Diagnose, indicate, and treat severe mental illness (DITSMI) as appropriate care: A three-year follow-up study in long-term residential psychiatric patients on the effects of re-diagnosis on medication prescription, patient functioning, and hospital bed utilization

BACKGROUND.: While polypharmacy is common in long-term residential psychiatric patients, prescription combinations may, from an evidence-based perspective, be irrational. Potentially, many psychiatric patients are treated on the basis of a poor diagnosis. We therefore evaluated the DITSMI model (i.e., Diagnose, Indicate, and Treat Severe Mental Illness), an intervention that involves diagnosis (or re-

Association of Polymorphisms of Serotonin Transporter (5HTTLPR) and 5-HT2C Receptor Genes with Criminal Behavior in Russian Criminal Offenders

Background: Human aggression is a heterogeneous behavior with biological, psychological, and social backgrounds. As the biological mechanisms that regulate aggression are components of both reward-seeking and adversity-fleeing behavior, these phenomena are difficult to disentangle into separate neurochemical processes. Nevertheless, evidence exists linking some forms of ag

Classification, actions and adverse effects of psychotropic drugs

Psychotropic drugs can be classified according to their chemical structures, their neurochemical characteristics, their pharmacological effects, and their clinical qualities. A categorization corresponding to their principal fields of indication results in the following classes: antipsychotic drugs, antidepressive drugs, mood stabilizers, antipanic drugs, anxiolytic drugs, anticonvulsant drugs, drugs for movement disorders, and a residual drug class. Both the chemical structure and the pharmacological properties offer clues to subdivide these psychotropic drug classes. This subdividion is clinically relevant as it corresponds to the efficacy in certain psychic and behavioural disorders and also with the occurrence of certain side effects. Desired and undesired effects are discussed in a general sense

Dealing with sadness, madness and hostility. New psychotropic drug remedies for the future

The objective of this article is to present an overview of new forms of psychotropic drug therapy that may be expected to play a role in psychiatric practice in the 1990s. In predicting these future developments, three lines of approach have been followed. Firstly, progress in elucidating basic neuronal mechanisms is described. The radioligand receptor binding technique has proved to be an especially powerful tool in the search for novel psychoactive compounds. Secondly, those mental health problems most likely to undergo intensive study are discussed. It is likely that special attention will be devoted to organic mental disorders related to aging (dementia) or chronic exposure to toxic substances. In addition, research will be aimed at explaining and reducing the occurrence of auto-aggressive and hetero-aggressive behaviour. Thirdly, the types of newly designed agents and treatment strategies currently under investigation are outlined. In particular, the development of pharmacological agents that interfere with serotonergic molecular mechanisms has opened the way to improving existing psychotropic drugs, to inventing drugs that achieve known clinical effects via different mechanisms of action, and even to discovering entirely new categories of psychotropic drugs