Abstract:
:Patients with serious psychiatric disorders are frequently treated by primary care physicians, who may have difficulty keeping up with recent advances in psychiatry. This paper presents an updated synopsis for three major psychiatric illnesses: major depression, bipolar disorder, and schizophrenia. Current definitions, updated diagnostic criteria, short- and long-term treatment strategies with algorithms, and special challenges for the clinician are discussed for each of these illnesses. On the basis of each illness's distinct characteristics, five treatment principles are emphasized: 1) Treatment strategies should be long-term and should emphasize adherence, 2) treatment choice should be empirical, 3) combinations of medications may be helpful, 4) a combination of psychosocial and pharmacologic treatments may be more useful than either alone, and 5) the family or "significant others" as well as a consumer organization need to be involved. Some of the new directions in dinical research to refine these strategies and meet these challenges are also described.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Glick ID,Suppes T,DeBattista C,Hu RJ,Marder Sdoi
10.7326/0003-4819-134-1-200101020-00013subject
Has Abstractpub_date
2001-01-02 00:00:00pages
47-60issue
1eissn
0003-4819issn
1539-3704pii
200101020-00013journal_volume
134pub_type
杂志文章,评审abstract::We performed selective venous catheterization and sampling for ACTH in six patients with ACTH-secreting pituitary adenomas (Cushing's disease) and four patients with occult ectopic ACTH-secreting neoplasms. In five patients with Cushing's disease in whom the inferior petrosal sinus could be catheterized, ACTH levels w...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-5-647
更新日期:1981-05-01 00:00:00
abstract::Subacute encephalitis caused by infection of the central nervous system by the human immunodeficiency virus (HIV) is the most frequent cause of neurologic dysfunction in patients with the acquired immunodeficiency syndrome (AIDS). This disorder results in progressive cognitive, motor, and behavioral abnormalities in a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-107-2-383
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To study the relation between housestaff coverage schedules and the occurrence of preventable adverse events. DESIGN:Case-control study. SETTING:Urban teaching hospital. PATIENTS:All 3146 patients admitted to the medical service during a 4-month period. MEASUREMENTS:A previously tested confidential self-r...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-121-11-199412010-00008
更新日期:1994-12-01 00:00:00
abstract::Medical devices have become an integral part of hospital-based care but also predispose patients to more than 850 000 device-related infections annually. Devices predispose to infection by damaging or invading epithelial and mucosal barriers to infection, by supporting growth of microorganisms and thus serving as rese...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-5-764
更新日期:1978-11-01 00:00:00
abstract::A group of 44 homosexual patients with immune thrombocytopenia and serologic evidence of infection with the human immunodeficiency virus (HIV) was observed for a total of 844 person-months. The risk of developing the acquired immunodeficiency syndrome (AIDS), an actuarial incidence of 36.5% in 37 months, was no differ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-3-383
更新日期:1987-03-01 00:00:00
abstract::Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-1330
更新日期:2016-01-19 00:00:00
abstract::Traditional educational methods change clinical practice only with considerable effort and difficulty. In particular, the teaching of critical appraisal in the setting of journal clubs does not increase the amount of medical research read by trainees. Experiential learning theory, corroborated by the success of proble...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-11-199706010-00006
更新日期:1997-06-01 00:00:00
abstract:DESCRIPTION:Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for peripheral artery disease (PAD). METHODS:The USPSTF reviewed the evidence on the use of resting ankle-brachial index (ABI) as a screening test for PAD or as a risk predictor for cardiovascular disease (CVD). The...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-159-5-201309030-00008
更新日期:2013-09-03 00:00:00
abstract:OBJECTIVE:To evaluate the amount of variation in in-hospital mortality and length of intensive care unit (ICU) stay that can be accounted for by clinical data available at ICU admission. DESIGN:Inception cohort study. SETTING:Forty-two ICUs in 40 hospitals, including 26 hospitals that were randomly selected and 14 la...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-118-10-199305150-00001
更新日期:1993-05-15 00:00:00
abstract:BACKGROUND:The optimum duration of anticoagulant therapy after an episode of deep venous thrombosis (DVT) is controversial. Contributing to the controversy is uncertainty about whether residual venous thrombosis, as assessed by repeated ultrasonography over time, increases the risk for recurrent thromboembolism. OBJEC...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-137-12-200212170-00008
更新日期:2002-12-17 00:00:00
abstract:BACKGROUND:Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality. PURPOSE:To systematically review benefits and harms of low-dose aspirin for preventing morbidity and mortality from preeclampsia. DATA SOURCES:MEDLINE, Database of Abstracts of Reviews of Effects, PubMed, and Cochrane Centra...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M13-2844
更新日期:2014-05-20 00:00:00
abstract::Antimicrobial prophylaxis prevents recurrent urinary tract infections in susceptible women, but its cost effectiveness has not been studied. In a recent placebo-controlled trial of urinary prophylaxis, we also assessed cost effectiveness using a decision analysis model. In our hospital the direct cost of 1 patient yea...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-94-2-251
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Even with optimal pharmacotherapy, symptomatic heart failure is associated with substantial morbidity and mortality. PURPOSE:To determine the efficacy and safety of cardiac resynchronization therapy in adults with advanced systolic heart failure. DATA SOURCES:The Cochrane Central Register of Controlled Tri...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-5-200409070-00101
