bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cortisol Awakening Response in Bipolar Illness: A Pilot Study
Authors: Deshauer Dorian , Duffy Anne , Alda Martin , Grof Eva , Albuquerque Joy , Grof Paul
Published: January 2017

Objective:

A growing body of data suggests that a significantly enhanced salivary cortisol response to waking may indicate an enduring tendency to abnormal cortisol regulation. Our objective was to apply the response test to a population already known to have long-term hypothalamo-pituitary-adrenocortical (HPA) axis dysregulation. We hypothesized that the free cortisol response to waking, believed to be genetically influenced, would be elevated in a significant percentage of cases, regardless of the afternoon Dexamethasone Suppression Test (DST) value.

Method:

Using the free cortisol response to waking and the short daytime profile, we tested 18 clinically stable, lithium-responsive subjects from our long-term naturalistic follow-up of monthly DSTs. These tests include salivary testing every 15 minutes during the first hour of waking, followed by samples taken at 3:00 PM and 8:00 PM.

Results:

While clinically stable on lithium prophylaxis, patients with bipolar disorder (BD) showed a significantly enhanced salivary cortisol response to waking, compared with control subjects ( P < 0.03). Cortisol levels 30 minutes after waking significantly exceeded those in the large normative data provided in the literature ( P < 0.001).

Conclusions:

Our observations support the hypothesis that the free cortisol response to waking can reflect relatively enduring HPA dysregulation, even when lithium-responsive BD patients are clinically well and their DSTs are normal. Because the test is easy to administer, the free cortisol response to waking may hold promise as a marker in studies of high-risk families predisposed to, or at risk for, mood disorders.
Mental Disorders and Reasons for Using Complementary Therapy
Authors: Rickhi Badri , Quan Hude , Moritz Sabine , Stuart Heather L , Arboleda-Flórez Julio
Published: January 2017

Objective:

To compare patients with and without mental disorders who seek services from a complementary therapy practitioner with regard to quality of life, reasons for seeking complementary therapies, complaints, and physical conditions.

Method:

We studied new patients who attended a complementary therapy clinic offering acupuncture treatment between July 1, 1993, and March 31, 1995. We collected data from a self-administered questionnaire and from a physician-conducted psychiatric assessment.

Results:

Of the 826 new patients at the clinic, 578 (70%) presented with a mental disorder. Patients with a mental disorder perceived their quality of life as poorer and reported greater levels of stress than did those without a mental disorder. However, the groups did not differ in their self-reported reasons for seeking complementary therapies, in their complaints, or in their physical conditions. Among patients with a mental disorder, the major reasons for choosing complementary therapies were personal preference, interest, or belief in complementary therapies (44.3%) and perceiving complementary therapies as a last resort (30.7%). Most patients with a mental disorder saw a complementary practitioner for musculoskeletal and connective-tissue disorders (44.1%), fatigue (26.6%), and headache (15.2%). The most frequent physical illnesses among patients with a mental disorder were diseases of the musculoskeletal system and connective tissue (42.6%).

Conclusion:

Like their counterparts without a mental disorder, individuals with a mental disorder use complementary therapies because of personal beliefs. The wide use of complementary therapies among individuals with a mental disorder may be ascribed to a poor quality of life and high levels of distress.
Readiness to Participate in Psychiatric Research
Authors: Zullino Daniele , Conus Philippe , Borgeat François , Bonsack Charles
Published: January 2017

Background:

The feasibility of clinical trials depends, among other factors, on the number of eligible patients, the recruitment process, and the readiness of patients to participate in research. Seeking patients' views about their experience in research projects may allow investigators to develop more effective recruitment and retention strategies.

Methods:

A total of 100 patients consecutively admitted to a psychiatric university hospital were interviewed with respect to their willingness to participate in a study. For a different study scenario, patients were asked whether they would be ready to participate if such a study were organized in the service and to indicate their reasons for refusing or for participating.

Results:

The general readiness to participate in a study ranged between 70% and 96%. The prospect of remuneration did not notably augment the potential consent rate. The most common and spontaneous motivation for agreeing to take part in a study was to help science progress and to allow future patients to benefit from improved diagnosis and treatment (87%). The presence or lack of a financial incentive was rarely chosen as an argument to agree (23%) or to refuse (7%) to participate. Patients relied mainly on their treating physicians when contemplating possible participation in a study (family physician [65%] and hospital physician [54%]).

Conclusions:

Clinicians and, in particular, treating doctors can play an important role in facilitating the recruitment process.
Determinants of the Public's Preference for Social Distance from People with Schizophrenia
Authors: Angermeyer Matthias C , Beck Michael , Matschinger Herbert
Published: January 2017

Objective:

To examine the extent to which the public's desire for social distance from people with schizophrenia is influenced by beliefs about the disorder and stereotypes about those suffering from it.

Methods:

In spring 2001, we carried out a representative survey of individuals of German nationality aged 18 years and over ( n = 5025). Each subject was given a fully structured interview that began with the presentation of a vignette.

