bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuronal expression of the mitochondrial protein prohibitin confers profound neuroprotection in a mouse model of focal cerebral ischemia
Authors: Kahl Anja , Anderson Corey J , Qian Liping , Voss Henning , Manfredi Giovanni , Iadecola Costantino , Zhou Ping
Published: July 2017

The mitochondrial protein prohibitin (PHB) has emerged as an important modulator of neuronal survival in different injury modalities . We previously showed that viral gene transfer of PHB protects CA1 neurons from delayed neurodegeneration following transient forebrain ischemia through mitochondrial mechanisms. However, since PHB is present in all cell types, it is not known if its selective expression in neurons is protective, and if the protection occurs also in acute focal ischemic brain injury, the most common stroke type in humans. Therefore, we generated transgenic mice overexpressing human PHB1 specifically in neurons (PHB1 Tg). PHB1 Tg mice and littermate controls were subjected to transient middle cerebral artery occlusion (MCAo). Infarct volume and sensory-motor impairment were assessed three days later. Under the control of a neuronal promoter (CaMKIIα), PHB1 expression was increased by 50% in the forebrain and hippocampus in PHB1 Tg mice. The brain injury produced by MCAo was reduced by 63 ± 11% in PHB1 Tg mice compared to littermate controls. This reduction was associated with improved sensory-motor performance, suggesting that the salvaged brain remains functional. Approaches to enhance PHB expression may be useful to ameliorate the devastating impact of cerebral ischemia on the brain.
Predictors of short-term and long-term incontinence after robot-assisted radical prostatectomy
Authors: Shao I-Hung , Chang Ying-Hsu , Hou Chun-Ming , Lin Zheng-Feng , Wu Chun-Te
Published: July 2017

Purpose

To determine retrospectively the prognostic factors for urinary incontinence following robot-assisted radical prostatectomy (RARP).

Methods

Altogether, 180 patients with localized prostate cancer underwent RARP (same surgeon). Preoperative physical status, disease characteristics, laboratory findings, and surgical technique were recorded and the patients checked 1, 6, 12, and 24 months after RARP regarding their contribution to predicting post-prostatectomy urinary incontinence (PPI).

Results

Overall, 114 (63.3%) patients had PPI 1 month after RARP and 19 patients (16.0%) at 24 months. Univariate analysis showed that age was a significant factor for predicting PPI at 1 month. PPI predictors at 24 months were age, body mass index, preoperative serum albumin level, previous transurethral resection of the prostate, total operative time, and bladder neck sparing. Multivariate analysis indicated that age and total operative time were significant predictors.

Conclusion

Older age and longer operative time were highly relevant to short- and long-term PPI occurrence after RARP.
Children’s invented notations: Extending knowledge of their intuitive musical understandings using a Vygotskian social constructivist view
Authors: Carroll Debbie
Published: July 2017

Children’s invented musical notations provide a fascinating window into their musical and metacognitive understandings. Using a Vygotskian social constructivist perspective that emphasizes the social nature of cognition, the purpose of this qualitative study was to examine the processes and products of children’s notations as they notated a song and then taught it to a peer, a multi-level task currently unstudied in the literature. Thirteen Canadian children, aged 5–9 years, without prior music instruction, notated a song learned the previous week, sung it back, explained what they did, and then taught the song to a classmate the following week. The children’s notations, as well as audio and videotapes of them carrying out the multi-level task, provided the primary data; audiotaped conversations with parents, teachers, and a school principal provided secondary data. Analyses generated descriptive and narrative portraits, which demonstrate the increasingly sophisticated representational strategies used by the children from three different age groups as they notated, refined, and taught a song. Select portraits are presented and discussed. Implications for research and practice highlight the value of the research task in eliciting children’s multiple intelligences and collaborative problem-solving skills, and painting more complete portraits of their intuitive and emergent musical and metacognitive understandings.
Validation of the Kenny Music Performance Anxiety Inventory (K-MPAI): A cross-cultural confirmation of its factorial structure
Authors: Chang-Arana Álvaro M. , Kenny Dianna T. , Burga-León Andrés A.
Published: July 2017

This research investigated whether music performance anxiety (MPA) can be theoretically understood as a unidimensional construct, and whether the factorial structure is robust across different populations of musicians with different levels of expertise. K-MPAI scores were obtained from 455 Peruvian tertiary music students (mean age = 21.19 years, SD = 3.13, range = 18–40 years) and 368 Australian professional orchestral musicians (mean age = 42.07 years, SD = 10.21, range = 18–68 years). A high order exploratory factor analysis with the Schmid-Leiman solution was performed on the K-MPAI items. Unweighted Least Squares extraction method and optimal implementation of parallel analysis revealed one high order factor and two first order factors for both samples. High Cronbach’s and ordinal alpha levels for items belonging to each first order and high order factor in both samples were also obtained. Structural similarities between the two samples and an invariance analysis signified a comparable structure and conceptual interpretation of K-MPAI scores in both populations. The factorial structure obtained supported a unidimensional interpretation of the construct of MPA. First order level interpretations are also possible and have been demonstrated to be clinically useful.
Toronto and the ‘Paris problem’: community policing in ‘immigrant neighbourhoods’
Authors: Saberi Parastou
Published: July 2017

