bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunotoxicity and Sensitizing Capacity of Metal Compounds Depend on Speciation
Authors: Di Gioacchino M. , Verna N. , Di Giampaolo L. , Di Claudio F. , Turi M.C. , Perrone A. , Petrarca C. , Mariani-Costantini R. , Sabbioni E. , Boscolo P.
Published: January 2017

Immunotoxicity of metal compounds is an issue of great importance due to the recent industrial application of metals with unknown toxicity on the immune system and the discovery of metal intermediary compounds not sufficiently studied yet. In this report we show results of our study on the immunotoxicity of the following metals: the Platinum group elements (Platinum, Palladium, Rhodium), Titanium and Arsenic. We applied functional and non functional assays and investigated both innate and adaptive immune systems, in particular, cell proliferation, cytokine production by PBMCs and O−2 production by neutrophils. We obtained the following results: only some Ti compounds (Titanocene, Ti ascorbate and Ti oxalate) show immunotoxicity. Trivalent As compounds (Sodium arsenite and tetraphenyl arsonium chloride) are more immunotoxic than the other investigated As compounds. Genotoxicity of Pt group compounds is in the following order: Pt < Rh < Pd. Immunotoxicity of Pt group compounds is in the following order: Pd < Pt < Rh. Lymphocytes and macrophages show a different reaction of neutrophils to metal toxicity. We can conclude that these studies show that metal immunotoxicity depends on speciation. In general speciation provides additional and often essential information in evaluating metal toxicity. However, there are many difficulties in applying speciation in investigating toxico-kinetic aspects to many metals, mainly due to the lack of information about the existence and significance of species and to the lack of analytical methods for measuring species in biological samples.
Identification of IP-10 and IL-5 as Proteins Differentially Expressed in Human Complicated and Uncomplicated Carotid Atherosclerotic Plaques
Authors: Profumo E. , Buttari B. , Tosti M.E. , Alessandri C. , Valesini G. , Marcuccio L. , Tesori C. , Capoano R. , Salvati B. , Riganò R.
Published: January 2017

Inflammation plays a crucial role in the development and progression of atherosclerotic plaques. The aim of this study is to compare culture supernatants from uncomplicated and complicated carotid atherosclerotic plaques by a multiplex approach, to assess the molecular mediators associated with a complicated plaque phenotype. Atherosclerotic plaques were obtained from 17 patients undergoing carotid endarterectomy. Supernatants from plaque cultures were evaluated by Bio-Plex cytokine assay to determine 27 pro- and anti-inflammatory cytokines, chemokines and growth factors. Complicated plaques secreted higher levels of IP-10 (p = 0.027) and lower levels of IL-5 (p = 0.045) than did uncomplicated ones. Distinctive secretory patterns of cytokines, chemokines and growth factors were present in the two types of plaque. Our study identifies IP-10 and IL-5 as proteins differentiating complicated and uncomplicated plaques from human carotid arteries and provides new insights into the interplay of molecular mediators with atherosclerotic plaque progression.
Beneficial Effects of Chlorella-11 Peptide on Blocking LPS-Induced Macrophage Activation and Alleviating Thermal Injury-Induced Inflammation in Rats
Authors: Cherng J.Y. , Liu C.C. , Shen C.R. , Lin H.H. , Shih M.F.
Published: January 2017

Chlorella possesses various remarkable biological activities. One component, Val-Glu-Cys-Tyr-Gly-Pro-Asn-Arg-Pro-Gln-Phe ( Chlorella-11 peptide) was found to be able to suppress LPS-induced NO production and inflammation. However, the molecular mechanism behind these findings and the consistency between in vitro and in vivo data have not been investigated. LPS-activated RAW 264.7 macrophages were used to study in vitro molecular anti-inflammatory effects of Chlorella-11 peptide. After activation, NO production and the expression of iNOS and NF-κB proteins as well as iNOS mRNA were measured using Griess colorimetric assay, Western blotting and RT-PCR, respectively. Alterations in PGE2 and TNF-α contents were also monitored by ELISA. For in vivo studies, thermal injury Wistar rats were used and inflammatory indications e.g. serum malondialdehyde (MDA), TNF-α levels and skin erythema were evaluated 48 h after injury implementation. In vitro results showed that Chlorella-11 peptide produced a dose- and time-dependent inhibition on NO production. The effective inhibition could remain for at least 6 h after LPS activation. It was also found that the expression of LPS-induced iNOS mRNA, iNOS and NF-κB proteins were diminished by the peptide treatment. Concurrently, the levels on TNF-α and PGE2 production after LPS activation were also inhibited. These findings are in agreement with the in vivo data that animal serum MDA and TNF-α levels and skin erythema in rats were considerably reduced compared to the control group (saline-treated). The significance of this study sheds light on the effectiveness of Chlorella-11 peptide in preventing inflammation progression in vitro and in vivo and its potential for clinical applications.
The Effects of Alcoholism Pharmacotherapy on Immune Responses in Alcohol-Dependent Patients
Authors: Franchi S. , Sacerdote P. , Moretti S. , Gerra G. , Leccese V. , Tallone M.V. , Panerai A.E. , Somaini L.
Published: January 2017

