bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-Episode Psychosis: A Comparative Review of Diagnostic Evolution and Predictive Variables in Adolescents versus Adults
Authors: Menezes Natasja M , Milovan Eduard 
Published: January 2017

Objective: To review the diagnostic evolution and predictive variables of diagnosis and outcome in first-episode psychosis in adolescents (age 13–19 years) and adults. Method Literature was reviewed through MEDLINE, Psycinfo, and PubMed, and supplemented by selected bibliographies. Results First-episode psychosis in the adolescent population has greater diagnostic instability than in adults. We identified trends in the predictive variables of diagnosis and outcome: 1) Premorbid adjustment (that is, personality) in adolescents and Global Assessment of Functioning (GAF) both before and after first-episode psychosis in adolescents and adults are the best predictors of diagnosis; 2) GAF (before and after) is the best predictor of outcome in both adolescents and adults. Conclusion Adolescent-onset psychosis appears to be in continuity with adult-onset psychosis. The greater diagnostic instability in adolescents and the absence of significant data on predictive variables suggest a need for specialized and continuous care and research in the adolescent population.
Anxiety Disorders in Suicidal Youth
Authors: Strauss John , Birmaher Boris , Bridge Jeffrey , Axelson David , Chiappetta Laurel , Brent David , Ryan Neal 
Published: January 2017

Objective: To test the hypothesis that anxiety disorders are associated with suicidal ideation and suicide attempts in a child and adolescent sample referred to a clinic. Method The sample comprised 1979 patients aged 5 to 19 years who were assessed using the Schedule for Affective Disorders and Schizophrenia for School Aged Children – Present Episode (K-SADS-P) at an outpatient mood and anxiety disorders clinic. Subjects were stratified by age and categorized into mutually exclusive groups as being non-suicidal (n = 817), having suicidal ideation (n = 768), or having attempted suicide (n = 394) in the current episode. Psychiatric diagnoses based on DSM-IV criteria were compared to determine if anxiety disorders were a risk factor for suicidal ideation and suicide attempts. Logistic regression was used to control for significant demographic characteristics and comorbid disorders. Results After stratifying by age, we found no differences across the 3 groups (ideators, attempters, and nonsuicidal youth) in rates of an anxiety disorder in general or in specific rates of panic disorder, agoraphobia, social phobia, simple phobia, and obsessive-compulsive disorder. Two salient findings involving anxiety disorders were noted with regression analysis. In younger children (age ≤ 15 years), attempters had a signficantly lower prevalence of separation anxiety disorder (SAD), compared with ideators (OR = 0.30; 95%CI, 0.11 to 0.80; P = 0.006) and nonsuicidal youngsters (OR = 0.14; 95%CI, 0.05 to 0.39; P < 0.0001). In older children (age >15 years), generalized anxiety disorder (GAD) was more prevalent in ideators (OR = 1.65; 95%CI, 1.03 to 2.66; P = 0.03) than in nonsuicidal patients. Conclusions Based on this clinical sample, the relation between pediatric anxiety disorder and suicidal ideation and suicide attempts is not straightforward. However, further studies in nonreferred samples are warranted.
Impact of Availability on Gambling: A Longitudinal Study
Authors: Jacques Christian , Ladouceur Robert , Ferland Francine 
Published: January 2017

Objective: Legalized gambling opportunities have markedly increased in most industrialized countries. While most authors agree that the rate of pathological gamblers is related to the accessibility of gambling activities, no published studies have yet empirically estimated the impact of the introduction of new gambling activities within a longitudinal study. Thus, we evaluate the impact of the opening of a casino on gambling activities among nearby inhabitants. Method A random sample of 457 respondents from the Hull area (experimental group) and 423 respondents from the Quebec City area (control group) completed the South Oaks Gambling Screen and related questions, both before the opening of the Casino de Hull and 1 year later. Within each household contacted, a resident was randomly chosen by selecting the adult whose birthday was next. Results The experimental group exposed to the new casino showed a significant increase in 1) gambling on casino games, 2) the maximum amount of money lost in 1 day on gambling, 3) reluctance toward the opening of a local casino, and 4) the number of participants who reported knowing a person who has developed a gambling problem in the last 12 months. Conclusion The impact of legalized gambling is discussed in relation to the availability of gambling.
Genetic Counselling for Schizophrenia in the Era of Molecular Genetics
Authors: Hodgkinson Kathleen A , Murphy Jillian , O'Neill Sheri , Brzustowicz Linda , Bassett Anne S 
Published: January 2017

