Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Psychiatry Reports
Published in: Current Psychiatry Reports 11/2016

01-11-2016 | Geriatric Disorders (W McDonald, Section Editor)

Apathy in Dementia: Systematic Review of Recent Evidence on Pharmacological Treatments

Authors: Fleur Harrison, Liesbeth Aerts, Henry Brodaty

Published in: Current Psychiatry Reports | Issue 11/2016

Login to get access

Abstract

Increasing recognition that apathy is one of the most prevalent behavioral and psychological symptoms of dementia and causes substantial caregiver distress has led to trials evaluating psychosocial and pharmacological treatments of apathy in dementia. We evaluated evidence of the efficacy of pharmacotherapies for apathy in dementia from studies since 2013. Previously reported benefits of acetylcholinesterase inhibitors and memantine were not replicated in recent studies. Antidepressants had mixed results with positive effects for apathy shown only for agomelatine, while stimulants, analgesics, and oxytocin study results were inconclusive. For some approaches, such as antipsychotic review, positive effects were found only in combination with nonpharmacological approaches. Relatively few studies assessed apathy outcomes specifically, complicating interpretation of potentially positive treatment effects; none dissected outcomes for emotional, motivational and behavioral components of apathy. Better trial design and more detailed analysis are needed in order to evaluate outcomes of pharmacological treatments for apathy.
Literature
1.
Selbæk G, Engedal K, Bergh S. The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. J Am Med Dir Assoc. 2013;14:161–9.CrossRefPubMed
2.
Ishii S, Weintraub N, Mervis JR. Apathy: A Common Psychiatric Syndrome in the Elderly. J Am Med Dir Assoc. 2009;10:381–93.CrossRefPubMed
3.
Borsje P, Wetzels RB, Lucassen PL, Pot AM, Koopmans RT. The course of neuropsychiatric symptoms in community-dwelling patients with dementia: a systematic review. Int Psychogeriatr. 2015;27:385–405.CrossRefPubMed
4.
5.
Robert P, Onyike CU, Leentjens AFG, Dujardin K, Aalten P, Starkstein S, et al. Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders. Eur Psychiatry. 2009;24:98–104.CrossRefPubMed
6.
Mulin E, Leone E, Dujardin K, Delliaux M, Leentjens A, Nobili F, et al. Diagnostic criteria for apathy in clinical practice. Int J Geriatr Psychiatry. 2011;26:158–65.CrossRefPubMed
7.
Lanctôt KL, Agüera-Ortiz L, Brodaty H, Francis PT, Geda YE, Ismail Z, et al. Apathy associated with neurocognitive disorders: recent progress and future directions. Alzheimers Dement. 2016
8.
Guercio BJ, Donovan NJ, Munro CE, Aghjayan SL, Wigman SE, Locascio JJ, et al. The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment. J Alzheimers Dis. 2015;47:421–32.CrossRefPubMedPubMedCentral
9.
Huang SS, Lee MC, Liao YC, Wang WF, Lai TJ. Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly. Arch Gerontol Geriatr Elsevier Ireland Ltd. 2012;55:55–9.CrossRef
10.
Lee DR, McKeith I, Mosimann U, Ghosh-Nodyal A, Thomas AJ. Examining carer stress in dementia: The role of subtype diagnosis and neuropsychiatric symptoms. Int J Geriatr Psychiatry. 2013;28:135–41.CrossRefPubMed
11.
Rosdinom R, Zarina MZN, Zanariah MS, Marhani M, Suzaily W. Behavioural and psychological symptoms of dementia, cognitive impairment and caregiver burden in patients with dementia. Prev Med (Baltim) Elsevier Inc. 2013;57:S67–9.CrossRef
12.