Chronic alcohol use has profound modulatory effects on the immune system. Both the innate and the acquired immunity are compromised. The use of pharmacotherapy is increasingly applied to enhance the percentage of success in maintaining alcoholic patients in remission. Disulfiram, naltrexone and gamma hydroxybutiric acid are the drugs used for this purpose in Italian Addiction Services. In this study we analyze the effect of pharmacotherapy of alcohol dependence on immune responses in alcoholics. Six groups were studied. Group A included 10 patients who were still using alcohol. Group B consisted of 10 patients abstinent from alcohol in treatment only with group therapy. Groups C, D and E were composed of 10 patients each, treated for at least 6 months with oral doses of gamma hydroxybutiric acid, naltrexone or disulfiram respectively. Ten age- and sex-matched healthy volunteers who never misused alcohol were included as a control group. Lymphoproliferation and peripheral mononuclear cell production of the Th1 cytokines IL-2 and IFN-γ, the Th2 cytokine IL-4, and of the pro-inflammatory cytokines IL-1 and TNF-α were evaluated in all the patients and controls. The level of activity of the hypothalamus pituitary adrenal axis was assessed. Both ACTH and cortisol levels in plasma were elevated in alcoholic patients with no treatment. In this group a significant alteration of cytokine production was observed. TNF and IFN-γ were lower than controls, while the Th2 cytokine IL-4 was increased. These altered levels state for a Th1/Th2 unbalance characterized by decreased Th1 response in the presence of Th2 predominance. In patients undergoing pharmacological treatment, none of the immune parameters were different from those observed in healthy controls, independently of the type of drug administered. These data indicate that pharmacotherapy more than group therapy treatment is able to ameliorate the immune system functioning in alcoholic patients.
Monomeric Allergoid Intragastric Administration Induces Local and Systemic Tolerogenic Response Involving IL-10-Producing CD4+CD25+ T Regulatory Cells in Mice
Authors: Petrarca C. , Lazzarin F. , Pannellini T. , Iezzi M. , Braga M. , Mistrello G. , Falagiani P. , Di Giampaolo L. , Di Gioacchino M.
Published: January 2017

The efficacy of sublingual immunotherapy, at present one of the treatments of choice for respiratory allergy, relies on the tolerance induced by oral mucosa-associated immune system; however, the gut-associated lymphoid tissue (GALT: Peyer's patches and isolated lymphoid follicles) and mesenteric lymph nodes could also be involved, being stimulated by the ingested part of the allergen extract. The aim of the present study is to assess whether the exposure of the allergen exclusively to the GALT induces a tolerogenic response. To this purpose, mice were sensitized with ovalbumin or Par j 1 allergens. The corresponding gastric-resistant monomeric allergoids were then administered via orogastric gavage. After treatment, all mice were tested for: serum IgE, in vitro Th1 and Th2 cytokine release by allergen-stimulated peripheral blood lymphocytes, CD4+CD25+ and CD4+CD25+IL-10+ T cells in Peyer's patches, mesenteric lymph nodes and spleen. Compared to the control, sensitized groups showed higher levels of serum IgE, lower frequency of CD4+CD25+IL-10+ T cells, at all sites, and higher amounts of in vitro-released IL-4, IL-6 and TNF-α. Compared to the sensitized groups, higher frequency of CD4+CD25+IL-10+ T cells was observed in the spleen of both Par-j 1 and OVA sensitized/treated groups and, only for ovalbumin-treated mice, in the Peyer's patches and mesenteric lymph nodes, IgE and in vitro cytokines were significantly lower and equivalent to the control group. The results give the first evidence that the intragastric-restricted administration of gastric-resistant allergens restores local and peripheral tolerance in allergen-sensitized mice.
Is Hypogammaglobulinemia a Constant Feature in Good's Syndrome?
Authors: Federico P. , Imbimbo M. , Buonerba C. , Damiano V. , Marciano R. , Serpico D. , Di Lorenzo G. , Palmieri G.
Published: January 2017

Thymomas are rare tumors, which can be associated to a variety of paraneoplastic syndromes, including a fatal hypogammaglobulinemia, namely Good's Syndrome (GS). Although the combination of thymoma and hypogammaglobulinemia is regarded as sufficient for diagnosis of Good's syndrome, some thymoma patients with a clear clinical picture of immunodeficiency present normal levels of immunoglobulins. We describe the case of a patient, with a 20-year history of thymoma, who underwent several operations and lines of chemotherapy, and suffered from recurrent infections, including one rare skin infection from Pseudoallescheria boydii. The patient constantly presented normal levels of gammaglobulins.
Acute Pneumonia in a Fire-Eater
Authors: Dell'omo M. , Murgia N. , Chiodi M. , Giovenali P. , Cecati A. , Gambelunghe A.
Published: January 2017

Fire-eater's lung, an acute exogenous lipoid pneumonia, is caused when street performers accidentally inhale pyrofluids. We report the case of a young fire-eater who, 12 hours after inhaling an iso-alkane-based pyrofluid, developed fever, dyspnoea, dry cough and intense right chest pain. Radiographic signs of pneumonia emerged two days later. Computed tomography (CT) scans visualized an irregular area of parenchymal consolidation with an air bronchiologram and peripheral ground-glass opacities in the right middle lobe. The diagnostic work-up included microbiological and lung function tests, optic fibre bronchoscopy and an in-depth cyto-immunological analysis of bronchoalveolar lavage fluid. Symptoms gradually improved over a few days. A CT scan one month later showed the thickened parenchymal area in the right middle lobe had almost completely disappeared.
Immunological Evaluation of Children Treated with Antiepileptic Drugs
Authors: Verrotti A. , Domizio S. , Chiarelli F. , Sabatino G. , Morgese G.
Published: January 2017