Objective: To review the role of genetic counselling for individuals with psychiatric illnesses. Method: Using schizophrenia as an example and including updated information about a genetic subtype (22q deletion syndrome), we discuss the value of the genetic counselling process in psychiatry, with support from the literature and our clinical experience. Results: Genetic counselling, the process through which knowledge about the genetics of illnesses is shared, provides information on the inheritance of illnesses and their recurrence risks; addresses the concerns of patients, their families, and their health care providers; and supports patients and their families dealing with these illnesses. For comprehensive medical management, this service should be available to all individuals with schizophrenia and their families. Conclusions: New findings in the genetics of psychiatric illness may have important clinical implications for patients and their families.
Major Depressive Disorder in Adolescence: A Brief Review of the Recent Treatment Literature
Authors: Milin Robert , Walker Selena , Chow Joy 
Published: January 2017

Objective: Treating adolescents with depression remains a major clinical and public health challenge. Because of the serious morbidity and mortality associated with adolescent major depressive disorder (MDD), there is a need to review the published literature on treatment efficacy to establish effective treatment choices for these adolescents. Method: We reviewed the recent literature on the treatment of MDD in adolescents using the Medline and PsycINFO computerized databases. Results: Results of open studies of MDD treatment in adolescents suggested therapeutic efficacy; however, later, better-controlled studies are more difficult to interpret, owing to the high rate of improvement with placebo. Currently, there is limited evidence of robust, effective therapeutic interventions in children and in adolescent depressive disorders. Conclusions: Despite limitations, current findings from studies investigating selective serotonin reuptake inhibitors (SSRIs), cognitive-behavioural therapy, and interpersonal therapy generally support these treatments as safe and effective for adolescent MDD. Still, further investigations into these treatments for adolescent depression are warranted.
Behavioural and Substance Use Problems in Rural and Urban Delinquent Youths
Authors: Elgar Frank J , Knight John , Worrall Graham J , Sherman Gregory 
Published: January 2017

Objective: To examine rates of behavioural and substance use problems in incarcerated young offenders and to explore rural and urban differences in the expression and severity of these problems. Method: We assessed a sample of 68 confined male young offenders (63.3% rural and 35.3% urban), using the Drug Use Screening Inventory (DUSI) and the Youth Self-Report (YSR). Results: Based on clinical cut-offs, data showed high rates of externalizing behavioural problems (75.4%) and substance use problems (95.7%). Urban delinquent youths showed higher rates of attention problems, delinquent behaviours, and externalizing behaviours than those in rural communities. Conclusions: Incarcerated young offenders show elevated rates of psychological problems that require treatment. Rural and urban differences in the rates of these problems may reflect differences in community service availability in these areas or in environmental influences on the development of child behavioural problems.
Evidence-Based Treatment of Opioid-Dependent Patients
Authors: van den Brink Wim , Haasen Christian 
Published: January 2017

