Apathy in Alzheimer’s disease is characterized as diminished motivation lasting for at least four weeks, with reduced goal-directed behaviour, goal-directed cognitive activity and emotions, and accompanied by functional impairments (Robert et al. Eur Psychiatry 2009;24:98-104).
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First-episode schizophrenia: two reports from the EUFEST study
May 8, 2013The European First Episode Schizophrenia Trial (EUFEST) was initiated in 2005 as a multicentre open-label trial comparing treatment with amisulpride, quetiapine, olanzapine or ziprasidone to low-dose haloperidol in patients with schizophrenia who had minimal prior exposure to antipsychotics (Fleischhacker et al. Schizophr Res 2005;78:147-156).
The EUFEST group reported that 12-month remission rates were higher with second-generation antipsychotics (amisulpride 40%; olanzapine 41%; quetiapine 24%, ziprasidone 28%) compared to haloperidol (17%) (Boter et al. Schizophr Res 2009;115:97-103). A subsequent finding was that the likelihood of remission at 12 months was correctly predicted at the week 2 assessment in 61% of cases (positive predictive power 0.61, negative predictive power 0.58), although accuracy was improved with the addition of 4-week (63%; PPP 0.67, NPP 0.55) and 6-week assessments (68%; PPP 0.73, NPP 0.61) (Derks et al. J Clin Psychopharmacol 2010;30:176-180).
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Web-based CBT effective for depression, QOL
May 8, 2013The Australian National University, Canberra, reports that a web-based cognitive-behavioural therapy (CBT) program can be an effective tool in improving depression and quality of life. Callers to a national helpline with moderate to high psychological distress were randomized to an Internet CBT program, weekly telephone follow-ups, Internet CBT plus weekly telephone follow-up, or usual care (Farrer et al. PLoS One 2011;6:e28099; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3227639/pdf/pone.0028099.pdf).
Mean patient age was 37-43 years, 82% of participants were female and 53% were not employed. Most (93%) had a history of depression, 60% had a history of social phobia, and 74% had experienced a panic attack in the preceding four weeks.
Effect of walking on cognitive function in Alzheimer’s disease
April 24, 2013A new study of early-stage Alzheimer’s disease reports that sedentary patients show significant deterioration in MMSE total score compared to more active patients, and that walking on a regular basis appears to stabilize cognitive decline (Winchester et al. Arch Gerontol Geriatr 2013;56:96-103). A total of 104 AD patients were followed over a 12-month period and categorized as Active or Sedentary based on Yale Physical Activity Survey scores.
Active patients who walked more than two hours per week had significant improvement in MMSE scores whereas Sedendary patients had significant worsening of MMSE scores.