bluuebunny/crossref_metadata_2025 huggingface dataset:
MGN-3/Biobran Enhances Generation of Cytotoxic CD8+ T Cells VIA Upregulation of DEC-205 Expression on Dendritic Cells
Authors: Ghoneum M. , Agrawal S.
Published: January 2017

Arabinoxylan rice bran (MGN-3/Biobran) has been shown to be a potent biological response modifier (BRM) that activates different arms of the immune system, including dendritic cells (DCs), which prime CD4+ helper T-cell responses. The present study explores the ability of MGN-3-activated DCs to prime CD8+ T cells and examines the mechanisms underlying its effect. Human monocyte-derived DCs were treated with MGN-3 (20 and 40 fig/ml). Results indicate that treatment with MGN-3 caused DCs to prime higher granzyme B-expressing CD8+ T cells. Tumor lysate-pulsed MGN-3 DC also increased tumor cell killing compared to DC-stimulated CD8+ T cells. This was associated with: i) increased expression of DEC-205 in MGN-3-activated DCs in a dose-dependent manner; and ii) MGN-3 induced significant production of Type III interferon, IL29, but not Type I IFNs α and β. These results suggest that MGN-3 is a potent natural adjuvant that efficiently activates DCs and may therefore be useful for mounting an efficient immune response against infections and cancer.
Wrong Melanoma Thickness Measurement: Check it or Leave It?
Authors: Chokoeva A.A. , Tchernev G. , Philipov S. , Cardoso J.C. , Zanardelli M. , Lotti T.
Published: January 2017

Cutaneous malignant melanoma (CMM) is one of the most aggressive forms of skin cancer, accounting for about 90% of deaths from cutaneous neoplasms, and its incidence has increased significantly in recent years. According to the 2012 European criteria for diagnosis and treatment of malignant melanoma, diagnosis should be based on the combination of clinical features, dermoscopic data and histological examination, preferably after excisional biopsy. Tumour thickness and other parameters for local staging according to the AJCC classification should be included in the pathology report. Although many factors influence the prognosis and course of the disease, it has been established in a number of studies that tumour thickness is the most important parameter. Therapy of malignant melanoma in its initial stages mostly consists of wide local excision with 1 to 2 cm margins, and sentinel lymph node biopsy that is usually performed in cases of tumours with a thickness greater than 1 mm. We present the case of a 58-year-old Bulgarian male with cutaneous superficial spreading malignant melanoma, in which, after complete excision, histological examination established an inaccurate tumour thickness (0.7 mm), with consequent inadequate staging and further management. After reassessment of the results in another institution (as well as their confirmation by two additional independent histopathology laboratories in our country −1.92 mm), in the National Oncological Hospital where the patient was initially evaluated, sentinel lymph node biopsy was not performed, contrary to the generally accepted European and World standards. With the present case we raise some current issues regarding diagnosis and therapy of Bulgarian patients (not only in the case presented) with malignant melanoma in the 21st century, and discuss the urgent need for external quality control procedures and standardization of the histopathologic reporting, which is of paramount importance in the staging and subsequent management of these patients.
Routine Use of a Protease Zymogen-Based Colorimetric Assay for the Detection of Beta-Glucan and its Role in Clinical Practice
Authors: Farina C. , Lombardi G. , Andreoni S. , Manso E. , Perin S. , Panellis D. , Fazii P. , Conte M. , Sanna S. , Pini P. , Blasi E.
Published: January 2017

The detection of Aspergillus antigen (galactomannan) is considered a reliable marker for the diagnosis of invasive aspergillosis (IA), yet the sensibility and specificity of the assays commonly employed in routine are not optimal. The aim of the present study was to investigate whether the detection of another panfungal antigen, the (1,3)-b-D-glucan could have an auxiliary role in the identification of patients with IA. The study was carried out on 63 sera belonging to patients who had been screened for galactomannan, according to the clinical suspect of IA. Our data show that the positive galactomannan results were not confirmed by positive (1,3)-b-D-glucan results in patients receiving therapy with beta-lactam antibiotics associated with tazobactam, whereas in all the other cases, with the exception of four, the results of the (1,3)-b-D-glucan test were confirmatory of the galactomannan results.
Effect of a Synthetic Immunomodulator on the Regulation of Gamma Interferon and Interleukin-10 Production during Salmonella Sepsis in Itys Mice
Authors: Ferlat S. , Bottex-Gauthier C. , Li M. , Picot F. , Vidal D. , Potier P.
Published: January 2017

