Targeting Obsessive-Compulsive Symptoms With rTMS and Perfusion Imaging

Abstract

suggestion, the effect of lithium on the rate of suiciderelated events increased in both bipolar I and bipolar II disorder when patients diagnosed with mixed episodes were excluded (1). However, the association remained nonsignificant for patients with bipolar I disorder. Two points should be noted, however. First, even though the patient register uses ICD-10 codes, many clinicians in Sweden used DSM-IV and translated diagnoses to ICD-10. In addition, DSM-IV requires that the criteria for both depression and mania be met (except the time criterion) in order to diagnose a mixed episode. This means that it is still possible that the bipolar I disorder group contains individuals with mixed features according to DSM-5. Thus, we cannot refute Dr. Terao and colleagues' suggestion. Future studies using DSM-5 criteria are needed to answer their question. Second, because ICD-10 does not distinguish between bipolar I and bipolar II disorder, we used data from a quality register for the subgroup analyses. This quality register contains only one-third of all Swedish patients with bipolar disorder, which decreases the size of the study sample. Thus, the fact that the results in bipolar I disorder do not reach statistical significance might be a power issue. Therefore, we agree with Terao et al. that more efforts are needed to explore the effect of lithium in preventing suicidal behavior in specific subgroups, where not only the subtype of bipolar disorder is taken into account, but also mixed features.

Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review

“…Despite considerable research, treatment remains unsatisfactory. In attempting to achieve more specificity in the search for treatment alternatives, single psychotic symptoms have been investigated [3][4][5][6]. The most prominent example is auditory verbal hallucinations.…”