- Joined
- Nov 30, 2009
- Messages
- 4,292
- Reaction score
- 9,715
Here is my updated list of 100 papers to read during the first two years of residency. It reflects my biases of course, but includes the most clinically relevant important papers in the field as well as some nice reviews and overviews. New additions are marked in bold.
Psychosis
Agid O, Kapur S, Arenovich T, Zipursky RB. Delayed-onset hypothesis of antipsychotic action: a hypothesis tested and rejected. Arch Gen Psychiatry 2003; 60:1228-1235
This study shows that if antipsychotics don’t have an effect in the first week, they probably never will, and the most pronounced effects are in the first two weeks of treatment.
Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a progressive longitudinal MRI study. Am J Psychiatry 2013; 170:609-615
Important study finding antipsychotics rather than relapses cause brain shrinkage, and suggest using the lowest doses possible
Chouinard G, Jones BD. Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. Am J Psychiatry 1980; 137:16-21
One of the first papers to introduce the possibility of a neuroleptic-induced supersensitivity psychosis
Demjaha A, Murray RM, McGuire PK, Kapur S, Howes OD. Dopamine synthesis capacity in patients with treatment-resistant schizophrenia. Am J Psychiatry 2012; 169:1203-1210
This paper shows that dopamine dysregulation is not found in those with treatment resistant schizophrenia and thus dopamine antagonists are worthless in these patients
Fazel S, Zetterqvist J, Larsson H, Langström N, Lichtenstein P. Antipsychotics, mood stabilisers, and risk of violent crime. Lancet 2014; 384:1206-1214
Population-based study found patients had significant reductions in violent crime when on antipsychotics compared to when not taking, and mood stabilisers also reduced violent crime in those with bipolar disorder
Fletcher PC, Frith CD. Perceiving is believing: a Bayesian approach to explaining the positive symptoms of schizophrenia. Nat Rev Neurosci 2009; 10:48-58
An extremely clever model uniting Schneider’s first rank symptoms as theory of mind deficits in context of other biological and neuropsychological findings in schizophrenia
Fusar-Poli P, Borgwardt S, Bechdolf A et al. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry 2013; 70:107-120
Extremely useful review of the field of prodromal or at-risk mental state
Honer WG, Thornton AE, Chen EYH et al. Clozapine alone versus clozapine and risperidone with refractory schizophrenia. N Engl J Med 2006; 354: 472-482
CARE study showed adding risperidone to clozapine no more effective than clozapine alone
Jones PB, Barnes TR, Davies L et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1) Arch Gen Psychiatry 2006; 63:1079-87
CUtLASS study was British equivalent of the CATIE using more of the typical antipsychotics and confirming the new drugs cost more and have no additional benefit on quality of life
Kahn RS, Fleischhacker WW, Boter H et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 2008; 371:1085-97
EUFEST study found that first-episode psychosis like chronic schizophrenia responds just as well to the older drugs as the newer drugs
Kane J, Hongfeld G, Singer J, Meltzer H and the Clozaril Collaborative Study Group. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45:789-796
Classic study demonstrating clozapine’s superiority to chlorpromazine in treatment-resistant schizophrenia that led to re-discovery of clozapine in clinical practice
Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 2003; 160:13-23
A modern classic, this paper describes how the dopamine hypothesis can explain the positive symptoms of schizophrenia
Leucht S, Cipriani A, Spineli L et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple treatments meta-analysis. Lancet 2013; 382:951-962
This meta-analysis shows substantial differences in efficacy and side-effect profiles of different antipsychotic agents with clozapine, amisulpride and olanzapine coming out as most effective, and asenapine, lurasidone, and iloperidone coming out as least effective
Lieberman JA, Stroup TS, McEvoy JP et al. Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia. N Engl J Med 2005; 353:1209-1223
CATIE study showed olanzapine was more effective than other atypical antipsychotics and ziprasidone less effective, with no difference between typical and atypical antipsychotics
Tiihonen J, Lonngvist J, Wahlbeck K et al. 11-year follow-up of mortality in patients with schizophrenia: a population based cohort study (FIN11 study). Lancet 2009; 374:620-627
This study found clozapine was associated with reduced morality in comparison to other antipsychotics or no treatment in schizophrenia
Wunderink L, Nieboer RM, Wiersma D, Sytema S, Nienhuis FJ. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry 2013; 70:913-920
Controversial study that confirms older data that continued antipsychotic use leads to poorer functional outcomes with better symptom control than discontinuation/early dose reduction
Depressive Disorders
Beck AT. The evolution of the cognitive model of depression and its neurobiological correlates. Am J Psychiatry 2008; 165:969-977
Very readable overview of the cognitive model of depression in a biopsychosocial perspective from the founder of cognitive therapy itself
Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373:747-758
Mirtazapine and venlafaxine are the most efficacious, duloxetine and reboxetine don’t work, and sertraline or citalopram are probably the best first-line agents for depression
Fava GA. Can long-term treatment with antidepressant drugs worsen the course of depression? J Clin Psychiatry 2003; 64:123-133
This paper suggests that antidepressants may be contributing to the poor prognosis for depression!
