bluuebunny/crossref_metadata_2025 huggingface dataset:
Estrogen Receptor Activation and Tardive Dyskinesia
Authors: Turrone Peter , Seeman Mary V , Silvestri Simone
Published: January 2017

Objective:

To undertake a selective review of the epidemiology, etiology, and treatment of tardive dyskinesia (TD), with emphasis on the potential influence of estrogen in its expression.

Method:

Both Medline and Psycinfo databases were used to search for articles with the following key words: tardive dyskinesia, humans, animals, dopamine, estrogen, estrogen replacement therapy, antioxidants and oxidative stress.

Results:

The studies reviewed here suggest that estrogen modulates dopamine-mediated behaviours and that it protects against oxidative stress-induced cell damage caused by long-term exposure to antipsychotic medication.

Conclusions:

Estrogen's multimodal role in the central nervous system may prove useful for the amelioration or prevention of TD. All the evidence suggests that a placebo-controlled, randomized trial with safer forms of estrogen should be conducted in postmenopausal women with TD.
Toward Effective Early Intervention and Prevention Strategies for Major Affective Disorders: A Review of Antecedents and Risk Factors
Authors: Duffy Anne
Published: January 2017

Objective:

To review critically the literature pertaining to riskfactors and antecedent symptoms and syndromes in order to determine an empirically based strategy for early treatment and prevention of major mood episodes.

Method:

The relevant literature is summarized, with particular emphasis on early-onset (child and adolescent) mood disorders.

Results:

A complex interaction between biological, psychological, and sociological factors contributes to the development of a major mood disorder. Having a positive family history of mood disorder (bipolar and unipolar) and being female (unipolar) are the strongest, most reliable risk factors. There is continuity between adolescent and adult mood disorders, and subsyndromal mood disturbance in adolescents has clinical and public health significance. However, more longitudinal study is required to reliably map the course and predictive importance of mood disorders in very young children.

Conclusions:

Substantial evidence supports the effectiveness of early intervention and prevention efforts in children at risk for mood disorders (identified as having affected family members) and in adolescents manifesting significant mood symptoms and syndromes (especially if associated with a positive family history). However, the current level of understanding regarding the etiological significance and mechanism of risk factors associated with mood disorders does not support broad community-based primary prevention strategies in unselected populations.
Community Attitudes toward People with Schizophrenia
Authors: Stuart Heather , Arboleda-Flórez Julio
Published: January 2017

Objective:

We surveyed public attitudes toward people with schizophrenia as part of a pilot project for the World Psychiatric Association's Global Campaign to Fight Stigma and Discrimination Because of Schizophrenia.

Methods:

We conducted random-digit telephone surveys with 1653 respondents (aged 15 years or over) residing in 2 adjacent rural and urban health regions (71.9% response rate). A brief interview collected information on experiences with people with a mental illness or schizophrenia, knowledge of causes and treatments for schizophrenia, and levels of social distance felt toward people with schizophrenia.

Results:

One-half of the sample had known someone treated for schizophrenia or another mental illness. Of those able to identify a cause of schizophrenia (two-thirds), most identified a biological cause, usually a brain disease. Social distance increased with the level of intimacy required. One in 5 respondents thought they would be unable to maintain a friendship with, one-half would be unable to room with, and three-quarters would be unable to marry, someone with schizophrenia. Those over 60 were least knowledgeable or enlightened and the most socially distancing. Greater knowledge was associated with less-distancing attitudes. When other factors were controlled, exposure to the mentally ill was not correlated with knowledge or attitudes, even among those who had worked in agencies providing services to the mentally ill.

Conclusions:

Most respondents were relatively well informed and progressive in their reported understanding of schizophrenia and its treatment. Clear subgroup differences were apparent with respect to age and knowledge. Knowledge of schizophrenia, not exposure to the mentally ill, was a central modifiable correlate of stigma.
Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists
Authors: Lavoie Kim L , Fleet Richard P
Published: January 2017

Background:

The debate over whether clinical psychologists should be granted the right to prescribe psychoactive medication has received considerable attention over the last 2 decades in the US, but there has been relatively little discussion of this controversial topic among Canadian mental health professionals, namely psychologists and psychiatrists. Proponents of prescription privileges (PPs), including the American Psychological Association (APA), argue that psychologists do not and cannot function as independent professionals because the medical profession places many restrictions on their practice. It is believed that PPs would help circumvent professional psychology's impending marginalization by increasing psychology's scope of practice. Proponents also argue that PPs would enhance mental health services by increasing public access to professionals who can prescribe.

Objective:

The purpose of this article is to inform psychiatrists about the major arguments presented for and against PPs for psychologists and to discuss the major implications of PPs for both professional psychology and psychiatry.

Methods:

We conducted a literature search of relevant articles published from 1980 to the present appearing on Psychlit and Medline databases, using “prescription privileges” and “psychologists” as search titles.