Results:

Both labelling and beliefs about the disorder's causes and prognosis, as well as the perception that those suffering from it are unpredictable and dangerous, had an impact on the public's desire for social distance. However, the latter proved to be more important. As expected, respondents who identified the disorder depicted in the vignette as mental illness, those who blamed the individual for its development, and those who anticipated a poor prognosis expressed a stronger desire for social distance. Endorsing biological factors as a cause was also associated with increased social distance.

Conclusions:

Our findings have important implications for interventions aimed at reducing stigma and discrimination related to schizophrenia. Targeting the stereotype of unpredictability and dangerousness appears to be particularly important.
Addiction: A Disease of Volition Caused by a Cognitive Impairment
Authors: Campbell William G
Published: January 2017

The common etiology of substance and behavioural addictions is one that suggests faulty volition caused by a cognitive impairment. A cognitive impairment that minimizes the recall of the negative effects of the addictive behaviour is viewed as necessary and causal to all addictions. The proposed definition for addiction clarifies the confusion associated with addictive disorders, explains the many variable presentations, and provides an explanation of comorbidity and treatment outcomes. In addition, this paper suggests why this process has not been previously identified.
Association of Substance Abuse and Depression among Adolescent Psychiatric Inpatients
Authors: Danielson Carla Kmett , Overholser James C , Butt Zeeshan A
Published: January 2017

Objective:

To determine whether depression levels differ among suicide-attempting and non–suicide-attempting adolescent inpatients in relation to their alcohol use.

Method:

Ninety-eight adolescents hospitalized at a midwestern psychiatric hospital completed the Children's Depression Inventory and the Rutgers Alcohol Problem-Drinking Index (RAPI). Based on RAPI scores, adolescents were classified as heavy drinkers ( n = 36) or light drinkers and nondrinkers ( n = 62).

Results:

Heavy drinkers had significantly more depression than those who were classified as light drinkers or nondrinkers regardless of suicide-attempting status.

Conclusions:

The results demonstrate a positive association between depression levels and problems with alcohol in adolescents, indicating that youth who both suffer from depression and abuse alcohol may be at higher risk for a suicide attempt.
Lay Beliefs about Treatments for People with Mental Illness and Their Implications for Antistigma Strategies
Authors: Lauber Christoph , Carlos Nordt , Wulf Rössler
Published: January 2017

Objective:

First, to describe factors influencing the public's attitude toward treatment recommendations for people with mental illness; second, to identify coherent belief systems about the helpfulness of specific interventions; and third, to discuss how to ameliorate mental health literacy and antistigma strategies.

Method:

Participants of a representative telephone survey in the general population ( n = 1737) were presented with a vignette depicting a person with either schizophrenia or depression. From a list of suggestions, they were asked to recommend treatments for this person. We used a factor analysis to group these proposals and used the factors as the dependent variables in a multiple regression analysis.

Results:

Treatment suggestions are summarized in 4 groups, each characterizing a specific therapeutic approach: 1) psychopharmacological proposals (that is, psychotropic drugs), 2) therapeutic counselling (from a psychologist or psychiatrist or psychotherapy), 3) alternative suggestions (such as homeopathy), and 4) social advice (for example, from a social worker). Medical treatments were proposed by people who had a higher education, who had a positive attitude toward psychopharmacology, who correctly recognized the person depicted in the vignette as being ill, who were presented with the schizophrenia vignette, who kept social distance, and who had contact with mentally ill people. The variables could explain alternative and social treatment proposals only to a small extent.

Conclusions:

The public's beliefs about treatment for people with mental illness are organized into 4 coherent systems, 2 of which involve evidence-based treatments. Medical treatment proposals are influenced by adequate mental health literacy; however, they are also linked to more social distance toward people with mental illness. Additionally, efforts to better explain nonmedical treatment suggestions are needed. Implications for further antistigma strategies are discussed.
Mental Health Service Use in a Nationally Representative Canadian Survey
Authors: Sareen Jitender , Cox Brian J , Afifi Tracie O , Yu Bo Nancy , Stein Murray B
Published: January 2017

Background:

Previous Canadian surveys have noted a wide range of prevalence rates for mental health service use and found no consistent relation between type of contact with mental health professionals and severity of illness. This study is the first investigation to examine the prevalence and correlates of mental health service use in a nationally representative Canadian survey.

Methods:

The Canadian Community Health Survey Cycle 1.1 was conducted between 2000 and 2001 ( n = 125 493; respondent age 12 years and over; response rate; 84.7%). Respondents were asked whether they had contacted a professional because of emotional symptoms in the past year and about their experience of barriers to treatment. DSM-IV major depression and alcohol dependence diagnoses were assessed with the Composite International Diagnostic Interview Short Form. The relation between a range of measures of clinical severity and the type of professional contacted for emotional symptoms was examined.