The present study examined the in vivo capacity of diHDA-glycerol, a new chemically defined compound that we synthesized, to enhance nonspecific resistance of Itys mice to a virulent Salmonella typhimurium challenge (>LD50). This compound derives from (E)-10 hydroxy-2 decenoic acid (10-HDA), a fatty acid isolated from Royal Jelly. Bacterial growth rate within the spleen, interferon-gamma (IFN-γ), interleukin-10 (IL-10), and nitric oxide (NO) levels were measured in splenocyte cultures from diHDA-glycerol-pretreated mice or saline infected controls, at various time intervals after infectious challenge. Repeated administration of diHDA-glycerol before bacterial inoculation resulted in increased bacterial clearance from the spleen, starting in the second week of infection, whereas in control mice, bacterial proliferation led to death beyond day 13 after challenge. In addition, spleen cells from infected mice produced elevated levels of IFN-γ but failed to produce IL-10. In contrast, on the second week post challenge, the time course of cytokine responses was modified by the pretreatment. Spleen cells from diHDA-glycerol pretreated mice exhibited significantly lower levels of IFN-γ and significantlty higher levels of the anti-inflammatory cytokine IL-10, when compared with those in infected controls. Furthermore, on the second week post challenge, the restored functional capacity of splenocytes to produce nitric oxide (NO) was apparently linked with diHDA-glycerol pretreatment. These results suggest that diHDA-glycerol accelerates some macrophage functions resulting in a more adequate modulation of the balance of inflammatory mediators and consequently, in an enhanced host defense against Salmonella infection.
Immunological Events during the Early Phase of Infection with Schistosoma Mansoni in Mice
Authors: Grelli S. , Matteucci C. , Cioli D. , El Sayed L.H. , Adam N. , Ghoneim H. , De Smaele E. , Favalli C. , Garaci E. , Mastino A.
Published: January 2017

Naturally occurring infection in humans or experimental infection in mice by Schistosoma mansoni lead to a Th1 towards Th2 switch of cytokine response in the chronic late phase of the disease. It has been proposed that an initial Th1 response is successively down-regulated and followed by an egg-antigen driven Th2 response. Here we report the results of a kinetic study on the capacity of spleen cells from experimentally infected Balb/c mice to produce Th1 or Th2 cytokines, following mitogen stimulation, during the phase which precedes the granulomatous response associated to egg-deposition. The main results were identified as an early increase in IL-4 and IL-10 Th2 cytokine production, particularly pronounced for IL-10, only a slight and delayed decrease in IL-2 production and an invariable or actually enhanced capacity to produce IFN-γ. The emergence of Th2 response was associated with only slight and delayed modifications in spleen lymphocyte subsets, mainly represented by a decrease in CD3+ T cells and an increase in B cells. The initial unbalance of the Th1/Th2 response precedes thus the egg-deposition and the chronic phase of the infection, being evident 3 weeks after the challenge with the parasite. This observation could represent a novel finding useful in understanding the complex mechanisms involved in the immunopathogenesis of schistosomiasis.
II. Cost-Effectiveness Analysis of Psychiatric Deinstitutionalization
Authors: Reinharz Daniel , Lesage Alain D , Contandriopoulos André-Pierre
Published: January 2017

Background:

The cost-effectiveness of the eventual deinstitutionalization of patients with severe and persistent mental disorders who are currently hospitalized in long-term care remains a controversial matter.

Methods

A retrospective cohort of 96 pairs of psychiatric hospital patients with 1 member deinstitutionalized between 1989 and 1998 was followed up for nearly 10 years. All use of medical and social services was documented. Patients were evaluated at the start and end of the study on various clinical and social dimensions, as well as on quality of life.

Results

On several dimensions, deinstitutionalized patients scored more positively than did those patients still hospitalized. The lower daily cost of living accommodations for deinstitutionalized patients easily offsets the cost of services required for treatment in the community.

Conclusion

Deinstitutionalization, as implemented in the hospital studied, remains for many patients a less costly option than continued hospitalization and is likely to improve their mental state and well-being.
Estimated Prevalence of the Seasonal Subtype of Major Depression in a Canadian Community Sample
Authors: Levitt Anthony J , Boyle Michael H , Joffe Russell T , Baumal Zillah
Published: January 2017

Objective:

To examine estimates of lifetime prevalence of seasonal affective disorder (SAD) in Toronto, Ontario.

Method

Random telephone numbers were generated for the city of Toronto, and 781 respondents completed a telephone interview. Trained nonphysician interviewers conducted all interviews, which involved structured questions for diagnosing major depression. Patterns of symptom change across seasons were evaluated to establish a diagnosis of SAD according to DSM-III-R criteria.

Results

Correcting for sex and age, the prevalence of SAD defined by DSM-III-R criteria was 2.9% (95%CI, 1.7% to 4.0%), and the overall lifetime prevalence of major depression in the sample was 26.4% (95%CI, 23.3% to 29.4%). Some subjects were contacted for a follow-up interview conducted in person; the positive predictive value for the diagnosis of major depression for the telephone interview was 100%, and the negative predictive value was 93%.

Conclusions

The seasonal subtype of depression represents 11% of all subjects with major depression, suggesting that SAD is a significant public health concern. The telephone interview demonstrated adequate reliability, indicating that it is appropriate for epidemiological surveys of this nature.
Pharmacologic Treatment of Eating Disorders
Authors: Zhu April J , Walsh B Timothy
Published: January 2017

Objective:

Eating disorders are a serious group of conditions that affect 3% of women in industrialized nations over their lifetimes. Recent years have seen considerable progress in the treatment of these disorders. This article reviews the current body of evidence for the pharmacologic treatment of eating disorders

Method:

We undertook a literature review.