Since 2005, references to the ‘Paris problem’ have become increasingly frequent among media pundits, urban policy-makers and police agencies to warn about the malaise of Toronto’s low-income, majority non-White neighbourhoods (referred to as ‘immigrant neighbourhoods’). A reference to the rebellion of the French banlieues against state power in France, the ‘Paris problem’ is code for the spectre of ‘race riots’ in Toronto. Here the author looks at the birth of the ‘Paris problem’ and examines the community policing strategies that were rolled out in its aftermath in Toronto. The article demonstrates how these were intertwined with urban policies of social development to which policing was integral. In this, policing needs to be understood holistically as not just coercive in function, but also as ‘productive’; that is, aimed at the manufacture of consent and ultimately of pacification of unruly populations. Underpinning these processes, and also engendered by them, is a racialised and territorialised security ideology crystallised around the figure of ‘the immigrant’ and the conception of ‘immigrant neighbourhoods’. At the heart of such policy-making is a corralling and containing of poor, working-class, ethnically defined communities – youth in particular – that serves to entrench division while maintaining heavy-handed state control.
Sexual Violence by Juveniles in Institutions: A Descriptive Study on Prevalence and Circumstances
Authors: Allroggen Marc , Ohlert Jeannine , Rau Thea , Fegert Jörg M.
Published: July 2017

Adolescents in institutionalized care are at a particularly high risk of exhibiting sexually aggressive behavior including sexual harassment. So far, however, studies about the prevalence of sexually aggressive behavior in institutions are lacking. In this survey, 322 adolescents (43% female, average age 16.7 years) from 32 residential care facilities and boarding schools across Germany were asked about sexually aggressive behavior via a standardized questionnaire. Overall, 23.5% of the participants engaged in some form of sexually aggressive behavior in their lives, and 4.6% reported having committed a sexual assault with (actual or attempted) penetration. A closer look at the circumstances of those offenses shows that the victims were in most cases acquainted with and of the same age as the offenders, that threats and violence were used in some cases, and especially in the case of actual or attempted penetration, and that only a minority of offenders suffered any consequences for their acts. The implementation of protective measures for institutions and the treatment of adolescents in institutions will be discussed.
Recurrent Childhood Animal Cruelty and Its Link to Recurrent Adult Interpersonal Violence
Authors: Trentham Caleb E. , Hensley Christopher , Policastro Christina
Published: July 2017

In the early 1960s, researchers began to examine the potential link between childhood animal cruelty and future interpersonal violence. Findings since then have been inconsistent in establishing a relationship between the two. This may be due to researchers failing to measure the recurrency of childhood animal abuse and the recurrency of later violent acts committed in adulthood. The current study, using data from 257 inmates at a medium-security prison in a Southern state, is a replication of research conducted by Tallichet and Hensley, and Hensley, Tallichet, and Dutkiewicz, which examined this recurrency issue. The only statistically significant predictor of recurrent adult interpersonal violence in this study was recurrent childhood animal cruelty. Inmates who engaged in recurrent childhood animal cruelty were more likely to commit recurrent adult interpersonal violence. Respondents’ race, education, and childhood residence were not significant predictors of the outcome variable.
Euro-Dependence—A Peripheral Look beyond the Monetary Union: A Proposal of Reform of the TARGET2
Authors: Barredo-Zuriarrain Juan , Molero-Simarro Ricardo , Quesada-Solana Alejandro
Published: July 2017

This paper seeks to present a proposal of reform of the TARGET2 (Trans-European Automated Real-Time Gross Settlement Express Transfer) system aimed to correct intra-European Union (EU) financial, trade, and productive imbalances. For this purpose, the proposal relies on the application of the Keynes Plan’s principles to a regional integration process. Previously, the origins of the EU imbalances are traced to the shortcomings of the European monetary integration. Finally, the reforms needed to make the TARGET2 a rebalancing system are discussed in depth.

JEL Classification: F32, F33, F36
Counter-cyclical public venture capital: Debt-funding as an anti-austerity innovation strategy
Authors: Etzkowitz Alex , Etzkowitz Henry
Published: July 2017

This article outlines a counter-cyclical innovation strategy to achieve prosperity, derived from an innovative project, the California Institute for Regenerative Medicine (CIRM). We identify an ‘innovation paradox’ in that the very point in the business cycle, when legislators are tempted to view austerity as a cure for economic downturns and to reduce innovation spend, is when an increase is most needed to create new industries and jobs and innovate out of recession or depression. It is both desirable and possible that policymakers resist the urge to capitulate to the innovation paradox. During periods that exhibit subdued inflation, elevated spare productive capacity, and low government borrowing rates, governments should increase their borrowings and use the proceeds to boost investment targeted towards innovation. We show how the State of California successfully utilized debt financing, traditionally reserved for physical infrastructure projects, to stimulate the development of intellectual infrastructure. Finally, we recommend a halt to European austerity policies and a ‘triple helix’ broadening of narrow ‘smart specialization’ policies that chase a private venture capital chimera. Europe should seize the present macroeconomic opportunity of low interest rates, borrow for innovation and be paid back manifold by ‘picking winners’, similarly to what the USA has been doing through DARPA (Defense Advanced Research Projects Agency) with GPS, as a response to Sputnik, the Internet and artificial intelligence, or the driverless car, formerly known as the ‘autonomous land vehicle’ in its military guise. Proactively targeted macroscopic investments in innovation are needed to solve the productivity/employment puzzle and foster the transition to a knowledge-based society.
The Effect of Electroconvulsive Therapy on Suicide Risk in Patients with Mood Disorders
Authors: Sharma Verinder
Published: July 2017

Objective:

To discuss the effect of electroconvulsive therapy (ECT) on suicide risk in patients with mood disorders.

