A child psychiatrist from Johns Hopkins argues that the nonspecific term “irritability” should be replaced in DSM-V with a new diagnosis, dysfunctional anger, which will lead to greater precision in understanding mood disorders and other psychiatric conditions. (The PDF of this article appears immediately above the abstract, with the journal name as the clickable result title.)

RESULT: Irritable Mood and the Diagnostic and Statistical Manual of Mental Disorders
Child and Adolescent Psychiatry and Mental Health | Oct 24, 2009

Search: conduct disorder

Call it what you will, irritability in adolescence is a specific predictor of depression and anxiety in early adulthood, according to this prospective study. The authors urge further study to clarify the relationship between the early symptom and the later mood disorder.

RESULT: Adult Outcomes of Youth Irritability: A 20-Year Prospective Community-based Study
American Journal of Psychiatry | Sep1, 2009

Search: irritability

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: schizophreniform disorder

RESULT: A Staging Model Guide to Psychological Interventions in Psychosis
Psychiatric Services | Nov 1, 2009

A paradigm that views the emergence of frank psychosis as part of a continuum should be part of the treatment plan for patients who have early symptoms that probably represent a prodrome, maintain two European psychologists. There’s a place for therapeutic interventions at a stage before the use of medication is justified, they add. (Scroll down to find this result.)

Search:  rape trauma syndrome

RESULT:  Readers React to “Abortion Trauma Syndrome”
Psychiatric Times | Oct 26, 2009

An incidental mention of the search term produces this recent set of letters in response to a controversial report from the APA meeting. Do some women who terminate their pregnancies experience a reaction that is beyond mere regret? Is the suggestion that they do motivated by clinical or political concerns?

Search: in-depth studies

RESULT: Prevalence of genetic muscle disease in northern England: An in-depth analysis of a muscle clinic population
Brain | Nov 1, 2009

This study that has nothing to do with psychiatry and little to do with neurology turns up in a general search because it appears in a neurology journal. It mentions hereditary neuropathy, which apparently accounts for its inclusion there.

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SEARCH TIP: Targeting clinical studies

This search and another this week on the term “double-blind study” are destined to deliver a random mix of topics. Yet again, someone has tried to use the search term to define article categories that are already built into SearchMedica.

The subject of your inquiry should be in the search box, and the choice of tabs and article categories (such as Research/Reviews or Evidence-based Articles) will determine the nature of information you see on that topic.

DSM-V should consider renaming schizophrenia “salience dysregulation syndrome” with 3 subtypes:

* Affective expression (high in mania/depression dimension)
* Developmental expression (high in developmental cognitive deficit/negative symptoms)
* Not otherwise specified

So contends Jim van Os, a member of the APA DSM-V Psychotic Disorders Workgroup, writing in the British Journal of Psychiatry.

He argues that the term “schizophrenia” has a powerful potential to cause discrimination, and is backed by poor science. Meanwhile, considerable research supports psychosis as a disorder of aberrant salience, an abnormality in learning stimulus-reinforcement associations.

This hypothesis was offered first in 1993. Much more has been published on the subject since then, some of it linking salience disorders with abnormalities in dopamine metabolism.

We found these other relevant results by looking at “Broaden/Narrow” in the left column, which suggested trying the term “psychosis” as well as “schizophrenia.”

Clinical Trials

A look in this article category turned up a new NIMH trial testing whether the drug D-cycloserine can improve cognitive flexibility in people with schizophrenia as they undergo cognitive behavioral therapy.

Top searches last week in Mental/Nervous
What are your colleagues looking at?

dsm-v

RESULT #1: Get Early Look at the DSM-V Development Process
Psychiatric News

implicit memory

RESULT #1: Does implicit memory during anaesthesia persist in children?
British Journal of Anaesthesia

typical versus atypical antipsychotics for children

RESULT #3: New Findings on Antipsychotic Use in Children and Adolescents With Schizophrenia Spectrum Disorders
American Journal of Psychiatry

CLINICAL QUERY of the week
Lessons from a genuine search result

Someone took pains to point out a fascinating new study that appears in first position just now with the query memory. It documents how quickly and how perfectly we are able register emotional expressions.

Full text is available by clicking on the article title.

RESULT #1: Flawless short-term memory for facial emotional expressions
Journal of Vision

TIP: This result appears under the All of Medicine tab, but not under Mental/Nervous, because it appears in an ophthalmology journal. Please remember than you’ll always find a wider range of results by using All of Medicine.

Choosing the Mental/Nervous tab will limit your results to sources in psychology, psychiatry, and neurology.

More on DSM-V from Psychiatric Times.