Results:

For patients with anorexia nervosa (AN), drug trials have been disappointing. In contrast, numerous studies have demonstrated a clear role for antidepressants in the treatment of bulimia nervosa (BN). Pharmacologic investigations of binge eating disorder (BED), a more recently defined entity, have identified several promising drugs. There is also support for the utility of combined medication and psychotherapy.

Conclusion:

Continued research efforts are necessary, particularly regarding the long-term effects of therapy and the development of new pharmacologic strategies.
La comorbidité dans le trouble d'anxiété généralisée: Prévalence et évolution suite à une thérapie cognitivo-comportementale
Authors: Provencher Martin D , Ladouceur Robert , Dugas Michel J
Published: January 2017

Objectif:

Évaluer la prévalence et l'évolution des troubles de l'axe I concomitants dans une population de patients ayant suivi une thérapie cognitivo-comportementale (TCC) pour le traitement du trouble d'anxiété généralisée (TAG).

Méthode:

La présente étude est une analyse secondaire combinant les patients de 3 études de traitement réalisées à l'Université Laval. Un total de 90 patients présentant un diagnostic de TAG selon le DSM-IV ont reçu entre 12 et 16 séances de TCC pour le traitement du TAG. La symptomatologie a été évaluée au pré-test, au post-test et 6 mois après le traitement à l'aide d'une entrevue diagnostique structurée, l'Anxiety Disorders Interview Schedule.

Résultats:

Le nombre de patients souffrant du TAG et présentant un diagnostic concomitant s'élève à 73 %. Les diagnostics les plus fréquents sont la phobie simple, la phobie sociale, le trouble panique et la dépression majeure. La TCC appliquée au TAG diminue le nombre de diagnostics concomitants. La présence d'un trouble panique ou d'un nombre plus élevé de diagnostics concomitants au pré-test est associée à une moins grande efficacité du traitement au rappel, 6 mois plus tard.

Conclusion:

Les patients souffrant du TAG présentent un taux élevé de comorbidité avec d'autres troubles de l'axe I, mais ces derniers diminuent significativement suite à une TCC brève ciblant le TAG. Les implications pour le traitement du TAG et les mécanismes pouvant expliquer ces résultats font l'objet d'une discussion.
Recent Advances in the Treatment of Delusional Disorder
Authors: Manschreck Theo C , Khan Nealia L
Published: January 2017

Objective:

Often considered difficult to treat in the past, even treatment-resistant, delusional disorder is now regarded as a treatable condition that responds to medication in many instances. Munro and Mok previously reviewed the published record of its treatment to 1994. This review aims to update and extend their observations and to examine the impact of new second-generation antipsychotic agents on the treatment of this condition.

Method:

We attempted to gather all published reports of delusional disorder from 1994 to 2004, using various database strategies. We then assessed the reports for clarity and completeness, treatment, and outcome descriptions, thereby selecting a patient sample for analysis.

Results:

Of 224 cases identified as delusional disorder, only 134 case descriptions provided sufficient treatment and outcome data to inform this review. The demographics of this sample were similar to those of the earlier review. Depression as a comorbid condition was more frequent than before. Adherence to medication regimens was seldom explicitly addressed. Most cases showed improvement regardless of which antipsychotic medication the patients received. Pimozide and other conventional antipsychotics, as well as second-generation antipsychotics, and even clozapine, were used in many of the case reports. Family history of delusional disorder was seldom recorded.

Conclusions:

A positive response to medication treatment occurred in nearly 50% of the cases in our review, which is consistent with the earlier review.
Characterization of the Facial Expression of Emotions in Schizophrenia Patients: Preliminary Findings with a New Electromyography Method
Authors: Wolf Karsten , Mass Reinhard , Kiefer Falk , Wiedemann Klaus , Naber Dieter
Published: January 2017

Objective:

We investigated facial expression of emotions (FEE) in schizophrenia patients, using an improved and highly selective facial electromyography (EMG) method, and we examined the correlation between FEE and psychopathology.

Method:

We compared unmedicated patients with schizophrenia ( n = 32) with healthy subjects ( n = 21) with regard to the activity of 3 joy-relevant facial muscles (the M.zygomaticus, the M.orbicularis oculi, and the M.levator labii). Emotions were induced by pictures from the International Affective Picture System. We measured previsible muscle activity with a new, highly selective facial EMG. We used the Positive and Negative Syndrome Scale to evaluate psychopathology.

Results:

Patients with schizophrenia showed fewer joy or smile reactions than did control subjects and displayed decreased activity of the M.orbicularis oculi and M.zygomaticus under presentation of positive pictures. Reduced activity of these muscles can be caused by depression. Increased activity of the M.levator labii correlates with positive symptoms.

Conclusions:

Our findings indicate that psychopathological syndromes correlate with schizophrenic mimic disturbances. These results can be used to compare various antipsychotics with regard to their influence on mimic disturbances.

Objectif:

Nous avons étudié l'expression émotionnelle du visage (EEV) chez des patients souffrant de schizophrénie, à l'aide d'une technique d'électromyographie (EMG) faciale améliorée et très sélective, et nous avons examiné la corrélation entre l'EEV et la psychopathologie.

