bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicated Anxious Children: Characteristics and Cognitive-Behavioural Treatment Response
Authors: Liashko Vitaly , Manassis Katharina 
Published: January 2017

Objective: To determine whether individual and family characteristics of children with anxiety disorders who take psychotropic medications differ from those that are unmedicated and whether there is a differential response to cognitive-behavioural therapy (CBT). Method: Children ages 8 to 12 years ( n = 102: 18 medicated, 84 unmedicated) were recruited in a specialized outpatient clinic over a 3-year period. All had a primary diagnosis of an anxiety disorder. Comparisons were done using t-tests for continuous measures and chi-square tests for discrete measures. Treatment-related changes were assessed using repeated measures analyses of variance. Results: Medicated and unmedicated groups did not differ by age, sex, socioeconomic status, or diagnostic profile. Initial ratings of anxiety symptoms, depressive symptoms, and global functioning were comparable. Greater family dysfunction and family frustration were reported in medicated children. With treatment, both groups improved symptomatically and showed improved family functioning. Families of medicated children showed a greater reduction in frustration than families of unmedicated children, whereas unmedicated children showed greater gains in global functioning. Conclusions: Initial family functioning of medicated children seems to show more disturbances. Both medicated and unmedicated children can benefit from CBT. Further studies of differential treatment effects for medicated and unmedicated children are indicated.
Psychosocial and Clinical Predictors of Symptom Persistence vs Remission in Major Depressive Disorder
Authors: Enns Murray W , Cox Brian J 
Published: January 2017

Objective: The present study evaluates the impact of a range of psychosocial factors on the outcome of major depression while controlling for the effect of clinical variables. Method: Patients ( n = 171) seen in consultation at a mood disorders clinic completed measures of neuroticism, rumination, coping style, sexual abuse history, and parental bonding experiences at Time 1 and completed measures of interpersonal and achievement life events and depression 12 months later. Results: In univariate analyses, neuroticism, rumination, interpersonal and achievement life events, and sexual abuse history were associated with nonremission, whereas avoidance coping was associated with remission at Time 2. Interpersonal and achievement life events and sexual abuse history were associated with nonimprovement, whereas avoidance coping was associated with improvement at Time 2. Significant predictors of both remission and improvement in logistic regression analyses controlling for clinical variables (depression and anxiety severity, duration of illness, and age) included avoidance, interpersonal life events, and the interaction between avoidance and interpersonal life events. Conclusions: Interpersonal events and responses to depression (that is, coping) play an important role in the outcome of major depression. Further attention to coping style and interactions between psychological factors and life events is warranted in future research on depression persistence.
Construct Validity of an Instrument to Assess Major Depression in Parents in Epidemiologic Studies
Authors: Roy Carmella A , Zoccolillo Mark , Gruber Reut , Boivin Michel , Pérusse Daniel , Tremblay Richard E 
Published: January 2017

Objective: The Longitudinal Study of Child Development in Quebec (LSCDQ) is a community study of children that examines the risk factors, such as parental depression, linked to childhood psychopathology and maladaptive functioning. Our goal was to test the construct validity of an instrument to assess major depression in the parents. Method: Parents of a representative sample of 2120 infants born in the province of Quebec in 1998 were selected. The major depression instrument was administered to the parents when the infants were aged 29 months. We tested the construct validity of the instrument by examining 1) sex differences in symptoms and prevalence, 2) the rank order of the prevalence of symptoms, 3) the clustering of symptoms, and 4) the association of depression with functional impairment and treatment-seeking behaviour. Results: Depression was twice as common in mothers as in fathers. Most mothers and fathers who reported ever being depressed for 2 or more weeks had also experienced at least 4 additional depression symptoms. The rank order of symptom prevalence was comparable to that found in other studies. At least 50% of parents reported having talked to a professional and that suffering from depression had interfered with their functioning. Conclusions: The expected sex differences, the rank order of symptom prevalence, the symptom clustering, and the associations with functional impairment and treatment-seeking behaviour support the construct validity of a brief questionnaire on parental major depression.
Polysomnographic and Symptomatological Analyses of Major Depressive Disorder Patients Treated with Mirtazapine
Authors: Shen Jianhua , Chung Sharon A , Kayumov Leonid , Moller Henry , Hossain Naheed , Wang Xuehua , Deb Prativa , Sun Frank , Huang Xin , Novak Marta , Appleton Darryl , Shapiro Colin M 
Published: January 2017

