bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical Antipsychotics in Psychiatric Practice: Practical Implications for Clinical Monitoring
Authors: Poulin Marie-Josée , Cortese Leonardo , Williams Richard , Wine Nina , McIntyre Roger S 
Published: January 2017

Objectives: To provide practical recommendations for monitoring patients both before and during treatment with atypical antipsychotics, to assist clinicians in implementing preventative measures against diabetes, and to establish baselines according to which clinicians should initiate diabetes treatment. Method: A working group of Canadian specialists in psychiatry and endocrinology reviewed peer-reviewed clinical studies published in this area and other relevant papers and abstracts. Results: The reviewed studies further confirm that atypical antipsychotic medications are the most effective components in the medical management of many psychotic conditions; they also further emphasize the need to more stringently monitor and recognize diabetes risk factors inherent in these patients. Recommendations are based on a review of the available data, on expert opinion and consensus, and on current Canadian guidelines for the treatment of schizophrenia and management of diabetes. Conclusions: Patients with psychiatric disorders, most particularly schizophrenia and mood disorders, have an increased risk for type 2 diabetes and should be screened frequently, especially when other risk factors are present. The resulting recommendations offer practical steps for effectively screening patients prior to and during treatment with atypical antipsychotics. They include 1) how to conduct an initial baseline assessment, 2) when and how to monitor blood glucose and lipid levels, and 3) how to educate patients regarding such lifestyle issues as nutrition, exercise, and diet.
Recent Evidence Linking Coronary Heart Disease and Depression
Authors: Frasure-Smith Nancy , Lespérance François 
Published: January 2017

Objectives: To review the recent literature on the relation between depression and coronary heart disease (CHD), including both etiologic studies (that is, depression preceding development of CHD) and prognostic studies (that is, depression predicting prognosis in established CHD), and to assess the degree to which the literature supports a causal interpretation of the link between depression and CHD. Method: We searched the MEDLINE, Current Contents, and PsycINFO databases for articles published between December 15, 2003, and December 15, 2005, containing combinations of several key words related to CHD, prognosis, and depression. We reviewed papers for evidence of 6 rule-of-thumb criteria for making causal inferences: objective CHD outcome measures, prospective designs, results showing consistent and strong dose-response relations, adequate covariate adjustment, biological plausibility, and evidence from clinical trials that changing depression alters CHD risk. Results: We found 8 recent etiologic studies, 16 prognostic studies, 2 publications with both types of data, and 23 review papers. Although there was much methodological variability concerning measurement of depression and assessment of cardiac outcomes, the recent etiologic studies increase the evidence of a role for depression. Recent prognostic data are less consistent. Small studies showing no link between depression and CHD prognosis continue to appear, despite lack of adequate statistical power. Conclusions: The recent literature continues to support both an etiologic and a prognostic role for depression in CHD. Despite this evidence, there have been few clinical trials of depression treatment in CHD patients and no clinical trials of depression prevention. Additional trials are needed.
Coronary Heart Disease and Depression: A Review of Recent Mechanistic Research
Authors: Skala Judith A , Freedland Kenneth E , Carney Robert M 
Published: January 2017

Objective: Both behavioural and physiological factors have been proposed as mechanisms that may explain the negative effect of depression on coronary heart disease (CHD). Our aim is to review some of the most important findings since our prior review. Method: We searched MEDLINE, PsycINFO, and other sources for recent studies of candidate mechanisms, with an emphasis on publications since 2002. Results: Physiological pathways have received far greater attention than behavioural ones in the emerging literature. Recent studies have identified shared genetic determinants, inflammation, blood clotting, and vascular mechanisms as plausible explanatory mechanisms. Conclusions: Future research should focus on relations between behavioural and physiological mechanisms and on the effects of pharmacologic and psychotherapeutic treatments for depression on candidate mechanisms.
A Prospective Study of the Impact of Opening a Casino on Gambling Behaviours: 2- and 4-Year Follow-ups
Authors: Jacques Christian , Ladouceur Robert 
Published: January 2017

Objective: It is widely believed that the rate of pathological gambling is related to the accessibility and availability of gambling activities. Few empirical studies have yet been conducted to evaluate this hypothesis. Using a longitudinal prospective design, the current study evaluates the impact of a casino in Canada's Hull, Quebec region. Method: A random sample of respondents from Hull (experimental group) and from Quebec City (comparison group) completed the South Oaks Gambling Screen (SOGS) and gambling- related questions before the opening of the Hull Casino (pretest), 1 year after the opening (posttest), and on follow-up at Years 2 and 4. Results: Although, 1 year after the opening of the casino, we did observe an increase in playing casino games and in the maximum amount of money lost in 1 day's gambling, this trend was not maintained over time (2- and 4-year follow-ups). In the Hull cohort, the rate of at-risk and probable pathological gamblers and the number of criteria on the SOGS did not increase at the 2- and 4-year follow-ups. The residents' reluctance to open a local casino was generally stable over time following the casino's opening. Conclusion: The discussion raises different explanatory factors and focuses on the context of the Regional Exposure Model as a potentially more applicable measure of studying the expansion of gambling.
Prévalence et caractéristiques de l'association de neuroleptiques chez une cohorte de patients souffrant de troubles psychotiques
Authors: Huguelet Philippe , Khan Aqal Nawaz , Morand-Collomb Sophie , Mohr Sylvia , Etter Manuela 
Published: January 2017