Method:

A review of the available data on the short-term and long-term effects of ECT on suicide mortality among patients with mood disorders.

Conclusion:

ECT has an acute but not a long-term beneficial effect on suicidality. Due to the significant limitations of studies in this area, however, the data need to be interpreted with caution.
Preventing Schizophrenia and Psychotic Behaviour: Definitions and Methodological Issues
Authors: Faraone Stephen V , Brown C Hendricks , Glatt Stephen J , Tsuang Ming T
Published: July 2017

Although schizophrenia onset usually occurs in late adolescence or early adulthood, much research shows that its seeds are planted early in life and that eventual onset occurs at the end of a neurodevelopmental process leading to aberrant brain functioning. This idea, along with the fact that current therapies are far from fully effective, suggests that preventive treatments may be needed to achieve an ideal outcome for schizophrenia patients and those predisposed to the disorder. In this article, we review the methodological challenges that must be overcome before effective preventive interventions can be created. Prevention studies will need to define the target population. This requires the identification of risk factors that will be useful in selecting at-risk people for preventive treatment. We review currently identified risk factors for schizophrenia: genes, psychosocial factors, pregnancy and delivery complications, and viruses. We also review 3 different types of prevention programs: universal, indicated, and selective. For schizophrenia, we distinguish prevention programs that target prodromal cases and those that target the disorder's premorbid precursors. Although those targeting prodromal cases provide a useful framework for early treatment of the disorder, studies of premorbid individuals are needed to design a truly preventive treatment.
Brief Screening Tests for Dementia
Authors: Lorentz Wendy J , Scanlan James M , Borson Soo
Published: July 2017

Objective:

To compare brief dementia screening tests as candidates for routine use in primary care practice.

Method:

We selected screening tests that met 2 criteria: 1) administration time of 10 minutes or less in studies including individuals with, and without, dementia; and 2) performance characteristics evaluated in at least 1 community or clinical sample of older adults. We compared tests for face validity, sensitivity, and specificity in a clearly defined subject sample; for vulnerability to sociodemographic biases unrelated to dementia; for direct comparison with an accepted standard; for acceptability to patients and doctors; and for brevity and ease of administration, scoring, and interpretation by nonspecialists.

Results:

Thirteen instruments met our inclusion criteria. Very short tests (1 minute or less) proved unacceptable by several criteria. Standard instruments requiring more than 5 minutes to complete, including the best-studied Mini-Mental State Examination (MMSE), were found to be too long for routine application. Several failed other performance tests or could not be adequately assessed. Short tests taking between 2 and 5 minutes that can be administered by nonspecialists with little or no training and are relatively unbiased by language and education level appear to be superior to both shorter and longer instruments.

Conclusions:

Three tests showed the most promise for broad application in primary care settings: the Mini-Cog, the Memory Impairment Screen, and the General Practitioner Assessment of Cognition (GPCOG). Formal practice intervention trials are now needed to validate the utility of short screens with regard to implementation, effect on rates of diagnosis and treatment of dementia patients, and outcomes for patients, families, and health care systems.
Antipsychotic Medication during Pregnancy and Lactation in Women with Schizophrenia: Evaluating the Risk
Authors: Patton Sheila W , Misri Shaila , Corral Maria R , Perry Katherine F , Kuan Annie J
Published: July 2017

Objective:

To review studies investigating the following: whether exposing developing infants to antipsychotic medication during pregnancy and lactation is associated with increased risks of teratogenic, neonatal, and long-term neurobehavioural sequelae; whether schizophrenia itself affects pregnancy outcome; and whether the course of schizophrenia symptoms is altered by pregnancy and lactation.

Method:

We summarize the results from articles identified via a MedLine search for the period January 1, 1966, to December 1, 2001.

Results:

Women with schizophrenia are at increased risk for poor obstetrical outcomes, including preterm delivery, low birth weight, and neonates who are small for their gestational age. A lack of information in the literature makes it difficult to comment on the relative risk of exposing developing infants to atypical antipsychotics. However, typical antipsychotics appear to carry an increased risk of congenital malformations when the fetus is exposed to phenothiazines during weeks 4 to 10 of gestation. Lack of information also precludes an understanding of whether changes associated with pregnancy and lactation significantly alter the course of schizophrenia symptoms.

