Diagnosing and managing psychotic and mood disorders

The diagnosis and management of psychotic and mood disorders is an evolving process and an important topic for continuing medical education. To facilitate a dialogue on the identification and treatment of psychotic and mood disorders, 4 expert faculty members present actual patient cases.

Each case presentation is followed by a panel discussion in which the faculty’s collective experience lends further practical insights into the nuances of management of such patients in both inpatient and outpatient settings. In particular, these cases underscore the importance of being alert to clues in a patient’s history or the family’s history.

We hope the insights you glean from this exchange of clinical issues will enhance and confirm your own thinking when diagnosing and treating patients with psychotic and mood disorders.

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Financial disclosures and conflict of interest

According to the disclosure policy of the University of Cincinnati, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with the commercial companies related to this activity. All relevant relationships that are identified are reviewed for potential conflicts of interest. If a conflict of interest is identified, it is the responsibility of the University of Cincinnati to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

The faculty has reported the following:

• Dr Nasrallah reports that he is on the advisory board of Abbott, AstraZeneca, Cephalon, Janssen, Pfizer, and Vanda Pharmaceuticals; is a consultant for AstraZeneca, Janssen, Pfizer, and Vanda Pharmaceuticals; receives grants from AstraZeneca, Forest Laboratories, Janssen, Otsuka America Pharmaceutical Inc., Pfizer, Roche, and sanofi-aventis; and is on the speakers bureau of AstraZeneca, Janssen, and Pfizer.
• Dr Black reports that he is a consultant for Forest Laboratories and Jazz Pharmaceuticals and receives grant(s) from Forest Laboratories.
• Dr Goldberg reports that he is on the advisory board, speakers bureau, and serves as a consultant for AstraZeneca, Eli Lilly & Co, and GlaxoSmithKline.
• Dr Pariser reports that he receives grants from Pfizer and is on the speakers bureau of AstraZeneca, GlaxoSmithKline, and Pfizer.
• Dr Muzina reports that he is on the advisory board of AstraZeneca and Bristol-Myers Squibb; and is on the speakers bureau of AstraZeneca, Bristol-Myers Squibb, Pfizer, Sepracor, and Wyeth.

Planning Committee: Kay Weigand, University of Cincinnati; and Kristen Georgi, Charles Williams, and Katherine Wandersee for Dowden Health Media have disclosed no relevant financial relationship(s) with any commercial interests.

Off-label/unapproved agents discussed: Lithium, valproate, and carbamazepine are not approved by the FDA for the treatment of schizophrenia; lithium is not approved for the treatment of suicidality; topiramate, sibutramine, and metformin are not approved for the treatment of antipsychotic-induced weight gain; quetiapine is not approved for the treatment of generalized anxiety disorder; and venlafaxine is not approved for the treatment of obsessive compulsive disorder.

A list of the FDA-approved agents mentioned in this activity appears on page S31.

None of the atypical antipsychotic agents have been approved in the psychosis or agitation of dementia, and the FDA has issued a class-effect black-box warning regarding the increased mortality in geriatric patients treated with atypical antipsychotics compared to those treated with placebo.

Acknowledgement

This CME activity was developed through the join sponsorship of the University of Cincinnati and Dowden Health Media, and supported by an educational grant from AstraZeneca. It was edited and peer reviewed by Annals of Clinical Psychiatry and Current Psychiatry. Reprinted with permission from Annals of Clinical Psychiatry.

Statement of support

This CME activity is supported by an educational grant from AstraZeneca.