bluuebunny/crossref_metadata_2025 huggingface dataset:
Long Term Outcome of an Attachment-Based Program for Conduct Disorder
Authors: Moretti Marlene M. , Holland Roy , Peterson Sherri
Published: April 2017

There is increasing concern among professionals and the public about the level of violence and antisocial behaviour among our youth. This has been coupled with confusion and a sense of helplessness about which types of interventions are most effective in responding to these difficulties. Some professionals and advocacy groups are calling for tougher disciplinary responses to violence and antisocial behaviour, including changes in the Young Offenders Act Yet, such interventions are rarely effective in producing the desired reductions in these behaviours. Other professionals have called for better forms of treatment. However, few treatments have been shown to be effective in bringing about long term reductions either in aggressive behaviour or in the concomitant psychological difficulties experienced by these youths. In this paper, a description is presented of an approach to understanding conduct disorder that focuses on attachment as an organizing principle of behaviour and affect. Also, a description is presented of a community-oriented program that is based on attachment theory, as well as the results of the program evaluation at six, 12 and 18 months following discharge. The findings replicate and extend earlier findings reported by Holland et al (1) on the effectiveness of this approach.
Agenesis of Corpus Callosum and Dementia of the Alzheimer'S Type: a review and Case Report
Authors: Rasgon Natalie , Ananth Jambur , Mena Ismael , Krout Boyd , Boone Kyle
Published: April 2017

This paper describes a previously sufficiently functioning 57 year old man who presented with a recent onset of frontal behaviour. Partial agenesis of corpus callosum was an incidental finding on a computerized tomography scan. The EEG was within normal limits and neuropsychological testing did not reveal any interhemispheric disconnection. A SPECT-Scan revealed bilateral hypoperfusion, consistent with Alzheimer's dementia. Normal functioning up to 50 years of age and a later manifestation of Alzheimer's disease along with agenesis of carpus callosum is of clinical interest as such an association has not been published.
Multiple Personality: a Psychiatric Misadventure
Authors: Seltzer Allan
Published: April 2017

Though multiple personality disorder has been diagnosed with increasing frequency over the past decade, its validity has been called into question. A brief review of the literature indicates a likelihood of socio-cultural influences and iatrogenicity in many if not most cases. Symptoms of multiple personality disorder parallel other psychiatric syndromes but are usually given diagnostic priority. The author has described five cases diagnosed multiple personality disorder by another health professional in which iatrogenic influences are clearly evident. All renounced both the diagnosis and the alleged sex abuse etiology. The patients possess insight into the role their attachment and dependency on their former therapist played in the development of their apparent multiple personality disorder.
Psychiatrists' Ratings of Expressed Emotion
Authors: King Suzanne , Lesage Alain D. , Lalonde Pierre
Published: April 2017

The purpose of this study was to determine the extent to which psychiatrists are familiar with the concept of expressed emotion and to determine the extent of its use in their day-to-day practices. We also wished to test the ability of psychiatrists to estimate the expressed emotion status of the relatives of their patients. Following the assessment of expressed emotion in 96 relatives using the Camberwell Family Interview, the psychiatrists treating the schizophrenic patients were surveyed about their knowledge of expressed emotion and were asked to estimate the expressed emotion of their relatives. Thirty-five percent of the respondents use the expressed emotion concept daily in their practice. When the Camberwell Family Interview ratings of expressed emotion were compared with those from the psychiatrists, the agreement rate was no better than chance (45.7%). Without formal training in the use of the Camberwell Family Interview, practitioners are cautioned against ascribing an expressed emotion status to the relatives of their patients.
Psychoimmunologie Et Sida: Une Revue De La Littérature
Authors: Montagne Gérard , Lauonde Richard , Brouiulette Marie-Josée
Published: April 2017

In recent years, several studies have been carried out concerning the effect of psychosocial factors on the course of infection due to the human immunodeficiency virus (HIV). After summarizing the current status of general knowledge in the field of psychoimmunology, this article reviews the results of studies conducted in regard to HIV. Two conclusions are reached. The first is that current research has not shown psychosocial factors to have any impact on either the immunity status of seropositive patients or the medical complications inherent to AIDS. The second conclusion is that several types of intervention, in particular psychoeducational approaches, stress management programs, and the strengthening of social and family support, give good results where the psychosocial well-being of patients is concerned and should motivate various health professionals to improve the focus of their interventions. Furthermore, significant methodological weaknesses in several indexed studies are noted, and these should be rectified to enable future studies to confirm or correct the present observations.
Severity as a Diagnostic Dimension of Borderline Personality Disorder
Authors: Marziali Elsa , Munroe-Blum Heather , Links Paul
Published: April 2017