Méthode:

Nous avons comparé des patients non médicamentés souffrant de schizophrénie ( n = 32) avec des sujets en santé ( n = 21) en ce qui concerne l'activité de 3 muscles faciaux liés à la joie (le muscle grand zygomatique, le muscle orbiculaire et le muscle releveur de la lèvre). Les émotions ont été provoquées par des images du système international d'images affectives (IAPS). Nous avons mesuré l'activité musculaire prévisible au moyen d'une nouvelle EMG faciale très sélective. Nous avons utilisé l'échelle de syndrome positif et négatif (PANSS) pour évaluer la psychopathologie.

Résultats:

Les patients souffrant de schizophrénie ont eu moins de réactions joyeuses ou souriantes que les sujets témoins et ont démontré une activité moindre du muscle orbiculaire et du muscle grand zygomatique devant les images positives présentées. L'activité réduite de ces muscles peut être causée par la dépression. L'activité accrue du muscle releveur de la lèvre est en corrélation avec les symptômes positifs.

Conclusions:

Nos observations indiquent que les syndromes psychopathologiques sont en corrélation avec les anomalies mimiques schizophrènes. Ces résultats peuvent servir à comparer divers antipsychotiques relativement à leur influence sur les anomalies mimiques.
Canadian Psychiatry Residency Training Programs: A Glance at the Management Structure
Authors: van Zyl Louis T , Davidson Paul R
Published: January 2017

Objectives:

To describe the administrative functioning of all current Canadian psychiatry residency training programs (RTPs) and to suggest available improvements to existing systems.

Method:

We obtained data about the 2004 RTPs by distributing 2 questionnaires to all Canadian psychiatry RTPs.

Results:

Residency program committees (RPCs) are mainly consultative and carry only a small amount of the workload of managing a residency program. Program directors (PDs) manage more than 80% of the work and report that the time allowance to perform their duties is suboptimal. PDs remain in office for about 5 years, departing during or at the end of a predetermined second term.

Conclusion:

RPCs bear only a small amount of the workload generated by the RTP. We piloted administrative changes that led to more equitable work distribution.
Getting beneath the Phenotype of Anorexia Nervosa: The Search for Viable Endophenotypes and Genotypes
Authors: Treasure Janet L
Published: January 2017

Treatment for anorexia nervosa has changed little from that described by Gull over a century ago. To focus merely on symptomatic relief from “not eating,” as occurs with some forms of hospital care, is primitive. The evidence base to guide treatment is thin. Nevertheless, there is hope that better understanding of the causes and maintaining factors may translate into more sophisticated treatments. This review aims to look beyond the overt and startling “not eating” phenotype of anorexia nervosa and consider eating disorder endophenotypes. The first part of the review sets the eating behaviour, clinical, and psychopathological features into the context of what is now understood about the central control of appetite. The evidence base for a framework of potential eating disorder endophenotypes follows. Finally, ideas about how to translate endophenotypes into treatment are introduced.
Mental Health Service Use among Adolescents and Young Adults with Major Depressive Disorder and Suicidality
Authors: Cheung Amy H , Dewa Carolyn S
Published: January 2017

Objectives:

Despite being recognized as a serious public health concern, suicidality among adolescents and young adults is frequently missed, and completed suicide remains the second leading cause of death for young Canadians. With such close links between depression, suicidality, and completed suicide, any intervention must address all 3 of these issues. However, to develop effective interventions, we must understand the types and rates of mental health service use among adolescents and young adults. This study examines service use rates in young Canadians with depression and suicidality and the influence of sex on the types of service provider chosen.

Methods:

We used data from the Canadian Community Health Survey: Mental Health and Well-Being. Our sample included 619 individuals, aged 15 to 24 years, who screened positive for depression and suicidality in the past 12 months. We examined mental health service use rates in general and by provider type.

Results:

Among adolescents aged 15 to 18 years with depression, 40% had not used any mental health services. This rate was higher for adolescents with suicidality at 50%. In young adults aged 19 to 24 with depression, 42% had not used any mental health services. Among young adults with suicidality, 48% had not accessed services. Female adolescents and young adults were more likely to receive services from nonspecialty mental health providers.

Conclusions:

In Canada, many adolescents and young adults with depression and suicidality do not receive mental health services. Further, there may be a preferential treatment of young men by mental health specialists. Further research is needed to understand the quality of care received by these young Canadians and the factors influencing service use.
Efficacy and Safety of Antidepressants for Treatment of Depression in Alzheimer's Disease: A Metaanalysis
Authors: Thompson Sarah , Herrmann Nathan , Rapoport Mark J , Lanctôt Krista L
Published: January 2017

Objective:

Depression in patients with Alzheimer's disease (AD) is common (15% to 63%) and is associated with significant morbidity and increased mortality. Our objective was to quantitatively summarize the data on the efficacy and safety of antidepressant treatment for depression complicating AD.