Results:

The prevalence of 12-month help seeking for emotional symptoms was 8.3% (99%CI, 8.10 to 8.55); an additional 0.6% (99%CI, 0.49 to 0.62) of the sample perceived a need for treatment without seeking care. Respondents endorsing contact with multiple professionals or with psychiatrists only had higher levels of severity than those who had contact with family doctors only or nonphysician professionals only.

Conclusions:

Although untreated depression remains a significant problem in Canada, more severe illness was more likely to be associated with seeing a psychiatrist (or multiple professionals), indicating a relation between greater severity of mental illness and receiving more specialized care.
The Relation between Childhood Adverse Experiences and Disability Due to Mental Health Problems in a Community Sample of Women
Authors: Tonmyr Lil , Jamieson Ellen , Mery Leslie S , MacMillan Harriet L
Published: January 2017

Objective:

The objective of this study was to examine the association between selected childhood adverse experiences and disability due to mental health problems in a community sample of women. Variables of interest included childhood physical and sexual abuse, parental psychiatric and substance abuse history, and sociodemographic factors.

Method:

Girls and women (aged 15 to 64 years) from a province-wide community sample ( n = 4239) were asked about disability and most childhood adverse experiences through interview; a self-administered questionnaire inquired about child abuse. Logistic regression (crude and adjusted odds ratios) was used to test the associations between childhood adversity and disability due to mental health problems.

Results:

Approximately 3% of the women had a disability due to mental health problems. Among women with a disability, about 50% had been abused while growing up. After controlling for income and age, we found that disability showed the strongest association with childhood sexual abuse, physical abuse, and parental psychiatric disorder.

Conclusion:

Disability due to mental health problems was experienced by women with and without exposure to abuse in childhood. However, childhood sexual abuse and physical abuse were important correlates of disability. Disability creates suffering and loss for the individual and society; this issue merits more research in relation to child abuse.
The Child Behavior Checklist Together with the ADHD Rating Scale Can Diagnose ADHD in Korean Community-Based Samples
Authors: Kim Jae-Won , Park Ki-Hong , Cheon Keun-Ah , Kim Boong-Nyun , Cho Soo-Churl , Hong Kang-E Michael
Published: January 2017

Objective:

The purpose of this study was to examine the clinical validities and efficiencies of the Child Behavior Checklist (CBCL) and the ADHD Rating Scale-IV (ARS) in identifying children with attention-deficit hyperactivity disorder (ADHD) in Korean community-based samples.

Method:

A large sample of elementary school students ( n = 1668) participated in this study. We used the CBCL and the ARS as the screening instruments. Diagnoses were determined by clinical psychiatric interviews and confirmed by DSM-IV–based structured interviews.

Results:

Of the 46 subjects who underwent clinical psychiatric interviews, 33 were diagnosed as having ADHD. A T score of 60 with regard to the Attention Problems profile of the CBCL resulted in a reasonable level of sensitivity or positive predictive value in the diagnosis of ADHD. In both the parent and teacher reports of the ARS, 90th percentile cut-off points resulted in a high level of predictive value. The highest levels of specificity and positive predictive value were obtained when we combined the CBCL ( T ≥ 60 in Attention Problems) and the ARS (parent–teacher total ≥ 90th percentile) reports.

Conclusions:

These findings suggest that the combined use of the CBCL and the ARS could serve as a rapid and useful clinical method of predicting or even diagnosing children with ADHD in epidemiologic case definitions.
Community Survey of Bipolar Disorder in Canada: Lifetime Prevalence and Illness Characteristics
Authors: Schaffer Ayal , Cairney John , Cheung Amy , Veldhuizen Scott , Levitt Anthony
Published: January 2017

Objective:

This study reports on the lifetime prevalence and illness characteristics of bipolar disorder (BD) in a large, representative sample of Canadians.

Method:

Data were obtained from the Canadian Community Health Survey: Mental Health and Well-Being. This representative, cross-sectional survey, conducted by Statistics Canada in 2002, examines the mental health of Canadians aged 15 years and over. The national response rate was 77%. We determined the prevalence rate of BD, correlates of a bipolar diagnosis, and illness characteristics.

Results:

The weighted lifetime prevalence rate of BD was 2.2% (95% confidence interval [CI], 1.94% to 2.37%). Younger age, low income adequacy, lifetime anxiety disorder, and presence of a substance use disorder in the past 12 months were each significantly associated with the presence of a BD diagnosis ( P < 0.001 for each). The largest effect found was for the presence of an anxiety disorder (odds ratio 7.94; 95%CI, 6.35 to 9.92). A lifetime history of anxiety disorder was reported by 51.8% (95%CI, 47.1% to 56.5%) of the respondents with BD, with both panic disorder and agoraphobia each being more frequent among women, compared with men ( P = 0.01 and P < 0.001, respectively). The mean age at onset of illness was 22.5 years, SD 12.0.