In order to evaluate cellular and humoral immunity in children who were given carbamazepine (CBZ), sodium valproate (VPA) or phenobarbital (PHB) as monotherapy, we studied 137 children and adolescents suffering from various types of epilepsy and 50 healthy control children. The patients were subdivided according to the type of drug received: in particular, Group 1: 50 (26 female, 24 male) children received only CBZ; their age ranged from 2.3 years to 16.0 years (mean ± SD, 8.1 ± 7.9 years); Group 2: 50 (26 female, 24 male) children received only VPA with age from 2.8 to 15.1 (8.9 ± 7.1) years; Group 3: 37 (20 female, 17 male) children who were given only PHB with age from 2.0 to 13.9 (8.4 ± 7.8) years. 50 sex and age- matched healthy children served as controls. All the patients of groups 1, 2 and 3 were studied before the beginning of antiepileptic drug therapy and after 6, 12 and 18 months of therapy. All plasma levels of AEDs were within the therapeutic range. All children of the three groups had a normal number of lymphocytes per millimeter of blood; also the values of CD3, CD4, CD8, CD20 and CD56 and the serum levels of complement (C3 and C4) were similar to those of healthy controls. The natural killer cell activity of children receiving CBZ showed a significant reduction: this reduction was present after 6 months of therapy (baseline: 45.2%; after 6 months: 32.6%; after 12 months 31.3 %; (all determinations vs baseline:p<0.01) and continued to be present until the end of the study (36.9%; p<0.05).

Our data suggest that, in children receiving CBZ, VPA and PHB on monotherapy significant abnormalities of serum immunoglobulin concentrations, serum complement values and lymphocyte subsets are not present. CBZ is shown to have a reducing effect on the natural killer cell activity, but the real role of this abnormality in the immune system of these patients needs more investigation.
Apolipoprotein E Genotyping for Pharmacogenetic Purposes in Alzheimer's Disease: Emerging Ethical Issues
Authors: Issa Amalia M , Keyserlingk Edward W
Published: January 2017

Objective:

To present some of the ethical concerns pertaining to the anticipated use of apolipoprotein E genotyping in selecting therapy in Alzheimer's disease.

Method:

We review studies that support the utility of apolipoprotein E (APO E) genotyping for predicting drug responsiveness along with the published consensus statements and position papers related to APO E genotyping. Ethical issues pertaining to the use of APO E genotyping for pharmacogenetic purposes have not yet been fully explored, and these are discussed.

Results:

This paper explores the bioethics surrounding the use of APO E genotyping for pharmacogenetic purposes. The rapidly increasing pace of clinical trials in Alheimer's disease necessitates a critical examination of the evolving ethical issues. A framework for establishing guidelines is suggested.

Conclusions:

Clinical research trials for Alzheimer's disease with a genotyping component will increasingly be influenced by and benefit from a serious analysis of the ethics emerging alongside the scientific and clinical advances.
« What's up, doc? » Le contexte, les limites et les enjeux de la médecine fondée sur des données probantes pour les cliniciens (Evidence-Based Medicine)
Authors: Lesage Alain D , Stip Emmanuel , Grunberg Frédéric
Published: January 2017

Contexte:

L'approche d'une pratique fondée sur les données probantes n'est-elle pas une nouvelle façon de nommer la dialectique de la médecine moderne entre la pratique d'un art et l'éclairage des meilleures données de la science?

Méthodes:

Cet essai en trois temps traite d'abord du contexte historique; ensuite, il aborde les limites conceptuelles et méthodologiques de l'approche par l'illustration de méta-analyses portant sur quatre situations qui ont cours en psychiatrie, avant de donner le mot de la fin au clinicien.

Contenu:

Le contexte associe la pratique fondée sur les données probantes premièrement à la période des restrictions budgétaires et deuxièmement, à l'avènement d'Internet. L'engrenage de la machine apparemment bien huilée semble se détraquer quelque peu lorsqu'on tient compte des éléments subjectifs qui interviennent dans les méta-analyses. Par ailleurs, les données non publiées, l'homogénéisation des populations étudiées et la présomption que seules les études randomisées conduisent à une connaissance scientifique valable posent problème. Nous croyons que le clinicien ne sera pas surpris et pourra même ramener le débat aussi loin que celui d'autrefois entre les empiristes et les rationalistes.

Conclusion:

La pratique médicale fondée sur les données probantes dans sa vision la plus noble relance le questionnement nécessaire sur nos pratiques.
Canadian and American Psychiatrists' Attitudes toward Dissociative Disorders Diagnoses
Authors: Lalonde Justine K , Hudson James I , Gigante Robin A , Pope Harrison G
Published: January 2017

Objective:

To compare the opinions of Canadian psychiatrists regarding dissociative disorder diagnoses with those of previously surveyed American psychiatrists.

Method:

We sent a 1-page questionnaire to a stratified representative sample of 550 Canadian psychiatrists.

Results:

Eighty percent of Canadian psychiatrists responded. Fewer than one-third replied that dissociative amnesia and dissociative identity disorder should be included without reservations in the DSM-IV; fewer than 1 in 7 felt that the validity of these diagnoses was supported by strong scientific evidence. French- and English-speaking Canadians had similar opinions. Overall, Canadians were significantly less accepting than Americans.