Conclusion:

Although proponents present several compelling arguments in favour of PPs for psychologists, pilot projects relating to feasibility and efficacy are either sparse or incomplete. Thus, it is too soon to tell whether PPs could or should be pursued. Clearly, more research is needed before we conclude that PPs for psychologists are a safe and necessary solution to psychology's alleged impending marginalization.
Motivational Interviewing and Clinical Psychiatry
Authors: Chanut Florence , Brown Thomas G , Dongier Maurice
Published: January 2017

Objectives:

Our objectives were as follows: 1) to survey the literature on motivational interviewing (MI), “a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence” and a well-established method of brief intervention, especially in the field of addictions treatment; 2) to review hypotheses about its mode of action; and 3) to discuss its possible impact on clinical psychiatry, in particular, on teaching communications skills.

Method:

Literature reviews and metaanalyses of numerous clinical trials of MI for addictions treatment have already been published and are briefly summarized. So far, no literature survey exists for MI applied to psychiatric patients. This review is limited to a synthesis of the articles relevant to psychiatry and to comments based on our team's experiences with MI.

Results:

There is no evidence that MI achieves better results than other established techniques for treating addictions; it may simply work faster. The explanation for the method's rapid effectiveness remains speculative. Outcomes concerning the application of MI to psychiatric patients, although preliminary, are promising. Methods of assessing the integrity of MI treatment are more developed than in most psychotherapies, which permits the learning progress of trainees to be measured.

Conclusions:

MI offers a complement to usual psychiatric procedures. It may be worthwhile to teach it, not only for addictions but also for other broad treatment issues, such as enhancing patients' medication compliance and professionals' communication skills. Questions remain concerning MI's feasibility in psychiatry settings.
Prediction of Suicidality and Violence in Hospitalized Adolescents: Comparisons by Sex
Authors: Becker Daniel F , Grilo Carlos M
Published: January 2017

Objective:

To examine psychological correlates of suicidality and violent behaviour in hospitalized adolescents and the extent to which these associations may be affected by their sex.

Method:

A sample of 487 psychiatric inpatients (207 male, 280 female), aged 12 to 19 years, completed a battery of psychometrically sound self-report measures of psychological functioning, substance abuse, suicidality, and violent behaviour. We conducted multiple regression analyses to determine the joint and independent predictors of suicide risk and violence risk. In subsequent analyses, we examined these associations separately by sex.

Results:

Multiple regression analysis revealed that 9 variables (sex, age, hopelessness, self-esteem, depression, impulsivity, alcohol abuse, drug abuse, and violence risk) jointly predicted suicide risk and that an analogous model predicted violence risk. However, we found several differences with respect to which variables made significant independent contributions to these 2 predictive models. Female sex, low self-esteem, depression, drug abuse, and violence risk made independent contributions to suicide risk. Male sex, younger age, hopelessness, impulsivity, drug abuse, and suicide risk made independent contributions to violence risk. We observed a few additional differences when we considered male and female subjects separately.

Conclusions:

We found overlapping but distinctive patterns of prediction for suicide risk and violence risk, as well as some differences between male and female subjects. These results may reflect distinct psychological and behavioural pathways for suicidality and violence in adolescent psychiatric patients and differing risk factors for each sex. Such differences have potential implications for prevention and treatment programs.
Changes in Mental Health Policy and Their Influence on Self-Injurious Behaviours in the Israeli Military Prison System
Authors: Iancu Iulian , Bodner Ehud , Sarel Amiram , Einat Haim
Published: January 2017

Objective:

Self-injurious behaviours (SIBs) are widespread among prisoners and are sometimes classified as potentially calculated acts intended to control others. Access to a psychiatrist may be valued by imprisoned soldiers seeking immediate release from service. The main goal of the study was to assess the effects of a new mental health regulation in the Israel Defense Forces (IDF) prison system, which requires ordering an immediate interview with a psychiatrist for inmates performing SIBs.

Method:

Frequency of SIBs in 2 military prisons was examined and compared for 11 months before and 10 months after the implementation of the regulation. Severity of injuries and rates of release from service were examined for 4 months.

Results:

The frequency of SIBs significantly increased after the implementation of the regulation in one prison, but not in the other. No effect was found for rate of release from service or for severity of injuries.

Conclusions:

Increased accessibility to a psychiatrist for military prisoners may have resulted in increased motivation for inmates to perform SIBs. These effects are limited to the prison that serves a higher proportion of highly stressed soldiers.
A Review of Repetitive Transcranial Magnetic Stimulation Use in the Treatment of Schizophrenia
Authors: Fitzgerald Paul B , Daskalakis Z Jeff
Published: January 2017

Patients with schizophrenia often fail to respond to standard antipsychotic medications or have a partial treatment response. Few treatment options are available for these patients. Repetitive transcranial magnetic stimulation (rTMS) was developed and investigated over the last 10 years as a potential treatment option for various psychiatric conditions.