Method:

We performed a metaanalysis of randomized, double-blind, placebo-controlled trials of antidepressants with a database search of the English literature (up to 2006) and a manual search of references in the retrieved articles. We extracted the proportion of subjects who responded and remitted, experienced adverse events (AEs), discontinued treatment due to AEs, or discontinued treatment for any reason. Cognition scores were also extracted.

Results:

We included 5 studies, which involved 82 subjects treated with antidepressants and 83 subjects who received placebo treatment. Antidepressants were superior to placebo for both treatment response (odds ratio [OR] 2.32; 95% confidence interval [CI], 1.04 to 5.16) and remission of depression (OR 2.75; 95%CI, 1.13 to 6.65). There were no significant differences between the 2 groups for change in cognition (weighted mean difference –0.71, 95%CI, –3.20 to 1.79), overall dropouts (OR 0.70; 95%CI, 0.29 to 1.66) or dropout due to AEs (OR 1.41; 95%CI 0.36 to 5.54). The numbers needed to treat for one additional AD patient to respond to antidepressant treatment were 5 (95%CI, 3 to 59) and 5 (95%CI, 2 to 24) for remission of depression.

Conclusions:

Antidepressant treatment for depression in AD is efficacious, with rates of discontinuation that are comparable to placebo. Nonetheless, clinicians must be vigilant regarding the potential side effects of antidepressants in this population.
The Sensitivity of the K6 as a Screen for Any Disorder in Community Mental Health Surveys: A Cautionary Note
Authors: Veldhuizen Scott , Cairney John , Kurdyak Paul , Streiner David L
Published: January 2017

Objective:

Short screening instruments, which exclude respondents unlikely to have psychiatric disorders, can make epidemiologic surveys shorter and more cost-effective. The Kessler 6-Item Psychological Distress Scale (K6), a measure of generalized distress, has been proposed for this role and has shown good agreement with the Composite International Diagnostic Interview (CIDI). However, performance of the K6 may vary for individual disorders or combinations of disorders. In this report, we examine the ability of the K6 to detect disorders among respondents in different diagnostic categories.

Method:

We used data from Cycle 1.2 of the Canadian Community Health Survey to assemble 5 groups of respondents with different 12-month psychiatric disorders ( n = 4481). A sixth group comprised those with 2 or more disorders. We examined the sensitivity of the K6 among respondents with an individual disorder as well as those with multiple disorders.

Results:

The sensitivity of the K6 varies significantly by disorder; it is highest among respondents with multiple disorders and lowest among those with agoraphobia only.

Conclusions:

Use of the K6 as a screen for the CIDI is likely to result in biased prevalence estimates. However, both instruments should be compared with a third standard to fully assess the benefits and drawbacks of their combination.
Catatonia: A Syndrome Appears, Disappears, and is Rediscovered
Authors: Fink Max
Published: January 2017

Catatonia is the psychiatric syndrome of disturbed motor functions amid disturbances in mood and thought first described in 1874. It was quickly found in 10% to 38% of psychiatric populations. After it was tied to schizophrenia as a type in the psychiatric classification, its recognition became increasingly limited and by the 1980s questions were asked as to where the catatonics had gone. The decline is largely owing to the change in venue for psychiatric practice from asylum to office, the rejection of physical examination, and the dependence on item rating scales for diagnosis.

In the 1970s, broad surveys again showed that catatonia was as common as before among patients with mania and depression, and as a toxic response to neuroleptic drugs. The latter recognition, that the neuroleptic malignant syndrome is the same syndrome as malignant catatonia, and is effectively treated as such, sparked a renewed interest. Clinicians developed rating scales to identify the catatonia syndrome and applied the immediate relief afforded by a barbiturate or a benzodiazepine as a diagnostic test, the lorazepam test. Effective treatments were described as high doses of benzodiazepines and electroconvulsive therapy (ECT).

Surveys using catatonia rating scales showed catatonia to have many faces. Catatonia is presently limited to a type of schizophrenia in the psychiatric classification. Its recognition as a disorder of its own, such as delirium and dementia, should now be recognized. This experience reinforced the utility of the medical model for diagnosis. An application for melancholia is described.
General Practice and Mental Health Care: Determinants of Outpatient Service Use
Authors: Vasiliadis Helen-Maria , Tempier Raymond , Lesage Alain , Kates Nick
Published: January 2017

Objective:

To examine the determinants that lead Canadian adults to consult family physicians, psychiatrists, psychologists, psychotherapists, and other health professionals for mental health reasons and to compare the determinants of service use across provider types.

Method:

Data from the Canadian Community Health Survey: Mental Health and Well-Being were used for people aged 18 years and older ( n = 35 236). A multivariate logistic regression was used to model outpatient consultations with different providers as a function of predictive determinants.

Result:

Three types of variables were examined: need, enabling, and predisposing factors. Among need, the most common predictors of service use for mental health reasons were self-rated mental health, the presence of chronic conditions, depression and panic attacks, unmet mental health needs, psychological well-being, and the ability to handle daily demands. Among enabling factors, emotional and informational support and income were important predictors. Among predisposing factors, men were less likely to consult with a family physician and other resources but not with psychiatrists; and people with less education were less likely to consult psychologists and other health providers.