Conclusion:

Both Canadian and American psychiatrists show little consensus regarding the diagnostic status or scientific validity of dissociative amnesia and dissociative identity disorder.
A Profile of Canadian Adults Seeking Treatment for Gambling Problems and Comparisons with Adults Entering an Alcohol Treatment Program
Authors: Wiebe Jamie , Cox Brian J
Published: January 2017

Objective:

To empirically describe problem gambling in the Canadian context, using a large sample of treatment-seeking adults.

Method:

We assessed 1376 Winnipeg adults seen in the problem gambling program at the Addictions Foundation of Manitoba (AFM) and compared them with 11661 alcohol-program clients seen over the same 4-year time period.

Results:

Sociodemographic comparisons revealed a higher-functioning profile for individuals with gambling problems compared with those having alcohol problems (for example, higher education and income levels). Most gambling clients did not report symptoms of substance abuse, but almost 70% smoked cigarettes. The most frequent gambling activity involved the use of video lottery terminals (VLTs) in local bars and restaurant lounges. Lottery tickets, bingo, and even casinos were infrequently used by problem gamblers.

Conclusions:

In several ways, gambling problems in the Canadian context represent a relatively novel form of addiction that many clinicians have not previously encountered. VLTs were only recently introduced in many parts of Canada, and they appear to play a large role in the expression of problem gambling. One potential reason for the popularity of neighbourhood bars over casinos or US venues is the increased availability of legalized gambling in the community.
Assessing Fitness to Stand Trial: The Utility of the Fitness Interview Test (Revised Edition)
Authors: Zapf Patricia A , Roesch Ronald , Viljoen Jodi L
Published: January 2017

Objective:

In Canada most evaluations of fitness to stand trial are conducted on an inpatient basis. This costs time and money, and deprives those defendants remanded for evaluation of liberty. This research assessed the predictive efficiency of the Fitness Interview Test, revised edition (FIT) as a screening instrument for fitness to stand trial.

Method:

We compared decisions about fitness to stand trial, based on the FIT, with the results of institution-based evaluations for 2 samples of men remanded for inpatient fitness assessments.

Results:

The FIT demonstrates excellent utility as a screening instrument. The FIT shows good sensitivity and negative predictive power, which suggests that it can reliably screen those individuals who are clearly fit to stand trial, before they are remanded to an inpatient facility for a fitness assessment.

Conclusion:

We discuss the implications for evaluating fitness to stand trial, particularly in terms of the need for community-based alternatives to traditional forensic assessments.
Studies of Altered Social Cognition in Neuropsychiatric Disorders Using Functional Neuroimaging
Authors: Grady Cheryl L , Keightley Michelle L
Published: January 2017

In this paper, we review studies using functional neuroimaging to examine cognition in neuropsychiatric disorders. The focus is on social cognition, which is a topic that has received increasing attention over the past few years. A network of brain regions is proposed for social cognition that includes regions involved in processes relevant to social functioning (for example, self reference and emotion). We discuss the alterations of activity in these areas in patients with autism, depression, schizophrenia, and posttraumatic stress disorder in relation to deficits in social behaviour and symptoms. The evidence to date suggests that there may be some specificity of the brain regions involved in these 4 disorders, but all are associated with dysfunction in the amygdala and dorsal cingulate gyrus. Although there is much work remaining in this area, we are beginning to understand the complex interactions of brain function and behaviour that lead to disruptions of social abilities.
Correlates of Therapeutic Response in Panic Disorder Presenting with Palpitations: Heart Rate Variability, Sleep, and Placebo Effect
Authors: Baker Brian , Khaykin Yaariv , Devins Gerald , Dorian Paul , Shapiro Colin , Newman David
Published: January 2017

Objective:

To examine the correlates of therapeutic response of patients with panic disorder presenting with palpitations, we hypothesized that therapeutic response would correlate with heart rate variability (HRV) and sleep measures.

Methods:

After a 1-week placebo washout, 27 patients free of structural heart disease and not on cardioactive drugs were randomized in a double-blinded fashion to 4 weeks of treatment with clonazepam (a known antipanic agent) or placebo. We performed standard sleep measures and recorded HRV from 24-hour Holter acquisitions at baseline and end of study. We defined response to therapy as a 50% improvement in the Hamilton Anxiety Rating Scale (HARS) score, confirmed by questionnaires and reaction to sodium lactate infusion.

Results:

There were 12 responders and 15 nonresponders. Normalization of sleep pattern (including less stage 1 and rapid eye movement [REM] sleep) was observed in both drug and placebo responders ( P = 0.011 and P = 0.05, respectively) and in placebo responders alone, compared with nonresponders ( P = 0.006 and P = 0.013, respectively). Placebo responders were more likely to show less depression, but even after we controlled for depression, main sleep effects remained. None of the HRV measures correlated with response, but compared with placebo, clonazepam led to a decrease in all the time and frequency domain measures of HRV (all P < 0.05).

Conclusions:

Central mechanisms are related to the therapeutic response of patients with panic disorder presenting with palpitations, but this does not directly correlate with HRV. Larger and longer studies may allow objective explanations of placebo response in panic disorder.
Children with Psychiatric Disorders: The Al Ain Community Psychiatric Survey
Authors: Eapen Valsamma , Jakka Mona Essa , Abou-Saleh Mohammed T
Published: January 2017

Objective:

The prevalence of child psychiatric morbidity in the community is unknown in most developing countries, including those in the Arab region.

Method:

An epidemiologic study was carried out to estimate the prevalence of psychiatric morbidity and to determine the sociodemographic correlates in a sample of children in the community, aged 6 to 18 years, in Al Ain, United Arab Emirates (UAE).