Increasingly, studies are focusing on potential applications of rTMS in schizophrenia. To date, most of these studies were symptom-specific rather than focused on the treatment of the disorder in general. The most extensive literature focuses on the use of low-frequency stimulation to attempt to disrupt or reduce the intensity of persistent refractory auditory hallucinations. This research tends to suggest that rTMS could have a role in this subset of patients. There is also preliminary but limited evidence that rTMS could have a role in reducing the negative symptoms of schizophrenia and perhaps in augmenting cognitive function. These findings also highlight the pressing need for further research including multisite studies to confirm the value of these options.
Palliative Care for People with Severe Persistent Mental Illness: A Review of the Literature
Authors: Woods Anne , Willison Kathleen , Kington Cindy , Gavin Alan
Published: January 2017

A systematic overview of the literature on palliative care for people with severe persistent mental illness (SPMI) was conducted to inform clinical practice, research, and education. Empirical studies and nonempirical papers were included. Few empirical studies exist. There is even less information about the palliative care needs of, or the nature of palliative care provided to, people with SPMI. Mental health, primary care, and palliative care providers need to partner with people who have SPMI in developing and providing palliative care. The field of palliative care for people with SPMI is wide open and in need of methodologically sound studies that will help define the issues that exist for this vulnerable population. Recognizing the similarities between mental health and palliative care should lead to collaborative ventures and discussions in an attempt to address common and parallel issues.
The Effectiveness of Telemental Health Applications: A Review
Authors: Hailey David , Roine Risto , Ohinmaa Arto
Published: January 2017

Objective:

To review the evidence of benefit from use of telemental health (TMH) in studies that reported clinical or administrative outcomes.

Method:

Relevant publications were identified through computerized literature searches using several electronic databases. Included for review were scientifically valid articles that described controlled studies, comparing TMH with a non-TMH alternative, and uncontrolled studies that had no fewer than 20 participants. Quality of the evidence was assessed with an approach that considers both study performance and study design. Judgments were made on whether further data were needed to establish each TMH application as suitable for routine clinical use.

Results:

Included in the review were 72 papers that described 65 clinical studies; 32 (49%) studies were of high or good quality. Quality of evidence was higher for Internet- and telephone-based interventions than for video conferencing approaches. There was evidence of success with TMH in the areas of child psychiatry, depression, dementia, schizophrenia, suicide prevention, posttraumatic stress, panic disorders, substance abuse, eating disorders, and smoking prevention. Evidence of success for general TMH programs and in the management of obsessive–compulsive disorder were less convincing. Further study was judged to be necessary or desirable in 53 (82%) of the studies.

Conclusion:

Evidence of benefit from TMH applications is encouraging, though still limited. There is a need for more good-quality studies on the use of TMH in routine care. The emerging use of Internet-based applications is an important development that deserves further evaluation.
Nature et gravité du trouble de l'opposition avec provocation et du trouble des conduites selon qu'ils surviennent ensemble ou séparément chez l'enfant
Authors: Lapalme Mélanie , Déry Michèle
Published: January 2017

Objectif:

La cooccurrence des symptômes du trouble de l'opposition avec provocation et du trouble des conduites est particulièrement fréquente, une situation pouvant être liée à l'augmentation de la gravité (nombre et nature des symptômes) de chacun des troubles. L'objectif de notre étude est de déterminer si les symptômes du trouble oppositionnel et du trouble des conduites varient selon que ces troubles se présentent seuls ou ensemble chez les enfants.

Méthode:

Notre étude a été réalisée auprès de 406 enfants (6 à 13 ans) répartis en quatre groupes (trouble oppositionnel seul, trouble des conduites seul, trouble oppositionnel et trouble des conduites, témoin) ne se différenciant pas selon l'âge et le sexe. Des entrevues diagnostiques structurées, réalisées séparément auprès d'un parent et de l'enfant, ont permis d'évaluer le nombre moyen des symptômes de chaque trouble de même que la fréquence d'apparition de chacun des symptômes.

Résultats:

Lorsqu'ils surviennent ensemble, le trouble oppositionnel et le trouble des conduites se manifestent de manière plus grave que s'ils se présentent seuls, eu égard au nombre et à la nature des symptômes présentés. Aussi, les enfants ayant un trouble oppositionnel ou un trouble des conduites uniquement présentent également plus de symptômes de l'autre trouble et à des fréquences plus élevées que les enfants du groupe témoin.

Conclusion:

Les résultats de l'étude suggèrent de prendre en compte lors de l'évaluation, et possiblement de l'intervention, la présence des deux troubles à la fois.
Three-Year Outcome of Treatment in an Early Psychosis Program
Authors: Addington Jean , Addington Donald
Published: January 2017

Objective:

Studies defining the course and outcome of people experiencing their first episode psychosis (FEP) generally report an improvement in symptoms and functioning. Little is known about the follow-up arrangements offered topatients when their timein a FEP comes to an end.