The purpose of this study was to identify diagnostic and severity subgroups within a cohort of patients with borderline personality disorder (BPD). Of 171 patients clinically diagnosed with BPD, 132 were Diagnostic Interview for Borderlines (DIB) positive. Through a process of random selection, 41 of the DIB positive subjects were also interviewed with the revised version of the DIB (DIBR) and approximately one half with two semi-structured research interviews, the Schedule for Affective Disorders (SADS) and the Personality Disorder Examination (PDE). All subjects completed four self-report measures of problematic behaviours, symptoms and social adaptation. The analyses included examination of: 1. the correspondence of the BPD diagnosis across the DIB, the DIBR and the PDE; 2. the association between DIBR scoring levels and scores on measures of symptoms and behavioural status; and 3. the co-occurrence of BPD with Axis I and other Axis II disorders. Correlations and analyses of variance between both the DIB and DIBR scoring levels and the scores on the four symptom and behavioural measures showed that the scoring levels (DIB 7 to 10; DIBR 8 to 10) could be used to distinguish three subgroups of BPD. The three groups differed in terms of concordance for BPD with the PDE and in terms of patterns of overlap with DSM-III-R, Axis I and other Axis II disorders. This study shows that BPD subgroups can be located on a continuum of symptomatic and behavioural severity and that each subgroup has a specific pattern of overlap with Axis I and other Axis II disorders.
Parasitic Diseases and Psychiatric Illness*
Authors: Weiss Mitchell G.
Published: April 2017

Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience. Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis. Emotional states may in turn affect the experience of medical illness. Psychiatrically significant features of medical illness are determined both by pathophysiology and by the personal and social context in which they occur. Many factors affect mental health in the tropics where the synergy of infection, emotional strengths, vulnerabilities, social supports and stressors is critical. This review discusses parasitic diseases of psychiatric interest by virtue of their effects on thinking, mood and behaviour; and it distinguishes issues that apply mainly to indigenous populations and visitors to endemic areas. In some paradoxical instances the psychiatric influence of parasitic diseases does not require infection; the review concludes by considering the prime example, delusions of parasitosis, which is a primary psychiatric disorder.
Recent Developments in Geriatric Psychopharmacotherapy
Authors: Flint Alastair J.
Published: April 2017

This paper highlights recent advances in the pharmacological management of geriatric affective disorders and dementia. The current roles of tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) in the treatment of depression in old age are discussed. Recent findings pertaining to continuation and maintenance of antidepressant treatment are also addressed. The treatment of bipolar affective disorder in the elderly has received much less study than has unipolar depression. A number of issues relating to efficacy, side-effects and optimal blood levels of lithium, carbamazepine and valproate in bipolar disorder remain unresolved and await further study. Finally, drug treatment of the cognitive impairment and psychiatric complications of Alzheimer's disease is reviewed.
Integrated Psychotherapy for the Elderly
Authors: Sadavoy Joel
Published: April 2017

The complexity of interacting variables in the geriatric patient imposes the therapeutic necessity to employ all effective therapeutic modalities in an interactive and integrated fashion. This paper examines the efficacy data on brief and longer term therapies as applied to the elderly, most particularly for treatment of depression and bereavement. In determining the development of an integrated psychotherapy treatment plan, the author suggests a decision pathway which incorporates concurrent utilization of theoretical principles derived from psychodynamic, interpersonal and cognitive behavioural theory. This tripartite approach informs the assessment and diagnosis of the patient as well as the specific choice of therapy. Directions for further research are suggested.
An Update on Elder Abuse and Neglect
Authors: Vida Stephen
Published: April 2017

Abuse and neglect of the elderly represent an important social problem in Canada. Forms of elder abuse and neglect include physical, psychological and material abuse; neglect, both intentional and unintentional; and violation of legal rights. The definitions, signs, and symptoms of elder abuse and neglect are discussed, as are estimates of incidence and prevalence, and descriptions of possible risk factors. The evolution of legislation regarding the reporting of elder abuse and neglect is reviewed, as are relevant areas of common law, the Civil Code, and the Criminal Code. This is followed by an overview of practical considerations in clinical management, and finally by recommendations for further research.
Self-Concept and Self-Consciousness in Adults with Tourette Syndrome
Authors: Thibert Anita L. , Day Hy I. , Sandor Paul
Published: April 2017

The hypothesis that adults with Tourette Syndrome (TS) have a lower level of self-concept and a higher level of public self-consciousness and social anxiety than the general population was examined. Ninety-eight suitable adults responded to a letter distributed to the members of the Tourette Syndrome Foundation of Canada. The findings indicated that the group with TS and high obsessive-compulsive symptoms, but not TS alone, had significantly lower self-concepts than the general population. Both males and females with TS and high obsessive-compulsive symptoms scored higher on social anxiety than the general population, but no differences in public self-consciousness were found. The results of this study argue that people with TS alone do not have impaired self-concepts or social anxiety, but both of these disorders tend to be present among those who suffer from both TS and significant obsessive-compulsive symptoms.
Le Rôle du Psychiatre Dans L'Examen De La Qualité
Authors: Reiss Jeffrey P.
Published: April 2017