Objectifs: La prescription combinée de médications antipsychotiques est fréquente, měme si elle n'est pas toujours justifiée par des données objectives. Il importe donc de déterminer l'ampleur de cette pratique et de mieux connaître les caractéristiques des patients concernés, afin notamment de pouvoir déterminer quelles associations étudier préférentiellement. Méthode: Les patients souffrant de troubles psychotiques et suivis pendant au moins un an dans une consultation ambulatoire de psychiatrie à Genève ont été étudiés ( n = 253). Les prescriptions qui leur ont été administrées à l'inclusion et pendant cette période ont été relevées, de měme que des données sociodémographiques et cliniques. Résultats: Trente-six pour cent des patients se sont vu prescrire une association de neuroleptiques pendant la période de suivi. Ces patients se distinguent par des caractéristiques évolutives défavorables: moins d'activité, assistance financière, placement en foyer, nombreuses hospitalisations avec début plus précoce du trouble. Trois quarts des patients ne changent pas de traitement pendant la période considérée. La stabilité du traitement est associée avec l'observance et l'absence d'hospitalisation pendant la période de suivi. Conclusion: L'association de neuroleptiques est fréquente et sans étayage scientifique, principalement chez des patients qui présentent des caractéristiques évolutives défavorables. Ces options thérapeutiques sont probablement des stratégies relativement inefficaces. De plus, ces pratiques risquent de compliquer l'évolution de ces patients, celle-ci étant déjà caractérisée par des éléments défavorables.
What Clinical and Symptom Features and Comorbid Disorders Characterize Outpatients with Anxious Major Depressive Disorder: A Replication and Extension
Authors: Fava Maurizio , Rush A John , Alpert Jonathan E , Carmin Cheryl N , Balasubramani GK , Wisniewski Stephen R , Trivedi Madhukar H , Biggs Melanie M , Shores-Wilson Kathy 
Published: January 2017

Objective: We previously found that 46% of the first 1450 outpatients with depression participating in the multicentre Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project qualified for the designation of anxious depression. This study was designed to replicate and extend our initial findings in a subsequent, larger cohort of outpatient STAR*D participants with nonpsychotic major depressive disorder (MDD). Methods: Baseline clinical and sociodemographic data were collected on 2337 consecutive STAR*D participants. A baseline 17-item Hamilton Depression Rating Scale Anxiety-Somatization factor score of 7 or higher was designated as anxious depression. We identified concurrent Axis I disorders with the Psychiatric Diagnostic Screening Questionnaire (PDSQ), using a 90% specificity threshold. Depressive symptoms were assessed by clinical telephone interview with the 30-item Inventory of Depressive Symptomatology–Clinician-Rated (IDS-C30). Results: The prevalence of anxious depression in this population was 45.1%. Patients with anxious MDD were significantly more likely to be in primary care settings and to be women, nonsingle, unemployed, Hispanic, less educated, and suffering from severe depression, both before and after adjustment for overall depression severity. Patients with anxious depression were significantly more likely to meet PDSQ thresholds for generalized anxiety disorder, panic disorder, obsessive–compulsive disorder, posttraumatic stress disorder, agoraphobia, hypochondriasis, and somatoform disorder, both before and after adjusting for baseline depression severity. Individuals with anxious depression were also significantly less likely to endorse IDS-C30 items concerning atypical features and were significantly more likely to endorse items concerning melancholic-endogenous depression features, both before and after adjusting for baseline depression severity. Conclusions: This study clearly replicates our previous STAR*D findings and supports the notion that anxious depression may be a valid diagnostic subtype of MDD, with distinct psychiatric comorbidities and clinical and sociodemographic features.
Canadian Psychiatrists' Current Attitudes, Practices, and Knowledge regarding Fitness to Drive in Individuals with Mental Illness: A Cross-Canada Survey
Authors: Ménard Ingrid , Korner-Bitensky Nicol , Dobbs Bonnie , Casacalenda Nicola , Beck Philip R , Gélinas Isabelle , Molnar Frank J , Naglie Gary 
Published: January 2017