Results:

We obtained a prevalence rate of 22.2% for overall morbidity, as classified in the DSM-1V, and 14.3% for those with significant dysfunction, with the most common diagnosis being mood disorders. Female sex, large family size, chronic life difficulties, family history of psychiatric disorder, and alcohol-related problems in a family member were significantly associated with DSM-IV diagnosis.

Conclusion:

Although the prevalence and symptomatology in this Middle East community are similar to those in Western studies, none of these children had received professional help, suggesting serious deficiencies in mental health care services in the country.
Anxiety-Related Visits to Ontario Physicians following September 11, 2001
Authors: Austin Peter C , Mamdani Muhammad M , Chan Benjamin TB , Lin Elizabeth
Published: January 2017

Objective:

To determine whether the climate of increased anxiety following the terrorist attacks of September 11, 2001, and the subsequent anthrax cases led to increased anxiety-related physician visits.

Method:

We undertook a retrospective, population-based study of all Ontario residents. We identified physician visits using Ontario's universal health care insurance program. Interventional autoregressive integrated moving average (ARIMA) time series models were used to examine the impact of the terrorist attacks and anthrax infections on the rate of anxiety-related physician visits.

Results:

Neither the terrorist attacks of September 11 ( P ≥ 0.40) nor the anthrax infections in October and November ( P ≥ 0.14) had a statistically significant impact on the rate of anxiety-related visits to physicians.

Conclusions:

The climate of heightened anxiety did not result in increased demand for mental health services.
Clinical Features of Bipolar Disorder with and without Comorbid Diabetes Mellitus
Authors: Ruzickova Martina , Slaney Claire , Garnham Julie , Alda Martin
Published: January 2017

Objective:

Several papers have reported higher prevalence of diabetes mellitus (DM) type 2 in patients suffering from bipolar disorder (BD). The possible links between these 2 disorders include treatment, lifestyle, alterations in signal transduction, and possibly, a genetic link. To study this relation more closely, we investigated whether there are any differences in the clinical characteristics of BD patients with and without DM.

Method:

We compared the clinical data of 26 diabetic and 196 nondiabetic subjects from The Maritime Bipolar Registry. Subjects were aged 15 to 82 years, with psychiatric diagnoses of BD I ( n = 151), BD II ( n = 65), and BD not otherwise specified ( n = 6). The registry included basic demographic data and details on the clinical course of bipolar illness, its treatment, and physical comorbidity. In a subsequent analysis using logistic regression, we examined the variables showing differences between groups, with diabetes as an outcome variable.

Results:

The prevalence of DM in our sample was 11.7% ( n = 26). Diabetic patients were significantly older than nondiabetic patients ( P < 0.001), had higher rates of rapid cycling ( P = 0.02) and chronic course of BD ( P = 0.006), scored lower on the Global Assessment of Functioning Scale ( P = 0.01), were more often on disability for BD ( P < 0.001), and had higher body mass index ( P < 0.001) and increased frequency of hypertension ( P = 0.003). Lifetime history of treatment with antipsychotics was not significantly associated with an elevated risk of diabetes ( P = 0.16); however, the data showed a trend toward more frequent use of antipsychotic medication among diabetic subjects.

Conclusions:

Our findings suggest that the diagnosis of DM in BD patients is relevant for their prognosis and outcome.
Defining Anxious Depression: Going beyond Comorbidity
Authors: Silverstone Peter H , von Studnitz Erica
Published: January 2017

Objective:

Since publication of the DSM-IV, there remains a group of patients with depression and anxiety symptoms who are not well classified. We therefore wanted to determine more accurately the type of patients best described by the term “anxious depression.” We also wanted to review the literature to assess the most appropriate treatment(s) for these patients.

Method:

We surveyed the medical literature published after 1994 for all articles containing the relevant terms and assessed all possible articles in detail to determine those relevant to the diagnosis and those that involved relevant clinical studies.

Results:

The term anxious depression can encompass 3 groups of patients: those with comorbid major depressive disorder (MDD) and an anxiety disorder, those with MDD but with subthreshold anxiety symptoms, and those with subthreshold depressive and subthreshold anxiety symptoms (also called mixed anxiety and depressive disorder).

Conclusions:

Based upon our literature review, we believe that the term anxious depression should only be used for the second group; that is, those patients with an MDD and subthreshold anxiety symptoms. From our literature review to determine the most appropriate treatment for this group of patients, it appears likely that drugs inhibiting the reuptake of both noradrenaline and serotonin may have greater clinical utility than single-action drugs such as the selective serotonin reuptake inhibitors (SSRIs). However, it is also clear that much more research needs to be undertaken in this important patient group so that we can better understand its prevalence, clinical features, and treatment.
Risk of Weight Gain Associated with Antipsychotic Treatment: Results from the Canadian National Outcomes Measurement Study in Schizophrenia
Authors: McIntyre Roger S , Trakas Kostas , Lin Daryl , Balshaw Robert , Hwang Pieway , Robinson Kimberly , Eggleston Andrew
Published: January 2017

Background:

Antipsychotic-induced weight gain occurs in a substantial percentage of treated persons. There remains a paucity of naturalistic data that describe relative weight-gain liability with the available novel atypical antipsychotics (NAPs). This investigation describes comparative NAP-induced weight gain in a prospective naturalistic cohort of persons with schizophrenia and related psychotic disorders.