Document préparé par la Commission des normes professionnelles et de la pratique de l'Association des psychiatres du Canada sous la présidence du Dr Mark Tapper et sanctionné par le Conseil d'administration de l'Association le 9 avril 1994.
Learning how to Differ: Agreement and Reliability Statistics in Psychiatry
Authors: David L. Streiner
Published: April 2017

Whenever two or more raters evaluate a patient or student, it may be necessary to determine the degree to which they assign the same label or rating to the subject. The major problem in deciding which statistic to use is the plethora of different techniques which are available. This paper reviews some of the more commonly used techniques, such as Raw Agreement, Cohen's kappa and weighted kappa, and shows that, in most circumstances, they can all be replaced by the intraclass correlation coefficient (ICC). This paper also shows how the ICC can be used in situations where the other statistics cannot be used and how to select the best subset of raters.
Immigrant and Refugee Children in Canada
Authors: Beiser Morton , Dion Rene , Gotowiec Andrew , Hyman Ilene , Vu Nhi
Published: April 2017

In view of Canada's commitment to immigration, understanding the sources of successful adaptation by immigrant and refugee children is vital. This paper reviews the literature on the mental health of migrant children and suggests an agenda for future research.
Screening for Post-Partum Depression in a Community Sample
Authors: Zelkowitz Phyllis , Tamara H. Milet
Published: April 2017

Objective

This study undertook to estimate the prevalence of post-partum depression in the community by means of telephone screening. Demographic correlates of post-partum depression were also investigated.

Method

The sample was identified through two community health centres. Over a period of 17 months, 1559 childbearing women were screened at six weeks post-partum, using the ten-item Edinburgh Postnatal Depression Scale (EPDS).

Results

The prevalence of post-partum depression was estimated to be 6.2%, using a outpoint of 10 on the EPDS, and 3.4% using the more stringent cut point of 12. Women who were not working, or those with lower occupational status, were at greater risk for depression. Recent immigrants, particularly those who were not working or who had given birth to a second child, were also at higher risk.

Conclusion

Telephone screening for post-partum depression is feasible, and can aid in the identification of women at risk.
Neuroendocrine Assessment of Serotonin (5-HT) Function in Chronic Fatigue Syndrome
Authors: Lakshmi N. Yatham , Rachel L. Morehouse , Terry Chisholm B. , David A. Haase , Dianne D. Macdonald , Thomas J. Marrie
Published: April 2017

Prolactin and Cortisol responses to dl-fenfluramine challenge were examined in 11 patients with chronic fatigue syndrome and in 11 healthy controls who were age and gender matched. After obtaining two baseline samples, each subject was given 60 mg of dl-fenfluramine orally and further blood samples were drawn hourly during the following five hours in order to measure prolactin and Cortisol levels. There was no difference in either baseline or fenfluramine-induced hormonal responses between patients with chronic fatigue syndrome and controls. There was also no correlation between depression scores on HAM-D and hormonal responses in patients with chronic fatigue syndrome. The findings of this study do not support a role for 5-HT in chronic fatigue syndrome.
Dépression Atypique: Évolution Vers Un Traitement Pharmacologique Spécifique Et Efficace?
Authors: Dassylva Benoit , Fontaine Réjean
Published: April 2017

The present article reviews different concepts of atypical depression. Of these, major depression associated with panic disorder would have a specific meaning according to some pharmacological and prognosis studies. It seems that this type of depression is quite frequent and has a significantly worse prognosis than major depression alone. Controlled studies comparing the efficacy of tricyclic antidepressants to phenelzine concluded in favour of the latter in general. It is generally thought that atypical depression would respond better to monoamine oxidase inhibitors(MAOI), but it would seem that it is mainly major depression associated with panic disorder that could predict this kind of response to treatment. Second generation antidepressants have not been studied systematically for this purpose even though preliminary reports seem promising.
L'érotomanie Mâle: Un Type De Harcèlement Sexuel Dangereux
Authors: Gagné Pierre , Desparois Lucie
Published: April 2017

Objective

The purpose of our study is to examine male erotomania and its consequences for women who are victims of it.

Method

We studied the clinical characteristics of erotomaniacal men and the physical and psychic consequences to women who were their victims.

Results

The men we met have a severe paranoid thought disorder which combines jealousy, projection and interpretation. Their behaviour is characterized by escalating violence in their involvement with women by whom they believe they are loved. During their contacts with the erotomaniac, the victims develop adjustment disorders and anxiety.

Conclusion

Our study leads us to conclude that erotomaniacs and their victims have symptoms and a clinical evolution identical to those found in harassing and violent ex-spouses. The positive response of some erotomaniacs to antipsychotic medication raises a therapeutic prospect for other violent men with the same thought disorders.
Post-Traumatic Stress Disorder in Prisoners of War and Combat Veterans of the Dieppe Raid: A 50-Year Follow-Up
Authors: Lynne Beal A.
Published: April 2017

Objective

This paper presents the first 50-year study of the differential effects of incarceration and combat on the development and persistence of post-traumatic stress disorder (PTSD) in Canadian veterans and prisoners of war (POWs) from the Dieppe Raid.

