotic medications and has low propensity to cause clinically significant side effects, including weight gain, hyperprolactinemia, and QT interval prolongation. We are reporting a case of acute akathisia along with suicidal ideations associated with a low dose of aripiprazole in a 23-year-old patient with a mood disorder. In this patient, suicidal ideations appeared suddenly for the first time concurrently with akathisia and disap
Fibromyalgia�A Review for the Psychiatrist
by Nikhil D. Nihalani, MD; Thomas Schwartz, MD; and Susan Chlebowski, MD

abstract This paper is a review article that collects and synthesizes up-to-date information about the complex etiological theories and treatment regimens associated with Fibromyalgia. The authors have written the paper in an evidence-based model in order to show the reader where adequate data exist in regards to these pharmacological, psychological, and physical strategies. A thorough MEDLINE search was utilized to collect many papers dedicated to this topic spanning 1970-2005. Measurements: The relevant papers were divided, based upon intervention used for the treatment of FM (pharmacological vs. non-pharmacological). They were also divided based on their scientific merit; randomized controlled trials were given the most evidence-based weight and the case studies the least. Results: The authors first review current epidemiologic and etiologic theories regarding fibromyalgia. A formal literature review is next presented to allow the reader to understand the evidence base that support

Forensic Files:
Overview of Child and Adolescent Forensic Evaluations
by Frank Fortunati, MD, JD; Charles A. Morgan, MD;Humberto Temporini, MD; Steven Southwick, MD; Vladimir Coric, MD; and Seth Feuerstein, MD, JD

Letters to the Editor:
Regarding dissociative amnesia and Cluster C personality traits
James J. Staudenmeier, MD, MPH; David G. Brown, PsyD
Regarding managing bipolar depression
Ronald Pies, MD
Regarding managing bipolar depression�AUTHORS’ RESPONSE
Raymond Pary, MD Paul Matuschka, PharmD Susan Lewis, PHD Steven Lippmann, MD