Rush AJ, Trivedi MH, Wisniewski SR et al. Acute and longer-term outcomes in depressed outpatient requiring one or several treatment steps: a STAR*D Report. Am J Psychiatry 2006; 163:1905-1917
This paper summarizes all of the arms of the STAR*D study and highlights the limited remission rates in the treatment of depression
Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. Br J Psychiatry 2009; 195:102-108
An attempt at explaining antidepressant action in cognitive neuropsychological terms
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Adminstration. PLOS Med 2008; 5:e45 doi:10.1371/journal.pmed.0050045
The best known study to report from unpublished data that antidepressants are no better than placebo except in the most severe depressive episodes
Kuhn R. The treatment of depressive states with G 22355 (imipramine hydrochloride). Am J Psychiatry 1958; 115:459-464
First paper to describe the use of TCA imipramine and suggest it is particular beneficial in melancholic depression
Rush AJ, Trivedi MH, Wisniewski SR et al. Bupropion-SR, Sertraline, or Venlafaxine-XR after failure of SSRIs for Depression. N Engl J Med 2005; 354:1231-1242
STAR*D trial finds only 20% remit after one failed antidepressant, and bupropion, sertraline and venlafaxine are just as bad as each other
Trivedi MH, Fava M, Wisniewski SR et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006; 354:1243-1252
STAR*D trials finds augmentation strategies all as bad as each other and no better than switching to another agent
West ED, Dally PJ. Effects of iproniazid in depressive syndromes. Br Med J 1959; 1:1491-1494
One of the first papers to report MAOIs are effective especially in atypical depressions
Bipolar Disorders
Cade JF. Lithium salts in the treatment of psychotic excitement. Med J Aust 1949; 2:349-352
Classic paper that first used lithium to treat mania, absolute must read.
Cipriani A, Barbui C, Salanti G et al. Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis. Lancet 2011; 378:1306-1315
This meta-analysis finds that antipsychotics are the best treatment for acute mania rather than lithium or mood stabilizers.
Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ 2013; 346:f3646
Updated meta-analysis finds lithium still appears to have anti-suicidal properties
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet 2013; 381:1672-1682
Reviews the evidence for pharmacological and psychological treatments in bipolar disorder
Janowsky DS, Epstein RS. Playing the manic game –interpersonal maneuvers of the acutely manic patient. Arch Gen Psychiatry 1970; 22:252-26
Describes the frustrating and destructive maneuvers ‘manic’ patients catch clinicians in. Possibly more relevant to borderline patients, I find this slightly outmoded and offensive, but seems well-loved by more seasoned psychiatrists of all stripes
McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet 2012; 379:721-728
Toxicity of lithium has been overblown with ESRD being a rare complication. Li also causes hyperparathyroidism and checking Ca periodically is recommended
Nierenberg AA, Ostacher MJ, Calabrese JR et al. Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. Am J Psychiatry 2006; 163:210-216
Bipolar depression is hard to treatment and augmenting antidepressants with lamictal, inositol or risperidone are just as bad as each other
Sachs GS, Nierenberg AA, Calabrese JR et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med 2007; 356:1711-1722
STEP-BD study found antidepressants don’t work in bipolar disorder
Geddes, JR, Goodwin GM, Rendell K et al. Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomized open-label trial. Lancet 2010; 375:385-395
Lithium is better than valproate, and the benefit of combining the two isn’t clear
Yonkers KA. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry 2004; 161:608-620
Nice review of management of bipolar disorder in women
Suicide
Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997; 170:205-228
Meta-analysis finds mental disorders except for mental ******ation and dementia increase risk of suicide
Gitlin MJ. A psychiatrist’s reaction to a patient’s suicide. Am J Psychiatry; 156:1630-1634
Discusses the experience of losing a patient to suicide
Mann JJ, Apter A, Bertolote J et al. Suicide prevention strategies: a systematic review. JAMA 2005; 294:2064-2074
A comprehensive but biased review of suicide prevention strategies that places too much emphasis on clinical approaches and not enough on means prevention but still worth reading
Rosen DH. Suicide survivors. A follow-up study of persons who survived jumping from the Golden Gate and San Francisco-Oakland Bay Bridges. West J Med 1975; 122:289-294
Classic study interviewing survivors of the Golden Gate Bridge attempted suicides argues for suicide barriers. Must read.
Stone M, Laughren T, Jones ML et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. BMJ 2009; 339:b2880
Extensive meta-analysis of clinical trials showing that risk of suicidality is age-related, and antidepressants may reduce suicides in the elderly
Anxiety Disorders, OCD, and PTSD
Abramowitz JS, Taylor S, McKay D. Obsessive-compulsive disorder. Lancet 2009; 374:491-499
Summarizes cognitive-behavioral and biological aspects of OCD and its treatment
Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res Therapy 2000; 38:319-345
An insightful and extremely useful model for understanding chronic PTSD from the cognitive perspective
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008; 31:453-463
mTBI is common in OIF Veterans and often highly comorbid with PTSD symptoms
Roy-Byrne PP, Craske MG, Stein MB. Panic disorder. Lancet 2006; 368:1023-1032
Concise overview of panic and its treatment
Summerfield D. The invention of posttraumatic stress disorder and the social usefulness of a psychiatric category. Br Med J 2001; 322:95-98
Provocative discussion of PTSD as a sociopolitical construct
Personality Disorders
Groves JE. Taking care of the hateful patient. N Engl J Med 1978; 299:883-887
Classic paper describes 4 ‘hateful’ patients in the medical setting
Macdonald JM. The threat to kill. Am J Psychiatry 1963; 120:125-130
Excellent paper discusses homicidal ideation, and describes the triad of childhood firesetting, bedwetting and cruelty to animals being linked to later sadistic/antisocial behavior
Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disorder. Lancet 2011; 377:74-84
Comprehensive review of borderline personality disorder and its treatment. The drugs don’t really work.