Objectives: To assess current attitudes, practices, and knowledge of Canadian psychiatrists regarding fitness to drive in individuals with mental illness and to explore variations according to provincial legislation. Method: We carried out a national cross-sectional survey, using a random sample of psychiatrists. We used a mail survey to collect data. Results: In total, 248 psychiatrists participated; the response rate was 54.2% on traced subjects. The majority (64.1%) reported that they strongly agreed or agreed that addressing patients' fitness to drive is an important issue. However, only 18.0% of respondents were always aware of whether their patients were active drivers. One-fourth strongly agreed or agreed that they were confident in their ability to evaluate fitness to drive. In discretionary provinces, 29.3% of psychiatrists reported not knowing their provincial legislation, as did 14.6% of psychiatrists in mandatory provinces; of those responding, 54.0% from discretionary provinces and 2.8% from mandatory provinces gave incorrect answers. Discussion: Psychiatrists' responses demonstrate a broad range of attitudes, practices, and knowledge. There appears to be a large gap between what is expected of psychiatrists and their readiness and self-perceived ability to make informed clinical decisions related to driving safety. Conclusion: There is a clear need for education and guidelines to assist psychiatrists in decision making about driving fitness.
Recurrent Depressive Symptomatology and Physical Health: A 10-Year Study of Informal Caregivers of Persons with Dementia
Authors: O'Rourke Norm , Cappeliez Philippe , Neufeld Eva 
Published: January 2017

Objective: To examine the degree to which recurrent depressive symptomatology predicts the decline in the health status of a randomly derived national sample of caregivers of persons with dementia. Method: Individuals with dementia and their caregivers were recruited from each Canadian province as part of a national epidemiologic study of dementia prevalence and the health and welfare of care providers. Both patients and caregivers were assessed at 3 points over a 10-year period. Cohabiting family members who shared the same residence as care recipients were selected for the current study ( n = 96 pairs). We computed a repeated measures analysis of variance to compare the health of caregivers who were consistently asymptomatic for depression, of those symptomatic at 1 of 3 points of measurement, and of those symptomatic at 2 of 3 points. Results: As hypothesized, caregivers presenting with elevated depressive symptomatology at multiple points of measurement reported poorer and worsening physical health over time. Conclusions: The results of this study support the assertion that depressive symptomatology significantly predicts the decline in health status of caregivers of persons with dementia. Concerted effort to treat depression in this population is warranted to forestall this trajectory of decline and premature patient institutionalization.
Depression Literacy in Alberta: Findings from a General Population Sample
Authors: Wang JianLi , Adair Carol , Fick Gordon , Lai Daniel , Evans Beth , Perry Brenda Waye , Jorm Anthony , Addington Donald 
Published: January 2017

Objective: To assess the public's knowledge about depression, attitudes toward treatments for depression, perceived causal factors for depression, and reported prognoses of depression, overall and by sex. Methods: We conducted a cross-sectional telephone survey in Alberta between February and June 2006. We used a random phone number selection procedure to identify a sample of adults in the community ( n = 3047). Participants were presented with a vignette describing an individual with depression and then asked questions to assess recognition of depression, attitudes toward mental health treatments, possible causal factors for depression, and prognosis of depression. Results: The response rate was 75.2 %. Among the final participants, 75.6% could correctly recognize depression described in a case vignette. General practitioners or family doctors were considered as being the best help for depression. Of the participants, 35% were in complete agreement with health professionals about appropriate interventions for depression, 28% believed in dealing with depression alone, and 43% thought that “weakness of character” was a likely cause of depression. Men had poorer mental health literacy than women and were more likely to endorse the use of alcohol to cope. Conclusions: Mental health promotion and education efforts are needed to improve the general public's mental health literacy and to clarify misunderstanding about depression. Men need to be a particular target of these efforts.
Clozapine-Induced Seizures: Recognition and Treatment
Authors: Wong Jason , Delva Nicholas 
Published: January 2017

Objectives: To inform clinicians about the types of seizures that can be induced by clozapine and to provide recommendations for treatment. Methods: We identified articles on clozapine-induced seizures from a MEDLINE search of the English-language literature from 1978 to July 2006. The frequency of each type of seizure and the dosages of clozapine associated with seizures were compiled. In addition to this review, we report a new case illustrating the challenge of diagnosing subtle seizure activity. Results: The tonic-clonic variety is the most frequently described clozapine-induced seizure. Myoclonic and atonic seizures together constitute about one-quarter of the reported seizures. The mean dosage of clozapine associated with seizures is not high (less than 600 mg daily). Conclusions: It may be difficult for clinicians to recognize subtle types of clozapine-induced seizures, such as myoclonic, atonic, or partial seizures. Clinicians should not place excessive reliance on the plasma level of clozapine or electroencephalogram findings to predict the occurrence of seizures. When a first seizure occurs, it is recommended that the dosage of clozapine be reduced or an alternative antipsychotic agent be employed. If a second seizure occurs, an anticonvulsant drug should be started. Special attention should be paid when commencing or discontinuing concurrent medication that may affect the plasma level of clozapine.
Perinatal Depression: Hiding in Plain Sight
Authors: Lusskin Shari I , Pundiak Tara M , Habib Sally M 
Published: January 2017