Objective: This study aimed to characterize the effects of mirtazapine on polysomnographic sleep, especially slow wave sleep (SWS) and rapid eye movement (REM) sleep, as well as its effects on clinical symptoms in patients with major depressive disorder (MDD). Method: Sixteen MDD patients were treated with mirtazapine 30 mg taken 30 minutes before bedtime. Polysomnographic and subjective sleep, as well as other clinical data, were collected at baseline and on Days or Nights 2, 9, 16, 30, and 58 during treatment. We used repeated measures analysis of variance, including pairwise comparison, to analyze data statistically. Results: Mirtazapine administration increased total SWS and the SWS in the first sleep cycle, but not SWS in the second sleep cycle. The medication increased REM latency and the duration of the first REM episode; it also decreased the number of REM episodes. Simultaneously, mirtazapine significantly reduced wake-after-sleep onset and scores on the Athens Insomnia Scale. After patients took the medication, scores on the Hamilton Depression Rating Scale-17 (HDRS-17) decreased rapidly and continuously. The changes on the Beck Depression Inventory-II were consistent with those on the HDRS-17. The medication has a tendency to increase weight. Conclusions: Mirtazapine significantly improved sleep quality, reversed sleep markers of depression, and reduced depressive symptoms in this group of MDD patients.
Status of First-Episode Psychosis Patients Presenting for Routine Care in a Defined Catchment Area
Authors: Payne Jennifer , Malla Ashok , Norman Ross , Windell Deborah , Brown Nicole 
Published: January 2017

Objective: To examine the clinical and behavioural status of all first-episode psychosis (FEP) patients admitted to hospital within a defined catchment area. Method: We used a structured format to review clinical records of all first admissions to hospitals from a catchment area (population 390 000) with diagnosis of a first episode of nonaffective psychosis over a 3-year period. Results: Patients were somewhat older than usually reported for FEP (mean age 31.3 years). They were mostly male (63.7%), single (80.8%), unemployed (87.4%), with a primary diagnosis of schizophrenia spectrum psychoses (85%), and had spent a mean of 31 days in an open inpatient unit and 2.93 days in an intensive care psychiatric unit during their first admission. Most (60.3%) were admitted involuntarily; 34.2% had a history of legal involvement; 18.8% had attempted suicide prior to admission; 31.5% had demonstrated violence toward people, property, or animals; 14.4% had suffered injuries; and 15.9% had shown aggressive behaviour during the hospital admission. Conclusions: These results identify some of the potential needs of FEP patients, toward whom early intervention services should be directed.
Agreement between Staff and Service Users concerning the Clientele's Mental Health Needs: A Quebec Study
Authors: Fleury Marie-Josée , Grenier Guy , Lesage Alain 
Published: January 2017

Objectives: This article examines the differences found between clientele with severe mental health problems and their key health workers in terms of assessing service users' needs in 6 Quebec service areas. Method: We questioned 165 pairs of users and staff, using the Camberwell Assessment of Needs questionnaire. The profile of serious and overall problems encountered by clientele from each of the sites was compared. Results: The sites with the greatest degree of user–staff agreement in identifying problems were also the ones where users considered that local services best met their needs. Conclusions: The study demonstrated that, in needs assessment, major differences exist between the perceptions of users and their key workers in the various sites. These differences can be explained in part by users' individual characteristics, by types of needs, by local particularities, and by service use. Objectifs: Cet article examine les différences décelées entre la clientèle souffrant de graves problèmes mentaux et ses principaux travailleurs de la santé, pour ce qui est de l'évaluation des besoins des utilisateurs de services, dans 6 réseaux de services du Québec. Méthode: Nous avons interrogé 165 paires d'utilisateurs et d'employés, à l'aide du questionnaire d'évaluation des besoins de Camberwell. Le profil des problèmes sérieux et généraux éprouvés par la clientèle de chaque site a été comparé. Résultats: Les sites ayant le niveau d'entente le plus élevé entre utilisateurs et employés dans l'identification des problèmes étaient aussi ceux où les utilisateurs estimaient que les services locaux répondaient au mieux à leurs besoins. Conclusions: L'étude a démontré qu'en matière d'évaluation des besoins, il existe des différences majeures entre les perceptions des utilisateurs et celles de leurs principaux travailleurs, à divers sites. Ces différences peuvent s'expliquer en partie par les caractéristiques individuelles des utilisateurs, par les types de besoins, par les particularités locales et par l'utilisation des services.
Psychopathy Checklist Score Predicts Negative Events during the Sentences of Prisoners with Hare Psychopathy: A Prospective Study at a German Prison
Authors: Huchzermeier Christian , Bruß Emelie , Geiger Friedemann , Godt Nils , von Nettelbladt Frederic , Aldenhoff Josef 
Published: January 2017