Conclusions:

According to the estimated lifetime prevalence of BD found in this study, over 500 000 Canadians likely suffer from this condition. Identifying those at highest risk for BD may assist in developing more effective community-based identification and intervention strategies.
Suicidality, Depression, and Mental Health Service Use in Canada
Authors: Rhodes Anne E , Bethell Jennifer , Bondy Susan J
Published: January 2017

Objective:

To determine the magnitude of depression and suicidal populations, the overlap between these populations, and the associated patterns of mental health service use.

Method:

We examined depression, suicidality (ideation and nonfatal behaviours), and the mental health service use of participants in the Canadian Community Health Survey Cycle 1.2: Mental Health and Well-Being. The sample comprised 36 984 household members aged 15 years or over.

Results:

Approximately 4% to 5% of the population suffered from a major depression or suicidality. About 2 of 3 of those who were suicidal did not suffer from depression, and over 70% of those with depression did not report suicidality. Persons with depression and suicidality or depression (but no suicidality) were the 2 groups most likely to report ambulatory mental health contacts, and the provider groups contacted most often included physicians. The use of provider groups was considerably lower for those who were suicidal (but had no depression). Whereas the latter were more likely to report contacts than not, suicidality, in and of itself, did not exert a strong effect on contact with any particular provider group. For those who were suicidal (but who had no depression), less than 1 in 3 reported any mental health service contact, including an inpatient mental health stay.

Conclusions:

The lack of contact by those who are suicidal (but who have no depression) is provocative, given that almost 2 of 3 of the suicidal subjects had no depression. Detrimental outcomes such as depression may develop without effective early interventions and uptake by a sufficient supply of appropriately trained and financially accessible personnel.
Building a Better Model: An Introduction to Structural Equation Modelling
Authors: Streiner David L
Published: January 2017

Confirmatory factor analysis (CFA) and structural equation modelling (SEM) are powerful extensions of path analysis, which was described in a previous article in this series. CFA differs from the more traditional exploratory factor analysis in that the relations among the variables are specified a priori, which permits more powerful tests of construct validity for scales. It can also be used to compare different versions of a scale (for example, English and French) and to determine whether the scale performs equivalently in different groups (for example, men and women). SEM expands on path analysis by allowing paths to be drawn between latent variables (which, in other techniques, are called factors or hypothetical constructs), that is, variables that are not seen directly but, rather, through their effect on observable variables, such as questionnaires and behavioural measures. Each latent variable and its associated measured variables form small CFAs, with the added advantage that the correlations among the variables can be corrected for the unreliability of the measures.
The Relation between Body Mass Index, Mental Health, and Functional Disability: A European Population Perspective
Authors: Bruffaerts Ronny , Demyttenaere Koen , Vilagut Gemma , Martinez Montserat , Bonnewyn Anke , De Graaf Ron , Haro Josep Maria , Bernert Sebastian , Angermeyer Matthias C , Brugha Traolach , Roick Christine , Alonso Jordi
Published: January 2017

Objective:

To examine the association between body mass, mental disorders, and functional disability in the general population of 6 European countries.

Method:

Data ( n = 21 425) were derived from the European Study on the Epidemiology of Mental Disorders (ESEMeD). The third version of the Composite International Diagnostic Interview was administered to assess mental disorders (mood, anxiety, and alcohol disorders) according to the Diagnostic Statistical Manual of Mental Disorders-fourth edition, body mass index (BMI) (kg/m2, based on self-reported height and weight), and functional disability in the previous 30 days, assessed with the World Health Organization Disablement Assessment Scale—second version.

Results:

About 3% of the respondents were underweight (BMI < 18.5 kg/m2), 53% had normal weight (BMI 18.5 to 24.9 kg/m2), 33% were overweight (BMI 25 to 29.9 kg/m2), and the remaining 12% met criteria for obesity (BMI > 30.0 kg/m2). Compared with individuals of normal weight, obese individuals were more likely to have mood (OR 1.3; 95%CI, 1.0 to 1.8) or more than one mental disorder (OR 1.4; 95%CI, 1.0 to 2.2). BMI had no impact on work loss days, whereas mental disorders had a considerable effect on work loss days.

Conclusions:

This is the first cross-national study investigating the role between BMI, mental disorders, and functional disability in the general population. Being overweight or obese is a common condition in the 6 ESEMeD countries. Although there is a moderate association between obesity and mental disorders, BMI did not independently influence functional disability.
Relation between Traumatic Events and Suicide Attempts in Canadian Military Personnel
Authors: Belik Shay-Lee , Stein Murray B , Asmundson Gordon JG , Sareen Jitender
Published: January 2017

Objective:

To determine whether exposure to particular types of traumatic events was differentially associated with suicide attempts in a representative sample of active military personnel.

Method:

Data came from the Canadian Community Health Survey: Mental Health and Well-Being Canadian Forces Supplement (CCHS-CFS), a cross-sectional survey that provided a comprehensive examination of mental disorders, health, and the well-being of currently active Canadian military personnel ( n = 8441; aged 16 to 54 years; response rate 81.1%). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicide attempts were measured using a question about whether the person ever “attempted suicide or tried to take [his or her] own life.”

