bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive Symptoms and Alcohol Consumption among Nonalcoholic Depression Patients Treated with Desipramine
Authors: Goldstein Benjamin I , Schaffer Ayal , Levitt Anthony , Zaretsky Ari , Joffe Russell T , Wesson Virginia , Bagby R Michael
Published: July 2017

Objective:

There are few data addressing the effect of alcohol consumption on response to antidepressants among nonalcoholics with depression. Similarly, the effect of antidepressant treatment on alcohol consumption in this group is not yet understood. This study focuses on changes in depressive symptoms and alcohol consumption in response to treatment with desipramine.

Method:

Twenty-seven nonalcoholic outpatients with major depression (as determined by the Schedule for Affective Disorders and Schizophrenia-Lifetime Version) completed measures of depression (that is, the 17-item Hamilton Depression Rating Scale and the Beck Depression Inventory) and alcohol consumption at intake and after 5 weeks of open treatment with desipramine. Subjects were characterized as minimal or mild-to-moderate drinkers.

Results:

There was no significant difference between the groups with respect to effectiveness of antidepressant treatment. Analysis for repeated measures demonstrated that alcohol consumption with desipramine was significantly lower after treatment than at intake ( F = 4.8, df 23:2, P < 0.01). Further, carbohydrate consumption was also significantly lower after treatment than at intake ( F = 4.4, df 23:2, P < 0.05).

Conclusions:

Desipramine treatment appeared to result in decreases in alcohol consumption in nonalcoholic patients with depression. Further research is needed to elucidate the effect of alcohol consumption on the course and outcome of major depressive illness among nonalcoholics as well as the effect of antidepressant medication on alcohol consumption in this population.
The State of Contemporary Risk Assessment Research
Authors: Norko Michael A , Baranoski Madelon V
Published: July 2017

The focus on assessing dangerousness in routine psychiatric practice developed when relatively little was known about factors related to violence, and the accuracy of predicting violence was distinctly below chance. Since the 1990s, however, significant research attention has been directed toward factors related to violence and mental illness, as well as toward factors related to the accuracy of risk assessment techniques. Sociodemographic and environmental variables have been identified as significant predictors of violence, as has the presence of substance abuse. However, the data on specific mental health variables are somewhat mixed. Many studies point to a modest increased risk of violence associated with major mental illness and psychosis, whereas other noteworthy studies have failed to confirm such findings. Studies of the accuracy of risk assessments indicate that both actuarial and clinical methodologies perform better than chance, although the former achieve greater statistical accuracy. Despite ongoing controversies, risk management strategies that encompass the strengths and limitations of our present knowledge are available to clinicians.
Screening for Mild Cognitive Impairment: Comparing the SMMSE and the ABCS
Authors: Molloy D William , Standish Timothy IM , Lewis David L
Published: July 2017

Objective:

To compare the sensitivity and specificity of the AB Cognitive Screen (ABCS) with the Standardized Mini-Mental State Examination (SMMSE) to differentiate normal cognition from mild cognitive impairment (MCI), especially when educational level and age are taken into account.

Method:

This cross-sectional study took place at geriatric outpatient memory clinics. Participants were community-dwelling adults, aged 55 years or over, referred from primary care settings (a minority of participants were referred from specialists) for assessment of memory loss and age-matched control subjects with no complaint of memory loss. Each participant had the ABCS and the SMMSE administered in random order on the same day.

Results:

Participants included 124 patients diagnosed with MCI and 111 with normal cognitive function. The ABCS showed a statistically significant difference between normal cognition and MCI (ABCS score 111.7 and 104.6 points, respectively, P < 0.001) for the whole group. This difference was significant with the ABCS, regardless of participants' age or education. There was a significant difference between normal cognition and MCI for SMMSE scores (SMMSE score 27.8 and 27.2 points, respectively, P = 0.040), but the differences were not significant when age and education were taken into account. Age and education were shown to affect the scores of both instruments except for the ABCS scores of MCI subjects, which were not significantly affected by education ( P = 0.059).

Conclusions:

The ABCS is more sensitive than the SMMSE in differentiating normal cognition from MCI. The ABCS appears to be less influenced by education. It has improved clinical utility with a wider range of scoring gradations, reduced ceiling effects, and shorter scoring and administration times.
Attention-Deficit Hyperactivity Disorder with and without Obsessive—Compulsive Behaviours: Clinical Characteristics, Cognitive Assessment, and Risk Factors
Authors: Arnold Paul Daniel , Ickowicz Abel , Chen Shirley , Schachar Russell
Published: July 2017

Objectives:

To determine the prevalence of obsessive–compulsive behaviours (OCB) in a clinical sample of children with attention-deficit hyperactivity disorder (ADHD) and to compare ADHD children (with and without OCB) with respect to clinical and cognitive characteristics and risk factors.