Vaillant GE. The beginning of wisdom is never calling a patient a borderline; or, the clinical management of immature defenses in the treatment of individuals with personality disorders. J Psychother Pract Res 1992; 1:117-134
Classic, extremely well written and useful discussion of managing different defenses in difficult patients
Eating Disorders
Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010; 375:583-93
Nice overview on biology of eating disorders and review of evidence for different therapies
Addiction Psychiatry
Anton RF, O’Malley SS, Ciraulo DA et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006; 295:2003-2017
Naltrexone is better than acamprosate for alcohol dependence when combined with CBT
Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. N Engl J Med 2016; 374:154-163
This review article highlights the importance of viewing prescription opioid and heroin use disorders from a unified perspective
D’Onofrio G, O’Connor PG, Pantalon MV et al. Emergency Department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA 2015; 313:1636-1644
This important trial highlights how ED-initiated Suboxone, compared with brief intervention enhances engagement of addiction services and reduces inpatient addiction service use.
Khantzian EH. The self-medication hypothesis of addiction. Am J Psychiatry 1985; 142:1259-1264
This psychodynamic view of addiction as self-medication has proved enduring and influential in clinical practice and popular culture despite no supporting evidence
Koston TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003; 348:1786-1795
Comprehensive overview of withdrawal syndromes and their management
Laaksonen E, Koski-Jannes A, Salspuro M, Ahtinen H, Alho H. A randomized, multicenter, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol 2008; 43:53-61
Disulfiram may actually be better than naltrexone or acamprosate when combined with behavior therapy in alcohol dependence
Martensen-Larsen O. Treatment of alcoholism with a sensitising drug. Lancet 1948; 252:1004-1005
First report of use of Antabuse in the treatment of alcoholism.
McKetin R, Lubman DI, Baker AL, Dawe S, Ali RL. Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study. JAMA Psychiatry 2013; 70:319-324
First prospective longitudinal study to establish causal relationship and dose-dependence between methamphetamine use and psychosis
Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 1998 22:1300-1311
12-step facilitation, CBT, and motivational interviewing are all beneficial in alcoholism, with patient characteristics helping to match best treatment. Angry alcoholics do better with MI.
Volkow ND, Baler Rd, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med 2014; 370:2219-2227
Nice overview of marijuana addiction, potential as a gateway drug role in mental illness, and other effects on health
Volkow ND, Koob GF, McLellan AT. Neurobiological advances from the brain disease model of addiction. N Engl J Med 2016; 374:363-371
Nice summary of the neurobiological findings in addiction (regardless of whether you subscribe to the disease model) and implications for treatment
Child and Adolescent Psychiatry
Baron-Cohen S. The extreme-male brain theory of autism. Trends Cogn Sci 2002; 6:248-254
This paper gives a compelling account of autism as the extreme variant of the ‘male brain’
Bowlby J. The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrist, 19 November 1976. Br J Psychiatry 1977; 130:201-210
Very readable paper summarizes key findings of attachment theory and its relevance to psychopathology throughout the lifespan
Jensen PS, Arnold LD, Swanson JM et al. 3-year follow-up of the NIMH MTA Study. J Am Acad Child Adolesc Psychiatry 2007; 56:989-1002
Important ADHD study showed benefits of stimulant treatment did not persist after initial phase of treatment compared with behavior therapy
March J, Silva S, Petrycki S et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescences with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. JAMA 2004; 292:807-820
TADS study showed combination of CBT and fluoxetine was best treatment for adolescent depression
Rutter M, Sroufe LA. Developmental psychopathology: concepts and challenges. Dev Psychopathol 2000; 12:265-296
The father of child psychiatry outlines the developmental approach to psychopathology
Swedo SE, Leonard HL, Garvey M. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry 1998; 155:264-271
First paper to describe the emotional lability, anxiety, obsessive-compulsive symptoms and behavioral disturbances in children following strep infection
Walkup JT, Albano AM, Piacentini J et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 2008; 359:2753-2766
CAMS study found combination of CBT and sertraline best for childhood anxiety disorders
Geriatric Psychiatry and Neuropsychiatry
Burns A, Jacoby R, Levy R. Psychiatric phenomena in Alzheimer’s disease. IV: Disorders of behavior. Br J Psychiatry 1990; 157:86-94
Outlines the most common behavioral disturbances in Alzheimer’s from a sample of 178 patients, and finds features of Klüver-Bucy syndrome occur more commonly than is realized
Cummings JL, Lyketsos CG, Peskind ER et al. Effect of dextromethorphan-quinidine on agitation in patients with Alzheimer disease dementia. JAMA 2015; 314:1242-1254
Despite my skepticisms, this promising trial found Nudexta had modest benefits over placebo in the management of agitation in dementia patients
Howard RJ, Juszszak E, Ballard CG et al. Donepezil for the treatment of agitation in Alzheimer’s Disease. N Engl J Med 2007; 357: 1382-1392
Donepezil doesn’t help agitation in context of Alzheimer’s disease
Howard RJ, McShane R, Lindesay J et al. Donepezil and memantine for moderate-to-severe Alzheimer’s Disease. N Engl J Med 2012; 366:893-903
There is a small functional benefit to donepezil or memantine in moderate-to-severe Alzheimer’s with no difference between the two and no additional benefit of the combination
Inouye SK. Delirium in older persons. N Engl J Med 2006; 354:1157-1165
Nice overview of diagnosis, causes and management of delirium in the elderly
McKee AC, Cantu RC, Nowinski CJ et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Ex Neurol 2009; 68:709-735
Describes cases of CTE, an important neuropsychiatric disease now recognized in athletes