Results:

The prevalence of lifetime suicide attempts for currently active Canadian military men and women was 2.2% and 5.6%, respectively. Sexual and other interpersonal traumas (for example, rape, sexual assault, spousal abuse, child abuse) were significantly associated with suicide attempts in both men (adjusted odds ratios [AORs] ranging from 2.31 to 4.43) and women (AORs ranging from 1.73 to 3.71), even after adjusting for sociodemographics and mental disorders. Additionally, the number of traumatic events experienced was positively associated with increased risk of suicide attempts, indicating a dose–response effect of exposure to trauma.

Conclusions:

The current study is the first to demonstrate that sexual and other interpersonal traumatic events are associated with suicide attempts in a representative sample of active Canadian military men and women.
Panic Attacks and Their Relation to Psychological and Physical Functioning in Canadians: Results from a Nationally Representative Sample
Authors: Kinley D Jolene , Cox Brian J , Clara Ian , Goodwin Renee D , Sareen Jitender
Published: January 2017

Objective:

US-based studies have suggested that panic attacks (PA) are common and associated with an increased prevalence of mental disorders and poorer quality of life, and may be a marker of severe psychopathology. Using a population-based survey with a greater sample size than has been previously used, we sought to determine the prevalence rates and correlates of PAs among Canadians aged 15 years and older.

Method:

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition classification was used to determine the past-year prevalence of PAs in the Canadian Community Health Survey: Mental Health and Well-Being ( n = 36 984, aged 15 and older, response rate = 77%). Psychological and physical function variables were compared among people with PAs, with panic disorder (PD), and without PAs.

Results:

The prevalence of past-year PAs was 6.4%. Compared to people without PAs, those with PAs had poorer overall functioning for disability, mental disorders, suicidal ideation, psychological distress, restriction of activity, chronic physical conditions, psychological well-being, and self-rated physical and mental health. PD was associated with poorer overall functioning than PAs for numerous variables; however, there were no significant differences between these 2 panic groups for several other variables.

Conclusions:

Though associated with less severe impairment than PD in some domains, PAs are associated with mental health problems and reduced overall psychological and physical functioning and may be an indicator of more severe psychopathology.
A Systematic Review of Cognitive Deficits in Homeless Adults: Implications for Service Delivery
Authors: Burra Tara A , Stergiopoulos Vicky , Rourke Sean B
Published: January 2017

Objective:

The primary goals of this systematic review were to assess studies of homeless adults and cognitive functioning, and to explore the clinical implications and potential impacts on social functioning of these cognitive deficits.

Method:

The MEDLINE, CINAHL, EMBASE, PsycINFO, Applied Social Sciences Index and Abstracts, ERIC, Social Sciences Abstracts, Social Sciences Citation Index, Social Services Abstracts, and Sociological Abstracts databases were searched from 1970 (or their inception) to October 2007. Abstracts from 582 studies were screened and 22 studies were found to meet inclusion criteria (published in the English language, reported results of neuropsychological tests, or screening tests for cognitive dysfunction in homeless people aged 18 years or older). Two investigators independently reviewed each study and rated its quality based on well-defined criteria.

Results:

Ten studies were of good or fair quality. Studies that administered the Mini Mental State Examination indicate about 4% to 7% of homeless people exhibit global cognitive deficits. Focal deficits in verbal and visual memory, attention, speed of cognitive processing, and executive function were also apparent. No studies of the functional implications of cognitive deficits were found.

Conclusions:

Cognitive deficits in homeless people likely have a significant mediating impact on the effectiveness of skills training and rehabilitation programs. Clinicians should be cognizant that cognitive deficits probably impair homeless patients' ability to maintain housing stability and follow treatment recommendations. Implications for housing options and health service delivery should also be considered. Research is lacking on interventions to improve cognitive functioning in the homeless.
Dimensions of Personality: Clinicians' Perspectives
Authors: Mullins-Sweatt Stephanie N , Smit Vera , Verheul Roel , Oldham John , Widiger Thomas A
Published: January 2017

Objective:

To obtain the opinions and preferences of practising clinicians about the clinical utility of personality scales included within 8 alternative dimensional models of personality disorder for inclusion within an official diagnostic nomenclature.

Method:

Psychiatrists ( n = 226) and psychologists ( n = 164) from 2 continents provided clinical utility ratings on personality scales organized from 8 alternative dimensional models of personality disorder.

Results:

The psychiatrists and the psychologists supported the inclusion of most of the scales from all 8 of the models that were compared. Normal personality traits were endorsed, although abnormal personality traits generally received higher levels of endorsement. The list of endorsed traits was reduced further by organizing the scales into groups based on redundancy within each of 5 broad domains and then selecting within each group the scale that received the highest rating.