Method

A large sample of Dieppe. POWs and nonPOWs completed a questionnaire diagnosing PTSD and other psychological and health problems of the veterans in 1946 and in 1992.

Results

The POWs showed a higher incidence of PTSD and other psychological symptoms than veterans with the same combat exposure. The POWs' experiences of malnutrition, maltreatment and torture, and mental suffering showed strong links to PTSD.

Conclusions

For many veterans, PTSD has lasted 50 years. Failure to be eligible for psychological disability pensions demonstrates that PTSD and other psychological disorders in these veterans have been greatly unrecognized by the Canadian Department of Veteran's Affairs.
Self-Reported Depressive Symptoms in Association with Medication Exposures among Medical Inpatients: A Cross-Sectional Study
Authors: Scott B. Patten , Jeanne V.A. Williams , Edgar J. Love
Published: April 2017

Objective

To evaluate associations between exposure to three classes of medications (angiotensin converting enzyme inhibitors, calcium channel blockers, and corticosteroids) and self-reported depressive symptoms.

Method

The study utilised a cross-sectional study design in a sample of medical inpatients.

Results

Associations between self-reported depressive symptoms and exposure to angiotensin converting enzyme inhibitors or calcium channel blockers were not observed. However, an association between self-reported depressive symptoms and corticosteroid exposure was identified. The association was strongest in subjects reporting apast history of depression or a family history of depression. The strength of the corticosteroid-depressive symptom association was comparable with that of associations observed for age, poverty and psychosocial stress.

Conclusions

Depressive symptoms among medical inpatients have a biopsychosocial etiology. Corticosteroid exposure may be a biological risk factor for depressive symptoms in this population.
Short-Term Efficacy of Interventions by a Youth Crisis Team
Authors: Greenfield Brian , Hechtman Lily , Tremblay Claudine
Published: April 2017

Objective

To determine the impact of an outpatient psychiatric Emergency Room Follow-up Team (ERFUT) on the hospitalization rate of youth in crisis (mostly suicidal adolescents).

Method

The rate of psychiatric admissions of youth to a general pediatric hospital during a year prior to the ERFUT creation was compared to that same rate after the team's creation. The proportion of patients returning to the Emergency Room (ER) 2 or more times was also compared for those same years. Deaths were identified at 3-year follow-up for the experimental group.

Results

A 16% reduction in the hospitalization rate followed the team's creation, without an increase in the proportion of patients returning to the ER. Also, none of the experimental group subjects had died at 3-year follow-up.

Conclusion

There is a subpopulation of previously hospitalized suicidal adolescents who can be effectively cared for as outpatients when treated rapidly and intensively.
Tricyclic Medication in Children and the QT Interval: Case Report and Discussion
Authors: Harvey R. Alderton
Published: April 2017

Objective

To identify the necessity for close monitoring of the QT interval in children and adolescents treated with tricyclics.

Method

Guidelines for permissible ECG changes are reviewed and a case report of a 12-year-old girl with idiopathic long QT syndrome, no history of cardiac disorder, a questionable family history, and normal physical examination and baseline ECG is presented.

Results

Marked increase in QT corrected for heart rate (QTc) occurred on low-dose tricyclic. Possible factors in deaths on desipramine are reviewed.

Conclusion

It is recommended that children and adolescents on tricyclics receive an ECG at baseline and after each dose increase. Recommendations are made regarding ECG parameters and indications for cardiac consultation.
Training Residents for Rural Child Psychiatry: Defining the Objectives
Authors: Leverette John , Massabki Albert
Published: April 2017

Objective

To discuss the contribution of consultative skills to the practice of child psychiatry and to develop curriculum which enhances the ability of residents to participate in community-based care.

Method

The development of a training site for residents and fourth year medical students in a weekly half-day travelling child psychiatry clinic to a rural children's aid society is described. A method of designing educational objectives for community-based training is reviewed and expanded to provide a template for constructing a comprehensive curriculum.

Results

The educational objectives specific to the rural training site chosen are provided and their contribution as a subset of the curriculum is defined.

Conclusion

The authors suggest that a more fulsome discussion of curriculum design and content in the Canadian literature will aid in the development of emerging practice patterns in child psychiatry.
The Function of the Multidisciplinary Team in Child Psychiatry — Clinical and Educational Aspects
Authors: Constantin E Benierakis
Published: April 2017

Objective

To present experiences with teams in a university hospital and various community settings that promote the learning of collaboration among different professionals.

Method

Research in developmental psychopathology has increasingly linked childhood vulnerabilities and risk factors to adolescent and adult disorders. In this context the multidisciplinary teams can be seen as the expression of the expanding knowledge and expertise of the medical and allied health professionals, which can be directed toward promotion of health as well as prevention and cure of illness.