Conclusion:

Need factors were the most important predictors of both psychiatrist and combined family physician and psychiatrist consultation in the previous year. However, sex barriers remain and promotion campaigns in seeking mental health care should be aimed toward men. Further, education and income barriers exist in the use of specialty providers of psychotherapy and policies should thus focus on rendering these services more accessible to disadvantaged people.
Comorbidity of Axis I and II Mental Disorders with Schizophrenia and Psychotic Disorders: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions
Authors: McMillan Katherine A , Enns Murray W , Cox Brian James , Sareen Jitender
Published: January 2017

Objective:

To examine the comorbidity of Axis I and II disorders within a community-based sample of adults with schizophrenia.

Methods:

The study was conducted using data from the National Epidemiologic Survey of Alcohol and Related Conditions. A diagnosis of schizophrenia was based on respondents' self-report that they had been diagnosed by a health professional with schizophrenia or a psychotic illness or episode (SPIE). Axis I disorders and Axis II personality disorders (PDs) were assessed using the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Mental and physical quality of life were assessed using the Medical Outcomes Study Short Form 12 questionnaire.

Results:

The prevalence of SPIE was 0.9%. We used multiple logistic regression to examine the association between the presence and absence of SPIE in Axis I and II mental disorders. Each of the Axis I and II mental disorders examined were significantly associated with a diagnosis of SPIE after controlling for age, sex, education, marital status, and household income.

Conclusions:

Clinicians should be aware of the patterns and extent of psychiatric comorbidities that may exist in schizophrenia. Possible mechanisms of these associations are discussed.
Sexual Orientation and Gender Identity in Youth Suicide Victims: An Exploratory Study
Authors: Renaud Johanne , Berlim Marcelo T , Begolli Melissa , McGirr Alexander , Turecki Gustavo
Published: January 2017

Objective:

Our study was designed to explore additional outcome variables of a suicide case–control study to determine the association between sexual orientation and gender identity in suicide completion in children and adolescents.

Method:

Fifty-five child and adolescent suicide victims and 55 community control subjects were assessed using semi-structured, proxy-based interviews and questionnaires regarding sexual orientation and gender issues, psychopathological diagnoses, and service use.

Results:

In our sample, no significant differences between suicide victims and control subjects were found regarding same-sex sexual orientation nor intimidation related to same-sex sexual orientation. Suicide victims with same-sex sexual orientation were more likely than suicide victims without same-sex sexual orientation, to meet criteria for anxiety disorders. Within the month preceding their deaths, these youth were more likely to have consulted a health professional, a psychiatrist, as well as having been hospitalized, and were more likely to have consulted a psychiatrist in the last year.

Conclusions:

In our sample, same-sex sexual orientation and gender identity issues do not appear to be more prevalent among youth who die by suicide, compared with youth recruited from the general population, nor for same-sex sexual-related intimidation. While exhibiting comparable levels of general psychopathological diagnoses associated with suicide, suicide victims with same-sex sexual orientation were more likely to meet criteria for anxiety disorders and to have consulted mental health professionals before their deaths.
An Increased Risk of Stroke among Panic Disorder Patients: A 3-Year Follow-up Study
Authors: Chen Yi-Hua , Hu Chaur-Jong , Lee Hsin-Chien , Lin Herng-Ching
Published: January 2017

Objective:

To explore whether panic disorder (PD) increases the risk for stroke, using a nationwide, population-based dataset.

Methods:

Our study used data from Taiwan's National Health Insurance Research Database. The study cohort included patients who received ambulatory psychiatric care for PD between 2002 and 2003, inclusive ( n = 3891). We selected our comparison cohort by randomly recruiting enrollees ( n = 19 455) matched with the study group by sex and age. Each patient was tracked for 3 years, from their index ambulatory care visit until the end of 2006, to identify whether or not a patient had a stroke during the follow-up period. Cox proportional hazard regressions were performed as a means of computing the 3-year survival rate, adjusting for potential confounding factors.

Results:

Among the total sample, 2029 patients (8.7%) experienced a stroke during the 3-year follow-up period, including 647 from the study cohort (16.6% of the PD patients) and 1382 (7.1%) from the comparison cohort. After adjusting for the patients' sex, age, monthly income, level of urbanization, and comorbid medical disorders, the hazard of stroke occurring during the 3-year follow-up period was 2.37 ( P < 0.001) times greater for patients with PD than for patients in the comparison cohort. In further analyses, stratified by medical diseases and age, the significant risk of PD on subsequent stroke persisted.

Conclusions:

We conclude that PD is an independent risk factor for stroke. For patients with PD, aggressive treatment of PD may be considered as part of stroke prevention.
Antenatal Depression and Anxiety Affect Postpartum Parenting Stress: A Longitudinal, Prospective Study
Authors: Misri Shaila , Kendrick Kristin , Oberlander Tim F , Norris Sandhaya , Tomfohr Lianne , Zhang Hongbin , Grunau Ruth E
Published: January 2017

Objective:

Postpartum depression has been associated with parenting stress, impacting attachment and child development. However, the relation between antenatal depression or anxiety and postpartum parenting stress has not been investigated. We studied the effect of antenatal depression and anxiety and treatment with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors (antidepressants [ADs]) on postpartum parenting stress.