Conclusion:

Research is needed so that physicians may more accurately inform women about the relative risks of using antipsychotic medications during pregnancy and lactation. Increased knowledge about the risks of medication exposure will allow clinicians to limit treatment to situations in which the risk of untreated maternal illness outweighs the risk of exposing a developing infant to medications.
The Relation between Memory of the Traumatic Event and PTSD: Evidence from Studies of Traumatic Brain Injury
Authors: Klein Ehud , Caspi Yael , Gil Sharon
Published: July 2017

Objective:

This paper focuses on the relation between memory and posttraumatic stress disorder (PTSD). More specifically, it addresses the debate regarding the role of memory of the traumatic event in the development of PTSD. Traumatic brain injury (TBI) is used as a naturally occuring model for traumatic exposure that is often associated with memory impairment.

Method:

We present a critical review of the literature on studies assessing the relation between TBI and PTSD, with a focus on memory of the traumatic event as a critical factor. We also discuss results from recent studies conducted by our group.

Results:

The literature review offers an inconclusive picture wherein a significant proportion of the studies indicate that PTSD and TBI are mutually exclusive, especially in individuals who exhibit lack of memory for the traumatic event. This finding supports the possibility that lack of memory may protect against the development of PTSD. However, some studies show that PTSD does occur in patients with head injury, suggesting that PTSD may develop in TBI survivors—even in those who cannot remember the traumatic event. Generally speaking, though, the overall balance of the findings (including our own findings) seems to support the possibility that, in subjects with TBI, impaired memory of the traumatic event is associated with reduced prevalence of PTSD.

Conclusions:

The suggestion that amnesia regarding the traumatic event may protect against the development of PTSD has both theoretical and practical importance. This review focused on the case of trauamtic brain injury as a model for impaired memory for the traumatic event. However, it still remains to be proven that the conclusions based on these findings are generalizable beyond the case of TBI. While some patients with posttraumatic amnesia do develop PTSD despite lack of memory for the traumatic event, the majority of those who lack memory for the event seem to be protected from developing the disorder. Nevertheless, based on this assumption, we suggest that pharmacologic disruption of newly acquired—or even old—traumatic memories, which has been shown to be possible in animals, might therapeutically benefit trauma survivors.
Evolutionary Perspectives on Schizophrenia
Authors: Polimeni Joseph , Reiss Jeffrey P
Published: July 2017

The theory of evolution may be relevant to psychiatric disorders. Evolution reflects changes in genes throughout time. Thus, evolutionary forces can shape any phenotype that is genetically rooted and that possesses a long history. Schizophrenia is likely an ancient condition with a substantial genetic component. Since the 1960s, several researchers have applied evolutionary principles to the study of schizophrenia. In general, schizophrenia is either viewed as an evolutionary advantageous condition or as a disadvantageous byproduct of normal brain evolution. This paper reviews major evolutionary explanations— historical and current—that speculate on the possible origins of schizophrenia.
Mastering CanMEDS Roles in Psychiatric Residency: A Resident's Perspective
Authors: Tuhan Isolda
Published: July 2017

Postgraduate trainees in psychiatry are being evaluated on their proficiency at competencies that comprise the physician roles identified by the CanMEDS 2000 Project. This paper provides an overview of each CanMEDS role and its associated competencies and suggests strategies to help residents prepare for the new format of the Royal College of Physicians and Surgeons (RCPSC) certification examination in psychiatry.
A Case—Control Study on Psychological Symptoms in Sleep Apnea-Hypopnea Syndrome
Authors: Yue Weihua , Hao Wei , Liu Pozi , Liu Tieqiao , Ni Ming , Guo Qi
Published: July 2017

Objectives:

To investigate the psychological status of patients with sleep apnea-hypopnea syndrome (SAHS) and to evaluate the association of SAHS with psychological symptoms, using the Symptom Checklist-90 (SCL-90) scale.

Methods:

The study comprised 30 SAHS patients (25 men, 5 women) and 30 matched, healthy control subjects. They all completed the SCL-90 and the Epworth Sleep Scale (ESS) and underwent a whole-night polysomnographic (PSG) examination. We used t-tests for group comparisons of nocturnal PSG characteristics, daytime sleepiness, and psychological symptoms. We employed Spearman's rank correlation analysis to indicate the effects of several nocturnal PSG variables (for example, total sleep time, percentage of wake at sleep, Apnea and Hypopnea Index [AHI], and oxygen desaturation) or subjective daytime sleepiness on psychological symptoms in SAHS.

Results:

SAHS patients suffered from fragmented sleep and decreased arterial oxygen saturations, compared with healthy control subjects. The General Severity Index (GSI) of SCL-90 was significantly higher in SAHS patients than in healthy control subjects, as were measures of somatization, obsession–compulsion, depression, anxiety, and hostility (P < 0.05). The severity of psychological symptoms in SAHS patients was negatively related to total sleep time and percentage of stage 2 nonrapid eye movement (NREM) sleep; it was positively related to percentage of wake time after sleep onset, percentage of stage 1 NREM sleep, and ESS scores.