Methods:

The Canadian National Outcomes Measurement Study in Schizophrenia (CNOMSS) is an ongoing prospective, longitudinal, naturalistic study involving 32 academic and community sites across Canada. Persons with DSM-IV–defined schizophrenia, schizophreniform or schizoaffective disorder, and psychosis not otherwise specified were consecutively enrolled. The overarching objectives of this initiative were to collect and compare global effectiveness, tolerability, safety, and humanistic outcomes in persons receiving commercially available NAPs in Canada. This analysis reports only weight change with the respective NAPs. Other outcomes were reported in separate companion papers.

Results:

A spectrum of weight-gain liability was noted with quetiapine (QUE) (mean 7.55 kg, SD 9.20; P = 0.28), olanzapine (OLZ) (mean 3.72 kg, SD 0.56; P = 0.15), and risperidone (RIS) (mean 1.62 kg, SD 7.72; P = 0.43). Categorically defined weight gain (that is, over 7% of baseline weight) was observed in 55.6% of QUE patients, 24.1% of OLZ patients, and 23.7% of RIS patients. Adjusting for demographic and disease-specific confounding factors, QUE patients had greater odds of gaining over 7% of their baseline weight, compared with RIS patients (odds ratio [OR] 3.62; 95%CI, 1.02 to 12.83; P = 0.05). No statistical difference was detected between OLZ patients and RIS patients for over 7% of baseline weight (OR 1.54; 95%CI, 0.63 to 3.75; P = 0.12) or over 10% weight gain (OR 1.44; 95%CI, 0.50 to 4.13; P = 0.58).

Conclusion:

Clinicians are reminded to monitor anthropometric and metabolic parameters in all NAP-treated persons. Clinically significant differences in weight gain liability exist among the available NAPs.
From Chlorpromazine to Clozapine—Antipsychotic Adverse Effects and the Clinician's Dilemma
Authors: Abidi Sabina , Bhaskara Sreenivasa M
Published: January 2017

The pharmacotherapy of schizophrenia remains an ongoing challenge for researchers and clinicians alike. Current medications remain suboptimal to effectively treat this illness despite the recent surge of what are considered to be better antipsychotics: the atypicals. The atypicals cause fewer extrapyramidal symptoms and tardive dyskinesia, but there is growing concern regarding the significant long-term metabolic and cardiac adverse effects of these novel antipsychotics. There are differences among the atypicals in their propensity to produce these adverse effects, and clinicians should weigh the risk–benefit ratio for each drug with each individual patient. Diabetes, heart disease, obesity, and unhealthy lifestyle choices are on the rise in the general population, and individuals with chronic schizophrenia are even more at risk. The dilemma clinicians face in trying to avoid the neurological morbidity of the typicals (extrapyramidal side effects and tardive dyskinesia) is the risk of consequently exposing patients to both the morbidity and potential mortality of the atypicals (cardiovascular, endocrine, and metabolic adverse effects). The importance of baseline investigations and monitoring at regular intervals as well as identification of patients at risk for obesity, diabetes, and cardiovascular morbidity has become crucial. Informed decision making is essential for successful antipsychotic pharmacotherapy. For a condition, which often necessitates long-term pharmacotherapy, the importance of prevention and (or) minimization of morbidity and mortality related to adverse effects of such pharmacotherapy cannot be understated.
Suicide Attempts and Associated Factors in Newfoundland and Labrador, 1998–2000
Authors: Alaghehbandan Reza , Gates Kayla D , MacDonald Don
Published: January 2017

Objective:

This study examined the epidemiology and associated factors for suicide attempts requiring hospitalization in the province of Newfoundland and Labrador.

Method:

We extracted data from the provincial hospital separation database. Outcome measures included incidence rates (IRs) of suicide attempts by age, sex, and geographical region of residence. We also analyzed sociodemographic data to determine associated factors.

Results:

A total of 978 patients who were hospitalized owing to suicide attempts were identified for 1998–2000, giving an overall IR of 68.7 per 100 000 person-years (P-Y). The age-specific rate for people aged 15 to 19 years was much greater, at 143.0 per 100 000 P-Y. The overall female-to-male ratio was 1.3, with an attempted suicide rate of 76.1 per 100 000 P-Y for female patients and 60.3 per 100 000 P-Y for male patients ( P = 0.001). Labrador (210.2 per 100 000 P-Y), a region with a high Aboriginal population, had a higher rate of suicide attempts, compared with the island portion of the province (59.0 per 100 000 P-Y) ( P < 0.001). More than 70% of hospitalizations were associated with psychiatric diagnosis. Poisoning was the most frequent method of attempting suicide. Higher IRs of suicide attempts were found among people who were divorced or separated and among those who were less educated ( P < 0.001).

Conclusions:

Suicide attempt represents a significant public health concern in the province, particularly in Labrador. An increased risk of suicide attempts was associated with single status, female sex, younger age (teen or young adult), and low educational level during the index attempt. Further research is needed to explicate these findings and increase our understanding of attempted suicide.
L'évaluation normalisée et clinique des mécanismes de défense: Revue critique de 6 outils quantitatifs
Authors: Soultanian Charlotte , Dardennes Roland , Mouchabac Stéphane , Guelfi Julien Daniel
Published: January 2017

Contexte:

Le concept de mécanisme de défense (MD) remonte aux fondements de la psychanalyse et en constitue un des piliers théoriques. Plus récemment, en raison de l'introduction de cette notion dans une rubrique expérimentale des classifications catégorielles, les MD sont devenus un nouveau champ à explorer dans le domaine de la recherche et de la communication scientifique. L'augmentation du nombre d'études prenant en compte les MD est allée de pair avec l'élaboration d'échelles d'évaluation clinique plus utilisables que les tests projectifs. Il n'existe à notre connaissance aucune analyse comparative de ces outils.