Objective: To provide an overview of treatment options for opioid-dependent patients. Method: We screened all published studies on the treatment of opioid dependence, with a special focus on systematic literature reviews, formal metaanalyses, and recent trials. Results: Both clinical experience and neurobiological evidence indicate that opioid dependence is a chronic relapsing disorder. Treatment objectives depend on the pursued goals: crisis intervention, abstinence-oriented treatment (detoxification and relapse prevention), or agonist maintenance treatment. The high quality of solid evidence in the literature demonstrates that there are numerous effective interventions available for the treatment of opioid dependence. Crisis intervention, frequently necessary owing to the high overdose rate, can be effectively handled with naloxone. Abstinence-oriented interventions are effective for only a few motivated patients with stable living conditions and adequate social support. Agonist maintenance treatment is considered the first line of treatment for opioid dependence. Numerous studies have shown efficacy for methadone and buprenorphine treatment, while maintenance with other agonists is also becoming available to a greater extent. Maintenance treatment with diamorphine should be made available for the small group of treatment-resistant, severely dependent addicts. Other harm-reduction measures can serve to engage individuals with opioid addiction who are not in treatment. Conclusion: Opioid dependence is a chronic relapsing disease that is difficult to cure, but effective treatments are available to stabilize patients and reduce harm, thereby increasing life expectancy and quality of life.
The Contribution of Social Factors to the Development of Schizophrenia: A Review of Recent Findings
Authors: Cantor-Graae Elizabeth 
Published: January 2017

Objective: To investigate recent evidence suggesting that social factors are causally related to the development of schizophrenia. Method: I conducted a sytematic review of MEDLINE to identify possibly relevant studies. The search was limited to peer-reviewed studies and review articles appearing in English-language journals since 1996. Studies were included if they used standardized diagnostic criteria for schizophrenia or standardized assessment instruments for psychotic symptoms. Results: Studies of migrants to western Europe provide compelling support for the notion that social factors contribute to the development of schizophrenia. Findings such as excessively high risk for schizophrenia in second-generation immigrants are difficult to explain solely in terms of biological or genetic factors. A growing number of studies implicate childhood exposure to social adversity as a risk factor for schizophrenia, although few studies have used prospective designs. The increased incidence of schizophrenia risk associated with urban birth and (or) urban upbringing suggests possible social causation, but these findings are more ambiguous. Thus far, no studies have explored actual mechanisms by which exposure to social factors might generate psychotic symptoms, although animal experiments suggest that social defeat or social exclusion may cause dopamine dysregulation or sensitization. Conclusions: The accumulating evidence suggesting a role for social factors in the development of schizophrenia arises primarily from studies of migrants conducted in Europe. The mechanisms by which social factors exert their influence remain unknown. Future investigations of social causation should clarify the temporal relation between exposure to social defeat and (or) social adversity and the development of psychotic symptoms.
An International Perspective on Worker Mental Health Problems: Who Bears the Burden and How are Costs Addressed?
Authors: Dewa Carolyn S , McDaid David , Ettner Susan L 
Published: January 2017

Objective: To discuss the burden of poor mental health in workers, who currently bears it, and how the associated rising costs are being addressed, from an international perspective. Method: We identify the stakeholder groups and the costs they incur as a result of problems related to mental health in 6 different domains. In addition, we offer examples of programs, services, and strategies being used to either decrease costs or enhance benefits. Results: Mental illness is associated with a wide range of costs distributed across multiple stakeholders including government, employers, workers and their families, and the health care system. The costs incurred by the groups are interrelated; an attempt to decrease the burden for one group of stakeholders will inevitably affect other stakeholders. Thus the answer to the question of who bears the costs of poor mental health is “everyone.” Conclusions: Everyone could benefit from investment in improved mental health in the workplace. However, because the benefits associated with improved worker mental health are often distributed among several stakeholders, the incentives for any single stakeholder to pay for additional services for workers may be diluted. As a consequence, no one invests. Nevertheless, there is a role for all stakeholders, just as there are potential benefits for all. Along with government, employers, employees, and the health care system must invest in promoting good workplace health.
Quality of Life in Treatment-Seeking Patients with Obsessive-Compulsive Disorder with and without Major Depressive Disorder
Authors: Cassin Stephanie E , Richter Margaret A , Zhang K Anne , Rector Neil A 
Published: January 2017

