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Cotreatment Strategies for Schizoprenia
Limited effectiveness of antipsychotic treatment has prompted many trials of combination treatment for patients with schizophrenia. Correll and colleagues present a systematic overview and quality analysis of 29 meta-analyses testing 42 combinations of antipsychotic medication with a second psychotropic medication. Fourteen combination strategies significantly improved overall symptoms, but effect sizes favoring combination treatment were inversely correlated with the quality of the meta-analyzed trials. Fleischhacker discusses the relevance of meta-analyses for the clinical management of patients with schizophrenia.
Suicide Rates After Discharge From Psychiatric Facilities
Many studies have reported high rates of suicide after psychiatric hospitalization. Chung and colleagues present a meta-analysis of 100 studies of 183 patient samples including a total of 17 857 suicides. The pooled estimate postdischarge suicide rate was 484 suicides per 100 000 person-years. In an editorial, Olfson discusses the importance of the findings for health policy and the treatment of patient transitioning from inpatient to outpatient treatment.
Adolescent Personality and Subsequent Serious Mental Illness
Our understanding of personality as a risk factor for serious mental illness remains limited. In this longitudinal cohort study, Hayes and colleagues analyzed social maturity, mental energy, and emotional stability in more than 1 million Swedish men. They found that low scores were associated with subsequent diagnosis of schizophrenia. In an editorial, Bentall discusses the implications for research on personality and mental illness.
Trajectories of Depression Before Dementia
Depression is common in patients with dementia, but whether depressive symptoms increase the risk for dementia is unclear. Singh-Manoux and colleagues followed more than 10 000 persons aged 35 to 55 years and assessed depression on 9 occasions between 1985 and 2012. Those reporting depressive symptoms in midlife did not have an increased risk for dementia but those reporting depressive symptoms in late life did. In an editorial, Steffens reviews the importance of the study for our understanding of depression as a prodrome of dementia.
Liraglutide Effects on Prediabetes and Weight in Schizophrenia
Patients with schizophrenia have a high mortality rate owing to cardiometabolic disturbances. In a randomized double-blind clinical trial, Larsen and colleagues treated 103 participants with schizophrenia spectrum disorders taking clozapine or olanzapine with subcutaneous injections of the glucagon-like peptide-1 receptor agonist liraglutide or placebo daily for 16 weeks. Participants taking liraglutide showed normalized glucose tolerance and reduced body weight. These findings indicate liraglutide may be a good option for reducing glucose intolerance and body weight.
Continuing Medical Education
In This Issue. JAMA Psychiatry. 2017;74(7):661. doi:10.1001/jamapsychiatry.2016.2526
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