bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ropinirole in Treatment-Resistant Depression: A 16-Week Pilot Study
Authors: Cassano Paolo , Lattanzi Lorenzo , Fava Maurizio , Navari Serena , Battistini Giulia , Abelli Marianna , Cassano Giovanni B 
Published: January 2017

Objective: The study aimed to assess the antidepressant efficacy and tolerability of adjunctive ropinirole in outpatients with treatment-resistant depression (TRD). Method: The study sample consisted of patients with a major depressive episode (diagnosed according to DSM-IV criteria) and TRD. Ropinirole 0.25 to 1.5 mg daily was added to tricyclic antidepressants or selective serotonin reuptake inhibitors. We conducted assessments at baseline and at weeks 2, 4, 8, 12, and 16. We defined response as a 50% or greater reduction of the Montgomery–Asberg Depression Rating Scale (MADRS) total score plus a score of 1 (“very much improved”) or 2 (“much improved”) on the Clinical Global Impression of Improvement scale at endpoint. Tolerability was monitored with the Dosage Record Treatment Emergent Symptom Scale. Results: Seven patients had major depressive disorder, and 3 had bipolar II disorder. The mean maximum dose of ropinirole was 1.33 mg daily. Mean (SD) scores on the MADRS decreased from 29.6 (7.6) at baseline to 16.9 (12.1) at endpoint ( P < 0.02). At endpoint, 4 of 10 (40%) patients were responders. Two patients discontinued ropinirole because of dizziness. Conclusions: These pilot data suggest that, in selected cases of TRD, ropinirole augmentation of antidepressants is effective and relatively well tolerated.
SCL-90-R and 16PF Profiles of Senior High School Students with Excessive Internet Use
Authors: Yang Chang-Kook , Choe Byeong-Moo , Baity Matthew , Lee Jeong-Hyeong , Cho Jin-Seok 
Published: January 2017

Objective: To investigate the psychiatric symptomatology and personality characteristics of Korean senior high school students considered to use the Internet to excess. Method: We administered a questionnaire packet to students that included 4 measures. These measures included a questionnaire on Internet use patterns during the previous month, the Internet Addiction Test (IAT), the Symptom Checklist-90-R (SCL-90-R), and the Sixteen Personality Factor Questionnaire (16PF). A total of 328 students, aged 15 to 19 years, participated in the study. Results: Students were divided into 4 Internet user groups according to their IAT total scores: nonusers ( n = 59, 18.0%), minimal users ( n = 155, 47.3%), moderate users ( n = 98, 29.9%), and excessive users ( n = 16, 4.9%). The SCL-90-R showed that the excessive users group, when compared with the other groups in this study, reported the highest levels of symptomatology. The 16PF also revealed that excessive users were easily affected by feeling, emotionally less stable, imaginative, absorbed in thought, self-sufficient, experimenting, and preferred their own decisions. Conclusions: This study suggests that senior high school students who use the Internet to excess report and subsequently exhibit significantly more psychiatric symptoms than students who use the Internet less frequently. In addition, excessive users appear to have a distinctive personality profile when compared with nonusers, minimal, and moderate users.
Spontaneous Parkinsonism in Antipsychotic-Naive Patients with First-Episode Psychosis
Authors: Chong Siow Ann , Subramaniam Mythily , Verma Swapna 
Published: January 2017

Objective: The purpose of this study was to establish rates of spontaneous parkinsonism (SP) among the different types of psychosis. We hypothesized that the rate would be higher among persons with affective symptoms. Methods: We included in the study consecutive patients admitted to a first-episode psychosis intervention program. We recorded sociodemographic data from interviews with patients and caregivers and from medical records. We used the Simpson–Angus Rating Scale at baseline to assess parkinsonism and a diagnosis of SP was established if the Simpson–Angus score was ≥ 0.3. Results: A total of 174 patients were examined; of these, only 4 (2.3%; 2 Chinese women, 1 Chinese man, and 1 Malay man) had SP. There was a significant difference in the rates of SP in patients with affective psychosis and schizoaffective disorder, compared with those with nonaffective psychoses (15.4% vs 1.2%; χ2 = 10.7, P = 0.001). The 2 groups did not differ significantly in age, duration of untreated psychosis, or sex distribution. Conclusions: The rate of SP in Asian patients with first-episode psychosis was low, and it was significantly higher in those with affective symptoms.
Inattention, Hyperactivity, and Impulsivity in Teenagers with Intellectual Disabilities, with and without Autism
Authors: Bradley Elspeth A , Isaacs Barry J 
Published: January 2017