Conclusions:

This list appears to represent each domain in a manner that is comprehensive both in its coverage of the respective domain, as well as in representing particular strengths of each of the alternative dimensional models, at least for the stated preferences of psychiatrists and psychologists.
Psychiatric Disorders in the Elderly
Authors: Skoog Ingmar
Published: January 2017

Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality.
Les complications obstétricales et les comportements d'agression physique avant l'âge de 2 ans
Authors: Baillargeon Raymond H , Thibodeau Élise , Lefebvre Francine , Jeyaganth Suganthiny
Published: January 2017

Objectif:

Déterminer si les nourrissons qui ont souffert de complications obstétricales (CO) ont davantage tendance à manifester de façon fréquente des comportements d'agression physique avant l'âge de 2 ans et cela, indépendamment ou non du sexe du nourrisson et du revenu familial. Un autre objectif était d'expliquer, du moins en partie, les différences sexuelles qu'on retrouve dans certains de ces comportements à l'aide des CO.

Méthode:

Les données provenaient de l'Étude longitudinale du développement des enfants du Québec. Les CO ont été mesurées par les scores d'Apgar (< 7) à 1 minute après la naissance. Le niveau de suffisance du revenu familial — suffisant ou non — a été mesuré quand l'enfant avait environ 5 mois. Douze comportements d'agression physique, d'opposition-défiance et d'hyperactivité ont été mesurés quand les enfants avaient environ 17 mois. Les données pondérées ont été analysées à partir de modèles log-linéaires hiérarchiques.

Résultats:

Les résultats suggèrent que les nourrissons qui présentent un Apgar inférieur à 7 après la naissance sont en général plus susceptibles de manifester de façon fréquente certains comportements agressifs à 17 mois, et cela, indépendamment du sexe du nourrisson et du revenu familial. De plus, ces résultats suggèrent qu'il est possible d'expliquer la propension plus marquée des garçons à manifester de façon fréquente certains comportements agressifs à 17 mois à l'aide des CO.

Conclusions:

Contrairement à certaines hypothèses, il s'avère qu'indépendamment du statut socio-économique, les CO ont un effet sur les comportements agressifs avant l'âge de 2 ans.
Changes in Treated Incidence of Borderline Personality Disorder in Denmark: 1970–2009
Authors: Clemmensen Lene Maria Ørts , Jensen Signe Olrik Wallenstein , Zanarini Mary C , Skadhede Søren , Munk-Jørgensen Povl
Published: January 2017

Objectives:

To investigate whether there are any trends in treated incidence of borderline personality disorder (BPD) in Danish psychiatric hospitals based on different diagnostic systems from 1970 to 2009.

Methods:

All patients diagnosed with BPD for the first time as a main or an auxiliary diagnosis treated in in- or outpatient facilities in Danish psychiatric hospitals were identified through the Danish Psychiatric Central Research Register. Age-standardized, sex-specific, and standardized rates were calculated for the International Classification of Diseases (ICD), Eighth Revision, diagnostic period from 1970 to 1993 and the ICD-10 diagnostic period from 1994 to 2009.

Results:

The incidence for BPD in females as a main or an auxiliary diagnosis increased linearly from 1970 to 2009 (β = 0.69 per 100 000 per year [95% CI 0.66 to 0.73]). The rates for males also increased linearly from 1970 to 1993 (β = 0.37 [95% CI 0.30 to 0.43]) followed by a linearly decrease (β = −0.22 [95% CI −0.29 to −0.15]) in the ICD-10 period from 1994 to 2009. The increase in females with BPD after the mid-1990s is smaller when controlling for outpatients mandatorily registered from 1995.

Conclusion:

The lack of defined criteria for BPD in ICD-8 may have been interpreted broadly to mean Kernberg's overarching concept of borderline personality organization, resulting in similar rates for males and females. However, in ICD-10, clinicians using the more narrow criteria for emotionally unstable personality disorder (borderline type), tended to diagnose BPD more commonly in women. These results suggest the importance of using specific criteria in diagnosing. They also suggest the importance of stability in the diagnostic criteria for BPD and other disorders. Changements de l'incidence traitée du trouble de la personnalité limite au Danemark: 1970–2009
Profiles of Patients Admitted to a Psychiatric Intensive Care Unit: Secluded with or without Restraint
Authors: Goulet Marie-Hélène , Larue Caroline , Stafford Marie-Christine , Dumais Alexandre
Published: January 2017

Objective:

To identify and describe the profiles of patients admitted to a psychiatric intensive care unit (PICU) as they relate to seclusion and restraint.

Method:

Multiple correspondence analysis (MCA) and cluster analysis were performed with data for 114 patients admitted to a PICU from June 8, 2010, to June 7, 2011.

Results:

The MCA revealed that the presence or absence of seclusion and restraint was the main factor explaining the variance. Admitted patients fall into 5 profiles, 2 of which are significantly associated with seclusion and restraint: young psychotic men and women with bipolar disorder.