Method:

We compared ADHD children ( n = 134) with and without OCB, and we compared all ADHD children with a group of normal control subjects ( n = 26) on various clinical, cognitive, and inhibitory control measures; neurobiological and psychosocial risk factors; and family histories of psychiatric illness.

Results:

Clinically significant OCB was identified in 11.2% (15/134) of children with ADHD. Comorbid OCB was associated with significantly increased perfectionism, improved teacher ratings of inattention, and a decreased likelihood of having a first-degree relative with ADHD. Comorbid ADHD and OCB may also be associated with increased oppositional behaviour at home and better inhibitory control, though these differences were not statistically significant.

Conclusions:

Comorbid OCB is common in clinically referred children with ADHD and is associated with increased impairment relative to ADHD alone. Further, children with ADHD and OCB may develop symptoms as the result of different genetic and environmental risk factors, compared with children with ADHD only.
The Gambling Follow-up Scale: Development and Reliability Testing of a Scale for Pathological Gamblers under Treatment
Authors: de Castro Viviane , Fuentes Daniel , Tavares Hermano
Published: July 2017

Objective:

To provide preliminary data on the Gambling Follow-Up Scale (GFS), a new scale assessing recovering gamblers. Secondary goals included assessing the impact of “work status,” “family relationship,” “leisure,” and “enrolment in Gamblers Anonymous (GA)” on gambling (all items from the scale), together with the impact of treatment.

Method:

Using the GFS, 3 independent raters interviewed gamblers under treatment. The sample was collected in 2 university centres in the city of São Paulo, Brazil. Patients attended psychotherapy coupled with psychiatric follow-up, participation in GA, or both.

Results:

We interviewed 47 pathological gamblers; 13 were interviewed twice, with a minimum interval of 6 months, for a total of 60 GFS interviews. Interviews took on average 6.0 minutes, SD 2.7. Interrater concordance ranged from 82% to 95% (intraclass correlation coefficient range 0.85 to 0.99, P < 0.001). A factorial analysis showed a 1-factor solution (Eigenvalue = 2.4, 47.6% of total variance accounted). “Leisure,” “frequency and time gambling,” and “family relationship” showed considerable loadings (0.84; 0.71; 0.71), whereas “enrolment in GA” and “work status” showed moderate loadings (0.59; 0.56). A linear regression model significantly correlated gambling ( R2 = 0.356; P < 0.001) with “leisure” and length of treatment. Treatment modalities affected “leisure” ( F2,43 = 5.00, P = 0.011), with GA attendees reporting more regular and gratifying activities.

Conclusions:

The GFS showed interrater reliability and construct validity. More leisure and lengthier treatment were significantly related to less gambling. GA enrolment seemed to particularly benefit the quality of leisure. Future studies could profit from the quickness and simple structure of the GFS in providing shareable outcome measures.
Qualitative Research in Psychiatry
Authors: Whitley Rob , Crawford Mike
Published: July 2017

This paper is an overview of qualitative research and its application to psychiatry. It is introductory and attempts to describe both the aims of qualitative research and its underlying philosophical basis. We describe the practice and process of qualitative research and follow this with an overview of the 3 main methods of inquiry: interviews, focus groups, and participant observation. Throughout the paper, we offer examples of cases where qualitative research has illuminated, or has the potential to illuminate, important questions in psychiatric research. We describe methods of sampling and follow with an overview of qualitative analysis, appropriate checks on rigour, and the presentation of qualitative results. The paper concludes by arguing that qualitative methods may be an increasingly appropriate methodology to answer some of the demanding research questions being posed in 21st century psychiatry.
Debunking Myths about Trauma and Memory
Authors: McNally Richard J
Published: July 2017

How trauma victims remember—or forget—their most horrific experiences lies at the heart of the most bitter controversy in psychiatry and psychology in recent times. Whereas experts maintain that traumatic events—those experienced as overwhelmingly terrifying at the time of their occurrence—are remembered all too well, traumatic amnesia theorists disagree. Although these theorists acknowledge that trauma is often seemingly engraved on memory, they nevertheless maintain that a significant minority of survivors are incapable of remembering their trauma, thanks to mechanisms of either dissociation or repression. Unfortunately, the evidence they adduce in support of the concept of traumatic dissociative amnesia fails to support their claims. The purpose of this review is to dispel confusions and debunk myths regarding trauma and memory.
Integrating Mindfulness Meditation with Cognitive and Behavioural Therapies: The Challenge of Combining Acceptance- and Change-Based Strategies
Authors: Lau Mark A , McMain Shelley F
Published: July 2017

Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments.
First-Episode Psychosis, Early Intervention, and Outcome: What Have We Learned?
Authors: Malla Ashok K , Norman Ross MG , Joober Ridha
Published: July 2017

Objective:

There has been increased interest in the potential of early intervention to positively influence outcome in first-episode psychosis (FEP) and, consequently, to influence mental health policy and practice. This study's objective was to examine the concept of early intervention and the evidence that currently exists to support such a shift in the delivery of care.