Conclusion:

In our study population, SAHS patients had decreased psychological well-being, which could be explained by fragmented sleep or excessive daytime sleepiness.
Hard Times and Good Friends: Negative Life Events and Social Support in Patients with Seasonal and Nonseasonal Depression
Authors: Michalak Erin E , Tam Edwin M , Manjunath Chinnapalli V , Yatham Lakshmi N , Levitt Anthony J , Levitan Robert D , Lam Raymond W
Published: July 2017

Objective:

Although a relatively large body of research has now accumulated concerning the relation between negative life events, social support, and major depressive disorder (MDD), little is known about the relation between seasonal affective disorder and these psychosocial variables. This study aimed to compare baseline levels of negative life events (NLEs) and perceived social support (SS) in patients with seasonal and nonseasonal depression.

Method:

Canadian patients with winter seasonal affective disorder (SAD) ( n = 26) and nonseasonal recurrent MDD ( n = 66) completed measures of recent NLEs (the List of Threatening Experiences) and perceived SS (the Social Support Survey) prior to treatment.

Results:

No significant between-group differences were observed in mean number of NLEs experienced or in quality of SS. Perceived SS was impaired in both groups, compared with patients with chronic medical conditions.

Conclusions:

The results of this study complement those of previous research reporting increased incidence of NLEs and decreased SS in primary care patients with high seasonality in the UK. Future research is required to determine the causal relation between these psychosocial risk factors and SAD and to assess whether they have an effect on, or are affected by, treatment interventions for SAD.
Canadian Outcomes Study in Dementia: Study Methods and Patient Characteristics
Authors: Sambrook Robert , Herrmann Nathan , Hébert Réjean , McCracken Peter , Robillard Alain , Luong Doanh , Yu Amanda
Published: July 2017

Objective:

To describe the methods and patient characteristics of the Canadian Outcomes Study in Dementia (COSID).

Methods:

COSID is a 3-year prospective study of dementia patients living in the community at the time of study registration. We assessed patients' cognition, behaviour, and functioning every 6 months, using the Modified Mini-Mental State Examination (3MS), the Neuropsychiatric Inventory (NPI), and the Functional Autonomy Measurement System (SMAF), respectively. We assessed caregivers, using the Zarit Burden Interview (ZBI). Additional information included the Global Deterioration Scale (GDS), patients' driving status, and clinical information including family history, dementia type, concomitant medications, and comorbid conditions. From the patient or caregiver, we collected details of inpatient and outpatient resources used by the patient and (or) caregiver.

Results:

We enrolled 766 patients from 31 Canadian sites. Overall mean age was 76.8 years, and mean age of onset was 73.1 years. Of the total patients, 98% were white, 54% were women, and 84% were diagnosed with Alzheimer's disease. Mean baseline 3MS was 66.5, NPI was 9.5, and SMAF was 18.30. Of these patients, 48% reported a GDS score of 3 (that is, moderate), 16% reported a GDS score of 4 (that is, moderately severe), and the remaining 36% reported a GDS score of 1 or 2 (that is, mild or very mild). At baseline, 83% of patients received cholinesterase inhibitors, 46% received nonsteroidal antiinflammatory drugs, 39% received vitamin E, and 25% received antidepressants. Adult day care and home help were the largest cost factors in this population, with mean monthly costs of $65 and $64, respectively. We found interesting differences in the resources used among geographic regions and care settings.

Conclusions:

COSID is already generating valuable information about treatment patterns, outcomes, and resource use in Canadian patients with dementia. As the data mature, it will be possible to build robust models on treatment effectiveness and costs of care.
Exploring the Links between Depression, Integrity, and Hope in the Elderly
Authors: Chimich William T , Nekolaichuk Cheryl L
Published: July 2017

Objective:

To explore the links between depression, integrity, and hope in the elderly.

Method:

For this pilot study, we recruited a voluntary sample of cognitively intact elderly patients receiving psychiatric care ( n = 35). Recruitment sources included an inpatient geriatric psychiatry unit ( n = 14), a geriatric psychiatry day program ( n = 6), and an outpatient geriatric psychiatry service ( n = 15). Participants completed a questionnaire designed to measure depression, acording to the Geriatric Depression Scale Short Form (GDSSF); integrity, according to the Sense of Coherence Scale-Short Form (SOC-13); and hope, according to the Hope Differential-Short (HDS) and the Hope Numerical Rating Scale (Hope-NRS). The HDS consists of 3 separate subscales: Personal Spirit, Risk, and Authentic Caring. We analyzed the data, using descriptive statistics, t tests, and Pearson correlations.

Results:

Patients with no depression ( n = 17) showed a greater sense of coherence (SOC) ( P < 0.01), higher levels of hope (Hope-NRS, P < 0.05), enhanced Personal Spirit (HDS subscale, P < 0.05), and greater risk taking (HDS subscale, P < 0.01) than did patients with depression ( n = 18). The 2 variables that correlated most highly with depression were SOC ( r = −0.65, P < 0.01) and Risk (HDS subscale, r = −0.62, P < 0.01).

Conclusions:

These findings suggest that depression, integrity, and hope are highly interrelated in the elderly population and may influence mastery of the developmental tasks of aging. Further research is warranted to better understand these complex experiences in late life.
Driving and Dementia in Ontario: A Quantitative Assessment of the Problem
Authors: Hopkins Robert W , Kilik Lindy , Day Duncan JA , Rows Catherine , Tseng Heidi
Published: July 2017

Background:

The population is becoming increasingly aged, and concomitantly, the prevalence of dementia is steadily rising. Persons aged 65 years and over are likely to continue driving for many years and often well into the dementia process.