Objective: To compare the quality of life of patients with obsessive–compulsive disorder (OCD) with and without depression comorbidity. Method: Treatment-seeking outpatients ( n = 56) with OCD ( n = 28) or comorbid OCD and major depressive disorder (MDD) ( n = 28), matched by age, sex, and antidepressant medication use, completed a multidimensional measure of quality of life. Results: Patients with comorbid OCD and MDD reported significantly greater decrements in their subjective feelings, social relations, and a composite measure of general activities (for example, overall well-being and life satisfaction) in comparison with patients with OCD without MDD. These differences were not owing to the presence of other Axis I comorbid disorders. Conclusions: Treatments addressing depression comorbidity in the context of primary OCD are required to improve the quality of life of this severely affected population of OCD sufferers.
Differences in Prevalence and Treatment of Bipolar Disorder among Immigrants: Results from an Epidemiologic Survey
Authors: Schaffer Ayal , Cairney John , Cheung Amy , Veldhuizen Scott , Kurdyak Paul , Levitt Anthony 
Published: January 2017

Objective: To add to the limited data on the prevalence, clinical characteristics, and treatment of bipolar disorder (BD) among immigrants. Method: Data were obtained from a large epidemiologic survey, the Canadian Community Health Survey—Mental Health and Well-Being (CCHS 1.2). Lifetime prevalence rates of BD were compared between immigrant and nonimmigrant respondents. Among BD subjects ( n = 831), sociodemographic, clinical, and mental health treatment use variables were compared based on immigrant status. Logistic regression was used to determine the correlates of lifetime contact with a mental health professional and 12-month psychotropic medication use. Results: Lifetime prevalence rate of CCHS 1.2–defined BD was significantly lower among immigrant, compared with nonimmigrant, participants (1.50% and 2.27%, P = 0.01). There were few sociodemographic or clinical differences, yet immigrants with BD were significantly less likely to report any lifetime contact with mental health professionals (OR = 0.25, 95% CI 0.13 to 0.50, P < 0.001). Past-year psychotropic medication use was numerically lower among immigrants with BD (24.5% and 41.0%); however, this did not reach statistical significance when controlling for other factors (OR = 0.49, 95% CI 0.24 to 1.01, P = 0.05). Conclusions: Based on the results of this study, there are in the range of 56 000 to 104 000 immigrants with BD in Canada. Further efforts are needed to better understand and address the barriers to mental health treatment use among immigrants who have BD.
A Brief Scale to Assess Hospital Doctors' Attitudes toward Collaborative Care for Mental Health
Authors: Thombs Brett D , Adeponle Ademola B , Kirmayer Laurence J , Morgan John F 
Published: January 2017

Objective: Collaborative care may improve mental health management in hospital settings. However, no scales assess doctors' attitudes toward its 2 core components: mental health management by nonpsychiatric physicians and psychiatric consultation. Our objective was to develop and assess the reliability and validity of the Doctors' Attitudes Toward Collaborative Care for Mental Health (DACC-MH) Scale. Method: Fifteen items assessing doctors' attitudes toward management of mental health problems (10 items) and psychiatric consultation (5 items) were administered to 225 physicians and surgeons from a London hospital. Item responses were dichotomous (agree or disagree). Confirmatory factor analysis models were conducted using Mplus for dichotomous data to identify items for inclusion in the DACC-MH and to test the validity of the 2 hypothesized factors. Known-groups validity was tested by comparing scores of surgeons and physicians, as physicians have been shown to view mental health management and psychiatric consultation more favourably. Results: The 8-item DACC-MH included a 4-item Attitudes Toward Management of Mental Health Problems factor (Cronbach's α = 0.65) and a 4-item Attitudes Toward Psychiatric Consultation factor (α = 0.67; overall scale α = 0.70). Model fit was good (χ2 = 12.7, df = 11, P= 0.31; Comparative Fit Index = 0.99; Tucker-Lewis Index = 0.99; root mean square error of approximation = 0.03) with all factor loadings of 0.46 or greater. As hypothesized, physician scores were significantly higher than surgeon scores on both subscales, indicating more positive attitudes toward management of mental health problems and psychiatric consultation. Conclusions: Preliminary evidence was found for the validity of the DACC-MH, which will facilitate efforts to evaluate readiness of doctors to engage in collaborative mental health care.
Predictors of the Longitudinal Course of Major Depression in a Canadian Population Sample
Authors: Patten Scott B , Wang Jian Li , Williams Jeanne VA , Lavorato Dina H , Khaled Salma M , Bulloch Andrew GM 
Published: January 2017