Method:

We examined the evidence for phase-specific treatment of FEP, looking for interventions that attempt to arrest the transition from a putative prodromal state to full psychosis, as well as for interventions that attempt to reduce delay in treatment.

Results:

Some evidence supports specialized FEP interventions for short-term outcome in terms of symptom reduction, relapse rates, and greater adherence to and retention in treatment. As well, there is modest support for benefits to aspects of social and community functioning and satisfaction with life. Limited evidence supports a positive effect of community-wide case detection in terms of reduced delays in treatment and pharmacologic and psychological interventions in the prodromal phase.

Conclusions:

The field of early intervention in psychosis is young, with encouraging preliminary results, especially for improving outcome in established FEP. It requires further study, especially of longer-term outcome. Further studies need to examine the effects of a specialized approach on longer-term outcome and to explore cost-effective methods to reduce delays in treatment and provide interventions in the prodromal phase.
A European Approach to Rural—Urban Differences in Mental Health: The ESEMeD 2000 Comparative Study
Authors: Kovess-Masféty Viviane , Alonso Jordi , de Graaf Ron , Demyttenaere Koen
Published: July 2017

Objective:

The study aimed to answer the following questions: Are there any rural–urban differences in mental health, once sociodemographic variables are controlled for, and are any of these differences observed in EU countries? Did the individuals suffering from mental health disorders have the same characteristics in rural and urban areas, particularly concerning self-reported impairment?

Method:

The European Study of the Epidemiology of Mental Disorders (ESEMeD 2000 study) is a cross-sectional, in-person, household interview survey based on probability samples representative of the adult population of 6 European countries: Belgium, France, Germany, Italy, the Netherlands, and Spain. The rural population is defined as those living in towns with fewer than 10 000 inhabitants, and the urban population is defined as those living in towns or cities with 10 000 or more inhabitants. A stratified, multistage, random sample without replacement was drawn in each country. The overall response rate of the study was about 61.2% (weighted response rate).

Results:

The study results confirmed previous findings on the variation in mood disorders between rural and urban areas. Overall, urbanicity seemed to be linked to a higher risk of mental health disorders, particularly depressive disorders, whereas the link to anxiety disorders was only moderate and there was no link at all to alcohol disorders. Country differences concerned male respondents and not female respondents, with the exception of Belgium, where the differences concerned women only (and showed fewer disorders in rural areas).

Conclusions:

This study will, hopefully, stimulate further intra-European studies using comparable methods and instruments to look at the experience across the European continent and introduce steps to harmonize rural–urban population limits across diverse countries.
Using Publication Statistics for Evaluation in Academic Psychiatry
Authors: Maunder Robert G
Published: July 2017

Objective:

The validity of using publication statistics to evaluate university faculty is not established. This study aimed to determine if publication statistics vary among psychiatric faculty members of different academic rank and if there are biases among disciplines.

Method:

Using the 10 most recent publications written by psychiatric faculty members at 2 schools of medicine, we compared the time to publish 10 papers, the 5-year impact, the citation rate, and the citation ratio according to academic rank and school. Leaders in neuroscience were compared with leaders in clinical subspecialties.

Results:

All statistics were associated with academic rank ( P ⩽ 0.001) and there were significant differences between the 2 schools. There were more basic scientists than clinical subspecialists in the 80th percentile for 5-year impact ( P = 0.04), but the latter disciplines performed equally in citation ratio.

Conclusions:

Publication statistics differ among academic ranks. Citation ratio minimizes the effect of biases among disciplines. Publication statistics may provide useful information for evaluating psychiatric faculty.
Les Réponses des Clients Souffrant de Troubles Psychiatriques et de Toxicomanie et Fréquentant des Ressources Pour Les Personnes Itinérantes Sont-Elles Valides?
Authors: Bonin Jean-Pierre , Fournier Louise , Blais Régis , Perreault Michel , White Noé Djawn
Published: July 2017

Objectif:

Vérifier la validité des réponses autodéclarées de clients souffrant de troubles mentaux et de toxicomanie et fréquentant des ressources pour personnes itinérantes de Québec et de Montréal quant à leur utilisation des services.

Méthode:

Comparer les données autodéclarées relatives à l'utilisation des services provenant d'une vaste enquête de santé auprès de la clientele de ressources pour personnes itinérantes (Fournier, 2001) avec des données administratives du Québec en matière de santé (MED-ÉCHO et RAMQ).

Résultats:

Les analyses démontrent des taux de concordance de modérés à élevés entre les réponses autodéclarées et les données officielles. La plupart des items analysés présentent des coefficients de corrélation intraclasse significatifs et modérés pour les hospitalisations générales et psychiatriques et l'utilisation de médicaments psychiatriques, et significatifs mais faibles pour les hospitalisations en santé physique. Les caractéristiques des participants, comme les troubles mentaux, le statut domiciliaire et la consommation de substances ne semblent pas avoir d'effet sur la validité des réponses données.