Objective: To explore inattentive, hyperactive, and impulsive behaviours in teenagers with intellectual disabilities (ID), with and without autism. Method: We identified teenagers with ID, with and without autism, in a single geographic area. Those with autism were matched for age, sex, and nonverbal IQ to those with ID only. We compared inattentive, hyperactive, and impulsive (IHI) behaviours in the 2 groups, along with adaptive functioning and medical circumstances. We further subdivided the autism group into those with IHI behaviours (autism IHI) and those without (autism non-IHI) and explored similarities and differences between autism subgroups. Results: As a group, those with autism and ID had more IHI behaviours than those with ID alone. More in the autism group met criteria for attention-deficit hyperactivity disorder and hyperkinetic syndrome. Lifetime exposure to psychotropic medication was greater in the autism group, with stimulant and antipsychotic medications predominating. However, just under one-half of those in the autism group showed no IHI behaviours. Comparison of autism IHI and autism non-IHI groups showed that those with IHI behaviours were significantly more likely to have past (but not current) exposure to stimulant medication. Conclusions: One in 2 teenagers with ID and coexisting autism displayed clinically significant inattentive, hyperactive, and (or) impulsive behaviours, compared with 1 in 7 of those with ID alone. Most of the remaining teenagers with autism displayed no IHI behaviours. Our results support the need for further investigation into the prevalence and etiology of these IHI behaviours in individuals with autism.
Electroconvulsive Therapy in Older Adults: 13-Year Trends
Authors: Rapoport Mark Jeffrey , Mamdani Muhammad , Herrmann Nathan 
Published: January 2017

Objectives: To examine temporal trends in electroconvulsive therapy (ECT) use among all 12 million Ontario residents between January 1992 and December 2004 and to examine the differential trends in older adults, compared with younger ones. Methods: We undertook a time-series analysis to examine annual trends in the use and prevalence of ECT, using linked provincial datasets. Descriptive data were presented for the population as a whole, and then trends were described separately by age groups (younger and older). As a comparator, we similarly examined antidepressant prevalence for older adults over the same time period. Results: Overall rates of ECT prevalence were stable. Annual population rates of individuals receiving ECT increased by about 27%, from 12.3 per 100 000 population in 1992 to 15.6 per 100 000 in 1997, and then decreased to 12.5 per 100 000 by 2004. The population rates of ECT were about threefold higher among older adults, relative to the younger population. Antidepressant prevalence increased by 90.1% among older adults over the same time period. The female-to-male ratio was relatively stable over time. Conclusions: The rate of ECT has been relatively stable since the early 1990s. Older adults were much more likely to be prescribed a course of ECT than younger adults. ECT remains a commonly prescribed treatment, particularly in old age.
Definition, Assessment, and Staging of Treatment—Resistant Refractory Major Depression: A Review of Current Concepts and Methods
Authors: Berlim Marcelo T , Turecki Gustavo 
Published: January 2017