Method:

Our study focuses on a sample of FEP patients ( n = 292) who were followed for up to 3 years in a multi-element specialized FEP service.

Results:

Improvement in positive symptoms and social functioning, but not negative symptoms, was observed in this sample both for people who completed 3 years in the program and for those who left early. About 40% were referred to specialized mental health services, whereas 24% were followed by their family physician. Patients who were followed by family physicians had decreased symptoms and improved functioning.

Conclusion:

Most patients treated in an early psychosis program will need follow-up, the largest group will require specialized mental health services in the community, but a significant group can be followed by family physicians.
Prevalence of Childhood Sexual Abuse and Timing of Disclosure in a Representative Sample of Adults from Quebec
Authors: Hébert Martine , Tourigny Marc , Cyr Mireille , McDuff Pierre , Joly Jacques
Published: January 2017

Objective:

Our study sought to explore patterns of disclosure of child sexual abuse (CSA) in a sample of adult men and women.

Method:

A telephone survey conducted with a representative sample of adults ( n = 804) from Quebec assessed the prevalence of CSA and disclosure patterns. Analyses were carried out to determine whether disclosure groups differed in terms of psychological distress and symptoms of posttraumatic stress, and a logistic regression was used to examine factors associated with prompt disclosure.

Results:

Prevalence of CSA was 22.1% for women and 9.7% for men. About 1 survivor out of 5 had never disclosed the abuse, with men more likely not to have told anyone, than women. Only 21.2% of adults reported prompt disclosure (within a month of the first abusive event), while 57.5% delayed disclosure (more than 5 years after the first episode). CSA victims who never disclosed the abuse and those who delayed disclosure were more likely to obtain scores of psychological distress and posttraumatic stress achieving clinical levels, compared with adults without a history of CSA. In the multivariate analysis, experiencing CSA involving a perpetrator outside the immediate family and being female were factors independently associated with prompt disclosure.

Conclusion:

A significant number of adult women and men reported experiencing CSA, and most victims attested to either not disclosing or significantly delaying abuse disclosure.
Psychological Treatment of Obsessive-Compulsive Disorder in Patients with Major Depression: A Pilot Randomized Controlled Trial
Authors: Rector Neil A , Cassin Stephanie E , Richter Margaret A
Published: January 2017

Objective:

To examine the efficacy of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) in patients with comorbid major depressive disorder (MDD).

Method:

Participants ( n = 29) diagnosed with comorbid OCD and MDD were randomized to receive standard CBT for OCD or integrated CBT that included an exclusive focus on treating MDD in the first phase of treatment and OCD in the second phase of treatment.

Results:

Both treatments resulted in statistically significant improvements in OCD and MDD symptoms. Treatment effects and recovery rates in the intent-to-treat sample were lower in both treatments, compared with past studies that excluded patients with MDD. However, among treatment completers, both treatments resulted in statistically significant and clinically meaningful improvements in OCD and MDD symptoms.

Conclusions:

CBT holds promise as an efficacious treatment for people with comorbid OCD and MDD. The high treatment dropout rate with comorbid patients suggests that additional treatment strategies are required to enhance retention and optimize clinical outcomes.
Immigration and Suicidality in the Young
Authors: Lipsicas Cendrine Bursztein , Mäkinen Ilkka Henrik
Published: January 2017

Objectives:

Little research has focused on the relation of immigration and suicidal behaviour in youth. Nevertheless, the impact of migration on the mental health of youth is an issue of increasing societal importance. This review aimed to present studies on the prevalence of suicidal behaviour in immigrant youth in various countries and to provide possible explanations for suicidal behaviour in immigrant youth, especially regarding acculturation.

Methods:

The review included a literature search to locate articles on the subject of suicidal behaviour in immigrant youth in the context of acculturation.

Results:

Studies on suicidal behaviour in culturally diverse youth are few and most of the existing research does not differentiate ethnic minorities from immigrants. Studies on epidemiology and on specific risk factors were found regarding various immigrant youth including Hispanics in the United States, Asians in North America and Europe, as well as comparative studies between different immigrant groups in specific countries.

Conclusions:

The relation between immigration status and suicidal behaviours in youth appears to vary by ethnicity and country of settlement. Time spent in the new country as well as intergenerational communication and conflicts with parents have, in many of the studies, been related to suicidality in immigrant youth. Summing up, there is a clear and urgent need to further pursue the work in this field, to develop targeted public health interventions as well as psychosocial treatment for preventing suicide in these youth.
Comparing Mental Health of Francophones in Canada, France, and Belgium: 12-Month and Lifetime Rates of Mental Health Service Use (Part 2)
Authors: Tempier Raymond , Vasiliadis Helen-Maria , Gilbert Fabien , Demyttenaere Koen , Bruffaerts Ronny , Lépine Jean-Pierre , Gasquet Isabelle , Lepnurm Marje , Lesage Alain , Puchala Chassidy , Mosier Karen , Kovess-Masféty Viviane
Published: January 2017

Objectives:

To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamples using data from national mental health surveys in Canada, Quebec, France, and Belgium. This is the second article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations.