Conclusions:

Les réponses des personnes présentant des problèmes de santé mentale, de statut domiciliaire et de consommation de substances concernant l'utilisation des services de santé s'avèrent généralement valides. Les réponses autodéclarées de ces personnes semblent donc être une source de données généralement fiable et peu coûteuse lors de recherches sur l'utilisation des services ou tout autre domaine.
Erratum
Authors: Kato T , Kakiuchi C , Iwamoto K.
Published: July 2017

It has come to the authors' attention that their article included an error on page 766, right column, line 7. The sentences: “Indeed, sample pH was significantly lower in BD group in the study of Konradi et al.21 Thus the finding in BD may be explained by those factors.” were incorrect. The text should have read: “Thus the finding in BD may be explained by those factors. However, there was no statistically significant difference in the sample pH between the diagnoses in the study of Konradi et al21 (bipolar: mean 6.46, SD 0.15, controls: 6.54, SD 0.27, schizophrenia: 6.54, SD 0.24) (Christine Konradi, 25 January 2008, personal communication).” The Canadian Journal of Psychiatry regrets the error and any inconvenience it may have caused.
No-Suicide Agreements: Current Practices and Opinions in a Canadian Urban Health Region
Authors: Page Stacey A , King Michael C
Published: July 2017

Objective:

To determine the extent to which no-suicide agreements (NSAs)—one method of intervening with people at risk of suicide—are used by a population of outpatient mental health therapists in a Canadian urban health region, and to describe therapists' perceptions and practices surrounding their use.

Method:

The survey was mailed to 516 therapists, including psychiatrists, psychologists, nurses, social workers, and occupational therapists.

Results:

Completed surveys were returned by 312 therapists (response rate = 60.5%). NSAs were used by 83%, although 43% had no formal training in their use. Among those who had used NSAs, 31% reported having had at least one patient attempt or complete suicide while an agreement was in place. Therapists from nonmedical disciplines were most likely to have used these agreements. Most therapists believed NSAs communicated care and concern to patients. Respondents were divided in their perceptions of whether NSAs afforded liability protection in the event of a patient suicide. Contextual factors associated with the perceived degree of suicide risk, the patient–therapeutic relationship influenced a therapist's use of NSAs. Most therapists attempted to have patients admitted to hospital if the patient refused to enter into an NSA.

Conclusions:

Use of NSAs is prevalent in this population of outpatient psychotherapists, suggesting that these therapists believe they are a useful intervention in the management of suicidal patients. Practitioners might benefit from increased formal training opportunities in the use and legal implications of NSAs.
Toward a Hippocratic Psychopharmacology
Authors: Ghaemi S Nassir
Published: July 2017

Objective:

To provide a conceptual basis for psychopharmacology.

Method:

This review compares contemporary psychopharmacology practice with the Hippocratic tradition of medicine by examining the original Hippocratic corpus and modern interpretations (by William Osler and Oliver Wendell Holmes).

Results:

The Hippocratic philosophy is that only some, not all, diseases should be treated and, even then, treatments should enhance the natural healing process, not serve as artificial cures. Hippocratic ethics follow from this philosophy of disease and treatment. Two rules for Hippocratic medicine are derived from the teachings of Osler (treat diseases, not symptoms) and Holmes (medications are guilty until proven innocent). The concept of a diagnostic hierarchy is also stated explicitly: Not all diseases are created equal. This idea helps to avoid mistaking symptoms for diseases and to avoid excessive diagnosis of comorbidities. Current psychopharmacology is aggressive and non-Hippocratic: symptom-based, rather than disease oriented; underemphasizing drug risks; and prone to turning symptoms into diagnoses. These views are applied to bipolar disorder.

Conclusions:

Contemporary psychopharmacology is non-Hippocratic. A proposal for moving in the direction of a Hippocratic psychopharmacology is provided.
Alcohol Factors in Suicide Mortality Rates in Manitoba
Authors: Mann Robert E , Zalcman Rosely Flam , Rush Brian R , Smart Reginald G , Rhodes Anne E
Published: July 2017

Objective:

To identify alcohol-related factors that influence mortality rates from suicide.

Method:

We examined the impact of per capita consumption of total alcohol, spirits, beer, and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total, male and female suicide mortality rates in Manitoba during 1976 to 1997. Time series analyses with autoregressive integrated moving average modelling were applied to total, male and female suicide rates. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines.

Results:

Total alcohol consumption, and consumption of beer, spirits, and wine individually, were significantly and positively related to female suicide mortality rates. Spirits and wine were positively related to total and male mortality rates. AA membership rates were negatively related to total and female suicide rates. Unemployment rates were positively related to male and total suicide rates.

