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The purpose of this paper is to compare predictors of receipt of recommended first‐line pharmacotherapy in three generational cohorts of patients with new episode depression.

This retrospective database cohort study included adolescent, adult and senior Quebec Public Prescription Drug Insurance Plan beneficiaries with new episode depression, who were diagnosed by primary care physicians or psychiatrists (October 2000 to March 2001) and received pharmacotherapy. Receipt of recommended first‐line pharmacotherapy, based on the first psychoactive medication dispensed following the depression diagnosis, was defined according to Canadian guidelines.

Receipt of first‐line pharmacotherapy was documented in 52 percent, 71 percent and 50 percent of adolescents, adults and seniors, respectively. Among adolescents and seniors, diagnosis by a psychiatrist was associated with a lower likelihood of receipt of recommended pharmacotherapy. Adolescent females and senior males were more likely and adults with comorbidity were less likely to receive recommended pharmacotherapy. For all age groups, having a physician who both diagnosed the depression and prescribed the initial pharmacotherapy was associated with an increased likelihood of receiving recommended pharmacotherapy. Relational continuity of care influenced receipt of recommended first‐line pharmacotherapy. Gender differences in treatment were found in adolescents and seniors.

This paper identifies predictors of receipt of recommended first‐line pharmacotherapy in three generational cohorts of patients with new episode depression.

This case report seeks to describe successful treatment of erotomania using cognitive behavioural psychotherapy in concert with community support providers applying similar psychotherapeutic approaches.

A case report is presented illustrating successful treatment of an individual with erotomania and intellectual disability. Pharmacotherapy assessment suggested its ineffectiveness and medicines were slowly reduced and discontinued. Cognitive behavioural psychotherapy provided a venue to discuss personal issues and work on solutions. The community support system was enlisted to approach the problem using two main psychotherapeutic strategies: eliminate social attention for the delusion; and increase social relationships.

Cognitive behavioural psychotherapy working in collaboration with the community support system resulted in great improvement. Within three years, the individual returned to previous functioning with no symptoms of the delusional disorder.

This case study illustrates the successful treatment of erotomania using cognitive behavioural psychotherapy and engaging the community support system in applying directed psychotherapeutic strategies. Erotomania occurs in people with intellectual disability and must be recognized and treated. Ineffective pharmacotherapy was successfully reduced and discontinued within the context of appropriate therapeutic supports.

The study evaluated the introduction of naltrexone in an Australian prison system for imprisoned male heroin users. Treatment outcomes were analysed for two sub‐samples taken from an unsuccessful randomised controlled trial. The first sample comprised 68 participants who were randomly allocated to naltrexone treatment. The second sample comprised 47 participants who commenced opioid pharmacotherapy during the study period. Thirteen per cent of subjects started naltrexone, with only 7% retained in treatment at six months. Six‐month retention was significantly lower in naltrexone compared to methadone (p = 0.0007). Poor patient acceptability and retention did not support oral naltrexone maintenance in this treatment group.

Across the world, 3.3 million people die every year as a result of harmful use of alcohol. In Australia, excessive alcohol intake is responsible for 3.2 percent of the total burden of disease and injury. Disulfiram is one of the few pharmacotherapies approved for the treatment of alcohol dependence, and interferes with the metabolism of alcohol causing unpleasant symptoms as a deterrent effect. To date, no studies have examined the efficacy of disulfiram in an outpatient setting in Australia. The purpose of this paper is to describe the medium term outcomes of patients commencing disulfiram in a specialized drug and alcohol outpatient setting in Australia.

Data were extracted from outpatient clinical notes for all patients commenced on disulfiram at any location in the drug and alcohol service between January 1, and December 31, 2013.

In total, 80 patients were included in the study. At three months following commencement of treatment, 42 patients (53 percent) were considered to have been successfully retained in treatment. Totally, 36 (45 percent) patients reported remaining completely abstinent from alcohol during their first three months of treatment. Patients that self-referred to outpatient disulfiram treatment had 75 percent lesser odds of succeeding in treatment compared to those that were referred by other means (i.e. via hospital, GP or forensic services).

This study demonstrates that patients receiving supervised disulfiram for three months in the context of this treatment model can achieve abstinence. Further work is needed to compare this with other treatment options.

National Health and Morbidity Survey of Malaysia 2011 revealed that hypercholesterolemia (35.1 per cent, 6.2 million) was the primary leading causes of cardiovascular disease in Malaysia. Currently, three established recommended approaches such as therapeutic lifestyle change (TLC) diet, pharmacotherapy (simvastatin) and TLC + simvastatin are available to the public but, to our knowledge, have never been compared in Malaysia Primary Health Care setting. Hence, this paper aims to compare the lipid lowering effects of these three approaches in a primary health care clinic.

This randomized trial enrolled 180 patients with hypercholesterolemia who met adult treatment panel III (ATP III) criteria. All participants were randomized to TLC diet, simvastatin (10-20 mg/d) or TLC + simvastatin diets. The TLC group was enrolled in a 12-week multidisciplinary lifestyle program that involved monthly 45 minutes to hour meetings. The simvastatin group received medication, and traditional counseling was conducted by registered medical officer. Another group was enrolled into TLC + simvastain treatment. The primary outcome measure was the percentage change in low-density lipoprotein-cholesterol. Secondary measures were changes in weight loss, blood pressure and dietary changes. Assessments were repeated at three-month interval.