Tekin S, Mega MS, Masterman DM, Chow T, Garakian J, Vinters HV, et al. Orbitofrontal and anterior cingulate cortex neurofibrillary tangle burden is associated with agitation in Alzheimer disease. Ann Neurol. 2001;49:355–61.CrossRefPubMed
13.
Förstl H, Burns A, Levy R, Cairns N, Luthert P, Lantos P. Neuropathological correlates of behavioural disturbance in confirmed Alzheimer’s disease. Br J Psychiatry. 1993;163:364–8.CrossRefPubMed
14.
Skogseth R, Mulugeta E, Jones E, Ballard C, Rongve A, Nore S, et al. Neuropsychiatric correlates of cerebrospinal fluid biomarkers in Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;25:559–63.CrossRefPubMed
15.
Lanctôt KL, Agüera-Ortiz L, Brodaty H, Francis PT, Geda YE, Ismail Z, et al. Apathy associated with neurocognitive disorders: recent progress and future directions. Alzheimers Dement. 2016
16.
Landes AM, Sperry SD, Strauss ME, Geldmacher DS. Apathy in Alzheimer’s Disease. J Am Geriatr Soc Blackwell Sci Inc. 2001;49:1700–7.CrossRef
17.
Levy R, Dubois B. Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb Cortex. 2006;16:916–28.CrossRefPubMed
18.
Cipriani G, Lucetti C, Danti S, Nuti A. Apathy and dementia. Nosology, assessment and management. J Nerv Ment Dis. 2014;202:718–24.CrossRefPubMed
19.
Levy R. Apathy: A pathology of goal-directed behaviour. A new concept of the clinic and pathophysiology of apathy. Rev Neurol (Paris). 2012;168:585–97.CrossRef
20.
Stanton B, Leigh P, Howard R. Behavioural and emotional symptoms of apathy are associated with distinct patterns of brain atrophy in neurodegenerative disorders. J Neurol. 2013;260:2481–90.CrossRefPubMed
21.
Agüera-Ortiz L, Hernandez-Tamames JA, Martinez-Martin P, Cruz-Orduña I, Pajares G, López-Alvarez J, et al. Structural correlates of apathy in Alzheimer’s disease: a multimodal MRI study. Int J Geriatr Psychiatry. 2016
22.
Ruthirakuhan M, Herrmann N, Abraham E, Lanctôt K. Pharmacological interventions for apathy in Alzheimer’s disease (Protocol). Cochrane Databse Syst Rev. 2016
23.
Kaufer D. Beyond the cholinergic hypothesis: the effect of metrifonate and other cholinesterase inhibitors on neuropsychiatric symptoms in Alzheimer’s disease. Dement Geriatr Cogn Disord. 1998;9 Suppl 2:8–14.CrossRefPubMed
24.
Mitchell RA, Herrmann N, Lanctôt KL. The role of dopamine in symptoms and treatment of apathy in Alzheimer’s disease. CNS Neurosci Ther. 2011;17:411–27.CrossRefPubMed
25.
Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004;10:196–9.CrossRefPubMed
26.
Lanctôt KL, Herrmann N, Rothenburg L, Eryavec G. Behavioral correlates of GABAergic disruption in Alzheimer’s disease. Int Psychogeriatr. 2007;19:151–8.CrossRefPubMed
27.
Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the apathy evaluation scale. Psychiatry Res. 1991;38:143–62.CrossRefPubMed
28.
Starkstein SE, Mayberg HS, Preziosi TJ, Andrezejewski P, Leiguarda R, Robinson RG. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4:134–9.CrossRefPubMed
29.
Clarke DE, Ko JY, Kuhl EA, van Reekum R, Salvador R, Marin RS. Are the available apathy measures reliable and valid? A review of the psychometric evidence. J Psychosom Res NIH Public Access. 2011;70:73–97.CrossRef
30.
Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–14.CrossRefPubMed
31.
Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48:S10–6.CrossRefPubMed
32.
Berman K, Brodaty H, Withall A, Seeher K. Pharmacologic treatment of apathy in dementia. Am J Geriatr Psychiatry. 2012;20:104–22.CrossRefPubMed
33.
Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ Br Med J Publishing Group. 2011;343:d5928.CrossRef
34.
Cumbo E, Ligori LD. Differential effects of current specific treatments on behavioral and psychological symptoms in patients with alzheimer’s disease: A 12-month, randomized, open-label trial. J Alzheimer’s Dis. 2014;39:477–85.
35.•
Oh Y-S, Kim J-S, Lee PH. Effect of Rivastigmine on Behavioral and Psychiatric Symptoms of Parkinson’s Disease Dementia. J Mov Disord. 2015;8:98–102. This study found that rivastigmine improved caregiver distress due to apathy, although actual apathy scores on the NPI did not significantly improve.CrossRefPubMedPubMedCentral
36.
Freund-Levi Y, Jedenius E, Tysen-Bäckström AC, Lärksäter M, Wahlund L-O, Eriksdotter M. Galantamine Versus Risperidone Treatment of Neuropsychiatric Symptoms in Patients with Probable Dementia: An Open Randomized Trial. Am J Geriatr Psychiatry. 2014;22:341–8.CrossRefPubMed
37.•
Tokuchi R, Hishikawa N, Matsuzono K, Takao Y, Wakutani Y, Sato K, et al. Cognitive and affective benefits of combination therapy with galantamine plus cognitive rehabilitation for Alzheimer’s disease. Geriatr Gerontol Int. 2015. Study demonstrating improved apathy outcomes when galantamine was combined with rehabilitation in individuals with AD.
38.•
Rea R, Carotenuto A, Traini E, Fasanaro AM, Manzo V, Amenta F. Apathy Treatment in Alzheimer’s Disease: Interim Results of the ASCOMALVA Trial. J Alzheimer’s Dis. 2015;48:377–83. This study highlights the potential of combining AChEIs with cholinergic precursors. Apathy and related caregiver distress were significantly lower for up to 2 years in participants receiving combination donepezil/precursor rather than donepezil alone.CrossRef
39.
Perry EK, Haroutunian V, Davis KL, Levy R, Lantos P, Eagger S, et al. Neocortical cholinergic activities differentiate Lewy body dementia from classical Alzheimer’s disease. Neuroreport. 1994;5:747–9.CrossRefPubMed
40.
Mori E, Ikeda M, Kosaka K, Donepezil-DLB Study Investigators. Donepezil for dementia with Lewy bodies: a randomized, placebo-controlled trial. Ann Neurol. 2012;72:41–52.CrossRefPubMed
41.
Ikeda M, Mori E, Kosaka K, Iseki E, Hashimoto M, Matsukawa N, et al. Long-term safety and efficacy of donepezil in patients with dementia with Lewy bodies: results from a 52-week, open-label, multicenter extension study. Dement Geriatr Cogn Disord. 2013;36:229–41.CrossRefPubMed
42.
Mori E, Ikeda M, Nagai R, Matsuo K, Nakagawa M, Kosaka K. Long-term donepezil use for dementia with Lewy bodies: results from an open-label extension of Phase III trial. Alzheimers Res Ther. 2015;7:5.CrossRefPubMedPubMedCentral
43.
Kimura T, Takamatsu J. Pilot study of pharmacological treatment for frontotemporal dementia: Risk of donepezil treatment for behavioral and psychological symptoms. Geriatr Gerontol Int. 2013;13:506–7.CrossRefPubMed
44.
Mendez MF, Shapira JS, McMurtray A, Licht E. Preliminary Findings: Behavioral Worsening on Donepezil in Patients With Frontotemporal Dementia. Am J Geriatr Psychiatry. 2007;15:84–7.CrossRefPubMed
45.
Spalletta G, Caltagirone C, Padovani A, Sorbi S, Attar M, Colombo D, et al. Cognitive and affective changes in mild to moderate Alzheimer’s disease patients undergoing switch of cholinesterase inhibitors: a 6-month observational study. PLoS One. 2014;9:e89216.CrossRefPubMedPubMedCentral
46.