Methods:

Comparable World Mental Health-Composite International Diagnostic Interviews (WMH-CIDI) were administered to representative samples of adults (aged 18 years and older) in Canada during 2002 and in France and Belgium from 2001 to 2003. Two groups of francophone adults in Canada, in Quebec ( n = 7571) and outside Quebec ( n = 500), and respondents in Belgium ( n = 389) and France ( n = 1436) completed the French version of the population survey. Prevalence rates of common mental health service use were examined for major depressive episodes and specific anxiety disorders (that is, agoraphobia, social phobia, and panic disorder).

Results:

Overall, most francophones with mental disorders do not seek treatment. Canadians consulted more mental health professionals than their European counterparts, with the exception of psychiatrists.

Conclusions:

Patterns of service use are similar among francophone populations. Variations that exist may be accounted for by differences in health care resources, health care systems, and health insurance coverage.
Subtyping Study of a Pathological Gamblers Sample
Authors: Álvarez-Moya Eva Ma , Jiménez-Murcia Susana , Aymamí Ma Neus , Gómez-Peña Mónica , Granero Roser , Santamaría Juanjo , Menchón Jose M , Fernández-Aranda Fernando
Published: January 2017

Objective:

To classify into subgroups a sample of pathological gambling (PG) patients according to personality variables and to describe the subgroups at a clinical level.

Method:

PG patients ( n = 1171) were assessed with the South Oaks Gambling Screen; the Temperament and Character Inventory—Revised; the Symptom Checklist-90—Revised; Eysenck's Impulsivity Scales, a diagnostic questionnaire for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) PG criteria; and the Structured Clinical Interview for the DSM-IV, Axis I disorders, substance use module. Clinical measures were collected through a semi-structured interview. We performed a 2-step cluster analysis based on the above-mentioned personality variables. Clinical data were compared across clusters.

Results:

Four clusters were generated. Type I (disorganized and emotionally unstable) showed schizotypic traits, high impulsiveness, substance and alcohol abuse, and early age of onset, as well as psychopathological disturbances. Type II (schizoid) showed high harm avoidance, social aloofness, and alcohol abuse. Type III (reward sensitive) showed high sensation seeking and impulsiveness but no psychopathological impairments. Type IV (high-functioning) showed a globally adaptive personality profile, low level of substance and alcohol abuse or smoking, and no psychopathological disturbances.

Conclusions:

At least 4 types of PG patients may be identified. Two types showed a response modulation deficit, but only one of them had severe psychopathological disturbances. Two other types showed no impulsiveness or sensation seeking and one of them even exhibited good general functioning. The different personality and clinical configuration of these clusters might be linked to different therapeutic approaches.
Measuring Quality of Mental Health Care: A Review of Initiatives and Programs in Selected Countries
Authors: Spaeth-Rublee Brigitta , Pincus Harold Alan , Huynh Phuong Trang ,   IIMHL Clinical Leaders Group, Mental Health Quality Indicator Project
Published: January 2017

This review article presents a systematic review of grey literature describing current initiatives that assess the quality of mental health care in 12 countries, as collected by the International Initiative for Mental Health Leadership. There have been increased efforts in many countries to develop and implement mental health indicator schemes to measure and monitor the quality of mental health care at the national and subnational level. Most mental health indicator sets are part of larger health policy initiatives at the national and (or) provincial or state level, with indicators and domains regularly reviewed and revised. The indicator sets described in health care quality initiatives vary widely in their scope, intended use, and degree of development, and they often cut across a broad range of domains, reflecting not only a country's specific health system and how it is organized and structured but also the implementation of such schemes (that is, collection and analysis of data) and the sociopolitical realities that determine mental health priorities.
Validation du questionnaire d'éreutophobie de la Salpětrière
Authors: Pelissolo Antoine , Lobjoie Corine , Montefiore Delphine
Published: January 2017

Objectif:

Étudier les principales caractéristiques psychométriques du questionnaire d'éreutophobie de la Salpětrière (QES) auprès d'un échantillon clinique et non clinique.

Méthode:

Trois groupes, constitués de patients souffrant de phobie sociale (PS) ( n = 212), de patients souffrant d'autres troubles anxieux ( n = 146), et de participants de la population générale ( n = 171), ont été étudiés. Ils ont rempli le QES ainsi que plusieurs échelles de symptomatologie anxieuse et dépressive. Le diagnostic d'éreutophobie était posé selon des critères standardisés et évalué sur une échelle d'impression clinique globale.