Conclusions:

The differentiation of patient profiles as they relate to seclusion and restraint should lead to the development of profile-specific interventions before, during, and after seclusion and restraint.
Validation of a French Version of the Dissociative Experiences Scale in a Rape-Victim Population
Authors: Darves-Bornoz Jean-Michel , Degiovanni Andrée , Gaillard Philippe
Published: January 2017

Objective:

To appreciate the extent and the features of dissociation in a hypothesized highly dissociated population, rape trauma victims, while assessing construct validity and internal consistency of a French version of the Dissociative Experiences Scale (DES), a simple screening instrument for dissociative symptoms.

Methods:

One hundred and forty rape victims (mean age 23. 6 years, 9% male) consecutively attending a Consultation for Victims of Psychological Trauma at the university hospital in Tours, France, were assessed through a French version of the 28-item self-rated DES.

Results:

The mean score (24.1) was high, and 33% of the scores exceeded a threshold set at 30. The Principal Components Analysis of the DES ratings yielded a 3-factor solution: depersonalization-derealization, amnestic fragmentation of identity, and absorption-imaginative involvement. DES reliability was studied through computation of Cronbach 's α coefficient (0.94).

Conclusion:

During validation of a French version of the DES, the study showed that dissociation is considerably linked to rape-trauma victim populations.
Calcium Channel Blockers in Psychiatric Disorders: A Review of the Literature
Authors: Hollister Leo E , Trevino Enrique Sergio Garza
Published: January 2017

Objectives:

To review the published literature of the past 15 years regarding use of calcium channel blockers (CCBs) in psychiatric practice. These drugs, especially verapamil, have been recommended as possible treatments for mania and other disorders.

Methods:

The Cumulative Medical Index and other databases were searched and back-tracked to locate relevant articles. Sixty-one such articles were uncovered: 37 anecdotal reports, 7 partially controlled reports, and 17 controlled trials.

Results:

Most studies involved treatment of mania using verapamil. Although anecdotal reports were generally favourable, results from partially controlled reports or controlled clinical trials were mixed. Generally, verapamil was less effective than was lithium or placebo. Treatment of depression with CCBs was not very successful, regardless of the type of trial; the best trial was negative. The same was true for the treatment of schizophrenia, although the cases studied were extremely chronic and treatment-resistant. Evidence for efficacy in other illnesses, such as Alzheimer's disease or tardive dyskinesia was scanty but suggested that further trials might be in order.

Conclusions:

CCBs do not at present have an established place in psychiatric treatment. Nonetheless, clinicians faced with a manic patient not responsive to other antimanic drugs, either alone or in combination, might consider adding verapamil as an adjunct. A study bearing on this specific issue is needed to determine whether or not such off-label use would really be justified.
Suicide in the Montreal Subway System: Characteristics of the Victims, Antecedents, and Implications for Prevention
Authors: Mishara Brian L
Published: January 2017

Objective:

To understand the characteristics of persons who commit suicide in the Montreal subway system (the Montreal Metro), their personal and psychiatric histories, and the nature of the event in order to develop better prevention strategies.

Method:

Systematic analysis of coroner's office investigations of the 129 suicides in the Montreal Metro from 1986 to 1996.

Results:

Of the 129 people who committed suicide, 81% had expressed a prior suicidal intention, 66% had previously attempted suicide, and 9% had attempted suicide in the metro. One hundred and five of the victims had serious mental health problems, most frequently depression; 73% had had inpatient psychiatric treatment, and at the time of death, 27% resided in a mental health treatment institution. Recent adverse life events included failed relationships, work problems, and family difficulties.

Conclusions:

Suicide victims intentionally go to the metro to kill themselves, often tell others beforehand, and are generally in treatment for serious psychiatric problems. Possible prevention strategies include modification of the environment and procedures in the metro, changing public conceptions of metro suicides, and modifying practice in psychiatric facilities.
From Psychological Theory to Practice: Improving Frail Elders' Quality of Life Through Control-Enhancing Interventions
Authors: Teitelman Jodi L. , Priddy J. Michael
Published: January 2017

We explore ways in which psychological control theory can be applied with frail elders in long-term care, particularly those in institutional settings. We review the importance of perceived control in the maintenance of physical and psychological well-being, with particular emphasis on the frail elderly population. Several recommendations for enhancing clients' perceptions of control in long-term care service provision settings are discussed: (1) promoting choice and predictability, (2) eliminating helplessness-engendering stereotypes, (3) promoting positive attributions and a sense of responsibility, (4) providing early success experiences, (5) modifying unrealistic goals, and (6) using control-enhancing communication skills. We also address considerations and caveats for implementing control-enhancing interventions in the long-term care facility, as identified by prior research.
Quality of Life: The Institutional Culture Defined by Administrative and Resident Values
Authors: Grossman Helene D. , Weiner Audrey S.
Published: January 2017