Matsuzono K, Sato K, Kono S, Hishikawa N, Ohta Y, Yamashita T, et al. Clinical Benefits of Rivastigmine in the Real World Dementia Clinics of the Okayama Rivastigmine Study (ORS). J Alzheimer’s Dis. 2015;48:757–63.CrossRef
47.
Shimizu S, Kanetaka H, Hirose D, Sakurai H, Hanyu H. Differential effects of acetylcholinesterase inhibitors on clinical responses and cerebral blood flow changes in patients with Alzheimer’s disease: A 12-month, randomized, and open-label trial. Dement Geriatr Cogn Dis Extra. 2015;5:135–46.CrossRefPubMedPubMedCentral
48.
Matsuzono K, Hishikawa N, Ohta Y, Yamashita T, Deguchi K, Nakano Y, et al. Combination Therapy of Cholinesterase Inhibitor (Donepezil or Galantamine) plus Memantine in the Okayama Memantine Study. J Alzheimers Dis. 2015;45:771–80.PubMed
49.
Zhang N, Wei C, Du H, Shi FD, Cheng Y. The Effect of Memantine on Cognitive Function and Behavioral and Psychological Symptoms in Mild-to-Moderate Alzheimer’s Disease Patients. Dement Geriatr Cogn Disord. 2015;40:85–93.CrossRefPubMed
50.
David R, Koulibaly M, Benoit M, Garcia R, Caci H, Darcourt J, et al. Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases: A SPECT study with partial volume effect correction. Clin Neurol Neurosurg. 2008;110:19–24.CrossRefPubMed
51.
Herrmann N, Rothenburg LS, Black SE, Ryan M, Liu BA, Busto UE, et al. Methylphenidate for the treatment of apathy in Alzheimer disease: prediction of response using dextroamphetamine challenge. J Clin Psychopharmacol. 2008;28:296–301.CrossRefPubMed
52.•
Rosenberg PB, Lanctôt KL, Drye LT, Herrmann N, Scherer RW, Bachman DL, et al. Safety and efficacy of methylphenidate for apathy in Alzheimer’s disease: a randomized, placebo-controlled trial. J Clin Psychiatry. 2013;74:810–6. Trial designed specifically for apathy, with promising effects of methylphenidate on one of two apathy outcomes in AD, however not in the one considered primary.CrossRefPubMedPubMedCentral
53.
54.
Ferré S. Mechanisms of the psychostimulant effects of caffeine: implications for substance use disorders. Psychopharmacology (Berl). 2016;233:1963–79.CrossRef
55.
Kromhout MA, Jongerling J, Achterberg WP. Relation between caffeine and behavioral symptoms in elderly patients with dementia: an observational study. J Nutr Health Aging. 2014;18:407–10.CrossRefPubMed
56.
Tagariello P, Girardi P, Amore M. Depression and apathy in dementia: Same syndrome or different constructs? A critical review. Arch Gerontol Geriatr. 2009;49:246–9.CrossRefPubMed
57.
Settle EJ. Antidepressant drugs: disturbing and potentially dangerous adverse effects. J Clin Psychiatry. 1998;59:25–30.PubMed
58.
Leontjevas R, Teerenstra S, Smalbrugge M, Vernooij-Dassen MJFJ, Bohlmeijer ET, Gerritsen DL, et al. More insight into the concept of apathy: a multidisciplinary depression management program has different effects on depressive symptoms and apathy in nursing homes. Int Psychogeriatr. 2013;25:1941–52.CrossRefPubMed
59.••
Callegari I, Mattei C, Benassi F, Krueger F, Grafman J, Yaldizli Ö, et al. Agomelatine Improves Apathy in Frontotemporal Dementia. Neurodegener Dis. 2016;16:352–6. The only recent pharmacological trial showing significant improvement of apathy, using agomelatine in individuals with bvFTD or semantic dementia.CrossRefPubMed
60.
Racagni G, Riva MA, Molteni R, Musazzi L, Calabrese F, Popoli M, et al. Mode of action of agomelatine: synergy between melatonergic and 5-HT2C receptors. World J Biol Psychiatry. 2011;12:574–87.CrossRefPubMed
61.
62.