Résultats:

La structure factorielle de l'échelle QES est claire, un seul facteur expliquant 83,9 % du score total, et son coefficient de cohérence interne alpha s'élève à 0,96. Le score du QES est corrélé significativement à une hétéro-évaluation dimensionnelle de la peur de rougir (rho = 0,91) et à des mesures de PS (rho = 0,23 à 0,55). La moyenne des scores au QES est plus élevée dans le groupe des patients avec PS, et encore supérieure dans celui des patients avec éreutophobie. Un score de 7 sur 24 permet de dépister l'éreutophobie avec une sensibilité de 92,1 % et une spécificité de 87,7 %. La stabilité test-retest du QES à 15 jours d'intervalle est satisfaisante (CCI = 0,83).

Conclusion:

Le QES est un outil valide et sensible pour dépister et mesurer l'intensité de l'éreutophobie, qui peut ětre utilisé dans des études psychopathologiques et thérapeutiques sur cette pathologie.
Screening Cognitive Performance with the Resident Assessment Instrument for Mental Health Cognitive Performance Scale
Authors: Jones Kendra , Perlman Christopher M , Hirdes John P , Scott Tracey
Published: January 2017

Objective:

The validity of the Cognitive Performance Scale (CPS) embedded in the Resident Assessment Instrument—Mental Health (RAI-MH) was evaluated among adult psychiatric inpatients.

Methods:

The CPS is a brief measure of cognitive performance, with scores ranging from 0 (intact) to 6 (very severe impairment). The CPS scores were compared with the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scores for 215 adult psychiatric inpatients.

Results:

The CPS scores were significantly correlated with MMSE scores ( r = −0.69, P < 0.001) and MoCA scores ( r = −0.69, P < 0.001). Higher scores on the CPS were associated with greater functional impairment, older age, and a greater prevalence of dementia diagnoses than lower CPS scores.

Conclusions:

Pilot data show the CPS is a valid screening measure of cognitive performance among adult psychiatric inpatients. Additional research is needed to replicate our study using a larger sample with more diverse mental health conditions.
Stresses of Passage, Balms of Resettlement, and Posttraumatic Stress Disorder among Sri Lankan Tamils in Canada
Authors: Beiser Morton , Simich Laura , Pandalangat Nalini , Nowakowski Matilda , Tian Fu
Published: January 2017

Objectives:

To explore the salience of pre- and postmigration stresses as risk factors for posttraumatic stress disorder (PTSD) and to identify resilience factors and explore their mental health salience.

Methods:

We conducted a mental health survey of 1603 Sri Lankan Tamils in Toronto, incorporating the World Health Organization Composite International Diagnostic Interview for PTSD.

Results:

According to the International Classification of Diseases, 10th Revision, criteria, lifetime prevalence for PTSD was 12%; according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria it was 5.8%. Female sex and the number of stresses of passage increased the probability of PTSD, whereas satisfaction with life and the availability of nonfamily social relations reduced it.

Conclusions:

Consideration of pre- and postmigration stresses of passage and of the nature of resilience contributes to an improved understanding of PTSD among refugees.
Erratum
Authors: Li Ning , Pang Lihua , Chen Gong , Song Xinming , Zhang Jun , Zheng Xiaoying
Published: January 2017

Li N, Pang L, Chen G, et al. Risk factors for depression in older adults in Beijing. Can J Psychiatry. 2011;56(8):466–473.

It has come to our attention that there was missing affiliation information for 3 authors. The correct positions and affiliations are shown below:

The Canadian Journal of Psychiatry regrets the error and any inconvenience it might have caused.
Economic Evaluation of the Impact of Memantine on Time to Nursing Home Admission in the Treatment of Alzheimer Disease
Authors: Lachaine Jean , Beauchemin Catherine , Legault Mark , Bineau Sébastien
Published: January 2017

Objective:

An observational study showed that combining memantine with a cholinesterase inhibitor (ChEI) treatment significantly delayed admission to nursing homes in patients with Alzheimer disease (AD). Our study aimed to evaluate the economic impact of the concomitant use of memantine and a ChEI, compared with a ChEI alone, in a Canadian population of patients with AD.

Method:

A cost-utility analysis using a Markov model during a 7-year time horizon was performed according to a societal and Canadian health care system perspective. The Markov model includes the following states: noninstitutionalized, institutionalized, and deceased. The model includes transition probabilities for institutionalization and death, adjusted with mortality rates specific to AD. Utilities associated with institutionalization and noninstitutionalization were included. For the health care system perspective, costs of medication as well as costs of care provided in the community and in nursing homes were considered. For the societal perspective, costs of direct care and supervision provided by caregivers were added.

Results:

From both perspectives, the concomitant use of a ChEI and memantine is a dominant strategy, compared with the use of a ChEI alone. On a per patient basis, there was a gain of 0.26 quality-adjusted life years with the treatment including memantine and cost decreases of Can$21 391 and Can$30 512, respectively, for the societal and health care system perspective.

