Clinical outcomes with risperidone were equal to those with olanzapine, and response may be more stable. Olanzapine may have an advantage for motor side effects. Both medications caused substantial rapid weight gain, but weight gain was greater with olanzapine.

Both the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and Personality Assessment Inventory (PAI; Morey, 1991) offer a large set of scales devoted to the identification of response styles. This study directly compared the effectiveness of the 2 inventories as indicators of overreporting. The 2 measures were administered to 52 college students instructed to fake bad under conditions describing either a forensic (n = 24) or psychiatric (n = 28) setting as well as to 432 psychiatric patients. Results indicated that the MMPI-2 F - K index and Fp Scale were the best single indicators of a faking bad response style and that the MMPI-2 scales were the better indicators as a set. However, the PAI scales demonstrated a significant level of incremental validity over the MMPI-2 indicators in every analysis conducted. The findings suggest that either inventory offers an effective approach to the detection of overreporting, and administering both inventories can enhance the accuracy of prediction further.

Techniques to assess violence risk are increasingly common, but no systematic approach exists to help clinicians decide which psychiatric patients are most in need of a violence risk assessment. The Fordham Risk Screening Tool (FRST) was designed to fill this void, providing a structured, systematic approach to screening psychiatric patients and determining the need for further, more thorough violence risk assessment. The FRST was administered to a sample of 210 consecutive admissions to the civil psychiatric units of an urban medical center, 159 of whom were subsequently evaluated using the Historical Clinical Risk Management-20, version 3, to determine violence risk. The FRST showed a high degree of sensitivity (93%) in identifying patients subsequently deemed to be at high risk for violence (based on the Case Prioritization risk rating). The FRST also identified all of the patients (100%) rated high in potential for severe violence (based on the Serious Physical Harm Historical Clinical Risk Management-20, version 3, summary risk rating). Sensitivity was more modest when individuals rated as moderate risk were included as the criterion (rather than only those identified as high risk). Specificity was also moderate, screening out approximately half of all participants as not needing further risk assessment. A systematic approach to risk screening is clearly needed to prioritize psychiatric admissions for thorough risk assessment, and the FRST appears to be a potentially valuable step in that process. (PsycINFO Database Record

This study examined signs of mania on the Rorschach, specifically whether manic inpatients (n = 24) produce different thematic content and thought disorder than comparison groups of paranoid schizophrenic (n = 27) and schizoaffective (n = 25) inpatients. Rorschach protocols were scored by a trained rater for the Thought Disorder Index and the Schizoid-Affective Rating Scale. Results indicated that all 3 groups had moderate levels of thought disorder, but the manic inpatients produced significantly more combinatory thinking and affective content responses than the other 2 groups. The paranoid schizophrenic and schizoaffective patients did not produce significantly more schizoid content and were not different on any other types of thought disorder than the manic patients. These findings are discussed in terms of the contribution of thought disorder and affective thematic content in making the diagnosis of mania on the Rorschach.

Psychological test differences between unipolar (UD) and bipolar (BD) depressed inpatients were examined using the Minnesota Multiphasic Personality Inventory (MMPI, Hathaway and McKinley, 1943; MMPI-2, Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), Millon Clinical Multiaxial Inventory (MCMI, Millon, 1983; MCMI-II, Millon 1987), and Symptom Checklist-90 (SCL-90-R, Derogatis, 1983). One hundred fifty-eight UD patients and 26 BD patients took these self-report tests at the beginning of their hospitalization. Results indicate that there were few consistent findings across the three tests (or versions of tests). Contrary to some previous studies, the BD patients did not exhibit a "social desirability" response set, nor did they produce "normal" test profiles. Although the tests were not able to identify depressed patients with past manic episodes, BD patients were more narcissistic, driven, and willing to engage in antisocial practices than were UD patients. These findings are discussed in terms of the clinical similarities between UD and BD patients during a depressive episode as well as the limitations of cross-sectional self-report measures to evaluate historical information regarding course of illness.