Objective: This study examined the predictive validity of the German translation of the Psychopathy Checklist-Screening Version (PCL-SV) for negative events during the course of the prison sentence of German prisoners. Method: Using the PCL-SV, we investigated 145 offenders in a German prison at the start of their sentences. We then compared the extreme groups identified by the PCL-SV—the high and low scorers—using a prospective design with respect to negative events and factors during the course of the sentences. This involved the standardized collection of data on both objective records of disciplinary incidents and subjective impressions from prison staff on the basis of operationalized criteria. Results: The high scorers were involved in significantly more disciplinary incidents and were also rated significantly less favourably by prison staff than the low scorers. Conclusion: Until now, the PCL has only been shown to predict recidivism following release from prison. The results of our study show that the PCL also has predictive validity for problems during the course of the sentence. It is therefore recommended that the PCL be used routinely at the start of the prison sentence to estimate the likelihood of subsequent difficulties.
One-Year Stability of Diagnosis in First-Episode Nonaffective Psychosis: Influence of Sex
Authors: Chaves Ana Cristina , Addington Jean , Seeman Mary , Addington Donald 
Published: January 2017

Objective: To determine whether sex influences the frequency and direction of diagnostic change 1 year after a first episode of nonaffective psychosis. Method: The subjects ( n = 228) were individuals diagnosed with schizophrenia and other psychoses according to DSM-IV criteria at baseline and at 1 year. Results: When diagnostic shifts occurred, men mainly shifted toward schizophrenia (84.6%), which was associated with more severe symptoms. In contrast, 72% of women in whom a diagnostic shift occurred shifted away from a schizophrenia spectrum disorder toward mood disorder. A shift to mood disorder in women was associated with an early age of illness onset. Conclusions: At initial presentation, nonaffective first-episode psychosis studies may underestimate the number of men and overestimate the number of women who will eventually receive a schizophrenia diagnosis.
Comparing Interventions for Selective Mutism: A Pilot Study
Authors: Manassis Katharina , Tannock Rosemary 
Published: January 2017

Objective: To examine the outcome within 6 to 8 months of medical and nonmedical intervention for children with severe selective mutism (SM). Method: Children with SM ( n = 17) and their mothers, seen in a previous study, attended follow-up appointments with a clinician. Obtained by maternal report were: treatment received, current diagnosis (based on semi-structured interview), speech in various environments, and global improvement. An independent clinician also rated global functioning. Results: The diagnosis of SM persisted in 16 children, but significant symptomatic improvement was evident in the sample. All children had received school consultations. Children who had been treated with selective serotonin reuptake inhibitors (SSRI) ( n = 10) showed greater global improvement, improvement in functioning, and improvement in speech outside the family than children who were unmedicated ( n = 7). No differences were evident for children receiving and not receiving additional nonmedical intervention. Conclusions: The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.
Trends in Antidepressant Prescriptions among the Elderly in Alberta during 1997 to 2004
Authors: Newman Stephen C , Schopflocher Don 
Published: January 2017

Objective: To analyze trends in antidepressant (AD) prescription rates among the elderly (aged 65 years and older) in Alberta during 1997 to 2004. Method: Numerical data on AD prescriptions were obtained from Alberta Blue Cross. Age-standardized prescription rates were calculated according to type of AD. Results: The prescription rate for all ADs combined increased by 59% for men and 55% for women. This change was due entirely to serotonin reuptake inhibitors (SSRIs) and other recently-introduced ADs, that by 2004 accounted for 72% of AD prescriptions for men and 69% for women. For each year and type of AD, the prescription rate for women was almost double that for men. Conclusions: In the elderly in Alberta, prescription rates for ADs increased markedly during 1997 to 2004, especially for SSRIs and other recently introduced ADs.
Incidence of Major Malformations in Infants following Antidepressant Exposure in Pregnancy: Results of a Large Prospective Cohort Study
Authors: Einarson Adrienne , Choi Jacquelyn , Einarson Thomas R , Koren Gideon 
Published: January 2017

Objective: To ascertain if antidepressants, as a group, increase the risk for major malformations, as well as assessing each individual antidepressant. Methods: At The Motherisk Program, we analyzed pregnancy outcomes of women ( n = 1243) from prospectively collected cases in our database, who were exposed to antidepressants during their pregnancy. We then compared them with a matched comparison group of women ( n = 1243) who were not exposed (nonteratogen group). Results: Women ( n = 928) who fit the criteria for inclusion, were exposed in the first trimester of pregnancy, and gave birth to a live-born infant were matched to women ( n = 928) in the comparison group. There were 30 (3.2%) major malformations in the antidepressant group and 31 (3.3%) in the comparison group (OR 0.9; 95% CI 0.5 to 1.61). The antidepressants included in the analysis were: bupropion (113), citalopram (184), escitalopram (21), fluvoxamine (52), nefazodone (49), paroxetine (148), mirtazepine (68), fluoxetine (61), trazodone (17), venlafaxine (154), and sertraline (61). Conclusions: As a group, antidepressant use in the first trimester of pregnancy is not associated with an increased risk for major malformation above the baseline. In addition, no individual antidepressant was associated with an increased risk of a specific malformation.
Gatekeeper Training as a Preventative Intervention for Suicide: A Systematic Review
Authors: Isaac Michael , Elias Brenda , Katz Laurence Y , Belik Shay-Lee , Deane Frank P , Enns Murray W , Sareen Jitender ,   The Swampy Cree Suicide Prevention Team (12 members)8
Published: January 2017

