bluuebunny/crossref_metadata_2025_split huggingface dataset:
Zoning out the ghetto
Authors: Lamarche Gara 
Published: January 2017

‘…we use the words of law and politics to fight the words that wound and exclude. We seek a legal system that recognises and remedies the harm of the structures of have and have-not…’ From Words That Wound: Critical Race Theory, Assaultive Speech and the First Amendment, by Mari Matsuda, Charles Lawrence, Richard Delgado and Kimberle Williams Crenshaw
Carbamazepine-Induced Hypersensitivity Syndrome in a Child with Epilepsy
Authors: Verrotti A. , Feliciani C. , Morresi S. , Coscione G. , Morgese G. , Toto P. , Chiarelli F. 
Published: January 2017

Carbamazepine is an effective anticonvulsant and is considered the drug of first choice for the treatment of partial and secondarily generalized seizures. Although carbamazepine is well tolerated, many side effects have been reported in the literature. The majority of these adverse effects are transient and do not lead to the discontinuation of the therapy. We present a case of a female child, aged 11 years and 6 months, who showed an anticonvulsant hypersensitivity syndrome induced by carbamazepine. This syndrome is a rare, potentially life-threatening adverse drug reaction. The patient developed a cutaneous nonpruritic rash, associated with high fever, diffuse lymphadenopathy, and arthralgias on the knees and the ankles with local signs of arthritis. Laboratory examination showed a lymphocytosis, mild thrombocytopenia, marked eosinophilia, and high transaminases. Corticosteroid therapy (betametasone 0,5 mg × 3 day) was started and carbamazepine was gradually withdrawn changing to valproic acid, with complete control of the seizures. The fever and the rash reduced gradually, beginning from the face and then disappearing completely after 10 days. Laboratory results showed a clear improvement: after 7 days the patient showed a complete normalization of the above parameters, except for transaminases. The complete normalization of these enzymes was observed after 2 weeks from the disappearance of the skin rash.
Morning Sudden Cardiac Death
Authors: Guagnano M. T. , Davì G. , Sensi S. 
Published: January 2017

A circadian variation of cardiac function with peak in the early morning was documented about twenty years ago. A circadian rhythm of platelet aggregability, in the same time of the day, was demonstrated in healthy young male subjects. The morning hours were also reported as crucial for sympathetic nervous system activity, for heart rate variability, and for the abrupt rise in blood pressure. Altogether, these trigger factors may explain the high incidence of sudden cardiac death during the morning. In the primary prevention of sudden death in patients with high cardiovascular risk, many strategies were proposed, such as implantable cardioverter-defibrillators, antiarrhythmic and antihypertensive therapies, particularly beta-blockers and more recently, aspirin. Also in subjects without cardiovascular risk factors, it is predictable that early and continuous administration of low-dose aspirin, by inhibiting platelet aggregation and thrombin formation, particularly in morning hours, may represent an effective therapy for the prevention of myocardial infarction and morning sudden cardiac death.
Canadian Psychiatry across 5 Decades: From Clinical Inference to Evidence-Based Practice
Authors: Paris Joel 
Published: January 2017

Objective: To examine the evolution of the epistemological basis of Canadian psychiatry over the last 50 years. Method: A comparison of the content of The Canadian Journal of Psychiatry in its early years, then known as the Canadian Psychiatric Association Journal, with publications from recent years, shedding light on broader trends in psychiatric theory and practice. Results: A dramatic change has occurred in Journal content, from clinical inference to an evidence-based approach, reflecting stronger biological orientations, as well as empirical psychosocial research. Conclusions: Epistemological changes in psychiatry are a positive development. The future should bring an even stronger neuroscience base as well as an evidence-based approach to psychotherapy.
The Epidemiology of Major Depression: Implications of Occurrence, Recurrence, and Stress in a Canadian Community Sample
Authors: De Marco Richard R 
Published: January 2017