Objective: Up to 15% of depression patients eventually present with treatment-resistant or refractory depression (TRD), a condition that causes significant social and economic burdens. Our paper aims to summarize the current medical literature on the conceptual and methodologic issues involved in the definition, assessment, and staging of TRD. Method: We reviewed the recently published medical literature to identify papers that specifically discuss TRD. For this, we searched MEDLINE, EMBASE, and PsycINFO for potentially relevant English-language articles published between January 1996 and June 2006. Results: Recent methodologic and conceptual advances have contributed to the achievement of an acceptable level of theoretical consensus on the general meaning of TRD. Accordingly, depression is usually considered resistant or refractory when at least 2 trials with antidepressants from different pharmacologic classes (adequate in terms of dosage, duration, and compliance) fail to produce a significant clinical improvement. Regarding diagnostic assessments, an accurate and systematic evaluation should be made to elicit the potential role of several contributing factors, such as medical and psychiatric comorbidity. Conclusion: Recently, 3 staging methods for TRD have been described, but they currently require extensive empirical support. Future research on TRD should include prospective studies addressing the validity of the proposed criteria, the impact of depression comorbid with other psychiatric disorders and (or) physical conditions, and the possible predictors of treatment outcome. There is an important and clear need for studies that empirically test current definitions, assessment strategies, and staging methods of TRD.
A National Survey of Canadian Psychiatry Residents' Perceptions of Psychotherapy Training
Authors: Hadjipavlou George , Ogrodniczuk John S 
Published: January 2017

Objective: To explore Canadian psychiatry residents' perceptions of their psychotherapy training and identify factors that may influence decisions to practise psychotherapy after graduation. Method: We surveyed psychiatry residents at all training sites across Canada, using a self-report questionnaire. Results: The response rate was 63%. Of the respondents, 68% indicated that the prospect of learning and practising psychotherapy was a factor in their decisions to become psychiatrists, and 87% considered their ability to practise psychotherapy to be important to their identities as psychiatrists. The majority of residents (71%) were generally satisfied with their psychotherapy training. Among the graduating class of residents, 84% anticipate practising psychotherapy in some capacity. Satisfaction with their overall training experience and supervision and feeling competent to perform psychotherapy were significantly associated with their decisions to practise psychotherapy after graduation. Conclusions: Most psychiatry residents currently enrolled in postgraduate training programs across Canada view psychotherapy as having an important role in the way they anticipate practising psychiatry.
Epidemiology of Schizophrenia
Authors: Häfner Heinz , an der Heiden Wolfram 
Published: January 2017

Objective: To characterize the epidemiology of schizophrenia. Method: Narrative literature review. Results: Each year 1 in 10 000 adults (12 to 60 years of age) develops schizophrenia. Based on a restrictive and precise definition of the diagnosis and using standardized assessment methods and large, representative populations, the incidence rates appear stable across countries and cultures and over time, at least for the last 50 years. Schizophrenic patients are not born into ecological and social disadvantage. The uneven distribution of prevalence rates is a result of social selection: an early onset leads to social stagnation, a late onset to descent from a higher social status. The main age range of risk for schizophrenia is 20 to 35 years. It is still unclear whether schizophrenia-like late-onset psychoses (for example, late paraphrenia) after age 60 should be classified as schizophrenia either psychopathologically or etiologically. In 75% of cases, first admission is preceded by a prodromal phase with a mean length of 5 years and a psychotic prephase of one year's duration. On average, women fall ill 3 to 4 years later than men and show a second peak of onset around menopause. Consequently, late-onset schizophrenias are more frequent and more severe in women than in men. The sex difference in age of onset is smaller in cases with a high genetic load and greater in cases with a low genetic load. Type of onset and core symptoms do not differ between the sexes. The most pronounced sex difference is the socially negative illness behaviour of young men. Conclusions: Among the factors determining social course and outcome are level of social development at onset, the disorder itself (for example, genetic liability, severity of symptoms, and functional deficits), general biological factors (for example, estrogen), and sex- and age-specific illness behaviour.
Psychosocial Aspects of Coronary Artery Disease Related to Military Patients
Authors: Grenier Jodi L , Swenson J Robert , FitzGibbon GM , Leach Alan J 
Published: January 2017