Objectif:

Nous décrivons dans un premier temps le mode d'utilisation et les qualités métrologiques des échelles les plus récentes. Nous proposons ensuite les avantages et les limites de ces instruments d'évaluation clinique. Ce travail vise à aider les cliniciens chercheurs dans le choix de l'outil le plus adapté à leur protocole.

Méthode:

Nous présentons les outils suivants au moyen d'une revue de la documentation: Defense Mechanism Inventory, Defense Mechanism Profile, Defense Style Questionnaire (DSQ), Defense Mechanism Rating Scale, Life Style Index, Response Evaluation Measure.

Conclusion:

L'utilisation des échelles cliniques comprend de nombreuses limites liées au concept de MD. Néanmoins, leur faisabilité et leur validité en justifient l'emploi. Les avantages du DSQ ressortent du fait de ses nombreuses qualités; néanmoins les spécificités des autres instruments restent à considérer en fonction des protocoles envisagés.
Correlates of Methylphenidate Use in Canadian Children: A Cross-Sectional Study
Authors: Charach Alice , Cao Hongmei , Schachar Russell , To Teresa
Published: January 2017

Objectives:

This study aimed to estimate the prevalence of methylphenidate (MPH) use among Canadian children aged 2 to 11 years, from 1994–1995 to 1998–1999 and to identify sociodemographic, child, and parent–family correlates are identified.

Methods:

Cross-sectional data collections from the National Longitudinal Survey of Children and Youth (NLSCY) for 1994–1995, 1996–1997, and 1998–1999 were used and samples weighted up to population levels ( n = 17 814 in 1994–1995, 13 575 in 1996–1997, and 18 980 in 1998–1999). Logistic regression identified correlates of parent-reported MPH use in each time period.

Results:

MPH use by Canadian children increased from 1.33% (95% confidence interval [CI], 1.17% to 1.50%) in 1994–1995 to 1.60% (95%CI, 1.42% to 1.78%) in 1998–1999. Use among school children aged 6 to 11 years increased from 1.94% (95%CI, 1.68% to 2.20%) in 1994–1995 to 2.42% (95%CI, 2.14% to 2.71%) in 1998–1999. Use of MPH increased among girls, from 0.52% (95%CI, 0.32% to 0.67%) in 1994–1995 to 0.97% (95%CI, 0.77% to 1.17%) in 1998–1999. For a child with parent-reported hyperactivity, the odds ratios for using MPH were 6.30 (95%CI, 4.94 to 8.90) in 1994–1995 and 12.54 (95%CI, 9.74 to 16.16) in 1998–1999. Age 6 to 11 years, male sex, and absence of parental alcohol use were significant correlates of MPH use in all time periods. Parental smoking correlated with MPH use in 1994–1995 and in 1998–1999.

Conclusions:

Less than 2% of Canadian children used MPH between 1994 and 1999. Some increase in use occurred among school-aged children and girls. Parent-reported hyperactivity was the most important correlate of MPH use.
Androgen Treatment of Depressive Symptoms in Older Men: A Systematic Review of Feasibility and Effectiveness
Authors: Shamlian Nathalie T , Cole Martin G
Published: January 2017

Objective:

To determine the feasibility and effectiveness of androgen treatment of depressive symptoms in older men.

Method:

We searched MEDLINE, PsycINFO, Eric, HealthStar, and the Cochrane Database of Systematic Reviews for potentially relevant articles. The bibliographies of relevant articles were searched for additional references and experts were consulted. Seventeen reports (8 open and 12 randomized trials; 3 articles reported studies of 2 designs) met the following inclusion criteria: original investigation; published in English or French, use of acknowledged criteria or scale for depression, and open or randomized trial of androgen treatment. Four criteria assessed study validity: randomization, double blinding, comparability of treatment and control groups at baseline, and description of dropouts. We abstracted, tabulated, and compared information from each article.

Results:

Most studies had methodological limitations. With regard to feasibility, there were few reported withdrawals due to adverse events. With regard to effectiveness, 6 of 8 open trials had positive results, and 5 of 12 randomized trials had positive results, although 1 was equivocal. However, testosterone was combined with antidepressant medication in 3 of these positive randomized trials. Only 2 open trials enrolled subjects whose mean age was 60 years or over. One had positive results, and the other had negative results.

Conclusion:

Androgen therapy may be feasible in the short term, but there is little evidence that it is an effective treatment for depressive symptoms in older men.
Demographic Characteristics of Participants in Studies of Risk Factors, Prevention, and Treatment of Postpartum Depression
Authors: Ross Lori E , Campbell Vashti LS , Dennis Cindy-Lee , Blackmore Emma Robertson
Published: January 2017

Objectives:

Metaanalyses have found that sociodemographic variables are not strong predictors of postpartum depression. However, no studies have systematically examined the extent to which the samples used in published research on postpartum depression have included sufficiently diverse samples of women to merit this conclusion. The objectives of this study were to examine the demographic characteristics of participants in previously published studies and to document existing gaps in the current literature.

Method:

We extracted age, ethnicity, relationship status, and socioeconomic status of 51 453 participants from 143 studies previously selected for systematic literature reviews.