Objective: To study the effects of stress process variables on the prevalence of major depressive disorder (MDD) and to explore the factors related to its onset and recurrence, using measures of stress and disorder that are more comprehensive than those in previous studies of depression. Method: Data were collected from a randomly selected community sample of 1393 adult respondents in Toronto, Ontario. Depression was measured using the Composite International Diagnostic Interview (CIDI). Results: Bivariate and multivariate analyses examine demographic and stress process correlates of MDD to assess their impact on both occurrence and recurrence. The effects of childhood experiences on lifetime MDD are examined as risk factors for the initial onset of depression. With respect to occurrence, the multivariate analyses tended to show agreement with established findings. Results using a subsample of people with lifetime depression to predict recurrence tended to mirror results using the full sample, except with respect to gender, birthplace, and, to a certain degree, stress differences. Finally, traumas experienced in childhood, as well as early childhood experiences involving parental substance abuse and mental health problems, were significant predictors of the onset of major depressive disorder. Conclusion: This research currently represents the only Canadian community study to examine the relationship between stress, social support, coping, and depression using outcome measures that approximate Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. In addition, it is among the few that use a comprehensive measure of life stress encompassing childhood experiences and current operant stress (both events and chronic problems).
Strategies for Managing Depression Refractory to Selective Serotonin Reuptake Inhibitor Treatment: A Survey of Clinicians
Authors: Mischoulon David , Nierenberg Andrew A , Kizilbash Leena , Rosenbaum Jerrold F , Fava Maurizio 
Published: January 2017

Objective: To examine treatment practices in cases where selective serotonin reuptake inhibitors (SSRIs) are ineffective. Methods: We surveyed 801 clinicians (including 630 psychiatrists) attending the Massachusetts General Hospital's annual psychopharmacology review course. Clinicians were presented with a vignette about a patient with depression who had responded partially to an SSRI and were asked to choose among various strategies available to manage this patient. Results: Of those surveyed, 466 clinicians had been in practice a mean of 16.6 years (SD 10.7). Not all clinicians chose to answer every question. Among 455 respondents, 84% (n = 382) chose to increase the dose of the SSRI, 10% (n = 47) chose augmentation or combination, and 7%(n = 31) opted for switching agents. When asked to switch to another agent, 448 responded, of whom 52% (n = 235) chose a newer antidepressant, 34% (n = 152) chose another SSRI, 10%(n = 44) chose a tricyclic antidepressant (TCA), 2%(n = 8) chose a serotonin norepinephrine reuptake inhibitor (SNRI), 1% (n = 5) chose a monoamine oxidase inhibitor (MAOI), and 1% (n = 4) chose an undefined “other” agent. Among 445 respondents, bupropion was the most widely chosen augmenting agent (30%, n = 134), followed by lithium (22%, n = 98). West coast and Canadian clinicians preferred to switch to another SSRI rather than to a newer antidepressant. Canadian clinicians preferred lithium to bupropion as their first-choice augmenting agent, as did clinicians from academic settings. Clinicians from community, individual practice, or group settings favoured bupropion. More experienced clinicians preferred bupropion as a first-choice augmenter, whereas less experienced ones showed a slight preference for lithium. Canadian clinicians were more likely to use MAOIs as second-line agents. Conclusions: Clinicians in this sample often followed strategies different from those recommended in the literature. Bupropion may have an important role in augmentating treatment with SSRIs.
Physical and Sexual Abuse Issues among Youths with Substance Use Problems
Authors: Ballon Bruce C , Courbasson Christine MA , Psych C , Smith Patrick D 
Published: January 2017

Objectives: To evaluate the prevalence of reported physical and sexual abuse among youths with substance use problems, to explore whether youths report relying on substances to cope with the abuse, and to examine whether individual factors related to substance use were associated with the outcome measures of reported physical abuse, sexual abuse, and using substances to cope. Method: We assessed 287 male and female youths (age 14 to 24 years) who presented for help for substance use problems, using a semistructured interview that focused on substance use, history of previous sexual and physical abuse, and coping strategies. Results: One-half of the female youth substance abusers reported having been sexually abused (50.0%), while male youth substance users reported a significantly lower rate (10.4%). Similarly, one-half of the female youths had a history of physical abuse (50.5%), and males again had a lower rate (26.0%). Of those who endorsed a history of abuse, more females (64.7%) than males (37.9%) reported using substances to cope with the trauma. Specific associations between the outcome measures and substance use variables were found for youths in both sexes. Conclusion: These findings underscore the importance of why clinicians should explore abuse issues with substance-using youth of both sexes. Identifying concurrent factors will help provide better intervention strategies. Suggestions for assessing sexual and physical abuse in youths with substance use disorders are provided.
Hidden Cardiac Lesions and Psychotropic Drugs as a Possible Cause of Sudden Death in Psychiatric Patients: A Report of 14 Cases and Review of the Literature
Authors: Frassati Dominique , Tabib Alain , Lachaux Bernard , Giloux Natalie , Daléry Jean , Vittori François , Charvet Dorothée , Barel Cécile , Bui-Xuan Bernard , Mégard Rachel , Jenoudet Louis Pierre , Descotes Jacques , Vial Thierry , Timour Quadiri 
Published: January 2017