McKeith IG, Dickson DW, Lowe J et al. Diagnosis and management of dementia with Lewy bodies. Neurology 2005; 12:1863-1872
Most recent guidelines for diagnosis and management of LBD (soon to be updated)
Saczynski JS, Marcanonio ER, Quach L, Fong TG, Gross A, Inouye SK, Jones RN. Cognitive trajectories after postoperative delirium. N Engl J Med 2012; 367:30-39
Reminder that most patients post-delirium do not return to baseline and experience significant decline in cognitive functioning
Schneider LS, Tariot PN, Dagerman KS et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med 2006; 355:1528-1538
CATIE-AD study compares antipsychotics for Alzheimer’s – they are all as bad as each other and do more harm than good
Snowden JS, Rollinson S, Thompson JC et al. Distinct clinical and pathological characteristics of frontotempoeral dementia associated with C9ORF72 mutations. Brain 2012; 135:693-708
Very important study finds 38% of patients with C9ORF72 gene expansion and frontotemporal dementia present with psychosis with another 28% presenting with paranoid or irrational thinking
Psychosomatic Medicine
Appelbaum PS. Assessment of patients’ competence to consent to treatment. N Engl J Med 2007; 357:1834-1840
Definitive review of decisional capacity assessment for clinicians
Barsky AJ, Saintford R, Rogers MP, Borus JF. Nonspecific medication side-effects and the nocebo phenomenon. JAMA 2002; 287:622-627
Describes the nocebo effect as a common occurrence in anxious patients, and a cognitive model for understanding its development
Beach SR, Celano CM, Noseworthy PA, Januzzi JL, Huffman JC. QTc prolongation, Torsades de pointes, and psychotropic medications. Psychosomatics 2013; 54:1-13
Comprehensive up-to-date review on QTc prolongation and psychotropic drugs. Turns out we vastly overestimate the significance of cardiac risk of drugs.
Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005; 352:1112-1120
Comprehensive review of serotonin syndrome comparing it to other differentials
Bass C, Halligan P. Factitious disorders and malingering: challenges for clinical assessment and management. Lancet 2014; 383:1422-1432
nice overview of challenges of evaluation and management of malingering placing on the illness deception spectrum including conversion disorder and compensation neurosis
Groves JE. Management of the borderline patient on a medical or surgical ward: the psychiatric consultant’s role. Int J Psychiatry Med 1975; 6:337-48
Practical suggestions on how to manage difficult patients in the medical setting
Kayser MS, Kohler CG, Dalmau J. Psychiatric manifestations of paraneoplastic disorders. Am J Psychiatry 2010; 167:1039-1050
Discusses the emerging field of autoimmune-mediated neuropsychiatric disorders
Levenson JL. Neuroleptic malignant syndrome. Am J Psychiatry 1985; 142:1137-1145
Though supplanted by more up to date reviews this remains the authoritative paper on the topic
Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry 2005; 76(Suppl I): i2-i12
Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: management. J Neurol Neurosurg Psychiatry 2005; 76(Suppl I): i13-21
These two papers discuss the assessment and management of conversion disorder including examination maneuvers for eliciting functional neurology
Electroconvulsive Therapy
Anjala AV, Smetana GW. Medical evaluation of patients undergoing electroconvulsive therapy. N Engl J Med 2009; 360:1437-1444
Discusses the medical workup and preparation of patients for ECT
Rose D, Fleischmann P, Wykes T, Leese M, Bindman J. Patients’ perspectives on electroconvulsive therapy: systematic review. BMJ 2003; 326:1363
This user-led study reveals that autobiographical memory problems persist more commonly than is believed
Kellner CH, Fink M, Knapp R et al. Relief of expressed suicidal intent by ECT: A consortium for research in ECT study. Am J Psychiatry 2005; 162:977-982
Though this study lacked a sham ECT arm, 40% of patient receiving ECT had resolution of SI in first week
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003; 361:799-808
The most comprehensive meta-analysis of ECT for depression showing its efficacy in depressive states
Psychiatric Diagnosis
Kendell RE, Cooper JE, Gourlay AJ, Copeland JRM, Sharpe L, Gurland BJ. Diagnostic criteria of American and British psychiatrists. Arch Gen Psychiatry 1971; 25: 123-130
The UK-US diagnostic study showed American Psychiatrists diagnosed more schizophrenia than their British counterparts in every case, including cases of depression, manic-depressive illness and even personality disorder, establishing importance of reliability in psychiatric diagnosis
Murphy JM. Psychiatric labeling in cross-cultural perspective. Science 1976; 191:1019-1028
This paper describes the concept of madness or mental illness existing across cultures dispelling mental illness as the result of simply labeling deviance or a convenient myth
Rosenhan DL. On being sane in insane places. Science 1973: 179:250-258
This classic study questioned the validity of psychiatric diagnosis by having pseudopatients get admitted to psychiatric hospital who then remained there despite no further reports of symptoms of mental illness!
Conceptual issues in psychiatry
Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977; 196:129-36
This classic paper popularizes the biopsychosocial model and the application of general systems theory to medicine.
Kandel ER. A New intellectual framework for psychiatry. Am J Psychiatry 1998; 155:457-469
Kandel suggests firmly rooting medicine of the mind in the biology of the brain
Kendler KS. Explanatory models for psychiatric illness. Am J Psychiatry 2008; 165:695-702
Kendler proposes psychiatric disorders are understood best pluralistically with multiple levels of explanation and biological understanding will not supplant more macro level understanding of disorders but enhance it
Szasz T. The myth of mental illness. Am Psychol 1960; 15:113-118
This classic article of the book with the same title claims because the mind is a metaphor, it cannot be diseased, and thus mental illness is a myth. Szasz prefers to conceive of psychiatric disorders as problems in living. Given the cachet of these views in popular culture, this is essential reading.