Conclusions:

The data confirm the important relations between per capita consumption measures and suicide mortality rates. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and alcohol abuse treatment can exert beneficial effects observable at the population level.
Suicide in Newfoundland and Labrador: A Linkage Study Using Medical Examiner and Vital Statistics Data
Authors: Edwards Nicole , Alaghehbandan Reza , MacDonald Don , Sikdar Khokan , Collins Kayla , Avis Simon
Published: July 2017

Objective:

To examine suicide epidemiology in Newfoundland and Labrador from 1997 to 2001.

Method:

Data from the Office of the Chief Medical Examiner (CME) were linked with data derived from the Canadian Vital Statistics Death Database. Ninety-five percent confidence intervals (CI) were calculated to assess variation of rates. We used the chi-square test to compare categorical data.

Results:

The CME recorded 225 suicide deaths, compared with 187 in the Canadian Vital Statistics Death Database. Most deaths not coded as suicide in the national database were coded as accidental. Using the CME data, the overall suicide rate was 9.5/100 000, aged 10 years and older. The rate among males (15.8/100 000, 95%CI, 10.7 to 20.8) was almost 5 times that of females (3.3/100 000; 95%CI, 1.0 to 5.5). Age-standardized rates decreased over the study period, from 10.9 to 8.0/100 000; however, the difference was not significant. The proportionate mortality ratio for suicide deaths was highest among those aged 10 to 19 years (20.0%) and decreased with age. The suicide rate was highest among those aged 50 to 59 years. The rate for unpartnered individuals (17.0/100 000, 95%CI, 10.7 to 23.0) was significantly higher, compared with partnered individuals (5.1/100 000; 95%CI, 2.5 to 7.8). Males used more violent methods than females. Suicide was significantly higher in Labrador (27.7/100 000, 95%CI, 18.4 to 37.0), an area with a higher Aboriginal population, compared with the island of Newfoundland (8.5/100 000, 95%CI, 7.3 to 9.7). Psychiatric illness was the most common predisposing factor.

Conclusions:

Suicide deaths are highest among males, unpartnered individuals, and individuals with psychiatric disorders.
Lithium Treatments: Single and Multiple Daily Dosing
Authors: Ljubicic Dulijano , Letica-Crepulja Marina , Vitezic Dinko , Bistrovic Ivana Ljubicic , Ljubicic Rudolf
Published: July 2017

Objective:

To review the feasibility and effectiveness of single daily dosing of lithium in patients with affective disorder and to discuss advantages and disadvantages of this schedule of administration.

Method:

A comprehensive search of the literature was conducted using a combination of electronic databases and a search of reference lists and relevant journals. English-language articles were selected for the review if they discussed the issues comparing multiple and single daily dosing schedules of lithium.

Results:

We found 9 comparative studies. Single daily dosing of lithium causes transient higher peak lithium concentrations; however, no comparative study revealed a significant difference in side effects between multiple and single daily dosing groups. Numerous reports concluded that taking lithium in a single dose prevents, or at least limits, the increase in urine output (and the reduction of osmolality) and subsequent thirst. There is no evidence that a single lithium dosing schedule preserves glomerular function.

Conclusion:

According to the presented data, it could be reasonable to use lithium as a single evening dose in patients who can tolerate this schedule because no studies have suggested any benefit from administration of multiple daily doses. Possible advantages of single daily dosing, especially in improved compliance, could not be veiled by disadvantages of transient and mild postabsorptive side effects.
Prevention Inherent in Services for Women with Schizophrenia
Authors: Seeman Mary V
Published: July 2017

Objective:

Effective care to women with serious mental illness provides an opportunity for prevention of mental health problems in their offspring. The objective of this study is to outline the preventive possibilities of a service targeted to women with schizophrenia.

Method:

An analysis of recently published literature on women suffering from schizophrenia, focusing on intervention.

Results:

Genetic counselling, prenatal care, prevention of obstetrical complications, substance abuse reduction, appropriate antipsychotic treatment, parenting support, safety issues, quality of life, ethics, cultural competence, and advocacy are components of a comprehensive service to women with schizophrenia.

Conclusions:

These components improve maternal health and, by also ensuring fetal and neonatal health, are potentially preventive against schizophrenia in the second generation.
Aging and Memory: A Cognitive Approach
Authors: Luo Lin , Craik Fergus IM
Published: July 2017

This article describes changes in memory during the normal aging process from the standpoint of cognitive psychology. There is now a great deal of evidence to show that memory is not one single function but may be described in terms of different memory systems that show differential effects of aging. For example, memory for procedures, and some perceptual memory functions, show few age-related changes, whereas working memory, episodic memory, and prospective memory decline substantially in the course of normal aging. Memory for facts and knowledge (semantic memory) holds up well in older individuals provided that the information is used frequently, although the ability to retrieve highly specific information (such as names) typically declines. The article discusses current theoretical accounts of the effects of aging; different theorists have attributed the changes in memory and cognition to mental slowing, declining attentional resources, an inability to inhibit unwanted information, and a decline in cognitive control. Other suggestions include the notion that memory performance in older adults is particularly vulnerable when the need for self-initiated processing is greatest; conversely, performance is greatly helped by the provision of environmental support. The practical implications of these research findings and ideas include the point that clinical memory assessments should incorporate tests designed to measure the different aspects of memory functioning.
Effect of Olanzapine and Risperidone on Subjective Well-Being and Craving for Cannabis in Patients with Schizophrenia or Related Disorders: A Double-Blind Randomized Controlled Trial
Authors: van Nimwegen Lonneke J , de Haan Lieuwe , van Beveren Nico JM , van der Helm Mischa , van den Brink Wim , Linszen Don
Published: July 2017