Method:

Ninety-four pregnant women (part of a larger study examining prenatal AD exposure on infants) were prospectively monitored for depression and anxiety during the third trimester and 3- and 6-months postpartum using the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale. Parenting stress was assessed using the Parenting Stress Index—Short Form at 3- and 6-months postpartum.

Results:

Both antenatal third trimester depression and anxiety were significant predictors of 3- and 6-month postpartum parenting stress, after controlling for maternal age, number of children, and exposure to prenatal ADs (all Ps < 0.001). Third trimester depression accounted for 13% to 22% of the variance in postpartum stress at 3 and 6 months. Prenatal AD use was not a significant predictor in any of the models (all Ps > 0.2). Twenty of 41 mothers on ADs achieved remission (HDRS = 7) in pregnancy and had average parenting stress scores of about 1 standard deviation lower than those who did not at 3- and 6-months postpartum ( t = 3.32, df = 32, P = 0.002 and t = 2.52, df = 32, P = 0.02, respectively).

Conclusions:

Our findings indicate that antenatal depression and anxiety directly impact postpartum parenting stress, regardless of antenatal AD treatment. Ongoing maternal mental illness in pregnancy is an important predictor of postpartum parenting stress. Early recognition and treatment to remission is key.
Weight Gain and its Correlates among Forensic Inpatients
Authors: Hilton N Zoe , Ham Elke , Lang Carol , Harris Grant T
Published: January 2017

Objective:

We investigated changes in weight, body mass index (BMI), and other indices of the metabolic syndrome in forensic inpatients. Weight gain associated with newer antipsychotics (APs) is well established in the general psychiatric population.

Methods:

We examined the medical records of 291 men admitted to a forensic hospital at admission and again at discharge or 365 days later if still in hospital. We also recorded diagnosis and smoker status on admission and quantified psychotropic treatment and adherence, physical activity, and daytime occupation during the hospitalization.

Results:

On admission, 33% were obese and 22% of the 106 patients for whom sufficient data were available met criteria for metabolic syndrome. Among patients staying at least 30 days, 60% were weighed again before discharge but repeated blood pressure and waist circumference measures were uncommon, even among those at greatest risk. The 122 forensic inpatients with sufficient information gained an average of 12% of their body weight and 40% increased by at least 1 BMI category, gaining an average of 3.67 kg per month. Weight gain was associated with duration of time and was not attributable to being underweight on admission, diagnosis of schizophrenia, atypical AP treatment, medication adherence, or having been a smoker.

Conclusions:

Patients gained weight during forensic hospitalization independent of medication use. We recommend further research using consistent measurement and wider sampling of both metabolic syndrome indicators and its individual and systemic causes in forensic populations.
Understanding Mental Health Service User Experiences of Restraint through Debriefing: A Qualitative Analysis
Authors: Ling Sara , Cleverley Kristin , Perivolaris Athina
Published: January 2017

Objective:

To examine debriefing data to understand experiences before, during, and after a restraint (seclusion, chemical, and physical) event from the perspective of inpatients at a large urban mental health and addiction hospital.

Method:

Audits were conducted on a purposeful sample of inpatient charts containing post-restraint event inpatient debrief forms ( n = 55). Qualitative data from the forms were analyzed thematically.

Results:

Loss of autonomy and related anger, conflict with staff and other inpatients, and unmet needs were the most common factors precipitating restraint events. Inpatients often reported that increased communication with staff could have prevented restraint. Inpatients described having had various negative emotional states and responses during restraint events, including fear and rejection. Post-restraint, inpatients often desired to leave the unit for fresh air or to engage in leisure activities.

Conclusions:

To our knowledge, our study is the first to use debriefing form data to explore mental health inpatients' experiences of restraint. Inpatients view restraint negatively and do not experience it as a therapeutic intervention. Debriefing, guided by a form, is useful for understanding the inpatient's experience of restraint, and should be used to re-establish the therapeutic relationship and to inform plans of care. In addition, individual and collective inpatient perspectives should inform alternatives to restraint.
The Racial Politics of Due Process Protection
Authors: Carmichael Jason T. , Kent Stephanie L.
Published: January 2017

Discoveries of wrongful convictions have increased substantially over the last several decades. During this period, practitioners and scholars have been advocating for the adoption of policies aimed at reducing the likelihood of convicting a person for a crime they did not commit. Implementing such policies are vitally important not only because they help ensure that the innocent do not receive unwarranted sanctions or that the guilty go unpunished but also because cases of wrongful conviction can erode public confidence in the criminal justice system and trust in the rule of law. To avoid such outcomes, many states have adopted policies through legislation that aim to reduce system errors. It remains unclear, however, why some states appear more willing to provide due process protections against wrongful convictions than others. Findings suggest that dimensions of racial politics may help explain the reluctance of some states to adopt protections against wrongful convictions. Specifically, interaction terms show that states with a Republican governor and a large African American population are the least likely to adopt policies aimed at protecting against wrongful convictions. We thus identify important differences in the political and social context between U.S. states that influence the adoption of criminal justice policies.
Trait Emotional Intelligence Questionnaire–Adolescent Short Form: A Psychometric Investigation in Greek Context
Authors: Stamatopoulou Maria , Galanis Petros , Tzavella Foteini , Petrides K. V. , Prezerakos Panagiotis
Published: January 2017