Objective: To confirm the hypothesis that psychotropic drugs, especially neuroleptics, lithium, and antidepressants, are implicated as a cause of unexpected sudden death in psychiatric patients because of their cardiotoxicity, especially when hidden cardiac lesions are present. Method: We performed a full pathological examination of 14 psychiatric patients who unexpectedly and suddenly died between 1980 and 1999. Results: Neuroleptics were involved in 13 instances, antidepressants in 9, and anxiolytics in 5. Psychotropic drugs were combined in all but a single patient. In all 14 patients, toxicological analyses discarded drug overdose as cause of death. At postmortem examination, the brain and abdominal organs were normal. In 13 patients, the following lesions were found in the heart and lungs: dilated cardiomyopathy (6 patients), left ventricular hypertrophy (2 patients, 1 of which was associated with mitral prolapse and anomalies of His bundle), arrhythmogenic cardiopathy of the right ventricle (1 patient), pericarditis (1 patient), mitral prolapse (1 patient), muscular bridge on the anterior interventricular artery (1 patient), and Mendelsons syndrome (1 patient). In 1 case, no changes were seen. Most of the drugs that were taken immediately prior to death can induce arrhythmias either by prolonging the QT interval, potentially resulting in torsades de pointes, or by widening QRS complexes, possibly leading to reentry and ventricular fibrillation. Conclusion: Our findings suggest that the arrhythmogenic effects of psychotropic drugs can be exacerbated when preexisting hidden cardiac lesions are present and can result in sudden death. Patients should be systematically evaluated for cardiac lesions prior to starting any treatment with psychotropic drugs; the minimal effective dosage should be used.
The 5-Factor Model of Personality and Antidepressant Medication Compliance
Authors: Cohen Nicole L , Ross Erin C , Bagby R Michael , Farvolden Peter , Kennedy Sidney H 
Published: January 2017

Objective: Medication noncompliance is a significant problem for effective pharmacologic treatment of major depressive disorder (MDD). Attempts to explore predictors of compliance have primarily focused on demographic characteristics; for the most part, these have been shown to be unrelated to compliance. Conversely, the relation between personality characteristics and compliance has been relatively understudied. The primary purpose of this study was to explore the relation between personality characteristics and compliance with antidepressant medication in patients with major depressive disorder (MDD). Method: Over 14 weeks, we evaluated a sample of outpatients ( n = 65) who were receiving antidepressant treatment. We monitored compliance electronically, using the Medication Event Monitoring System. We assessed personality characteristics with the NEO Five-Factor Inventory–Revised. We also assessed depression severity and the frequency and severity of side effects. Results: Extraversion was a significant negative predictor of compliance. This was largely explained by the relation between compliance and the Activity facet within Extraversion. We also found a negative relation between the Feelings facet and compliance, while the Modesty facet was a significant positive predictor of compliance with antidepressant medication. Neither severity of depression nor side effects predicted compliance. Conclusions: These results suggest that correlates of personality are important, although frequently ignored, predictors of compliance with antidepressant medication. Identifying predictors of medication compliance may help in the development of individualized treatment regimens and lead to improved therapeutic outcome in the treatment of MDD.
Social, Demographic, and Clinical Factors Related to Disruptive Behaviour in Hospital
Authors: Boggild Andrea K , Heisel Marnin J , Links Paul S 
Published: January 2017

Objective: This study addresses 2 issues: first, whether the diagnosis of borderline personality disorder (BPD) or borderline traits differentiates adult patients who demonstrate disruptive behaviour during hospitalization from those patients who do not; and second, whether other clinical variables can be assessed during the emergency visit to differentiate patients who are likely to show disruptive behaviour in hospital from those who are not. Method: We completed a case–control, chart-based, retrospective analysis of patients consecutively admitted to an inpatient psychiatric service. We assembled 44 subjects who demonstrated evidence of disruptive behaviour during inpatient hospitalization. These subjects were matched with 61 control subjects admitted during the same time period. Potential participants were excluded if they had a diagnosis of schizophrenia, psychotic disorders, delirium, or dementia or if they had a diagnosis receiving a psychotic specifier. Results: Univariate analyses revealed that patients with disruptive behaviour were significantly more likely to have been diagnosed with BPD or borderline traits than the comparison group (32.6% vs 13.4%; χ2 = 4.45, df 1; P < 0.05). According to stepwise logistic regression analysis, 4 variables significantly contributed to the final model ( R2 = 0.37, P < 0.001) predicting disruptive behaviours with the following odds ratios (ORs): Axis III infectious diseases (OR 7.63; 95% CI, 1.41 to 41.67), Axis IV housing problems (OR 3.58; 95%CI, 1.21 to 10.64), history of suicidal behaviours (OR 3.46; 95% CI, 1.24 to 9.71), and problems with primary supports (OR 0.12; 95% CI, 0.03 to 0.46). This last variable was related to a reduced risk of disruptive behaviours in hospital. Conclusions: Patients at risk for disruptive behaviour during psychiatric hospitalization are characterized by a history of suicidal or impulsive-aggressive behaviour and social disadvantage.
Psychiatric Comorbidity and Eating Disorder Inventory (EDI) Profiles in Eating Disorder Patients
Authors: Milos Gabriella , Spindler Anja , Schnyder Ulrich 
Published: January 2017