Methods:

Ontario Ministry of Transportation driving data, census data, and dementia prevalence data were combined to determine the number of persons with potential dementia who are driving, both now and in about 25 years' time.

Results:

Actual and projected Ontario figures show that the number of senior drivers will increase markedly from just under 500 000 in 1986 to nearly 2 500 000 in 2028. Similarly, the number of drivers with dementia is also increasing. Although not all drivers with dementia are necessarily dangerous, most are estimated to continue driving well into the disease process. By combining the above-mentioned data sets, a best estimate of the number of drivers with dementia in Ontario was derived. It is estimated that this group has grown from just under 15 000 in 1986 to about 34 000 in 2000 and will number nearly 100 000 in 2028.

Interpretation:

Increasingly, the responsibility for identifying drivers with dementia has fallen on the health care system, a role for which it was never designed nor equipped to handle. The risks associated with the dramatically increasing number of drivers with dementia demand a psychometrically sensitive and efficient screening procedure.
GABAergic Function in Alzheimer's Disease: Evidence for Dysfunction and Potential as a Therapeutic Target for the Treatment of Behavioural and Psychological Symptoms of Dementia
Authors: Lanctôt Krista L , Herrmann Nathan , Mazzotta Paolo , Khan Lyla R , Ingber Neil
Published: July 2017

Alzheimer's disease (AD) is characterized by disruptions in multiple major neurotransmitters. While many studies have attempted to establish whether GABA is disrupted in AD patients, findings have varied. We review evidence for disruptions in GABA among patients with AD and suggest that the variable findings reflect subtypes of the disease that are possibly manifested clinically by differing behavioural symptoms. GABA, the major inhibitory neurotransmitter, has long been a target for anxiolytics, hypnotic sedatives, and anticonvulsants. We review the clinical use of GABAergic agents in treating persons with AD symptoms. While newer generation GABAergic medications are now available, they have yet to be evaluated among patients with AD.
Suicidal Ideation in Inpatients with Acute Schizophrenia
Authors: Kontaxakis Vassilis , Havaki-Kontaxaki Beata , Margariti Maria , Stamouli Sophia , Kollias Costas , Christodoulou George
Published: July 2017

Objective:

Schizophrenia has been associated with a high rate of suicide. This study investigates the prevalence of suicidal ideation in a population of inpatients with acute schizophrenia, together with the clinical parameters associated with suicidal thoughts.

Method:

We assessed 93 schizophrenia patients. We matched subjects for age and sex and compared subjects with and without suicidal thoughts. We performed stepwise multiple regression analysis to assess the association between specific clinical symptoms and suicidal ideation.

Results:

Of the patients, 20.4% reported suicidal thoughts during the last 15 days. Severity of depressive symptoms, motor retardation, guilt feelings, pathological guilt, and self-depreciation predicted the patients' suicidal ideation.

Conclusions:

Suicidal thoughts are frequent among inpatients with acute schizophrenia. Prevention of suicidal behaviour should include helping patients improve their self-esteem and reducing depression and guilt feelings.
Validation de la version française de l'inventaire de détresse péritraumatique
Authors: Jehel Louis , Brunet Alain , Paterniti Sabrina , Guelfi Julien D
Published: July 2017

Objectif:

Cet article présente la traduction et la validation en français de l'Inventaire de détresse péritraumatique (PDI) dans un échantillon de patients en consultations externes de psychotraumatisme.

Méthode:

Au total 127 personnes francophones ont été évaluées de 2001 à 2002 lors de leurs premières consultations en psychiatrie pour un événement traumatique. Une évaluation à 3 mois était proposée par courrier pour vérifier la stabilité temporelle de l'instrument.

Résultats:

La validation en français du PDI a une bonne cohésion interne, avec un alpha de Cronbach de 0,83. Le test-retest montre une stabilité temporelle très satisfaisante avec un coefficient de corrélation intraclasse de 0,79 dans un intervalle de confiance de 0,61 à 0,89. La validité convergente analysée par la corrélation avec l'IES-R (Impact of Event Scale Revised), le PDEQ (Peritraumatic Dissociation Questionnaire) et le GHQ (General Health Questionnaire) est très bonne. De plus l'analyse en composantes principales propose une solution à 2 dimensions qui explique 45 % de la variance.

Conclusion:

La version française du PDI présente une validité psychométrique satisfaisante. De plus la structure factorielle de cette traduction est très proche de celle proposée dans la version originale du PDI.
Dépersonnalisation—Données actuelles
Authors: Khazaal Yasser , Zimmermann Grégoire , Zullino Daniele Fabio
Published: July 2017

Objectif:

La dépersonnalisation est un phénomène clinique fascinant désignant un trouble de la conscience de soi avec un détachement émotionnel des sentiments propres, des pensées ou des actes propres. Cet article a pour but de résumer la documentation actuelle sur le sujet.

Méthode:

En parcourant la base de données électronique Medline, nous avons examiné la documentation abordant la clinique, l'étiologie, la nosologie, la physiopathologie et la thérapie de la dépersonnalisation.