Results

Collaboration reflects the application of biopsychosocial principles to consultation and research both in the community and in hospital, and the general trend in medicine to move from solo to team practice.

Conclusion

Psychiatrists have the obligation to promote, develop and maintain the psychosocial and personal dimension in the teaching and practice of medicine.
Shared Psychotic Disorder: A Critical Review of the Literature
Authors: José M Silveira , Mary V Seeman
Published: April 2017

Objective

To search the literature to reassess the concept of shared psychotic disorder (SPD) using modern nosology and current biopsychosocial formulation.

Method

Analyzing published case reports from 1942 through to 1993 that meet DSM-IV criteria for SPD according to patient age, sex, nature and duration of the relationship with the “primary”, length of exposure to primary's psychosis, family psychiatric history, comorbidity, social isolation of the dyad, presence of hallucinations, delusional type, and the diagnosis of the primary.

Results

Findings revealed: 1. males and females were affected with equal frequency; 2. there was equal prevalence in younger and older patients; 3. the majority of shared psychoses (90.2%) were equally distributed among married couples, siblings, and parent-child dyads; 4. comorbid dementia, depression, and mental retardation were common; 5. hallucinations were common; 6. the majority of dyads (67.3%) were socially isolated.

Conclusions

SPD probably occurs in premorbidly disposed individuals in the context of social isolation which is shared with a psychotic person.
Treatment of Seasonal Affective Disorder: A Review
Authors: Tam Edwin M , Lam Raymond W , Levitt Anthony J
Published: April 2017

Objective

To review the status of current treatment of seasonal affective disorder (SAD).

Method

Treatment studies of SAD published between January 1989 and March 1995 were identified using a computerized MEDLINE literature search. Additional citations were obtained from the reference sections of these articles. Studies included in this review were selected using operational methodologic criteria.

Results

Many studies support the efficacy of bright light therapy using a fluorescent light box. The best studied protocol is >2500 lux white light for 2 hours per day, but newer protocols using 10,000 lux for 30 minutes have comparable response rates. Studies of light visors and other head-mounted devices also report similar response rates, but have not yet shown superiority over putative control conditions. There are fewer medication studies in SAD, but controlled studies suggest that fluoxetine, d-fenfluramine and propranolol are effective. Other treatments such as dawn simulation require further study. No studies of psychological treatments for SAD were found. Many studies had methodologic limitations, including brief treatment periods, small sample sizes, and lack of replication, that limit the generalizability of findings.

Conclusion

There are several well-studied, effective treatments for SAD, including light therapy and medications. However, further research must be done to demonstrate sustained treatment response over time, to clarify the intensity-response relationship of light therapy, to clarify the role of light therapy and medications, and to assess combination treatments.
Comparative Analysis of Native Admissions and Registrations to Northwestern Ontario Treatment Facilities: Hospital and Community Sectors
Authors: Dalrymple Andrew J , O'doherty James J , Nietschei Karin M
Published: April 2017

Objective

To study Native and non-Native admissions to acute psychiatric care in the northwestern region of Ontario in 1992.

Method

To replicate a 1986 to 1987 study comparing Native to non-Native admissions to acute psychiatric care in the northwestern region of Ontario in 1992 and examine Native registrations to community mental health agencies in the first 6 months of 1993.

Results

The comparative analysis of hospital admissions revealed that: Natives are still being admitted at 33% more than the rate expected on the basis of population; depression appears to be underdiagnosed for Natives; they continue to be admitted mainly for reasons other than major psychiatric conditions; substance abuse and forensic history are commonly involved; they stay in hospital for twice as long as their non-Native control; they more often come from rural settings; and they are less likely to be followed by the outpatient service and more likely to be followed by the criminal justice system. The examination of registrations to community mental health agencies revealed that: the same overrepresentation of Natives; mood- and thought-presenting problems of Natives in this sector were identical to non-Natives; and their length of stay was similar. The psychiatric hospital appears to be providing acute care treatment, not for the serious psychiatric illnesses for which it is mandated, but for atypical admissions that result from economic, social and cultural dislocation. There may be under diagnosis of atypical depression in the Native hospitalized population. When asked what they are being treated for the diagnostic profile of Natives and non-Natives is identical on mood and thought dimensions.

Conclusion

No appreciable change has occurred over the 5 years in the way hospital psychiatric services are used by Natives. Cultural stereotypes may be influencing the diagnosis of Natives in inappropriate ways. Enhancing Native control of treatment programs and community development may provide a partial solution. Properly mandated and accountable community agencies (both generic- and culture-specific) will help reduce unnecessary hospitalization.
Is a Diagnosis-Based Classification System Appropriate for Funding Psychiatric Care in Alberta?
Authors: Wellock Chantelle M
Published: April 2017

Objective

This study evaluated the appropriateness of the Refined Group Number (RGN) classification system for funding psychiatric discharges in Alberta.