Objective: Suicide prevention remains a challenge across communities in North America and abroad. We examine a suicide prevention effort that is widely used, termed gatekeeper training. There are 2 aims: review the state of the evidence on gatekeeper training for suicide prevention, and propose directions for further research. Method: Studies were identified by searching MEDLINE (PubMed) and PsycINFO from inception to the present for the key words suicide, suicide prevention, and gatekeeper. In addition, a manual scan of relevant articles' bibliographies was undertaken. Results: Gatekeeper training has been implemented and studied in many populations, including military personnel, public school staff, peer helpers, clinicians, and Aboriginal people. This type of training has been shown to positively affect the knowledge, skills, and attitudes of trainees regarding suicide prevention. Large-scale cohort studies in military personnel and physicians have reported promising results with a significant reduction in suicidal ideation, suicide attempts, and deaths by suicide. Conclusions: Gatekeeper training is successful at imparting knowledge, building skills, and molding the attitudes of trainees; however, more work needs to be done on longevity of these traits and referral patterns of gatekeepers. There is a need for randomized controlled trials. In addition, the unique effect of gatekeeper training on suicide rates needs to be fully elucidated.
Improvement of Metabolic Risk Profile under Second-Generation Antipsychotics: A Pilot Intervention Study
Authors: Blouin Mélissa , Binet Mario , Bouchard Roch-Hugo , Roy Marc-André , Després Jean-Pierre , Alméras Natalie 
Published: January 2017

Objective: To assess the impact of a weight management program on metabolic health of second-generation antipsychotic (SGA)-treated patients. Methods: A prospective 12-week intervention program including individual exercise training and nutritional group sessions was performed as a pilot study. An intervention group of 6 SGA-treated patients (5 men and 1 woman; mean 15.0, SD 11.8 months) was compared with 10 reference patients under SGAs (8 men and 2 women; mean 14.0, SD 14.2 months), presenting similar age and baseline weekly levels of physical activity. For patients of both groups, anthropometric measurements and basic fasting lipid profile were assessed. For patients in the intervention group, an adapted Rockport Test was performed to evaluate their aerobic fitness and compliance to training sessions, and was recorded. Results: After the 12-week period, reference patients significantly gained weight ( P = 0.001), whereas intervention patients showed significant weight loss and decreased body mass index ( P = 0.02); interaction between groups: P < 0.01. This weight loss was accompanied by a decreased cholesterol–high-density lipoprotein cholesterol ratio ( P = 0.04). Overall, the intervention patients' adherence to exercise prescription was 95.1 %, and this adherence induced a significant improvement of their aerobic fitness ( P = 0.05). Conclusion: This pilot study suggests that patients under SGAs may benefit from a weight management program and improve their metabolic health, as well as their aerobic fitness.
First- Generation Immigrants and Hospital Admission Rates for Psychosis and Affective Disorders: An Ecological Study in Ontario
Authors: Durbin Anna , Lin Elizabeth , Taylor Lawren , Callaghan Russell C 
Published: January 2017

Objective: The immigrant population in Canada, and particularly in Ontario, is increasing. Our ecological study first assessed if there was an association between areas with proportions of first-generation immigrations and admissions rates for psychotic and affective disorders. Second, this study examined if area-level risks would persist after controlling for area socioeconomic factors in census-derived geographical areas—Forward Sortation Areas (FSAs)—in Ontario. Methods: Ontario's inpatient admission records from 1996 to 2005 and census data from 2001 were analyzed to derive FSA rates of first admissions for psychotic disorders and affective disorders per 100 000 person-years. Negative binomial regression models were adjusted, first, for FSA age and sex and, second, also for FSA population density and average income. Results: Using age- and sex-adjusted models, admission rates for psychotic disorders were higher in areas with greater proportions of immigrants. These areas were associated with lower admission rates for affective disorders. When FSA average income and population density were added to the models, the influence of immigrants was attenuated to nonsignificant levels in models predicting psychotic disorders admission rates. However, greater proportions of immigrants remained significantly protective when predicting rates of affective disorders. Discussion: Our study provides insight about the influence of area-level variables on risk of admission for psychotic and affective disorders in high immigrant areas. There is a dearth of current Canadian research on immigrant admission for psychotic disorders at the individual or area level. Future area- and individual-level studies may better identify groups at risk and possible explanations.