Objective:

To examine whether subjective well-being and craving for cannabis were different in patients with schizophrenia or related disorders treated with either olanzapine or risperidone.

Method:

A 6-week, double-blind, randomized trial of olanzapine and risperidone was carried out in 128 young adults with recent onset schizophrenia or related disorders. Primary efficacy measures were the mean baseline-to-endpoint change in total scores on the Subjective Well-Being under Neuroleptics scale, the Obsessive–Compulsive Drug Use Scale, the Drug Desire Questionnaire, and the cannabis use self-report. An analysis of covariance was used to test between-group differences.

Results:

Estimated D2 receptor occupancy did not differ between olanzapine ( n = 63) and risperidone ( n = 65). Similar improvements in subjective well-being were found in both groups. In the comorbid cannabis-using group ( n = 41, 32%), a similar decrease in craving for cannabis was found in both treatment conditions.

Conclusions:

Both olanzapine and risperidone were associated with improved subjective well-being. No evidence was found for a differential effect of olanzapine or risperidone on subjective experience or on craving for cannabis in dosages leading to comparable dopamine D2 occupancy.

Objectif:

Examiner si le bien-être subjectif et l'état de manque de cannabis étaient différents chez les patients souffrant de schizophrénie ou de troubles connexes traités à l'olanzapine ou à la rispéridone.
Services for Adults with an Autism Spectrum Disorder
Authors: Shattuck Paul T , Roux Anne M , Hudson Laura E , Taylor Julie Lounds , Maenner Matthew J , Trani Jean-Francois
Published: July 2017

The need for useful evidence about services is increasing as larger numbers of children identified with an autism spectrum disorder (ASD) age toward adulthood. The objective of this review was to characterize the topical and methodological aspects of research on services for supporting success in work, education, and social participation among adults with an ASD and to propose recommendations for moving this area of research forward. We reviewed the literature published in English from 2000 to 2010 and found that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Extant research does not reflect the demographic or impairment heterogeneity of the population, the range of services that adults with autism require to function with purposeful lives in the community, and the need for coordination across service systems and sectors. Future studies must examine issues related to cost and efficiency, given the broader sociopolitical and economic context of service provision. Further, future research needs to consider how demographic and impairment heterogeneity have implications for building an evidence base that will have greater external validity.
Comparing the Clinical Presentation of First-Episode Psychosis across Different Migrant and Ethnic Minority Groups in Montreal, Quebec
Authors: van der Ven Elsje , Bourque François , Joober Ridha , Selten Jean-Paul , Malla Ashok K
Published: July 2017

Objective:

To explore differences in severity and nature of symptoms of first-episode psychosis (FEP) according to ethnic group and migrant status.

Method:

We administered rating scales to assess positive and negative symptoms, as well as general psychopathology, to 301 consecutive patients presenting with an FEP within a defined catchment area in Montreal, Quebec, classified according to ethnicity and migrant status. Symptom scores of Euro-Canadian patients without a recent history of migration, that is, the reference group ( n = 145), were compared with those of African and Afro-Caribbean ( n = 39), Asian ( n = 27), Central and South American ( n = 15), Middle Eastern and North African ( n = 24), and European and North American ( n = 39) patients.

Results:

Except for referral source, there were no significant differences between ethnic groups on any demographic variables. The African and Afro-Caribbean group had a higher level of negative symptoms (especially alogia) and general psychopathology scores on the Positive and Negative Syndrome Scale (especially, uncooperativeness, preoccupation, and poor attention), compared with the reference group. Ethnic groups did not differ on the Scale for the Assessment of Positive Symptoms scores.

Conclusions:

A comparison of FEP patients from different ethnic groups and native-born Euro-Canadians revealed no significant differences in the nature of positive symptoms at first presentation or in age at onset, suggesting that there was no evidence for the hypothesis that ethnic minorities are misdiagnosed as psychotic. Increased severity of negative symptoms and general psychopathology, specifically among the black ethnic minority group, may have implications for the role of ethnicity for the treatment and outcome of the initial episode of psychotic disorders.
Perceived Relational Evaluation as a Predictor of Self-Esteem and Mood in People with a Psychotic Disorder
Authors: Norman Ross M G , Windell Deborah , Lynch Jill , Manchanda Rahul
Published: July 2017

Objective:

There is evidence that social support predicts self-esteem and related moods for people with psychotic disorders. However, there has been little investigation of relative importance of specific components of social support. Evidence from social psychology suggests that perceived relational evaluation (PRE) or the extent to which people see others as valuing them, is a particularly important determinant of self-esteem and mood. Our study compared the importance of PRE and other types of social support, in predicting self-esteem and depressive mood, anxiety, and anger-hostility in a sample of patients in an early intervention program for psychotic disorders.