Objective: Most psychiatric epidemiologic studies have used cross-sectional methods, resulting in a lack of information about the longitudinal course of depressive disorders. The objective of our study was to describe the longitudinal epidemiology of major depressive episodes (MDEs) in a Canadian sample using data from the National Population Health Survey (NPHS). Methods: The NPHS started data collection in 1994 and has evaluated past-year MDE using repeat interviews of the same cohort every 2 years since then. In our study, we examined the number of weeks depressed during years when MDEs occurred, the proportion of respondents having MDEs at consecutive cycles, and MDE counts during follow-up. Results: A sizable proportion of MDEs were brief: about one-half of respondents with past-year MDE reported 8 or fewer weeks of depression during that year. Less than 10% reported that they were depressed for the entire year. However, a larger proportion (19.1%) fulfilled criteria for MDE on consecutive interview cycles, suggesting either persistence or rapid recurrence. The mean number of detected MDEs among those with at least 1 detected MDE up to 2006 was 2. Positive family history, evidence of comorbidity, negative cognitive style, stress, pain, and smoking were associated with a more negative course. Conclusions: The longitudinal course of MDE in the general population is heterogeneous, including a mixture of brief and more protracted MDEs. Many risk factors for MDE are also associated with a negative course, exceptions being (younger) age and sex. These epidemiologic observations may assist with identification of patients requiring more intensive management in clinical practice.
Psychiatric Comorbidities in Adolescents with Attention- Deficit Hyperactivity Disorder and Their Siblings
Authors: Yang Li-Kuang , Shang Chi-Yung , Gau Susan Shur-Fen 
Published: January 2017

Objective: Despite high psychiatric comorbidities in adolescents with clinical diagnosis of attention-deficit hyperactivity disorder (ADHD), little is known about psychiatric comorbidities in their siblings. We investigated the psychiatric comorbid conditions in adolescents with ADHD, their siblings, and healthy control subjects from their school. Method: The sample included 136 adolescent probands with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria; 136 siblings (47 affected and 89 unaffected) and 136 age- and sex-matched healthy school control subjects. All participants and their parents received the structured psychiatric interviews for current and lifetime DSM-IV psychiatric disorders of the participants. Results: The rate of ADHD (34.6%) in the siblings of probands with ADHD was about 7 times higher than in the general population. Probands with ADHD were significantly more likely than unaffected siblings (OR 6.38; 95% CI 3.43 to 11.88) and healthy school control subjects (OR 9.60; 95% CI 5.31 to 17.34) to have a DSM-IV psychiatric disorder, including oppositional defiant disorder (ODD), conduct disorder (CD), tic disorders, major depressive disorder, specific phobia (more than control subjects only), nicotine use disorder, and sleep disorders. The affected siblings were significantly more likely than healthy school control subjects to have ODD, CD, specific phobia, and to have consumed alcohol (ORs ranging from 2.30 to 20.16). Conclusions: Our findings suggest that siblings of probands with ADHD have increased risks for ADHD and that the affected siblings have more psychiatric comorbidities than healthy school control subjects. It warrants early identification of ADHD symptoms and other psychiatric comorbid conditions as well in siblings of adolescents with ADHD.