Low 25-(OH) D level was found in a high percentage of psychiatric inpatients in Kansas City. Screening for vitamin D deficiency could be a routine work-up for psychiatric inpatients. Vitamin D supplement for African American inpatients with low vitamin D levels could be considered.

Mirtazapine may be considered a treatment option for antipsychotic-induced akathisia. It may be especially useful for patients with contraindications or intolerability to beta-blockers and for those with comorbid depression or negative symptoms. Additional studies should be conducted to provide further evidence of mirtazapine's effectiveness in treating akathisia.

Despite the advantages of second‐generation antipsychotics, effectiveness trials and cost‐effective analyses have caused first‐generation antipsychotics to be reexamined with regard to place in therapy. Developing an understanding of all aspects of first‐generation antipsychotics, including the pharmacokinetic complexity of long‐acting decanoate formulations, are essential for practitioners in order to optimally manage both symptoms and adverse events. We describe a 55‐year‐old schizophrenic man with a severe movement disorder whose symptoms were mistaken for lithium toxicity. Further examination revealed that his fluphenazine plasma level was still detected 4 months after his last dose of fluphenazine decanoate had been administered. The incorrect diagnosis of lithium toxicity resulted in delayed treatment of his severe extrapyramidal symptoms. Administration of a routine dosage of benztropine titrated to 4 mg/day resolved his drug‐induced movement disorder within 72 hours. This case report demonstrates the persistent need for practitioners' awareness of the complex pharmacokinetic properties of long‐term fluphenazine decanoate treatment, resulting in prolonged absorption, and the continued importance of both recognizing adverse events resulting from dopamine D2‐receptor antagonism and developing the ability to distinguish between various types of movement disorders. The potential for increasing use of first‐generation antipsychotics highlights the need to revisit the nuances of long‐acting, injectable pharmacokinetics to improve patient outcomes.

There has been much research on Major Depressive Disorder (MDD) in terms of functional impairment associated with the disorder. On the other hand, Dysthymic Disorder (DD) has not received much attention in the literature in relation to the functional disability associated with the disorder. Similarly, the moderator effect of religiosity has been studied in many physical and mental health disorders, but has not been explored in DD. The aims of the present study were to explore the association between DD and functional disability, and to study the moderator effect of religiosity on the association. The data for the study was obtained from consortium of Psychiatric Epidemiologic Survey (CPES). The survey collected data on prevalence of mental health problems and the sociocultural determinants, in the national population. The present study utilized the data on DD and factors such as race, gender, marital status, employment status, and religiosity, in order to explore association between DD and disability and the effect of religiosity on the association. Results show that the subjects who have endorsed DD are 1.092 times more likely to have functional disability than those who have not endorsed DD. The association is statistically significant with the 95% CI for the Odds Ratio (OR) as 1.072 -1.113. The religiosity has not shown a significant effect on the association between DD and functional disability. In conclusion there is statistically significant association between DD and the functional disability. Although the cross-sectional study design makes it difficult to determine the causal relationship, the results may signify that DD could potentially cause significant functional impairment. Further longitudinal studies are needed to probe the association between DD and disability.