Method

Multiple regression was used to calculate the amount of variation explained (R2) in length of stay by RGNs for psychiatric discharges. The distribution of short-stay cases (less than 5 days) was also reviewed.

Results

The R2 value was higher than those from American studies (0.284 versus less than 0.10) for psychiatric discharges. The length of stay distribution by RGN indicated that the mean was not representative of typical cases. Short-stay cases made up the majority of cases from rural hospitals and had a negative impact on the average length of stay.

Conclusions

The RGN methodology performed better than diagnosis-based classification systems in the United States. However, there were significant weaknesses in the classification system which suggest that a funding system using the RGN grouper would result in inequitable funding for psychiatric discharges.
The Psychopathology of Incarcerated Self-Mutilators
Authors: Haines Janet , Williams Christopher L , Brain Kerryn L
Published: April 2017

Objective

To investigate the symptomatology of severe psychopathology reported by male incarcerated self-mutilators.

Method

Comparisons were made with a nonmutilating incarcerated group and a nonincarcerated, nonmutilator group.

Results

A distinctive pattern of symptomatology emerged. Self-mutilators evidenced a wide range of elevated scores on general measures of psychological/psychiatric symptoms, particularly depression and hostility. Aspects of hostility that distinguished self-mutilators from other groups included the urge to act out hostile feelings, critical feelings towards others, paranoid feelings of hostility and guilt. Self-mutilators demonstrated substantial problems with substance abuse, particularly alcohol.

Conclusion

A pattern of passive-aggressive, schizoid and avoidant personality styles distinguished self-mutilators from other groups.
Depression Associated with Multiple Sclerosis: An Etiological Conundrum
Authors: Feinstein Anthony
Published: April 2017

Objective

Although depression frequently occurs in multiple sclerosis (MS), an association with cerebral pathology is unclear. This sets MS apart from other common neurological disorders. The reasons for this are explored.

Method

The literature on depression and magnetic resonance imaging (MRI) is reviewed and methodological issues are critically evaluated.

Results

Failure to demonstrate cerebral correlates of depression is in part a function of poor study design. However, the diffuse nature of cerebral demyelination creates difficulties in image analysis peculiar to MS.

Conclusions

More research using valid psychiatric assessment procedures, high field strength MRI and automated lesion detection is needed to resolve the issue. It is premature to reject psychosocial causes at this stage.
Self-Esteem and Cancer: Theory and Research
Authors: Katz Mark R , Rodin Gary , Devins Gerald M
Published: April 2017

Objective

To examine the relationship between self-esteem and the psychosocial response to cancer.

Methods

The authors review methodological issues associated with measuring self-esteem inpatients with cancer and examine existing empirical studies in light of these issues.

Results

Self-esteem in cancer has been variously viewed as an outcome variable, a mediator of other psychosocial outcomes, and as a personal resource that facilitates coping. Unidimensional measures of global self-esteem have been most often employed in research studies, despite increasing recognition that self-esteeem is multidimensional. Evaluation of global self-esteem has generally revealed no differences between cancer patients and controls. Aspects of multidimensional self-esteem, particularly body self-esteem, appears to be disturbed in many patients with cancer.

Conclusions

The clinical and theoretical literature have emphasized the importance of self-esteem to the psychosocial response to cancer. Empirical study of self-esteem in cancer has been limited by conceptual and methodological issues. Strategies for future research are discussed.
The Clozapine Experience from a Family Perspective
Authors: Dickson Ruth A , Williams Richard , Dalby J Thomas
Published: April 2017

Objective

To examine how the lives of family members of clozapine-treated patients with schizophrenia have been affected by this treatment.

Methods

Through the use of a questionnaire and an interview of family members, this qualitative study focused on the families' perceptions of change in their family member and the impact on the family unit.

Results

Fourteen patients and their family members participated. The family interview was conducted an average of 1.78 years after clozapine inititation (range 0.58 years to 3.73 years). Global ratings of behavioural change were positively and significantly correlated between all raters: patients, family members, and clinicians. Family members were positive about clozapine's effect on their relatives and the impact on the family.

Conclusion

A positive response to clozapine decreases the burden on the family. This is in part the result of a decreased need for rehospitalization.
Understanding Symptoms of Schizophrenia
Authors: Ashok K. Malla
Published: April 2017

In examining the heterogeneity of symptomatology in schizophrenia, several theoretical models have been advanced. These models are useful in understanding the psychopathology of the disease, as well as possibly guiding treatment and determining prognosis. This paper discusses the two-syndrome and three-syndrome models for the primary symptoms of schizophrenia and their relationship to other symptoms often encountered. In addition, their significance and relevance for treatment are explored.
The Psychobiology of First-Episode Schizophrenia
Authors: Waring Em
Published: April 2017

Objective:

To examine research and clinical interest in the first episode of schizophrenia. Pathobiological features have been shown to be a consequence of the disorder rather than the effects of chronicity, drug treatment or institutionalization. There is increasing evidence that ventricular enlargement is a robust finding and hypofrontality on PET and SPECT is associated more with symptomatology than with neuroleptic treatment.