Method:

One hundred and two patients of the Prevention and Early Intervention Program for Psychoses in London, Ontario, completed measures of PRE, appraisal, tangible and general emotional social support, self-esteem, and mood. In addition, ratings of positive and negative symptoms were completed for all participants.

Results:

In general, perceived relational value was the most important predictor of self-esteem and mood. These relations were not a result of confounding with positive or negative symptoms.

Conclusions:

PRE appears to be a particularly important aspect of social support in predicting self-esteem and mood states. Possible implications of these findings and future research directions are discussed.
Conformance to Evidence-Based Treatment Recommendations in Schizophrenia Treatment Services
Authors: Addington Donald , McKenzie Emily , Smith Harvey , Chuang Henry , Boucher Stephen , Adams Beverly , Ismail Zahinoor
Published: July 2017

Objective:

To assess quality of health care provided in a representative Canadian mental health service using conformance to evidence-based treatment recommendations, and to examine differences from published US results.

Method:

We used a cross-sectional cohort design involving a randomly selected sample of patients diagnosed with schizophrenia attending 1 of 3 mental health clinics in 1 Canadian regional health system. The sample size was calculated to detect differences with the US sample. Conformance criteria were based on a published protocol. Data were collected using patient interviews and a structured review of health records. Conformance to 9 key Schizophrenia Patient Outcomes Research Team recommendations was assessed.

Results:

Conformance ranged between 58% and 90% for pharmacological recommendations, and 0% to 81% for psychosocial recommendations. No patients who met criteria for assertive case management had been referred to an assertive case management team. Significant differences in conformance rates to some treatment recommendations were found between Canadian and published US results.

Conclusions:

It proved possible to assess health care quality using process measures of conformance to treatment recommendations. Conformance to clinical recommendations for pharmacotherapy is higher than for psychosocial therapies. The absence of barriers to access for pharmacological therapies likely enhances the higher conformance to these recommendations. Limited or variable access to psychosocial services, specifically assertive community treatment, likely negatively affects conformance to psychosocial treatment recommendations. Methodological limitations preclude drawing conclusions on comparisons between Canadian and US services.
Is Mental Health in the Canadian Population Changing over Time?
Authors: Simpson Keith R S , Meadows Graham N , Frances Allen J , Patten Scott B
Published: July 2017

Objective:

Mental health in populations may be deteriorating, or it may be improving, but there is little direct evidence to support either possibility. Our objective was to examine secular trends in mental health indicators from national data sources.

Methods:

We used data (1994–2008) from the National Population Health Survey and from a series of cross-sectional studies (Canadian Community Health Survey) conducted in 2001, 2003, 2005, and 2007. We calculated population-weighted proportions and also generated sex-specifc, age-standardized estimates of major depressive episode prevalence, distress, professionally diagnosed mood disorders, antidepressant use, self-rated perceived mental health, and self-rated stress.

Results:

Major depression prevalence did not change over time. No changes in the frequency of severe distress were seen. However, there were increases in reported diagnoses of mood disorders and an increasing proportion of the population reported that they were taking antidepressants. The proportion of the population reporting that their life was extremely stressful decreased, but the proportion reporting poor mental health did not change.

Conclusions:

Measures based on assessment of symptoms showed no evidence of change over time. However, the frequency of diagnosis and treatment appears to be increasing and perceptions of extreme stress are decreasing. These changes probably reflect changes in diagnostic practice, mental health literacy, or willingness to report mental health concerns. However, no direct evidence of changing mental health status was found.
Prevalence and Frequency of Mental Health Care Provided by General Practitioners: Differences between 2 National Data Sources for the Same Population
Authors: Palin JoAnne L , Goldner Elliot M , Koehoorn Mieke , Hertzman Clyde
Published: July 2017

Objective:

Estimates from Canada's first national mental health surveillance initiative- which is based on diagnostic codes in administrative health care utilization databases- indicate that the proportion of Canadians who receive mental health care is more than twice as high as reported in Canada's national mental health survey. Our study examines and clarifies the nature and extent of differences between 2 predominant types of data that are used for mental health services research and planning.

Method:

A person-by-person data linkage was conducted between the Canadian Community Health Survey: Mental Health and Well-Being and administrative health care utilization records (British Columbia Ministry of Health Services-Medical Services Plan, and Hospital Discharge Abstract Database) within a universal-access, publically funded health care system, to examine the level of agreement between the data sources and respondent characteristics associated with agreement ( N = 2378).