Conclusions:

This economic evaluation indicates that institutionalization is the largest cost component in AD management and that the use of memantine, combined with a ChEI, to treat AD is a cost-effective alternative, compared with the use of a ChEI alone.
The Challenges Faced by Caregivers of Children with Impairments of Psychological Functions: A Population-Based Cross-Sectional Study
Authors: Baillargeon Raymond H , Bernier Julie , Normand Claude L
Published: January 2017

Objective:

To assess the challenges faced by caregivers of children with impairments of psychological functions (IPFs).

Method:

Data came from the 2001 Participation and Activity Limitation Survey, a post-census national survey of people with disabilities residing in the 10 Canadian provinces. Interviews of caregivers of children aged 5 to 14 years with a disability ( n = 3908) were conducted between September 2001 and January 2002.

Results:

Caregivers of children with IPFs who are severely limited in their everyday activities were more likely to: need respite care; be refused a child care program or service; not receive health services for their children when needed; and not take a job, quit work, and work fewer hours to care for their children.

Conclusions:

This highlights the importance of both removing barriers and obstacles to the full participation of children with IPFs in everyday activities and improving their caregivers' access to health and child care services. It also argues in favour of family-centred care that explicitly considers caregivers' concerns, identifies their needs and problems, and supports families in their caregiving roles.
A Longitudinal Study of Risk Factors for Incident Drug Use in Adults: Findings from a Representative Sample of the US Population
Authors: Harrington Michael , Robinson Jennifer , Bolton Shay-Lee , Sareen Jitender , Bolton James M
Published: January 2017

Objective:

To examine baseline mental disorders and other correlates among people who have not previously used drugs as potential risk factors for incident drug use at 3-years' follow-up.

Method:

Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (commonly referred to as the NESARC) Wave 2 (2004 to 2005; n = 34 653), a longitudinal nationally representative survey of mental illness in community-dwelling adults. The study group consisted of people who reported no history of any illicit drug use or prescription drug misuse at Wave 1 (2001 to 2002). Logistic regression analyses were used to compare people with first-episode drug use at Wave 2 ( n = 1145) to those who remained abstinent ( n = 25 790) across various Wave 1 correlates, including sociodemographic factors, mental disorders (including alcohol use disorders and nicotine dependence), childhood adversity, and family history of substance use disorders.

Results:

All measures of childhood adversity were associated with an increased risk of incident drug use, as were alcohol or drug problems in first-degree relatives. In models adjusted for childhood adversity and a family history of addiction, a pre-existing mood disorder (AOR 1.31; 95% Cl 1.04 to 1.64), personality disorder (AOR 1.82; 95% Cl 1.50 to 2.20), previous nicotine dependence (AOR 1.41; 95% Cl 1.09 to 1.83), and alcohol abuse or dependence (AOR 1.96; 95% Cl 1.48 to 2.60) were independently associated with new-onset drug use at follow-up.

Conclusions:

Specific mental disorders independently increase the risk of progression to incident drug use among people who were previously abstinent. Early-life adversities and addiction in family members accounts for some, but not all, of this observed relation.
Evolutionary Theories of Depression: A Critical Review
Authors: Hagen Edward H
Published: January 2017

We critically review evolutionary theories of major depressive disorder (MDD). Because most instances of MDD appear to be caused by adversity, evolutionary theories of MDD generally propose that sadness and low mood evolved as beneficial responses to adversity, and that MDD is dysfunctional sadness and low mood. If so, MDD research should focus much more heavily on understanding the healthy functions of sadness and low mood to better understand how they dysfunction. A debate about the boundary between healthy sadness and MDD is then reviewed. In part, this debate turns on whether MDD's costliest symptoms could provide unknown benefits. Therefore, the review concludes by discussing 2 theories that explore possible benefits of prolonged anhedonia and suicidality.
Prévalence des habitudes de jeu en Gaspésie et aux Îles-de-la-Madeleine en 2009
Authors: Giroux Isabelle , Jacques Christian , Ladouceur Robert , Leclerc Martin , Brochu Priscilla
Published: January 2017

Objectif:

Estimer la prévalence des habitudes aux jeux de hasard et d'argent (JHA), du jeu à risque (JAR) et du jeu pathologique probable (JPP) dans la région de la Gaspésie et des Îles-de-la-Madeleine (GIM) (Québec).

Méthode:

Un sondage téléphonique portant sur les habitudes de jeu a été réalisé auprès de 1014 adultes résidents de la région de la GIM. Les participants ont été sélectionnés aléatoirement. L'échelle Problem Gambling Severity Index de l'Indice canadien du jeu excessif a servi à l'évaluation du jeu pathologique.

