A Review of Community-Based Gun Violence Prevention Programs and the Physician's Role.

Gun violence (GV) and safety is a contentious topic in the United States, despite increasing morbidity and mortality among children and adolescents. It is important for physicians to take a role in preventing future GV. This article aims to present several methods that physicians can use to prevent GV in their own communities, ranging from implementation of large-scale intervention programs to simple screenings and anticipatory guidance. As the problem of GV persists, it is important for physicians to use their role to identify individuals who are at high-risk and advocate for changes that will benefit their future health.

Reported maladaptive decision-making in unipolar and bipolar depression and its change with treatment.

Mood disorder patients frequently experience difficulty making decisions and may make sub-optimal decisions with adverse life consequences. However, patients' styles for decision-making when ill and after treatment have received little study to date. We assessed healthy controls (HC, n = 69) and patients with major depressive disorder (MDD, n = 61) or bipolar disorder (BP, n = 26) in a current major depressive episode using the Melbourne Decision-making Questionnaire. A subset of participants was re-evaluated after completing six weeks of pharmacotherapy. HC demonstrated significantly greater use of the healthy vigilance style, and significantly lower use of maladaptive decision-making styles, than the MDD and depressed BP patients. After six weeks of treatment, neither the MDD nor BP patients reported meaningful improvements in the vigilance style of decision-making, but scores on most maladaptive decision-making styles declined. BP patients who remitted reported significantly lower buckpassing and procrastination scores than healthy controls. Among MDD patients, however, the maladaptive passive buckpassing style of decision-making did not significantly diminish. For MDD patients, reported decision-making styles may remain impaired even after achieving remission. Among BP patients, low levels of adaptive vigilance decision-making may be a trait component of the illness, whereas for MDD patients, reported maladaptive passive decision-making styles are persistent.