Conclusions:

La déréalisation se rapporte à une altération de la perception du monde et de la réalité extérieure. Ces 2 phénomènes sont souvent associés. Ils ne sont spécifiques d'aucune entité psychiatrique et sont rapportés dans une large variété de syndromes psychiatriques, et de nombreux facteurs, entre autres différentes substances, ont participé à leur émergence. La physiopathologie est encore peu connue. Cependant, certains modèles théoriques supposent une combinaison de l'inhibition d'une partie de l'amygdale et une activation d'autres structures amygdaliennes. Une perturbation du fonctionnement sérotoninergique est évoquée par différentes études pharmacologiques. Différentes substances psychotropes, surtout les antidépresseurs sérotoninergiques, ont été proposées comme pharmacothérapie, il n'existe cependant pas d'études randomisées concluantes et la question de l'apport de la psychothérapie se pose encore dans le traitement de ces patients.
Comorbidity of Major Depression and Migraine — A Canadian Population-Based Study
Authors: Molgat Carmen V , Patten Scott B
Published: July 2017

Objective:

To estimate the prevalence of major depressive episodes (MDEs) in patients with migraine and to compare the strength of association with that of other long-term medical conditions.

Methods:

This study used a large-scale probability sample (over 130 000 sample) from the Canadian Community Health Survey (CCHS), a cross-sectional survey conducted by Statistics Canada. The CCHS screened for a broad set of medical conditions. Major depression was evaluated with the Composite International Diagnostic Interview Short Form for Major Depression, and the diagnosis of migraine was self-reported. The annual prevalence of major depression was calculated in the general population, in subjects with migraine, and in those with chronic conditions other than migraine.

Results:

The prevalence of major depression in subjects reporting migraine was higher than that in the general population or in subjects with other chronic medical conditions (17.6%, compared with 7.4% and 7.8%, respectively).

Conclusions:

There is a strong association between major depression and migraine. The migraine–MDE association may account for a large fraction of the chronic condition–MDE association. The association between migraines and MDE differs from that of other chronic conditions, as the association persists into older age groups.
Family Background and Genius II: Nobel Laureates in Science
Authors: Rothenberg Albert
Published: July 2017

Objective:

In a previous study of literary creative achievement, we presented evidence refuting the still-influential statistical studies of Frances Galton on the inheritance of genius and also described a family background constellation of creativity. This study aims to assess empirically the hereditary transmission hypothesis with respect to creative achievement in the natural sciences.

Methods:

Family background data were collected on 435 of all 488 Nobel laureates in chemistry, physics, and medicine and physiology, from 1901 through 2003. These were compared with a matching group of 548 eminent nonscientists for incidence of occupational inheritance (that is, same parent–offspring occupations) and with 560 high-IQ nonprizewinners for predominant type of occupation.

Results:

The incidence of one or both parents having the same occupation was only 2% for science Nobel laureates but 20% for eminent nonscientists ( P < 0.001). The predominant family background constellation (63%) for science Nobel laureates consisted of the same-sex parent either having a performance-equivalent occupation involving applied science, technology, or a natural-world focus and skills ( P < 0.001, compared with the matching group) or having an unrelated occupation with unfulfilled scientific interests and wishes for creative expression.

Conclusions:

Nobel laureates in the natural sciences do not manifest direct inheritance of creativity from their parents; instead, congruent-sex parents are predominantly in applied or performance-equivalent occupations, with unfulfilled creative and scientific wishes. Early developmental influences on motivation involving identification and competition with the congruent-sex parent are suggested.
Trends in Psychostimulant and Antidepressant Use by Children in 2 Canadian Provinces
Authors: Mitchell Brendon , Carleton Bruce , Smith Anne , Prosser Robert , Brownell Marni , Kozyrskyj Anita
Published: July 2017

Objective:

We used population-based administrative prescription medication data to examine regional differences in psychostimulant and antidepressant (AD) use among children from 2 Canadian provinces: British Columbia (BC) and Manitoba (MB).

Method:

Using 1997 to 2003 prescription data, annual rates of psychostimulant and AD use were determined for children aged 19 years and under in both provinces. Further comparisons of rates were made according to sex, age group, and specific classes of dispensed medications.

Results:

During 1997 to 2003, psychostimulant use rose by 44.9% in MB and 13.3% in BC. Among male children, psychostimulant use increased by 40.2% in MB, compared with an increase of only 8.6% in BC. AD utilization was similar between provinces, with increases of 80% and 75% in MB and BC, respectively. In both provinces, AD use was highest among older children.

Conclusions:

Our observations of regional variation in psychotropic medication use potentially reflect provincial differences in drug benefit policies, disease prevalence, and (or) physician diagnosis and treatment.
Expenditures on Mental Health and Addictions for Canadian Provinces in 2003 and 2004
Authors: Jacobs Philip , Yim Rita , Ohinmaa Arto , Eng Ken , Dewa Carolyn S , Bland Roger , Block Ray , Slomp Mel
Published: July 2017

Objective:

To measure total public and private expenditures on mental health in each province.