Rajkumar AP, Ballard C, Fossey J, Corbett A, Woods B, Orrell M, et al. Apathy and Its Response to Antipsychotic Review and Nonpharmacological Interventions in People With Dementia Living in Nursing Homes: WHELD, a Factorial Cluster Randomized Controlled Trial. J Am Med Dir Assoc. 2016;17:741–7.CrossRefPubMed
63.
Kimura T, Takamatsu J. Pilot study of pharmacological treatment for frontotemporal lobar degeneration: effect of lavender aroma therapy on behavioral and psychological symptoms. Geriatr Gerontol Int. 2013;13:516–7.CrossRefPubMed
64.
Kung F-C, Ishii R, Liu H-C, Takeda M. New possibility of traditional Chinese and Japanese medicine as treatment for behavioral and psychiatric symptoms in dementia. Clin Interv Aging Dove Press. 2012;7:393–6.
65.
Teranishi M, Kurita M, Nishino S, Takeyoshi K, Numata Y, Sato T, et al. Efficacy and tolerability of risperidone, yokukansan, and fluvoxamine for the treatment of behavioral and psychological symptoms of dementia: a blinded, randomized trial. J Clin Psychopharmacol. 2013;33:600–7.CrossRefPubMed
66.
Ballard C, Smith J, Husebo B, Aarsland D, Corbett A. The role of pain treatment in managing the behavioural and psychological symptoms of dementia (BPSD). Int J Palliat Nurs MA Healthcare London. 2011;17:420, 422, 424.
67.
Husebo BS, Ballard C, Fritze F, Sandvik RK, Aarsland D. Efficacy of pain treatment on mood syndrome in patients with dementia: a randomized clinical trial. Int J Geriatr Psychiatry. 2014;29:828–36.CrossRefPubMed
68.
Marsh AA, Yu HH, Pine DS, Blair RJR. Oxytocin improves specific recognition of positive facial expressions. Psychopharmacology (Berl). 2010;209:225–32.CrossRef
69.
Hurlemann R, Patin A, Onur OA, Cohen MX, Baumgartner T, Metzler S, et al. Oxytocin enhances amygdala-dependent, socially reinforced learning and emotional empathy in humans. J Neurosci. 2010;30:4999–5007.CrossRefPubMed
70.
Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E. Oxytocin increases trust in humans. Nature. 2005;435:673–6.CrossRefPubMed
71.
Guastella AJ, Hickie IB. Oxytocin treatment, circuitry, and autism: A critical review of the literature placing oxytocin into the autism context. Biol Psychiatry. 2016;79:234–42.CrossRefPubMed
72.
MacDonald K, Feifel D. Oxytocin in schizophrenia: A review of evidence for its therapeutic effects. Acta Neuropsychiatr Blackwell Publishing Ltd. 2012;24:130–46.CrossRef
73.
Jesso S, Morlog D, Ross S, Pell MD, Pasternak SH, Mitchell DGV, et al. The effects of oxytocin on social cognition and behaviour in frontotemporal dementia. Brain. 2011;134:2493–501.CrossRefPubMed
74.•
Finger EC, MacKinley J, Blair M, Oliver LD, Jesso S, Tartaglia MC, et al. Oxytocin for frontotemporal dementia: a randomized dose-finding study of safety and tolerability. Neurology. 2015;84:174–81. Safety and tolerability study of oxytocin demonstrated, with preliminary outcomes suggesting potential benefits for apathy treatment in bvFTD.CrossRefPubMedPubMedCentral
75.
Shelef A, Barak Y, Berger U, Paleacu D, Tadger S, Plopsky I, et al. Safety and Efficacy of Medical Cannabis Oil for Behavioral and Psychological Symptoms of Dementia: An-Open Label, Add-On. Pilot Study J Alzheimers Dis. 2016;51:15–9.CrossRefPubMed
76.
Dykstra Goris E, Ansel KN, Schutte DL. Quantitative Systematic Review of the effects of Non-pharmacological Interventions on Reducing Apathy in Persons with Dementia. J Adv Nurs. 2016;1–17.
77.
Brodaty H, Burns K. Nonpharmacological management of apathy in dementia: a systematic review. Am J Geriatr Psychiatry. 2012;20:549–64.CrossRefPubMed