Results:

Neuroleptic threshold studies suggest that lower daily dosages and onset of medication may be the most important response prediction parameters.

Conclusion:

The role of novel antipsychotics in the treatment of first-onset schizophrenia merits investigation for lower rates of extrapyramidal syndromes and tardive dyskinesia. To reduce relapse rates, psychiatrists need to introduce practice standards employing those biopsychosocial features in the management of first-episode schizophrenia.
Negative Symptoms and Affective Disturbance in Schizophrenia and Related Disorders
Authors: Malla Ak
Published: April 2017

Objective:

To review the data and discuss clinical recommendations for treating negative symptoms of schizophrenia. Negative symptoms (e.g., poverty of thought, affective blunting) have been regarded as part of schizophrenia since Kraepelin's early descriptions, although they remain a subject of controversy. For example, it is unclear if negative symptoms are distinct from other psychiatric symptoms such as depression, or are in actuality depression within schizophrenia. Recent evidence suggests that negative symptoms are independent of depression.

Method:

Factor analytic studies have suggested that a negative factor (loss of affect, volition, poverty of thinking) may be distinguished from other components and is separable from a depression factor. Experimental use of vignettes have also been useful in the assessment of negative symptoms. A second controversial area is whether or not the presence or absence of affect is the fundamental issue separating schizophrenia from other psychoses.

Results:

A continuum of psychosis has been hypothesized, with unipolar psychotic depression at one pole and schizophrenia with defect state at the other. Within this proposed continuum, negative symptoms are associated only with schizophrenia without affect and with defect state schizophrenia. As such, variation in affect could be a primary determinant of the type of psychosis.

Conclusion:

It appears that negative symptoms are a distinct aspect of schizophrenia and may aid in our understanding of psychotic disorders.
An Integrative Index for Predicting Extubation Outcomes After Successful Completion of a Spontaneous Breathing Trial in an Adult Medical Intensive Care Unit
Authors: Wu Tsung-Ju , Shiao Judith Shu-Chu , Yu Hsin-Liang , Lai Ruay-Sheng
Published: April 2017

Background:

Among respiratory predictors, rapid shallow breathing index (RSBI) has been a commonly used respiratory parameter to predict extubation outcomes. However, the outcome of prediction remains inconsistent. Regarding nonrespiratory predictors, serum albumin, hemoglobin, bicarbonate, and patients’ alertness have been reported to be associated with successful weaning or extubation. We aimed to develop an integrative index combining commonly used predictors in the adult medical intensive care units (MICUs) and to compare the predictability of the index with RSBI.

Methods:

This prospective observational study with retrospective data collection of planned extubations was conducted in a 14-bed adult MICU. We enrolled patients who received mechanical ventilation via an endotracheal tube in the adult MICU for >24 hours and passed a 2-hour spontaneous breathing trial and underwent extubation. Extubation failure was defined as reinstitution of invasive mechanical ventilation within 48 hours of extubation. Respiratory parameters and Glasgow Coma Scale (GCS) scores of patients were recorded prospectively. Nonrespiratory parameters were recorded retrospectively. Logistic regression was used to determine significant predictors of extubation outcomes.

Results:

Fifty-nine patients comprising 70 extubations were enrolled. Extubation failure was significantly and positively associated with lower serum albumin (albumin < 2.6 g/dL, odds ratio [OR] = 5.1; 95% confidence interval [CI], 1.04-24.66), lower hemoglobin (hemoglobin < 10.0 g/dL, OR = 10.8; 95% CI, 2.00-58.04), and lower GCS scores (GCS score ≤ 8, OR = 6.1; 95% CI = 1.15-32.34). By using an integrative index combining the 3 parameters together, the sensitivity and specificity to predict extubation outcomes were 78.6% and 75.9%, respectively. The area under the receiver operating characteristic curve of the index was significantly higher than RSBI (0.84 vs 0.61, P = .026).