Method:

Data for expenditures on mental health services were collected in the following categories: physician expenditures (general and psychiatrist fees for service and alternative funding), inpatient hospital (psychiatric and general), outpatient hospital, community mental health, pharmaceuticals, and substance abuse. Data for 2 years, 2003 and 2004, were collected from the Canadian Institute for Health Information (hospital inpatient and fees for service physicians), the individual provinces (pharmaceuticals, alternative physician payments, hospital outpatient, and community), and the Canadian Centre on Substance Abuse. Totals were expressed in terms of per capita and as a percentage of total provincial health spending.

Results:

Total spending on mental health was $6.6 billion, of which $5.5 billion was from public sources. Nationally, the largest portion of expenditures was for hospitals, followed by community mental health expenses and pharmaceuticals. This varied by province. Public mental health spending was 6% of total public spending on health, while total mental health spending was 5% of total health spending.

Conclusions:

Canadian public mental health spending is lower than most developed countries, and a little below the minimum acceptable amount (5%) stated by the European Mental Health Economics Network.
High School Mental Health Survey: Assessment of a Mental Health Screen
Authors: Roberts Nasreen , Stuart Heather , Lam Mui
Published: July 2017

Objective:

To estimate the size of the population in need of psychiatric diagnostic assessment, based on the 12-month period prevalence of child and adolescent psychiatric disorders in one local high school, and to evaluate the validity of the Diagnostic Interview Schedule for Children Predictive Scales 8 (DPS-8) screen against the National Institute of Mental Health—Diagnostic Interview Schedule for Children-IV (NIMH-DISC-IV) for any diagnosis.

Method:

This 2-stage cross-sectional study included high school students aged 13 to 19 years. In the first stage, we administered the DPS-8 screen. In the second stage, we used the NIMH-DISC-IV. Prevalence and validity were estimated using the Bayesian formula owing to the unequal subsample fractions in the second stage.

Results:

A total of 222 students participated in the first stage screen. Of these, 153 completed the second stage NIMH-DISC-IV. In this sample, the prevalence for anxiety disorders was 17%, behaviour disorders was 11%, and depressive disorders was 1%. The overall prevalence of any one of these disorders was 29%. The sensitivity of the DPS-8 screen was 53.4%, specificity was 87.6%, the positive predictive value was 63.8%, and the negative predictive value was 82%. The overall accuracy of the screen was 77%.

Conclusion:

This study highlights some of the difficulties in conducting psychiatric research in a high school population. Despite the difficulties, the DPS-8 screen, if used judiciously by school counsellors, may be helpful in identifying students needing further comprehensive psychiatric assessment.
Memory and Cognition in Preclinical Dementia: What We Know and What We Do Not Know
Authors: Bäckman Lars
Published: July 2017

This overview focuses on the cognitive transition between normal aging and dementia. Numerous studies indicate that individuals who will go on to develop dementia show cognitive deficits many years before the time at which a clinical diagnosis could be rendered. The degree of preclinical impairment is remarkably similar for tasks assessing episodic memory, executive functioning, and perceptual speed, consistent with the view that multiple brain alterations occur prior to clinical disease onset. Although most research in this area has dealt with Alzheimer disease (AD), several recent reports indicate that the pattern of preclinical impairment is very similar in the second largest dementia disorder, vascular dementia (VaD). This is important because currently the possibility for interventions to postpone disease onset is greater in VaD than in AD. Despite pronounced preclinical cognitive deficits in dementia, the performance distributions between cases and controls are largely overlapping, hampering the ability to identify high-risk individuals. To alleviate this problem, future research should evaluate hybrid models for the prediction of dementia. In such models, multiple indicators of cognitive functioning should be included along with markers from other domains that have been linked to subsequent dementia (such as brain imaging, genetics, and lifestyle variables). To the extent that these categories of variables add unique variance, classification accuracy will increase and the overlap in performance scores between incident cases and controls will decrease, thereby enhancing clinical usefulness. This approach would also facilitate the examination of interactive effects among classes of preclinical markers.
Contact of Mental and Nonmental Health Care Providers Prior to Suicide in Taiwan: A Population-Based Study
Authors: Lee Hsin-Chien , Lin Herng-Ching , Liu Tsai-Ching , Lin Shiyng-Yu
Published: July 2017

Objective:

Higher rates of health care service use prior to suicide were previously reported in Western countries; however, these studies have tended to suffer from small sample sizes. This nationwide, population-based study examines the distribution and patterns of health care service use among suicide victims in Taiwan.

Method:

A retrospective cohort study was conducted using linked population-based data to determine the proportion of health care service use among suicide victims aged 15 years and older within the 1-year and 1-month period prior to their deaths. After adjusting for demographic, socioeconomic and health care indices, the differences in health care service use patterns were assessed for age and sex.

Results:

Among the 19 426 suicide victims in the sample, 83.1% had used nonmental health care services within the 1-year period prior to their death, while only 22.2% had used mental health care services. Men, and suicide victims aged 55 years and older, were less likely to have had any contact with mental health care professionals prior to their deaths ( P < 0.001).

Conclusions:

In line with prior studies, similarly high rates and distinct patterns of health care service use were found in Taiwan prior to suicide. These findings will be of practical interest and should support designing appropriate methods of suicide intervention and effective preventive strategies.