Psychosis
Agid O, Kapur S, Arenovich T, Zipursky RB. Delayed-onset hypothesis of antipsychotic action: a hypothesis tested and rejected. Arch Gen Psychiatry 2003; 60:1228-1235
This study shows that if antipsychotics don’t have an effect in the first week, they probably never will, and the most pronounced effects are in the first two weeks of treatment.
Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a progressive longitudinal MRI study. Am J Psychiatry 2013; 170:609-615
Important study finding antipsychotics rather than relapses cause brain shrinkage, and suggest using the lowest doses possible
Chouinard G, Jones BD. Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. Am J Psychiatry 1980; 137:16-21
One of the first papers to introduce the possibility of a neuroleptic-induced supersensitivity psychosis
Demjaha A, Murray RM, McGuire PK, Kapur S, Howes OD. Dopamine synthesis capacity in patients with treatment-resistant schizophrenia. Am J Psychiatry 2012; 169:1203-1210
This paper shows that dopamine dysregulation is not found in those with treatment resistant schizophrenia and thus dopamine antagonists are worthless in these patients
Fazel S, Zetterqvist J, Larsson H, Langström N, Lichtenstein P. Antipsychotics, mood stabilisers, and risk of violent crime. Lancet 2014; 384:1206-1214
Population-based study found patients had significant reductions in violent crime when on antipsychotics compared to when not taking, and mood stabilisers also reduced violent crime in those with bipolar disorder
Fletcher PC, Frith CD. Perceiving is believing: a Bayesian approach to explaining the positive symptoms of schizophrenia. Nat Rev Neurosci 2009; 10:48-58
An extremely clever model uniting Schneider’s first rank symptoms as theory of mind deficits in context of other biological and neuropsychological findings in schizophrenia
Fusar-Poli P, Borgwardt S, Bechdolf A et al. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry 2013; 70:107-120
Extremely useful review of the field of prodromal or at-risk mental state
Honer WG, Thornton AE, Chen EYH et al. Clozapine alone versus clozapine and risperidone with refractory schizophrenia. N Engl J Med 2006; 354: 472-482
CARE study showed adding risperidone to clozapine no more effective than clozapine alone
Jones PB, Barnes TR, Davies L et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1) Arch Gen Psychiatry 2006; 63:1079-87
CUtLASS study was British equivalent of the CATIE using more of the typical antipsychotics and confirming the new drugs cost more and have no additional benefit on quality of life
Kahn RS, Fleischhacker WW, Boter H et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 2008; 371:1085-97
EUFEST study found that first-episode psychosis like chronic schizophrenia responds just as well to the older drugs as the newer drugs
Kane J, Hongfeld G, Singer J, Meltzer H and the Clozaril Collaborative Study Group. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45:789-796
Classic study demonstrating clozapine’s superiority to chlorpromazine in treatment-resistant schizophrenia that led to re-discovery of clozapine in clinical practice
Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 2003; 160:13-23
A modern classic, this paper describes how the dopamine hypothesis can explain the positive symptoms of schizophrenia
Leucht S, Cipriani A, Spineli L et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple treatments meta-analysis. Lancet 2013; 382:951-962
This meta-analysis shows substantial differences in efficacy and side-effect profiles of different antipsychotic agents with clozapine, amisulpride and olanzapine coming out as most effective, and asenapine, lurasidone, and iloperidone coming out as least effective
Lieberman JA, Stroup TS, McEvoy JP et al. Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia. N Engl J Med 2005; 353:1209-1223
CATIE study showed olanzapine was more effective than other atypical antipsychotics and ziprasidone less effective, with no difference between typical and atypical antipsychotics
Tiihonen J, Lonngvist J, Wahlbeck K et al. 11-year follow-up of mortality in patients with schizophrenia: a population based cohort study (FIN11 study). Lancet 2009; 374:620-627
This study found clozapine was associated with reduced morality in comparison to other antipsychotics or no treatment in schizophrenia
Wunderink L, Nieboer RM, Wiersma D, Sytema S, Nienhuis FJ. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry 2013; 70:913-920
Controversial study that confirms older data that continued antipsychotic use leads to poorer functional outcomes with better symptom control than discontinuation/early dose reduction
Depressive Disorders
Beck AT. The evolution of the cognitive model of depression and its neurobiological correlates. Am J Psychiatry 2008; 165:969-977
Very readable overview of the cognitive model of depression in a biopsychosocial perspective from the founder of cognitive therapy itself
Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373:747-758
Mirtazapine and venlafaxine are the most efficacious, duloxetine and reboxetine don’t work, and sertraline or citalopram are probably the best first-line agents for depression
Fava GA. Can long-term treatment with antidepressant drugs worsen the course of depression? J Clin Psychiatry 2003; 64:123-133
This paper suggests that antidepressants may be contributing to the poor prognosis for depression!