Lifestyle changes combined with simvastatin had a better lipid lowering effect compared to the other two treatments. However, TLC had a better weight and blood pressure reduction compared to the other two treatments. Nevertheless, TLC group showed reduction proportions similar to standard therapy with simvastatin or TLC + simvastatin. TLC has proven as an alternative approach to hyperlipidemia for a subset of patients unwilling or unable to take statins especially in a community-based, primary health care setting.

Weight loss was not recorded for simvastatin participants, and this was the major drawback of this study, and there was no comparable weight loss reduction with other groups.

In Malaysia, the efficacy of hypocholesterolemic therapies among patients who are receiving the most common lipid-lowering drug, simvastatin, in primary health care setting has not been clearly defined. There is also a lack of research on the efficacy of TLC conducted by registered dietitian in a primary health care setting in Malaysia.

Women are nearly twice as likely as men to suffer a major depressive episode (Kessler et al., 1994). Risk of onset for single mothers is twice that of married mothers and financial hardship also doubles the risk of becoming depressed (Brown & Moran, 1997). If diagnosed, depression can be effectively treated, typically with pharmacotherapy or psychotherapy or some combination of the two (Goldman et al., 1999; Sirey et al., 1999). But a sizable majority of sufferers remain undiagnosed and untreated (Lennon et al., 2001). Such treatment can be prohibitively expensive to patients who lack health insurance, particularly those with few financial resources. Although most low-income women have a safety net in Medicaid, welfare reform’s delinking of Medicaid from welfare cash assistance has left uncovered many who are eligible for the benefits (Garrett & Holahan, 2000).

Cigarette smoking remains the primary preventable cause of mortality and morbidity globally. The overarching goal of the paper is to disseminate the Behavioral Activation Treatment for Smoking (BATS), which integrates behavioral activation principles with standard treatment guidelines to assist individuals in achieving short- and long-term smoking cessation. Through a series of sequential steps, BATS guides individuals who wish to quit smoking to increase their engagement in healthy, pleasurable, and value-consistent activities.

The document provides the BATS rationale and contains an abridged manual for use by clinicians and/or researchers in the context of clinical trials. Findings: BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

A description of key components, forms, and strategies to address common treatment barriers are included.

BATS’s strong roots in learning theories and its idiographic nature allow for the intervention to be implemented flexibly across a wide range of settings and smoking populations. The treatment may also be combined seamlessly with pharmacotherapies. BATS targets both cigarette smoking and depressive symptoms, which constitute a significant barrier to cessation, through a common pathway: increasing rewarding activities. The treatment offers a parsimonious complement to standard smoking cessation treatments.

The purpose of this paper is to investigate the effectiveness of classical yoga not only as a complementary therapy but also as a viable option in the management of anxiety and depression.

Papers were retrieved using a combination of databases including PubMed/MEDLINE and PsycINFO.

The findings revealed that the practice of yoga as complementary therapy and also as a stand-alone therapy is effective in managing and reducing anxiety and depression.

All the studies reviewed in this paper were methodologically limited in terms of sample size, sample heterogeneity, yoga intervention styles, duration of practice and teaching methods. Further research is needed to address key areas such as how much yoga is needed per week, duration of each class and specifically the types of asanas and pranayama to practise to bring about change in the anxiety and depressive states.

This review has provided substantial insight to yoga as a complementary and/or stand-alone therapy for anxiety and depression which is much needed in this contemporary society. The Malaysian community especially teenagers and adults, should consider incorporating yoga as part of their daily routine to experience and reap its benefits. It is suggested that yoga be included as part of the physical education curriculum in learning institutions and as a recreational activity for staff in public and private organisations.

The findings of this review provide an avenue for victims to cope with and manage anxiety and depression through the practice of yoga.

Obesity among elderly consumers precipitates undesirable health outcomes. This study aims to investigate the effects of environmental cues on food intake of elderly consumers in an aged-care facility.

A longitudinal study conducted over 17 weeks in situ within an aged-care facility with 31 residents investigated how auditory (soothing music), olfactory (floral-scented candle) and visual (infographic on health benefits of the main meal component) cues influenced food intake quantity during a meal, while accounting for portion size effect (PSE).

Analysing the cross-sectional results of individual treatments and rounds did not reveal any consistent patterns in the influence of the three environmental cues. Longitudinal analyses, however, showed that the presence of auditory and olfactory cues significantly increased food intake, but the visual cue did not. Moreover, PSE was strong.

Extending research into environmental factors from a commercial to a health-care setting, this study demonstrates how the presence of auditory and olfactory, but not cognitive cues, increased food intake behaviour among elderly consumers. It also shows that a cross-sectional approach to such studies would have yielded inconclusive or even misleading findings. Merely serving more would also lead to higher food intake amount.

Environmental factors should be a part of health-care providers’ arsenal to manage obesity. They are practical and relatively inexpensive to implement across different health-care settings. However, the same environmental factors would have opposite desired-effects with normal or underweight residents, and hence, aged-care facilities need to separate the dining experience (or mealtime) of obese and other residents. Quantity served should also be moderated to discourage overeating.

While studies into managing obesity, particularly among older adults, have mainly focused on techniques such as pharmacotherapy treatments with drugs, dietary management or even lifestyle change, less attention has been given to the influence of environmental cues. This study, executed in situ within an aged-care facility, provided evidence of the importance of considering the impact of environmental factors on food intake to help reduce obesity.