78.
Tampi RR, Tampi DJ, Balachandran S, Srinivasan S. Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses. Ther Adv Chronic Dis. SAGE Publications; 2016;2040622316658463.
79.
Ligthart SA, Richard E, Fransen NL, Eurelings LSM, Beem L, Eikelenboom P, et al. Association of Vascular Factors With Apathy in Community-Dwelling Elderly Individuals. Arch Gen Psychiatry Am Med Assoc. 2012;69:243–54.
80.
Groeneweg-Koolhoven I, Comijs HC, Naarding P, de Waal MWM, van der Mast RC. Apathy in Older Persons With Depression: Course and Predictors: The NESDO Study. J Geriatr Psychiatry Neurol SAGE Publ. 2016;29:178–86.CrossRef
81.
Brodaty H, Liu Z, Withall A, Sachdev PS. The Longitudinal Course of Post-Stroke Apathy Over Five Years. J Neuropsychiatry Clin Neurosci. [Internet]. American Psychiatric AssociationArlington, VA; 2013 [cited 2016 Aug 15];25:283–91. Available from: http://​psychiatryonline​.​org/​doi/​abs/​10.​1176/​appi.​neuropsych.​12040080
82.
Yao H, Takashima Y, Mori T, Uchino A, Hashimoto M, Yuzuriha T, et al. Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects: the Sefuri brain MRI study. Hypertens Res Nat Publishing Group. 2009;32:586–90.CrossRef
83.
Eurelings LSM, Jaccard J, van Charante EP M, Eikelenboom P, Ligthart SA, van Gool WA, et al. The mediating role of cardiovascular risk factors in the relationship between symptoms of apathy and incident cardiovascular disease in community-dwelling older individuals. Int. Psychogeriatrics. Camb Univ Press. 2016;28:669–79.
84.••
Cummings J, Friedman JH, Garibaldi G, Jones M, Macfadden W, Marsh L, et al. Apathy in Neurodegenerative Diseases: Recommendations on the Design of Clinical Trials. J Geriatr Psychiatry Neurol. 2015;28:159–73. Important review with recommendations on how to address current challenges in trial design for apathy treatment in neurological disease.CrossRefPubMed
85.
Arciniegas DB, Anderson CA. Donepezil-Induced Confusional State in a Patient With Autopsy-Proven Behavioral-Variant Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci. 2013;25:E25–6.CrossRefPubMed
86.
Links KA, Black SE, Graff-Guerrero A, Wilson AA, Houle S, Pollock BG, et al. A case of apathy due to frontotemporal dementia responsive to memantine. Neurocase. 2013;19:256–61.CrossRefPubMed
Metadata
Title
Apathy in Dementia: Systematic Review of Recent Evidence on Pharmacological Treatments
Authors
Fleur Harrison
Liesbeth Aerts
Henry Brodaty
Publication date
01-11-2016
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 11/2016
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-016-0737-7

Other articles of this Issue 11/2016

Current Psychiatry Reports 11/2016 Go to the issue

Disaster Psychiatry: Trauma, PTSD, and Related Disorders (E Foa and A Asnaani, Section Editors)

Psychological Mechanisms of PTSD and Its Treatment

Child and Adolescent Disorders (TD Benton, Section Editor)

Emergency Department Screening for Suicide and Mental Health Risk

Disaster Psychiatry: Trauma, PTSD, and Related Disorders (E Foa and A Asnaani, Section Editors)

The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

Mood Disorders (MA Oquendo and MF Grunebaum, Section Editors)

Cognitive, Emotional, Temperament, and Personality Trait Correlates of Suicidal Behavior

Anxiety Disorders (A Pelissolo, Section Editor)

Anxiety Disorders and Cardiovascular Disease

Genetic Disorders (W Berrettini, Section Editor)

A Slice of the Suicidal Brain: What Have Postmortem Molecular Studies Taught Us?