Rush AJ, Trivedi MH, Wisniewski SR et al. Acute and longer-term outcomes in depressed outpatient requiring one or several treatment steps: a STAR*D Report. Am J Psychiatry 2006; 163:1905-1917
This paper summarizes all of the arms of the STAR*D study and highlights the limited remission rates in the treatment of depression
Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. Br J Psychiatry 2009; 195:102-108
An attempt at explaining antidepressant action in cognitive neuropsychological terms
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Adminstration. PLOS Med 2008; 5:e45 doi:10.1371/journal.pmed.0050045
The best known study to report from unpublished data that antidepressants are no better than placebo except in the most severe depressive episodes
Kuhn R. The treatment of depressive states with G 22355 (imipramine hydrochloride). Am J Psychiatry 1958; 115:459-464
First paper to describe the use of TCA imipramine and suggest it is particular beneficial in melancholic depression
Rush AJ, Trivedi MH, Wisniewski SR et al. Bupropion-SR, Sertraline, or Venlafaxine-XR after failure of SSRIs for Depression. N Engl J Med 2005; 354:1231-1242
STAR*D trial finds only 20% remit after one failed antidepressant, and bupropion, sertraline and venlafaxine are just as bad as each other
Trivedi MH, Fava M, Wisniewski SR et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006; 354:1243-1252
STAR*D trials finds augmentation strategies all as bad as each other and no better than switching to another agent
West ED, Dally PJ. Effects of iproniazid in depressive syndromes. Br Med J 1959; 1:1491-1494
One of the first papers to report MAOIs are effective especially in atypical depressions
Bipolar Disorders
Cade JF. Lithium salts in the treatment of psychotic excitement. Med J Aust 1949; 2:349-352
Classic paper that first used lithium to treat mania, absolute must read.
Cipriani A, Barbui C, Salanti G et al. Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis. Lancet 2011; 378:1306-1315
This meta-analysis finds that antipsychotics are the best treatment for acute mania rather than lithium or mood stabilizers.
Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ 2013; 346:f3646
Updated meta-analysis finds lithium still appears to have anti-suicidal properties
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet 2013; 381:1672-1682
Reviews the evidence for pharmacological and psychological treatments in bipolar disorder
Janowsky DS, Epstein RS. Playing the manic game –interpersonal maneuvers of the acutely manic patient. Arch Gen Psychiatry 1970; 22:252-26
Describes the frustrating and destructive maneuvers ‘manic’ patients catch clinicians in. Possibly more relevant to borderline patients, I find this slightly outmoded and offensive, but seems well-loved by more seasoned psychiatrists of all stripes
McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet 2012; 379:721-728
Toxicity of lithium has been overblown with ESRD being a rare complication. Li also causes hyperparathyroidism and checking Ca periodically is recommended
Nierenberg AA, Ostacher MJ, Calabrese JR et al. Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. Am J Psychiatry 2006; 163:210-216
Bipolar depression is hard to treatment and augmenting antidepressants with lamictal, inositol or risperidone are just as bad as each other
Sachs GS, Nierenberg AA, Calabrese JR et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med 2007; 356:1711-1722
STEP-BD study found antidepressants don’t work in bipolar disorder
Geddes, JR, Goodwin GM, Rendell K et al. Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomized open-label trial. Lancet 2010; 375:385-395
Lithium is better than valproate, and the benefit of combining the two isn’t clear
Yonkers KA. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry 2004; 161:608-620
Nice review of management of bipolar disorder in women
Suicide
Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997; 170:205-228
Meta-analysis finds mental disorders except for mental ******ation and dementia increase risk of suicide
Gitlin MJ. A psychiatrist’s reaction to a patient’s suicide. Am J Psychiatry; 156:1630-1634
Discusses the experience of losing a patient to suicide
Mann JJ, Apter A, Bertolote J et al. Suicide prevention strategies: a systematic review. JAMA 2005; 294:2064-2074
A comprehensive but biased review of suicide prevention strategies that places too much emphasis on clinical approaches and not enough on means prevention but still worth reading
Rosen DH. Suicide survivors. A follow-up study of persons who survived jumping from the Golden Gate and San Francisco-Oakland Bay Bridges. West J Med 1975; 122:289-294
Classic study interviewing survivors of the Golden Gate Bridge attempted suicides argues for suicide barriers. Must read.
Stone M, Laughren T, Jones ML et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. BMJ 2009; 339:b2880
Extensive meta-analysis of clinical trials showing that risk of suicidality is age-related, and antidepressants may reduce suicides in the elderly
Anxiety Disorders, OCD, and PTSD
Abramowitz JS, Taylor S, McKay D. Obsessive-compulsive disorder. Lancet 2009; 374:491-499
Summarizes cognitive-behavioral and biological aspects of OCD and its treatment
Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res Therapy 2000; 38:319-345
An insightful and extremely useful model for understanding chronic PTSD from the cognitive perspective
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008; 31:453-463
mTBI is common in OIF Veterans and often highly comorbid with PTSD symptoms
Roy-Byrne PP, Craske MG, Stein MB. Panic disorder. Lancet 2006; 368:1023-1032
Concise overview of panic and its treatment
Summerfield D. The invention of posttraumatic stress disorder and the social usefulness of a psychiatric category. Br Med J 2001; 322:95-98
Provocative discussion of PTSD as a sociopolitical construct
Personality Disorders
Groves JE. Taking care of the hateful patient. N Engl J Med 1978; 299:883-887
Classic paper describes 4 ‘hateful’ patients in the medical setting
Macdonald JM. The threat to kill. Am J Psychiatry 1963; 120:125-130
Excellent paper discusses homicidal ideation, and describes the triad of childhood firesetting, bedwetting and cruelty to animals being linked to later sadistic/antisocial behavior
Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disorder. Lancet 2011; 377:74-84
Comprehensive review of borderline personality disorder and its treatment. The drugs don’t really work.