Results:

The prevalence of mental health care from general practitioners (GPs) was higher in administrative data (19.3%; 95% CI 17.7% to 20.9%) than survey data (8.5%; 95% CI 7.5% to 9.8%). Agreement between prevalence estimates from the 2 data sources was associated with age, mental health characteristics, and the number of GP visits. The median number of visits per person was significantly higher in the survey data.

Conclusions:

GPs saw more than twice as many patients for mental health issues according to administrative data, compared with survey data; however, the number of visits per patient was higher in survey data.
Folates and S-Adenosylmethionine for Major Depressive Disorder
Authors: Papakostas George I , Cassiello Clair F , Iovieno Nadia
Published: July 2017

Interest in nonpharmaceutical supplements for treating major depressive disorder (MDD) has increased significantly, both among patients and among clinicians during the past decades. Despite the large array of antidepressants (ADs) available, many patients continue to experience relatively modest response and remission rates, in addition to a burden of side effects that can hinder treatment compliance and acceptability. In this article, we review the literature on folates and S-adenosylmethionine (SAMe), 2 natural compounds linked in the 1-carbon cycle metabolic pathway, for which substantial evidence supports their involvement in mood disorders. Background information, efficacy data, proposed mechanisms of action, and side effects are reviewed. Based on existing data, supplementation with SAMe, as well as with various formulations of folates, appears to be efficacious and well tolerated in reducing depressive symptoms. Compared with other forms of folates, 5-methyltetrahydrofolate (L-methylfolate or 5-MTHF) may represent a preferable treatment option for MDD given its greater bioavailability in patients with a genetic polymorphism, and the lower risk of specific side effects associated with folic acid. Although further randomized controlled trials in this area appear warranted, SAMe and L-methylfolate may represent a useful addition to the AD armamentarium.
Common and Unique Risk Factors and Comorbidity for 12-Month Mood and Anxiety Disorders among Canadians
Authors: Meng Xiangfei , D'Arcy Carl
Published: July 2017

Objective:

To explore the common and unique risk factors for mood and anxiety disorders. What sociodemographic, psychological, and physical risk factors are associated with mood and anxiety disorders and their comorbidities? What is the impact of multiple risk factors?

Method:

Data from the Canadian Community Health Survey: Mental Health and Well-Being were analyzed. Appropriate sampling weights and bootstrap variance estimation were employed. Multiple logistic regression was used to estimate odds ratios and confidence intervals.

Results:

The annual prevalence of any mood disorder was 5.2%, and of any anxiety disorder 4.7%. Major depressive episode was the most prevalent mood and anxiety disorder (4.8%), followed by social phobia, panic disorder, mania, and agoraphobia. Among people with mood and anxiety disorders, 22.4% had 2 or more disorders. Risk factors common to mood and anxiety disorders were being young, having lower household income, being unmarried, experiencing greater stress, having poorer mental health, and having a medical condition. Unique risk factors were found: major depressive episode and social phobia were associated with being born in Canada; panic disorder was associated with being Caucasian; lower education was associated with panic and agoraphobia; and poor physical health was associated with mania and agoraphobia. People who were young, unmarried, not fully employed, and had a medical condition, greater stress, poorer self-rated mental health, and dissatisfaction with life, were more likely to have a comorbid mood and (or) anxiety disorder. As the number of common risk factors increases, the probability of having mood and anxiety disorders also increases.

Conclusions:

Common and unique risk factors exist for mood and anxiety disorders. Risk factors are additive in increasing the likelihood of disease.
What is a Mental Disorder? A Perspective from Cognitive-Affective Science
Authors: Stein Dan J
Published: July 2017

Defining disease and disorder remains a key conceptual question in philosophy of medicine and psychiatry, and is currently a very practical matter for psychiatric nosology, given the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the upcoming International Classification of Diseases, 11th Revision. There have been advances in the cognitive-affective science of human categorization, and it is timely to consider implications for our understanding of the category of psychiatric disorder. The category of mental disorder has graded boundaries, and conditions within this category can be conceptualized using MEDICAL or MORAL metaphors. One key set of constructs used in MEDICAL metaphors relates to the notion of dysfunction, and it may, in turn, be useful to conceptualize such dysfunction in evolutionary terms. For typical disorders, it is relatively easy to agree that dysfunction is present. However, for atypical disorders, there may be considerable debate about the presence and extent of dysfunction. Rational arguments can be brought to bear to help decide whether particular entities should be included in our nosologies, and, if so, what their boundaries should be. However, it is appropriate that there should be ongoing debate on diagnostic validity, clinical utility, and other relevant facts and values, for cases that are difficult to decide. The perspective here can be illustrated using many nosological debates within the anxiety disorders and the obsessive-compulsive and related disorders, including the question of delineating normal from abnormal anxiety, of deciding whether anxiety is psychiatric or medical, and the debate about the optimal meta-structure for anxiety disorders.