Objective: Coronary artery disease (CAD) is a major cause of nontraumatic morbidity and mortality in military personnel. Most studies of the psychosocial impact of CAD have dealt with civilian populations. The purpose of this paper is to highlight differences between military and civilian populations with CAD in 4 areas: depression and anxiety, social support, return to work, and stress. Method: A computerized literature search from 1985 to 1995 using the search terms “stress,” “cardiovascular,” “cardiac,” “depression,” “military,” “anxiety” and “psychosocial” was undertaken. Controlled and prospective studies of civilian patients were selected along with relevant studies involving military populations. Results: Unique characteristics of the military may be important factors in affecting the psychosocial outcome of military patients with CAD. These characteristics include a high level of denial of illness, strong social supports, a powerful military work ethic, and stressful situations unique to the military. Conclusions: Most studies of the psychosocial impact of CAD are based on civilian populations. A review of available studies suggests that little is known about how military patients adapt to CAD, particularly with regard to symptoms of depression and anxiety, social impairment, and rates of return to work. Studies in this area are needed regarding the psychosocial aspects of CAD in military populations.
Nature of Pathology: The Character of Danger Implicit in Functional Impairment
Authors: Leighton Alexander H , Murphy Jane M 
Published: January 2017

Objective: To facilitate clinical and scientific consensus in definitions of psychiatric disorders and with regard to the nature and meaning of pathology more generally. Method: An essay based on a review of definitional problems encountered by psychiatric epidemiologists, with examples taken from selected studies of historic importance. A remedy is suggested and illustrated by experiences with its use in the Stirling County Study. Results: A concept of pathology, termed for reference as “impairment-risk,” is defined as the danger that functional impairment carries for subsequent health adversities. The concept is based on the classical notions of Rudolf Virchow, the empirical orientations of Adolf Meyer's psychobiology, the functional concepts of physiology, and the dynamics implied by evolutionary biology. The ideas embedded in “impairment-risk” are beginning to be represented in official classifications of mental disorders. Conclusions: Impairment-risk has potential in the further development of psychiatric epidemiology because of the connections made possible among neuroscience, genetics, general medicine, psychology, and the more empirical of the social and behavioural sciences.
The Nature of Generalized Anxiety Disorder and Pathological Worry: Current Evidence and Conceptual Models
Authors: Brown Timothy A 
Published: January 2017

Objective: To examine the nature and conceptualization of generalized anxiety disorder (GAD) and chronic worry as well as data bearing on the validity of GAD as a distinct diagnosis. Method: Narrative literature review. Results: Although a wealth of data have been obtained on the epidemiology, genetics, and nature of GAD, many important questions remain regarding the validity of current conceptual models of pathological worry and the discriminability of GAD from certain emotional disorders (for instance, mood disorders) and higher-order trait vulnerability dimensions (for example, negative affect). Conclusion: Because the constituent features of GAD are salient to current conceptual models of emotional disorders (for example, models that implicate negative affect or worry/anxious apprehension as vulnerability factors), research on the nature of GAD and its associated features should provide important information on the pathogenesis, course, and cooccurrence of the entire range of anxiety and mood disorders.
The Incidence of Delirium in Psychiatric Inpatient Units
Authors: Patten Scott B , Williams Jeanne VA , Haynes Laura , McCruden Jane , Arboleda-Flórez Julio 
Published: January 2017

Objectives: To estimate prospectively the incidence of delirium in psychiatric inpatients and to identify risk factors for delirium in this population. Method: The subjects were nondelirious patients newly admitted to the Calgary General Hospital. The Delirium Symptom Interview (DSI), the Confusion Assessment Method (CAM), and the Mini-Mental State Examination (MMSE) were used to identify incident cases of delirium. In order to evaluate the potential impact of selection bias, we conducted a supplementary analysis using record linkage to an electronic administrative data base with coverage of the target population. Results: Of 420 admissions to the hospital, 401 subjects provided informed consent and were not delirious at the time of admission. There were 9 incident cases of delirium. The cumulative incidence rate was, therefore, 2.14 per 100 admissions. The record linkage analysis did not uncover evidence of selection bias. Delirium was associated with a significantly increased length of stay in hospital. Conclusions: Delirium is an uncommon incident event in the psychiatric inpatient population. The incidence rate reported here may be useful as a benchmark for the identification of excessive rates in other inpatient settings. Since delirium is sometimes related to modifiable therapeutic factors, an excessive rate should prompt a search for its causes.
Behaviour Therapy for Obsessive—Compulsive Disorder: A Decade of Progress
Authors: Marks Isaac 
Published: January 2017