更新日期:2004-09-07 00:00:00
abstract:OBJECTIVE:To define the incidence of and possible risk factors for invasive Haemophilus influenzae disease in adults. DESIGN:Prospective, population-based surveillance of hospital and referral bacteriology laboratories. SETTING:Metropolitan Atlanta, Georgia community. PATIENTS:All patients with H. influenzae isolate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-10-806
更新日期:1992-05-15 00:00:00
abstract:BACKGROUND:Ear involvement is not unusual in autoimmune diseases, but few data on this problem in the Sjögren syndrome are available. OBJECTIVES:To determine whether the incidence of hearing loss is increased in patients with the Sjögren syndrome and to determine what factors might be involved in the pathogenesis of S...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-6-199703150-00005
更新日期:1997-03-15 00:00:00
abstract:BACKGROUND:Despite extensive literature, the diagnostic role of d-dimer for deep venous thrombosis (DVT) or pulmonary embolism (PE) remains unclear, reflecting multiple d-dimer assays and concerns about differing sensitivities and variability. PURPOSE:To systematically review trials that assessed sensitivity, specific...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-140-8-200404200-00005
更新日期:2004-04-20 00:00:00
abstract:Background:Whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection is unknown. Objective:To assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis. Des...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M18-2753
更新日期:2019-09-03 00:00:00
abstract:PURPOSE:To review available information on the epidemiology, cause, diagnosis, prognosis, and treatment of acute myocardial infarction during pregnancy or in the early postpartum period and to develop guidelines for the management of this condition. DATA SOURCES:MEDLINE and Index Medicus searches and a manual search o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-125-9-199611010-00009
更新日期:1996-11-01 00:00:00
abstract::Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, a...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-101-5-594
更新日期:1984-11-01 00:00:00
abstract:Description:The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update an...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M17-2640
更新日期:2018-03-20 00:00:00
abstract:Background:Acute pancreatitis (AP) varies in severity, prompting development of systems aimed at predicting prognosis to help guide therapy. Although several prediction approaches are available, their test characteristics and clinical utility are not completely understood. Purpose:To evaluate the test characteristics ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0650
更新日期:2016-10-04 00:00:00
abstract:BACKGROUND:Exercise therapy encompasses a heterogeneous group of interventions. There continues to be uncertainty about the most effective exercise approach in chronic low back pain. PURPOSE:To identify particular exercise intervention characteristics that decrease pain and improve function in adults with nonspecific ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-142-9-200505030-00014
更新日期:2005-05-03 00:00:00
abstract::Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture rejec...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-136-5-200203050-00010
更新日期:2002-03-05 00:00:00
abstract::Three patients with the acquired immunodeficiency syndrome had biliary obstruction resulting from benign strictures of the biliary tract. Stenosis of the distal common bile duct with differing degrees of irregularity of the smaller intrahepatic and extrahepatic ducts was seen in association with either cryptosporidial...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-2-207
更新日期:1986-08-01 00:00:00
abstract::Common variable immunodeficiency (CVI) is a heterogenous immunodeficiency syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections, and various immunologic abnormalities. In addition to recurrent infections, patients with this syndrome also have an increased incidence of autoimmune disease and m...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-118-9-199305010-00011
更新日期:1993-05-01 00:00:00
abstract::Our review focuses on low density lipoprotein (LD lipoprotein) and very low density lipoprotein (VLD lipoprotein) in their roles as transporters of cholesterol and triglyceride and as factors contributing to premature arteriovascular disease. We describe the clinical manifestations of the common, primary hyperlipoprot...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-85-4-497
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:HIV-1 genotypic and phenotypic susceptibility testing (GPT) optimizes antiretroviral selection, but its effect on survival is unknown. OBJECTIVE:To evaluate the association between GPT and survival. DESIGN:Cohort study. SETTING:10 U.S. HIV clinics. PATIENTS:2699 HIV-infected patients eligible for GPT (pl...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-151-2-200907210-00003
更新日期:2009-07-21 00:00:00
abstract::Prospective data at Framingham and elsewhere have shown conclusively that risk of coronary heart disease in persons younger than age 50 is strikingly related to the serum total cholesterol level. Within so-called normal limits risk has been found to mount over a five-fold range. The impact has been found to be augment...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-90-1-85
更新日期:1979-01-01 00:00:00
abstract::Women comprise more than one third of the active physician workforce, an estimated 46% of all physicians-in-training, and more than half of all medical students in the United States. Although progress has been made toward gender diversity in the physician workforce, disparities in compensation exist and inequities hav...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章
doi:10.7326/M17-3438
更新日期:2018-05-15 00:00:00
abstract:OBJECTIVE:To describe how the results of bone densitometry affect women's decisions about measures to prevent fractures and to determine whether labeling women as having below-normal bone density has adverse effects. DESIGN:Mail survey of a random sample of women. SETTING:Four community hospitals in the San Francisco...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-12-990
更新日期:1992-06-15 00:00:00