Résultats:

Quatre-vingt-cinq pour cent des répondants rapportent avoir joué à un JHA au cours de l'année précédente. Les activités les plus populaires sont l'achat de billets de loterie, la participation à des tirages et collectes de fonds, le bingo, les cartes ou jeux de société en famille ou avec des amis pour de l'argent, la loterie vidéo et les jeux de casino. Les taux de prévalence du JAR et du JPP s'élèvent à 1,5 % et 0,8 % respectivement. La loterie vidéo s'avère le jeu le plus souvent identifé comme étant problématique, suivi des loteries instantanées et ordinaires (par exemple, Lotto 6/49).

Conclusion:

Les habitudes de jeu des Gaspésiens et des Madelinots sont similaires à celles observées chez l'ensemble des Québécois. La discussion soulève entre autres la question de la validité de l'évaluation de la présence d'un problème de jeu parmi les membres de l'entourage, et certaines perceptions à risque, dont celle qu'il est impossible de développer un problème aux loteries instantanées et au bingo.
Emerging Risk Factors for Postpartum Depression: Serotonin Transporter Genotype and Omega-3 Fatty Acid Status
Authors: Shapiro Gabriel D , Fraser William D , Séguin Jean R
Published: January 2017

Objective:

Depression is a leading cause of disability and hospitalization. Women are at the highest risk of depression during their childbearing years, and the birth of a child may precipitate a depressive episode in vulnerable women. Postpartum depression (PPD) is associated with diminished maternal somatic health as well as health and developmental problems in their offspring. This review focuses on 2 PPD risk factors of emerging interest: serotonin transporter (5-HTT) genotype and omega-3 polyunsaturated fatty acid (n-3 PU FA) status.

Method:

The MEDLINE, PubMed, and Web of Science databases were searched using the key words postpartum depression, nutrition, omega-3 fatty acids, and serotonin transporter gene. Studies were also located by reviewing the reference lists of selected articles.

Results:

Seventy-five articles were identified as relevant to this review. Three carefully conducted studies reported associations between the 5-HTT genotype and PPD. As well, there is accumulating evidence that n-3 PUFA intake is associated with risk of PPD. Preliminary evidence suggests that there could be an interaction between these 2 emerging risk factors. However, further studies are required to confirm such an interaction and to elucidate the underlying mechanisms.

Conclusions:

Evidence to date supports a research agenda clarifying the associations between n-3 PUFAs, the 5-HTT genotype, and PPD. This is of particular interest owing to the high prevalence of poor n-3 PUFA intake among women of childbearing age and the consequent potential for alternative preventive measures and treatments for PPD.
Melancholia: Past and Present
Authors: Healy David
Published: January 2017

Objective:

To investigate commonalities in the clinical presentation of melancholia over time.

Method:

I conducted a comparative study to 2 epidemiologically complete databases from 1875–1924 and 1995–2005.

Results:

Patients in the historical period (1875–1924, compared with 1995–2005) with a diagnosis of melancholia show a classic profile of endogenous onset, with remission after 6 months, neurovegetative features, and, commonly, psychosis. The incidence of psychotic presentations appears to have fallen in recent decades. Patients in the contemporary period (1995–2010, compared with 1875–1924) at first admission for severe depressive disorders are more likely at an older age, more likely to go on to die by suicide, and will have much more frequent admissions.

Conclusions:

The data from this study support classical perceptions of melancholia. The poor outcomes in contemporary cases of severe depressive disorders support arguments for distinguishing between melancholia and other depressive disorders.
The Costs Associated with Antidepressant Use in Depression and Anxiety in Community-Living Older Adults
Authors: Vasiliadis Helen-Maria , Latimer Eric , Dionne Pierre-Alexandre , Préville Michel
Published: January 2017

Objective:

To determine the costs associated with antidepressant (AD) use by depression and anxiety status in a public-managed health care system.

Methods:

Data were obtained from a population-based health survey of 1869 older adults. Depression and anxiety were based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and measured at 2 time points 1 year apart. AD and health service use and costs were identified from provincial administrative databases and included hospitalizations, physician fees, outpatient medications, and ambulatory visits. Patient costs considered were related to drug copayments, transportation, and time spent seeking medical care. Annual costs associated with AD use were studied as a function of mental health status at baseline and follow-up interviews (persistence, incidence, remission, or no illness). Generalized linear models with a gamma distribution were used to control for individual factors.

Results:

The costs incurred by participants using ADs as a whole (17.8%) reached $6678 (95% CI $5449 to $8182), significantly more than in participants not using ADs ($4698; 95% CI $3710 to $5949). AD use was associated with greater total adjusted costs among respondents with no depression (adjusted difference = $1769; 95% CI $236 to $3702) and no anxiety (adjusted difference = $1845; 95% CI $203 to $3486).

Conclusion:

The results showed that AD use was not associated with cost savings in any group, and indeed with greater costs among participants who were neither depressed nor anxious at any time point. Future cost studies may consider the analyses of different AD classes regarding the different clinical mental health profiles in older adults.
Phenomenology and Treatment of Behavioural Addictions
Authors: Grant Jon E , Schreiber Liana RN , Odlaug Brian L
Published: January 2017

Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.