Vaillant GE. The beginning of wisdom is never calling a patient a borderline; or, the clinical management of immature defenses in the treatment of individuals with personality disorders. J Psychother Pract Res 1992; 1:117-134
Classic, extremely well written and useful discussion of managing different defenses in difficult patients
Eating Disorders
Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010; 375:583-93
Nice overview on biology of eating disorders and review of evidence for different therapies
Addiction Psychiatry
Anton RF, O’Malley SS, Ciraulo DA et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006; 295:2003-2017
Naltrexone is better than acamprosate for alcohol dependence when combined with CBT
Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. N Engl J Med 2016; 374:154-163
This review article highlights the importance of viewing prescription opioid and heroin use disorders from a unified perspective
D’Onofrio G, O’Connor PG, Pantalon MV et al. Emergency Department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA 2015; 313:1636-1644
This important trial highlights how ED-initiated Suboxone, compared with brief intervention enhances engagement of addiction services and reduces inpatient addiction service use.
Khantzian EH. The self-medication hypothesis of addiction. Am J Psychiatry 1985; 142:1259-1264
This psychodynamic view of addiction as self-medication has proved enduring and influential in clinical practice and popular culture despite no supporting evidence
Koston TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003; 348:1786-1795
Comprehensive overview of withdrawal syndromes and their management
Laaksonen E, Koski-Jannes A, Salspuro M, Ahtinen H, Alho H. A randomized, multicenter, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol 2008; 43:53-61
Disulfiram may actually be better than naltrexone or acamprosate when combined with behavior therapy in alcohol dependence
Martensen-Larsen O. Treatment of alcoholism with a sensitising drug. Lancet 1948; 252:1004-1005
First report of use of Antabuse in the treatment of alcoholism.
McKetin R, Lubman DI, Baker AL, Dawe S, Ali RL. Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study. JAMA Psychiatry 2013; 70:319-324
First prospective longitudinal study to establish causal relationship and dose-dependence between methamphetamine use and psychosis
Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 1998 22:1300-1311
12-step facilitation, CBT, and motivational interviewing are all beneficial in alcoholism, with patient characteristics helping to match best treatment. Angry alcoholics do better with MI.
Volkow ND, Baler Rd, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med 2014; 370:2219-2227
Nice overview of marijuana addiction, potential as a gateway drug role in mental illness, and other effects on health
Volkow ND, Koob GF, McLellan AT. Neurobiological advances from the brain disease model of addiction. N Engl J Med 2016; 374:363-371
Nice summary of the neurobiological findings in addiction (regardless of whether you subscribe to the disease model) and implications for treatment
Child and Adolescent Psychiatry
Baron-Cohen S. The extreme-male brain theory of autism. Trends Cogn Sci 2002; 6:248-254
This paper gives a compelling account of autism as the extreme variant of the ‘male brain’
Bowlby J. The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrist, 19 November 1976. Br J Psychiatry 1977; 130:201-210
Very readable paper summarizes key findings of attachment theory and its relevance to psychopathology throughout the lifespan
Jensen PS, Arnold LD, Swanson JM et al. 3-year follow-up of the NIMH MTA Study. J Am Acad Child Adolesc Psychiatry 2007; 56:989-1002
Important ADHD study showed benefits of stimulant treatment did not persist after initial phase of treatment compared with behavior therapy
March J, Silva S, Petrycki S et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescences with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. JAMA 2004; 292:807-820
TADS study showed combination of CBT and fluoxetine was best treatment for adolescent depression
Rutter M, Sroufe LA. Developmental psychopathology: concepts and challenges. Dev Psychopathol 2000; 12:265-296
The father of child psychiatry outlines the developmental approach to psychopathology
Swedo SE, Leonard HL, Garvey M. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry 1998; 155:264-271
First paper to describe the emotional lability, anxiety, obsessive-compulsive symptoms and behavioral disturbances in children following strep infection
Walkup JT, Albano AM, Piacentini J et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 2008; 359:2753-2766
CAMS study found combination of CBT and sertraline best for childhood anxiety disorders
Geriatric Psychiatry and Neuropsychiatry
Burns A, Jacoby R, Levy R. Psychiatric phenomena in Alzheimer’s disease. IV: Disorders of behavior. Br J Psychiatry 1990; 157:86-94
Outlines the most common behavioral disturbances in Alzheimer’s from a sample of 178 patients, and finds features of Klüver-Bucy syndrome occur more commonly than is realized
Cummings JL, Lyketsos CG, Peskind ER et al. Effect of dextromethorphan-quinidine on agitation in patients with Alzheimer disease dementia. JAMA 2015; 314:1242-1254
Despite my skepticisms, this promising trial found Nudexta had modest benefits over placebo in the management of agitation in dementia patients
Howard RJ, Juszszak E, Ballard CG et al. Donepezil for the treatment of agitation in Alzheimer’s Disease. N Engl J Med 2007; 357: 1382-1392
Donepezil doesn’t help agitation in context of Alzheimer’s disease
Howard RJ, McShane R, Lindesay J et al. Donepezil and memantine for moderate-to-severe Alzheimer’s Disease. N Engl J Med 2012; 366:893-903
There is a small functional benefit to donepezil or memantine in moderate-to-severe Alzheimer’s with no difference between the two and no additional benefit of the combination
Inouye SK. Delirium in older persons. N Engl J Med 2006; 354:1157-1165
Nice overview of diagnosis, causes and management of delirium in the elderly
McKee AC, Cantu RC, Nowinski CJ et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Ex Neurol 2009; 68:709-735
Describes cases of CTE, an important neuropsychiatric disease now recognized in athletes
McKeith IG, Dickson DW, Lowe J et al. Diagnosis and management of dementia with Lewy bodies. Neurology 2005; 12:1863-1872
Most recent guidelines for diagnosis and management of LBD (soon to be updated)
Saczynski JS, Marcanonio ER, Quach L, Fong TG, Gross A, Inouye SK, Jones RN. Cognitive trajectories after postoperative delirium. N Engl J Med 2012; 367:30-39
Reminder that most patients post-delirium do not return to baseline and experience significant decline in cognitive functioning
Schneider LS, Tariot PN, Dagerman KS et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med 2006; 355:1528-1538
CATIE-AD study compares antipsychotics for Alzheimer’s – they are all as bad as each other and do more harm than good
Snowden JS, Rollinson S, Thompson JC et al. Distinct clinical and pathological characteristics of frontotempoeral dementia associated with C9ORF72 mutations. Brain 2012; 135:693-708
Very important study finds 38% of patients with C9ORF72 gene expansion and frontotemporal dementia present with psychosis with another 28% presenting with paranoid or irrational thinking
Psychosomatic Medicine
Appelbaum PS. Assessment of patients’ competence to consent to treatment. N Engl J Med 2007; 357:1834-1840
Definitive review of decisional capacity assessment for clinicians
Barsky AJ, Saintford R, Rogers MP, Borus JF. Nonspecific medication side-effects and the nocebo phenomenon. JAMA 2002; 287:622-627
Describes the nocebo effect as a common occurrence in anxious patients, and a cognitive model for understanding its development
Beach SR, Celano CM, Noseworthy PA, Januzzi JL, Huffman JC. QTc prolongation, Torsades de pointes, and psychotropic medications. Psychosomatics 2013; 54:1-13
Comprehensive up-to-date review on QTc prolongation and psychotropic drugs. Turns out we vastly overestimate the significance of cardiac risk of drugs.
Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005; 352:1112-1120
Comprehensive review of serotonin syndrome comparing it to other differentials
Bass C, Halligan P. Factitious disorders and malingering: challenges for clinical assessment and management. Lancet 2014; 383:1422-1432
nice overview of challenges of evaluation and management of malingering placing on the illness deception spectrum including conversion disorder and compensation neurosis
Groves JE. Management of the borderline patient on a medical or surgical ward: the psychiatric consultant’s role. Int J Psychiatry Med 1975; 6:337-48
Practical suggestions on how to manage difficult patients in the medical setting
Kayser MS, Kohler CG, Dalmau J. Psychiatric manifestations of paraneoplastic disorders. Am J Psychiatry 2010; 167:1039-1050
Discusses the emerging field of autoimmune-mediated neuropsychiatric disorders
Levenson JL. Neuroleptic malignant syndrome. Am J Psychiatry 1985; 142:1137-1145
Though supplanted by more up to date reviews this remains the authoritative paper on the topic
Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry 2005; 76(Suppl I): i2-i12
Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: management. J Neurol Neurosurg Psychiatry 2005; 76(Suppl I): i13-21
These two papers discuss the assessment and management of conversion disorder including examination maneuvers for eliciting functional neurology
Electroconvulsive Therapy
Anjala AV, Smetana GW. Medical evaluation of patients undergoing electroconvulsive therapy. N Engl J Med 2009; 360:1437-1444
Discusses the medical workup and preparation of patients for ECT
Rose D, Fleischmann P, Wykes T, Leese M, Bindman J. Patients’ perspectives on electroconvulsive therapy: systematic review. BMJ 2003; 326:1363
This user-led study reveals that autobiographical memory problems persist more commonly than is believed
Kellner CH, Fink M, Knapp R et al. Relief of expressed suicidal intent by ECT: A consortium for research in ECT study. Am J Psychiatry 2005; 162:977-982
Though this study lacked a sham ECT arm, 40% of patient receiving ECT had resolution of SI in first week
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003; 361:799-808
The most comprehensive meta-analysis of ECT for depression showing its efficacy in depressive states
Psychiatric Diagnosis
Kendell RE, Cooper JE, Gourlay AJ, Copeland JRM, Sharpe L, Gurland BJ. Diagnostic criteria of American and British psychiatrists. Arch Gen Psychiatry 1971; 25: 123-130
The UK-US diagnostic study showed American Psychiatrists diagnosed more schizophrenia than their British counterparts in every case, including cases of depression, manic-depressive illness and even personality disorder, establishing importance of reliability in psychiatric diagnosis
Murphy JM. Psychiatric labeling in cross-cultural perspective. Science 1976; 191:1019-1028
This paper describes the concept of madness or mental illness existing across cultures dispelling mental illness as the result of simply labeling deviance or a convenient myth
Rosenhan DL. On being sane in insane places. Science 1973: 179:250-258
This classic study questioned the validity of psychiatric diagnosis by having pseudopatients get admitted to psychiatric hospital who then remained there despite no further reports of symptoms of mental illness!
Conceptual issues in psychiatry
Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977; 196:129-36
This classic paper popularizes the biopsychosocial model and the application of general systems theory to medicine.
Kandel ER. A New intellectual framework for psychiatry. Am J Psychiatry 1998; 155:457-469
Kandel suggests firmly rooting medicine of the mind in the biology of the brain
Kendler KS. Explanatory models for psychiatric illness. Am J Psychiatry 2008; 165:695-702
Kendler proposes psychiatric disorders are understood best pluralistically with multiple levels of explanation and biological understanding will not supplant more macro level understanding of disorders but enhance it
Szasz T. The myth of mental illness. Am Psychol 1960; 15:113-118
This classic article of the book with the same title claims because the mind is a metaphor, it cannot be diseased, and thus mental illness is a myth. Szasz prefers to conceive of psychiatric disorders as problems in living. Given the cachet of these views in popular culture, this is essential reading.