Results:

Few studies reported complete demographic data; however, existing data indicate that participants were predominantly aged 25 to 35 years, white, partnered, and of mid- or high-socioeconomic status.

Conclusions:

To assess the external validity of the findings, improved reporting of demographic characteristics is required in publications related to postpartum depression. Additional research is needed to understand postpartum depression among understudied populations.

Objectifs:

Les méta-analyses ont révélé que les variables sociodémographiques ne sont pas des prédicteurs fiables de la dépression postpartum. Cependant, aucune étude n'a examiné systématiquement la mesure dans laquelle les échantillons utilisés dans les études publiées de la dépression postpartum incluaient des échantillons suffisamment diversifiés de femmes pour arriver à cette conclusion. Les objectifs de la présente étude étaient d'examiner les caractéristiques démographiques des participantes à des études déjà publiées et à documenter les écarts existant dans la documentation actuelle.

Méthode:

Nous avons extrait l'âge, l'origine ethnique, l'état relationnel et le statut socio-économique de 51 453 participantes à 143 études préalablement sélectionnées pour des revues systématiques de la documentation.

Résultats:

Peu d'études ont présenté des données démographiques complètes; cependant, les données existantes indiquent que les participantes étaient majoritairement âgées de 25 à 35 ans, blanches, en couple, et de statut socio-économique moyen à élevé.

Conclusions:

Une meilleure présentation des caractéristiques démographiques est nécessaire dans les publications liées à la dépression postpartum pour évaluer la validité externe des résultats. Il faut plus de recherche pour comprendre la dépression postpartum chez les populations sous-étudiées.
Psychosis and Violence: Stories, Fears, and Reality
Authors: Taylor Pamela J
Published: January 2017

Individuals with psychosis are often feared. In fact, they are themselves likely to be victims of violence; however, the main aim of this review is to provide an overview of the evidence on relations between psychosis and violence to others. The terms psychosis and violence were used in a literature search limited to the Cochrane Library and PubMed, a manual search of 8 journals, and a follow-up of additional references in the articles found. The overview draws on new empirical data and major reviews. Almost all sound epidemiologic data on psychosis and violence dates from 1990. There is consistency on a small but significant relation between schizophrenia and violent acts. Since then there has also been movement toward understanding the nature of associations and progress on strategies for managing individuals who have psychosis and are violent. Public fears about individuals with psychotic illnesses are largely unfounded, although there would be benefit in greater attention to the safety of those in their close social circle. The task for the next 10 years must be the development and application of knowledge to improve specific treatments—that is, interventions that go beyond holding and caring to bring about substantial change.
The Evolving Understanding of Major Depression Epidemiology: Implications for Practice and Policy
Authors: Patten Scott B , Bilsker Dan , Goldner Elliott
Published: January 2017

Objectives:

Epidemiologic studies have confirmed that major depression (MD) is an extremely common condition, but also one that is associated with an unexpectedly broad spectrum of morbidity. It is no longer a tenable position to regard MD as being a simple indicator of treatment need, nor is a one-size-fits-all approach to treatment likely to be an effective guide to health care delivery. The objective of this commentary is to explore the implications of these new epidemiologic findings for policy and practice in Canada.

Method:

This paper is a selective review and commentary.

Results:

Whereas the acute and long-term treatment needs of a subset of individuals with MD have received much attention in the literature, the needs of other groups have not. A sizable proportion of individuals with episodes meeting the Diagnostic and Statistical Manual of Mental Disorders-fourth edition definition in community populations may not need the intensive treatment emphasized by current Canadian practice guidelines. The strategy of watchful waiting may have a role in primary care. On the policy front, guided and perhaps self-guided management strategies deserve greater emphasis than they have received. Stepped-care strategies are an appealing option, but how best to effectively implement these in the Canadian context is unclear.

Conclusions:

The spectrum of morbidity among individuals with MD in community populations is much wider than has been previously appreciated. The health system should respond with an appropriate spectrum of services, but many questions remain about how to facilitate this.
Patient Sex as Moderator of Effects of Transference Interpretation in a Randomized Controlled Study of Dynamic Psychotherapy
Authors: Ulberg Randi , Johansson Paul , Marble Alice , Høglend Per
Published: January 2017

Objective:

To examine whether men and women respond differentially to brief dynamic psychotherapy, with or without transference interpretations.

Method:

Data from the First Experimental Study of Transference Interpretation were used. Patients ( n = 100) were randomized to receive 2 different dynamic psychotherapies during 1 year, with either a moderate level of transference interpretations or no transference interpretations. We used the following outcome measures: the Psychodynamic Functioning Scales, Inventory of Interpersonal Problems-Circumplex Version, Global Assessment of Functioning (GAF), and total mean score of Symptom Checklist-90-Revised (Global Severity Index [GSI]). Change was assessed using linear-mixed models.

Results:

On average, men and women responded equally across treatments. The moderator analyses, using the 2 secondary outcome measures, GAF and GSI, demonstrated that women responded better to therapy with transference interpretations, compared with men, whereas men responded better to therapy without transference interpretations, compared with women. When the moderator sex was combined with the moderator quality of object relations (QOR), a strong effect emerged: men with high QOR showed a large negative effect of transference interpretations, and women with low QOR showed a large positive effect.

Conclusions:

In terms of symptom change, women responded better to therapy with transference interpretations, while men responded better to therapy without transference interpretations. Patient sex showed moderator effects over and above the moderator effects of QOR.