Objective: To promote prompt identification and treatment of perinatal depression and enhance preventive care for women at risk. Methods: Using MEDLINE and PubMed searches, we reviewed the recent research on the origins, course, and consequences of pregnancy-related depression. Results: Depressive disorders are more common in pregnancy and postpartum than widely assumed, and there is no predictable protective effect of pregnancy. Relapse rates are high, and the postpartum period represents a time of increased vulnerability to depression. Conclusion: Early identification and treatment of perinatal depression will minimize morbidity and mortality for the woman, the child, and the family.
Executive Function Impairments in Children with Attention-Deficit Hyperactivity Disorder: Do They Differ between School and Home Environments?
Authors: Mares Daniela , McLuckie Alan , Schwartz Michael , Saini Michael 
Published: January 2017

Objective: The primary purpose of this study was to compare parent and teacher reports of executive function (EF), as measured by the Behavior Rating Inventory of Executive Function (BRIEF), on a sample of children who had been diagnosed with attention-deficit hyperactivity disorder (ADHD). If differences were found, the secondary purpose was to explore these differences by determining which of the 8 BRIEF scales, each representing a different EF, would best predict symptoms of ADHD by the 2 proxy reporters. Method: We performed a secondary data analysis on the assessment information pertaining to 240 children, aged 5 to 15 years, accessing services at an urban Toronto psychiatric program specializing in ADHD. We compared parent and teacher ratings and applied logistical binary regressions to predict the probability of a child's meeting the criteria for clinically significant inattention and hyperactivity–impulsivity on the ADHD Rating Scale-IV. Results: As expected, teachers reported more variety and severity of EF impairments than did parents. In addition, teachers used inhibition, organization of materials, and planning and organizing as predictors of ADHD symptoms, whereas parents relied predominantly on inhibition, working memory, and planning and organizing as the risk factors. Conclusion: Consistent with the current theory, EF impairments, particularly in inhibition, appear to underlie the behavioural manifestation of ADHD. However, parents and teachers do not always agree when reporting EF impairments at home and in school. Thus information from both types of informants is essential for understanding and treating children with this disorder.
Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review
Authors: Meterissian Gb 
Published: January 2017

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.
Impulsivity, Defensive Functioning, and Borderline Personality Disorder
Authors: Van Reekum Robert , Links Paul S , Mitton M Janice E , Fedorov Cecilia , Patrick Jayne 
Published: January 2017

Objective: To replicate previous research suggesting that impulsivity highly predicts current DIB(R) score and social functioning, with the additional inclusion of other measures, including defensive functioning. Method: Correlational analyses between impulsivity and other measures, and regression analyses with DIB(R) and SAS-SR as outcome measures, and impulsivity and other measures as predictor variables, were performed on data derived from n = 57 initially borderline personality disorder (BPD) subjects recruited as part of a 7-year follow-up study of BPD. Results: Data showed strong correlations between the elements of impulsivity described previously and defensive functioning. The initial study results were repeated, and only a minor contribution from defensive functioning additionally contributed to the regression models. No other variables entered the model, unless anger was dropped from the variables entered into the analysis. Conclusions: The results may contribute to a better definition of the term “impulsivity” as related to BPD, and may lead to further, improved research into the cause, treatment, and prognosis of BPD.
The Assessment of Competence to Make a Treatment Decision: An Empirical Approach
Authors: Bean Graham , Nishisato Shizuhiko , Rector Neil A , Glancy Graham 
Published: January 2017

Objective: To compare physicians' judgements of competency in routine clinical practice with the findings obtained from a structured clinical interview. Methods: Ninety-six patients referred for electroconvulsive therapy were administered the Competency Interview Schedule (CIS) prior to their first treatment. Cluster analysis was employed to categorize patients to 1 of 5 cluster centres represented by case studies previously judged competent or incompetent by lawyers and health professionals. Results: A match-mismatch table revealed 88% (N = 66) of the 75 patients found competent by the attending physician and 90.5% (N = 19) of the 21 patients found incompetent by the attending physician were classified in agreement with the CIS. The 9 misclassified patients found competent by the attending physician but classified incompetent by the CIS had consented to treatment. The 2 misclassified patients found incompetent by the attending physician but classified competent by the CIS had refused treatment. Examination of individual item scores from the CIS indicated that, in some cases, a different standard of competency was applied in routine clinical practice depending upon the patient's treatment decision. Conclusions: The CIS is presented as a useful guide for clinicians with an interest in competency evaluations but caution is advised in using the instrument to make formal evaluations of competency owing to the imprecise definition of competency in various jurisdictions.