This article aims to investigate the reliability and validity of the Trait Emotional Intelligence Questionnaire–Adolescent Short Form (TEIQue-ASF) score in a sample of 440 Greek adolescents. The instrument’s score demonstrated good internal consistency and was significantly correlated with core self-evaluations as well with somatic complaints, self-report psychopathology, and personal strengths. It also explained a statistically significant increase in the prediction of outcome variables beyond core self-evaluations. It is concluded that the findings of the present study provide evidence that support the interpretation and use of the TEIQue-ASF score to assess the emotional self-perceptions of Greek adolescents.
Participant Diversity in Special Education Research: Parent-Implemented Behavior Interventions for Children With Autism
Authors: Robertson Rachel E. , Sobeck Emily E. , Wynkoop Kaylee , Schwartz Rachel
Published: January 2017

Evidence-based practices for children with disabilities have empirical support for their effectiveness; however, the demographics of participants making up the evidence base are generally unknown, leaving generalizability of the evidence unclear. This study presents a systematic literature review of participant racial and socioeconomic demographics in one area of special education research, parent-implemented interventions for reducing problem behavior in children with autism, to examine demographic reporting practices, participant characteristics, and their similarity to the general population. Participant race, income, education level, and marital status were aggregated across 23 studies and compared with population-level demographics using chi-square analyses. Results indicated (a) these demographics were infrequently reported; (b) participants with reported demographics were overwhelmingly from White, well-educated, two-parent families; and (c) participants were significantly different from the U.S. population on every tested demographic. Implications of findings and recommendations for reporting participant demographics and increasing diversity in special education research are discussed.
Safety of the Peripheral Administration of Vasopressor Agents
Authors: Lewis Tyler , Merchan Cristian , Altshuler Diana , Papadopoulos John
Published: January 2017

Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL. The objective was to describe the vasopressors administered peripherally, PVL size and location, the incidence of extravasation events, and the management of extravasation events. The primary vasopressors used were norepinephrine and phenylephrine. The most common PVL sites used were the forearm and antecubital fossa. The incidence of extravasation was 4%. All of the events were managed conservatively; none required an antidote or surgical management. Vasopressors were restarted at another peripheral site in 88% of the events. The incidence of extravasation was similar to prior studies. The use of a PVL for administration of vasopressors can be considered in patients with a contraindication to a CVC.
The Moderating Role of Insulin-Like Growth Factor 1 in the Relationship Between Cognitive and Aerobic Endurance Change
Authors: Anderson Jason R. , Calvo Dayana , Glickman Ellen , Gunstad John , Spitznagel Mary Beth
Published: January 2017

Background:

Improvements in cognition often accompany fitness improvements in older adults, and research suggests insulin-like growth factor 1 (IGF-1) may influence this association. No prior work has examined this in mild cognitive impairment (MCI). We predicted that IGF-1 would moderate the relationship between cognition and aerobic endurance improvement, such that greater baseline IGF-1 would accompany a stronger relationship between cognition and aerobic endurance change.

Method:

Twenty-seven individuals with MCI completed assessments of aerobic endurance (2-minute step test [2MST]) and global cognition (Modified Mini-Mental State [3MS]) before and after a 6-month period of twice-weekly exercise. Serum IGF-1 levels were assessed at baseline via fasted blood draw. The Johnson-Neyman technique determined whether baseline IGF-1 levels moderated the relationship between changes in aerobic endurance (Δ2MST) and cognition (Δ3MS).

Results:

A significant interaction was found; however, Δ2MST was inversely associated with Δ3MS in individuals with above-average serum IGF-1 levels; this relationship was strengthened as IGF-1 increased and was not seen when IGF-1 was below average.

Conclusion:

The relationship between cognitive and aerobic endurance change varies as a function of IGF-1 in persons with MCI. Additional work is needed to clarify the mechanisms of these findings.
Measuring Organizational Performance in the Hospital Industry: An Exploratory Comparison of Objective and Subjective Methods
Authors: McCracken Melody Je' , McIlwain Thomas F. , Fottler Myron D.
Published: January 2017

One of the major challenges facing health services management researchers is the measurement of various aspects of organizational performance. This challenge is exacerbated by a reluctance of many healthcare organizations to share data with researchers because of a fear of competitor access to these data. Even where objective, reliable and valid measures of organizational performance are available, typically they are available only in aggregate form, rather than for individual organizations. In response to these constraints, researchers have used subjective measures of performance often based on the perception of key executives. This research compares the subjective perceptions of hospital executives to the objective financial performance data of 60 hospitals. While the correlations between the subjective and objective measures vary, return of assets (ROA) and operating margin are the most valid subjective financial measures of hospital performance. Implications for future research are discussed.