BE-ACTIV was superior to TAU in moving residents to full remission from depression. The treatment was well received by nursing home staff and accepted by residents. A large proportion of participants remained symptomatic at posttreatment, despite taking one or more antidepressants. The results illustrate the potential power of an attentional intervention to improve self-reported mood and functioning, but also the difficulties related to both studying and implementing effective treatments in nursing homes.

Introduction The object of this study1 was to provide an updated evaluation of the quality of antidepressant management and prescribing patterns in nursing homes in the context of organizational and resident factors. Design Pearson correlation and chi-square analyses were conducted using information gathered from random nursing home charts. Setting Nursing home facilities in and around the Louisville, KY metropolitan area (N = 10). Participants Chart reviews were randomly chosen for 20% of long-term care resident records in participating homes (N = 209). Measurements Demographic information, documentation of depression diagnoses and antidepressant prescribing patterns were evaluated using the Quality of Depression Management and Antidepressant Prescribing rating (QDMAP) scale and information found the Minimum Data Set 2.0. Results 59.8% of the sample was prescribed antidepressants at the time of the chart review. 205 chart reviews indicated the absence or presence of a depression diagnosis, For those with documented depression diagnoses (n=126), nearly one quarter were not prescribed antidepressants. Out of 79 chart reviews indicating no depression diagnosis, nearly a third were receiving an antidepressant. Documentation related to changes in dosing, the presence or absence of side effects, or reasons for continuation were suboptimal. Conclusion Discrepancy between antidepressant prescribing and the presence/absence of depression diagnoses continue to exist for nursing home residents. The quality of antidepressant documentation in nursing home charts continues to be inadequate. Future research should aim to explore possible solutions to these discrepancies and deficiencies in documentation.

Catatonia is a complication of numerous psychiatric and medical conditions. The first-line treatment is typically management of the underlying primary condition as well as scheduled benzodiazepines or electroconvulsive therapy. Electroconvulsive therapy and benzodiazepines are not always tolerated or available when treating patients with catatonia. For this reason, other treatment regimens have been trialed in recent years, including the GABA-modulatory Z drugs such as zolpidem. Some alternative treatment modalities have shown great promise. However, which populaces these are most beneficial for is still unclear. In this article, we examine a case report of a woman who suffered from post-traumatic stress disorder with secondary psychotic features who experienced recurrent akinetic catatonia that was refractory to benzodiazepine therapy. She responded rapidly to scheduled zolpidem with minimal side effects. It is our author’s belief that when managing catatonia in patients with post traumatic stress disorder with secondary psychosis, Z drugs may be preferable to benzodiazepines.

No abstract