Objective: To review the last decade of behaviour therapy research in obsessive–compulsive disorder (OCD). Method: The most salient research was analyzed. Results: Many studies confirmed that exposure and ritual prevention (ERP) effectively reduced compulsive rituals and obsessive thoughts in most patients in all age groups, although a minority of the patients did not complete treatment. Gains persisted to follow-up 2 to 6 years later in several countries. Improvement after ERP generalized to obsessive–compulsive beliefs, mood, work, and social adjustment, and was accompanied by reduction in cerebral blood flow in the right caudate nucleus. Teaching patients how to prevent relapse seems to reduce the risk of recurrence. ERP yields slightly more improvement than does appropriate antidepressant medication and is followed by far less relapse after treatment has stopped, so ERP may be more cost-effective in the long term. Antidepressant medication is a useful adjunct to ERP when OCD is accompanied by comorbid depression. The therapist now tends to teach patients how to carry out self-exposure and self-imposed ritual prevention, rather than to impose ERP on them. Self-help manuals help patients to do this, and computer aids to allow patients to learn how to do ERP at home have been valuable in pilot studies. Cognitive therapy without ERP was as useful as ERP. Conclusion: ERP is of lasting value for OCD. Long-term cost-effectiveness comparisons are needed of self-administered ERP versus cognitive therapy and versus medication. Studies are also needed of brief psychological treatment for depression comorbid with OCD.
Neurocognitive Correlates of Positive and Negative Syndromes in Schizophrenia
Authors: Voruganti LNP , Heslegrave RJ , Awad AG 
Published: January 2017

Objective: To identify the neurocognitive correlates of positive and negative schizophrenic syndromes using a battery of information-processing measures as the principal method of evaluation. Method: Fifty-two treated, symptomatically stable, schizophrenic (DSM-III-R) patients and 24 age-matched, healthy volunteers were administered a computerized cognitive test battery (COGLAB). The battery included measures of preattentional, attentional, conceptual, and psychomotor performance. The patients' psychopathology was rated with the positive and negative syndromes scale (PANSS), which derived scores for positive symptoms, negative symptoms, general psychopathology, and insight. Results: Compared with controls, schizophrenic patients, as a group, showed significant deficits on all of the neurocognitive tasks. Impaired performance on the backward masking, span of apprehension, and Wisconsin card sorting tasks correlated significantly with negative symptoms (r = 0.27–0.40), general psychopathology (r = 0.29–0.42) and impaired insight (r = 0.34–0.52), but no clear association was found between positive symptom scores and neurocognitive deficits. Conclusions: Schizophrenic patients with predominantly negative symptoms and impaired insight seem to exhibit more severe neurocognitive deficits, which lends support to the evolving concept of schizophrenia subtypes and their distinctive neurobiological mechanisms.
The QuickLift: Featuring an Encircling Double Purse-String Plication Technique with Blunt Neck/Jowl Undermining and Small Submental Tuck for Tightening the Sagging Superficial Musculoaponeurotic System, Platysma, and Skin
Authors: Brandy Dominic A. 
Published: January 2017

Introduction: The QuickLift is a modification of the S-lift that varies from the S-lift primarily in the shape of the incision, the areas of undermining, the method of plication, and the vector of advancement. Two negative aspects of the purse-string plication technique used with the original QuickLift were an intraoperative bulging centrally that required trimming and minimal midface improvement. In 1 of the 85 patients reported in the original article, the aforementioned complication became noticeable as a slight bulge once swelling subsided. Materials and Methods: Instead of using 1 large oval-shaped purse string for plication, a firmly anchored small oval-shaped purse-string is encircled by a larger purse-string, with the latter purse-string modified to provide improved advancement of the midface. Results: The encircling double purse-string plication technique not only reduces the bulging effect of the deep tissues, but also provides stronger soft tissue support because of increased suture placement and anchoring sites. The cosmesis in the midface is improved over the former technique. Conclusions: A new variation of the originally described QuickLift plication technique reduces bulging of the deep tissues while simultaneously providing stronger superficial musculoaponeurotic system support to the neck, jowls, and midface. Blunt undermining or liposuction of the neck and/or jowl with a small submental tuck further enhances the result.