Dear Colleagues:

Welcome to the May-June 2019 edition of Innovations in Clinical Neuroscience (ICNS). In this issue, we revisit the topic of postpartum depression in men with a review article of the same name by Scarff. Here, the author describes the symptoms, risk factors, and treatment options for this disorder in men, and highlights the importance of screening new fathers, as well as new mothers, for depression following the birth of a child.

Next, Citrome et al describe the study protocol of an upcoming clinical trial in their article titled, “Olanzapine plus Samidorphan in Subjects with Schizophrenia and Comorbid Alcohol Use Disorder [AUD]: Rationale and Design for a Phase II, Double-blind, Randomized Study.” The investigators discuss the design of their Phase II, double-blind, randomized trial that will evaluate adult outpatients with schizophrenia and comorbid AUD receiving a combination of olanzapine plus samidorphan, a novel entity currently under development for the treatment of schizophrenia. The authors state, “This study is, to our knowledge, the largest and longest trial [involving this difficult-to-study population] with a randomized, double-blind, active-controlled design.”

Following this, Leppien et al present their study titled, “Exploring the Effectiveness of Team-based Enablement Interventions to Improve Antibiotic Prescribing within a Psychiatric Hospital.” In this study, using a pre-test and post-test survey, investigators sought to determine “1) whether psychiatric inpatients were appropriately treated for a urinary tract infection (UTI) prior to educational interventions, and 2) whether there is a relationship between different modes of educational interventions and increased knowledge attainment and retention among healthcare clinicians regarding UTI treatment.” Additionally, the researchers  “sought to determine if 3) health-team teaching used as an enablement method improves antibiotic prescribing and if 4) the number of appropriate UTI treatment regimens increased following educational intervention compared to baseline (prior to educational intervention).”

Next, Kumar et al attempt to clarify the controversial topic of neurogenesis in adult humans in their review article titled, “Adult Neurogenesis in Humans: A Review of Basic Concepts, History, Current Research, and Clinical Implications.” The authors provide an overview of the basic concept of neurogenesis as well as review its history and evolution. The authors also review the currently available research (with both supporting and disputing data) regarding the concept of adult neurogenesis in humans and animals, as well as discuss research challenges and potential solutions. The authors also offer insight regarding clinical implications that adult neurogenesis in humans might have in the development of effective pharmacological treatments for various CNS disorders.

Following this, we revisit another popular topic among our readers (especially those who treat young children)—play therapy. In the latest installment of the “Psychotherapy Rounds” department, Senko and Harper present their article titled, “Play Therapy: An Illustrative Case.” Here, the authors review the eight tenets of play therapy and provide an illustrative case vignette to demonstrate how play therapy can be used to overcome common ego defenses and developmental hurdles often encountered in the psychotherapeutic setting when treating young children with mental illness and/or behavioral problems.

Next, in the article titled, “A Case of Peripartum Obsessive-compulsive Disorder [OCD]: The Potential Role of Corticosteroids, Gonadal Steroids, and the Neuropeptide Oxytocin in its Pathogenesis,” Spiegel et al describe a case of a female patient who presented with peripartum generalized anxiety disorder (GAD) and new-onset postpartum OCD. The authors primarily review the emerging evidence regarding the roles oxytocin and gonadal steroids might play in the pathogenesis of some forms of OCD.

Next, in a case series by Wang et al titled, “Russian Stimulation/Functional Electrical Stimulation in the Treatment of Foot Drop Resulting from Lumbar Radiculopathy: A Case Series,” the authors describe the successful use of functional electrical stimulation, specifically Russian stimulation, to treat foot drop secondary to lumbar radiculopathy in three patients.

And finally, in the latest installment of “Risk Management,” by McNary titled, “Establishing the Psychiatrist–Patient Relationship When is a Duty of Care Owed?” the author discusses ways to reduce litigation risk in situations when physicians are asked to provide healthcare advice, treatment, or general healthcare information outside the established patient–physician relationship, such as treatment or prescription requests from strangers or casual acquaintances in an informal setting, as well as from family and/or friends; during initial consultations; via electronic communications (e.g., email, website); during independent medical evaluations; and during lectures. The author also provides suggestions on how to reduce the risk of entering into treatment relationships with patients who are not suitable for your practice.

We hope you enjoy this issue of ICNS. As always, we welcome your submissions and feedback.


Amir Kalali, MD

Editor, Innovations in Clinical Neuroscience