As the graying population, increasing costs, and public regulation place new demands on the institutional long-term care setting, administrators face a major challenge in ensuring quality of care and of life. Quality of life in long-term care has been defined by the subjective importance and perceived availability of autonomy, interpersonal relations, and security. Quality of care is the effective provision of health care resources in appropriate quantity and duration to respond to actual need. As such, it is but one, albeit essential, component of quality of life in the nursing home. These two concepts are based on somewhat different underlying values that create different criteria for decision making. We use the experience of one urban 1, 100-bed multilevel nursing home to illustrate how a multifaceted quality-assurance program including resident input can be developed and implemented using quality of life standards to define and evaluate institutional culture and practices. Mechanisms for monitoring quality of life include a quality-assurance department, grievance/complaint procedures, resident government, staff committees, structured rounds, and educational programs. Examples illustrate how an emphasis on quality of life and of care can result in institutional conflict and how such conflicts can be reconciled.
Pneumonia in the Intensive Care Unit Setting
Authors: Gleeson Kevin , Reynolds Herbert Y.
Published: January 2017

Nosocomial pneumonia is a common and serious occurrence in the ICU. It most often results from aspiration of oropharyngeal secretions that have become colonized with pathogenic enteric gram-negative bacilli. Colonization occurs in association with acute and chronic illness and particularly with therapy that includes nasogastric or endotracheal tubes, H2 blocking antacid drugs, or antibiotics; aspiration is increased by anesthesia, sedative drugs, and upper airway instrumentation. The diagnosis of ICU-acquired pneumonia is complicated greatly by the nonspecificity of clinical and laboratory data, and the difficulty in distinguishing the organisms producing infection from those merely colonizing the airway when using routine culture techniques. Among specialized diagnostic techniques, quantitative culture of specimens obtained with the protected sampling brush offers the most promise in establishing a specific microbacteriologic diagnosis of nosocomial pneumonia. Empirical treatment with broad spectrum antibiotics is frequently necessary when a specific diagnosis cannot be made. The poor outcome associated with nosocomial pneumonia, regardless of treatment, suggests that methods to prevent dissemination and oropharyngeal colonization of the offending organisms should be emphasized.
Regional Metabolic Supply Dependency in Chronic Congestive Heart Failure
Authors: Ross David J. , Williams Adrian J. , Mandelkern Mark , Gee Manyee , Mohsenifar Zab
Published: January 2017

We present a 64-year-old man with New York Heart Association (NYHA) Class III chronic congestive heart failure (CHF) who was examined for an alteration in cerebral cortex regional oxygen utilization as reflected by changes in local cerebral metabolic rates for glucose (LCMRglu). LCMRglu was determined by positron emission tomography at baseline and while oxygen delivery (DO2) was optimized during dobutamine infusion. Baseline DO2 was 8.31 mL/min/kg and cardiac output (CO) was 3.4 L/min, whereas oxygen consumption (VO2) measured by respired gas analysis was 3.64 mL/min/kg. At optimal dobutamine effect (7.5 μg/kg/min), DO2 increased to 16.8 mL/min/kg, CO to 7.2 L/min, and VO2MEAS was 3.67 mL/min/kg. Mean percentage Increase in cortical gray matter LCMRglu was 99.4 ± 11.7% (mean ± SD) and was statistically significant ( p < 0.001; Student's paired t-test). Our results demonstrate that the cerebral glucose utilization and therefore oxygen consumption increased parallel with Increases in DO2. This phenomenon is contrary to the conventional concept that cerebral perfusion is strictly autoregulated and that substrate utilization is independent of oxygen delivery.
Measuring the Processes of Change From the Transtheoretical Model for Physical Activity and Exercise in Overweight and Obese Adults
Authors: Romain Ahmed Jerôme , Bernard Paquito , Hokayem Marie , Gernigon Christophe , Avignon Antoine
Published: January 2017

Purpose:

This study aimed to test three factorial structures conceptualizing the processes of change (POC) from the transtheoretical model and to examine the relationships between the POC and stages of change (SOC) among overweight and obese adults.

Design:

Cross-sectional study.

Setting:

This study was conducted at the University Hospital of Montpellier, France.

Subjects:

A sample of 289 overweight or obese participants (199 women) was enrolled in the study.

Measures:

Participants completed the POC and SOC questionnaires during a 5-day hospitalization for weight management.

Analysis:

Structural equation modeling was used to compare the different factorial structures.

Results:

The unweighted least-squares method was used to identify the best-fit indices for the five fully correlated model (goodness-of-fit statistic = .96; adjusted goodness-of-fit statistic = .95; standardized root mean residual = .062; normed-fit index = .95; parsimonious normed-fit index = .83; parsimonious goodness-of-fit statistic = .78). The multivariate analysis of variance was significant ( p < .001). A post hoc test showed that individuals in advanced SOC used more of both experiential and behavioral POC than those in preaction stages, with effect sizes ranging from .06 to .29.

Conclusion:

This study supports the validity of the factorial structure of POC concerning physical activity and confirms the assumption that, in this context, people with excess weight use both experiential and behavioral processes. These preliminary results should be confirmed in a longitudinal study.