Conclusion:

The integrative index combining serum albumin, hemoglobin, and GCS scores could predict extubation outcomes better than RSBI in an adult MICU.
Geometric parameter identification of a dual-arm robot by using closed-chain constraint and optimization technique
Authors: Yang Wu-Te , Li Kuan-Lin , Chan Kuei-Yuan , Lin Pei-Chun
Published: April 2017

The positioning accuracy of the empirical robot manipulators is determined by various factors, such as kinematic accuracy, structure rigidity, and controller performance. Here, we report on the development of a new and straightforward technique to calibrate the kinematic parameters of a dual-arm robot under uncertainty. In comparison with other techniques, which generally rely on using other instruments to calibrate the manipulators, the proposed method utilizes the intrinsic characteristics of the dual-arm robot for calibration. In particular, when the two arms grasp each other, a formed closed chain can be operated as the constraint equation for the kinematic parameter optimization of the two arms. In the optimization process, the dual-arm robot has to pose in various configurations to yield better performance, and thus a motion generation strategy of the dual-arm robot is proposed, where one arm serves as the master to track the designated trajectory and the other arm serves as the slave to track the motion of the master arm by using a compliance control strategy. The proposed calibration method was experimentally validated, and the results confirm that the positioning accuracy of both arms can be improved.
On integrated wheel and track damage prediction using vehicle–track dynamic simulations
Authors: Casanueva Carlos , Enblom Roger , Stichel Sebastian , Berg Mats
Published: April 2017

The renewal costs for wheels and rails are a substantial part of the costs for rolling stock operators and infrastructure managers all over the world. The causes for reprofiling or grinding are, in most cases, related to the following: (1) wheel or rail profiles with unacceptable wear, (2) appearance of rolling contact fatigue cracks in the surface, and (3) wheel flats caused by locking wheels during braking. The first two causes are related to the dynamic behavior of the vehicle–track system, and can be predicted using multibody simulations. However, there are several limitations that restrain the usefulness of these prediction techniques, such as simulation time constraints, necessary simplifications, and lack of experimental data that lead to educated assumptions. In this paper, we take the end-user perspective in order to show whether the latest developments in wheel–rail damage prediction can be integrated in a simplified framework, and subsequently used by the different stakeholders for an improved management of the different assets involved in the operation of rail vehicles.
Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis
Authors: Restrepo-Escobar M , Granda-Carvajal P A , Jaimes F
Published: April 2017

Objective

Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intra-observer reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis.

Methods

We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria.

Results

We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair.

Conclusion

The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field.
MiR-26a downregulates retinoblastoma in colorectal cancer
Authors: López-Urrutia Eduardo , Coronel-Hernández Jossimar , García-Castillo Verónica , Contreras-Romero Carlos , Martínez-Gutierrez Antonio , Estrada-Galicia Diana , Terrazas Luis Ignacio , López-Camarillo César , Maldonado-Martínez Hector , Jacobo-Herrera Nadia , Pérez-Plasencia Carlos
Published: April 2017

MicroRNAs are non-coding short RNAs that target the 3′ untranslated region of messenger RNAs (mRNAs) and lead to their degradation or to translational repression. Several microRNAs have been designated as oncomirs, owing to their regulating tumor suppressor genes. Interestingly, a few of them have been found to target multiple genes whose simultaneous suppression contributes to the development of a tumoral phenotype. Here, we have showed that miR-26a is overexpressed in colorectal cancer data obtained from TCGA Research Network and in human colon cancer pathological specimens; moreover, an orthotopic in vivo model of colon cancer showed overexpression of miR-26a, while Rb1 expression inversely correlated to miR-26a in TCGA Research Network data, pathological samples, and the in vivo model. Then, by means of luciferase assay, we demonstrated that miR-26a targets the 3′ untranslated region of Rb1 mRNA directly. This is, to our knowledge, the first report of miR-26a targeting Rb1 in colon cancer. The results of this study suggested that miR-26a could serve as a progression biomarker in colorectal cancer. Further validation studies are still needed to confirm our findings.
Astragaloside IV sensitizes non–small cell lung cancer cells to gefitinib potentially via regulation of SIRT6
Authors: Dai Peng-Chen , Liu De-Ling , Zhang Lei , Ye Jia , Wang Qing , Zhang Hong-Wen , Lin Xiu-Hua , Lai Guo-Xiang
Published: April 2017

Astragaloside IV, the active component of Astragalus membranaceus, exhibits diverse biological roles including the anti-tumor activity. In this study, we evaluated the chemosensitive role of astragaloside IV in non–small cell lung cancer cells. Cell Counting Kit-8 analysis was performed to determine cell viability. Real-time polymerase chain reaction and western blot were used to measure the messenger RNA and protein expression. Results showed that astragaloside IV treatment could suppress the proliferation of non–small cell lung cancer cells. In addition, combined treatment with astragaloside IV remarkably enhanced the chemosensitivity to gefitinib in three non–small cell lung cancer cell lines including NCI-H1299, HCC827, and A549. Furthermore, compared with gefitinib-treated cells, the messenger RNA expression of SIRT6 was obviously increased in non–small cell lung cancer cells treated with gefitinib combined with astragaloside IV. In addition, downregulation of SIRT6 was accomplished using small interference RNA technology. As a result, SIRT6 inhibition abolished the sensitization role of astragaloside IV in non–small cell lung cancer cells. Taken together, these data demonstrated that astragaloside IV sensitized tumor cells to gefitinib via regulation of SIRT6, suggesting that astragaloside IV may serve as potential therapeutic approach for lung cancer.