Objective: This study examines potential overlaps between psychiatric comorbidity (Axis I and II) and scores on the subscales of the Eating Disorder Inventory (EDI) in women with eating disorders (EDs). Method: In a sample of 248 women (72 with anorexia nervosa, 140 with bulimia nervosa, and 36 with eating disorders not otherwise specified), we determined psychiatric comorbidity using the Structured Clinical Interview for DSM-IV. Behavioural and psychological characteristics of EDs were quantified with the EDI. Results: Psychiatric comorbidity was high in both axes (74% for Axis I and 68% for Axis II). While most EDI subscales pertaining to psychological traits showed significant associations with Axis I and II disorders, the subscales concerning eating and perception of weight and shape were much less associated with psychiatric comorbidity. Affective and anxiety disorders, as well as personality disorders of clusters A and C, showed a similar pattern with links to most psychological subscales. The profile for substance-related disorders was different, showing associations with the Ineffectiveness and Interoceptive Awareness scales. Personality disorders of cluster B were related only to the Bulimia subscale and not to any of the psychological subscales. Conclusions: The EDI appears to primarily reflect Axis I and II disorders related to affective and anxiety problems. Clinicians and researchers employing the EDI should be aware that it is not sensitive for all forms of comorbidity prevalent in ED patients.
Family Background and Genius
Authors: Rothenberg Albert , Wyshak Grace 
Published: January 2017

Objective: It is widely believed among professionals and laity that genius is born and not made. However, the early and still-influential statistical studies of Frances Galton on the inheritance of genius have neither been supported nor definitively refuted. This study empirically assesses the hereditary transmission hypothesis. Methods: We collected family background data on 50 Nobel Prize laureates in literature, 31 Booker Prize awardees, 135 Pulitzer Prize winners, and 20 National Book and National Book Critics Circle awardees. We compared these for incidence of occupational inheritance (that is, same parent–child occupations) with a matching group of 392 eminent persons in noncreative occupations; for predominant occupation type, we also compared subject data with data for 560 high-IQ nonprizewinners, as well as with general population occupational data. Results: Incidence of one or both parents in the same occupation was only 1% for literary prizewinners but 16% for eminent noncreative persons ( P < 0.0001). The predominant (76%) family background constellation for prizewinners consisted of parent–child sex congruency either in applied-equivalent occupations requiring language, persuasion, or artisan skills ( P < 0.0001, compared with control subjects) or in unrelated occupations with unfulfilled wishes for creative expression. Conclusions: Outstanding literary prizewinners do not manifest direct inheritance of creativity from their parents; instead, parents and children of the same sex are predominantly in applied-equivalent or performance occupations and have unfulfilled creative wishes. We suggest that early developmental influences on child motivation involve identification and competition with the parent of the same sex.
Barriers to Access to Mental Health Services for Ethnic Seniors: The Toronto Study
Authors: Sadavoy Joel , Meier Rosemary , Ong Amoy Yuk Mui 
Published: January 2017

Objective: To identify and describe barriers to access to mental health services encountered by ethnoracial seniors. Method: A multiracial, multicultural, and multidisciplinary team including a community workgroup worked in partnership with seniors, families, and service providers in urban Toronto Chinese and Tamil communities to develop a broad, stratified sample of participants and to guide the study. This participatory, action-research project used qualitative methodology based on grounded theory to generate areas of inquiry. Each of 17 focus groups applied the same semistructured format and sequence of inquiry. Results: Key barriers to adequate care include inadequate numbers of trained and acceptable mental health workers, especially psychiatrists; limited awareness of mental disorders among all participants; limited understanding and capacity to negotiate the current system because of systemic barriers and lack of information; disturbance of family support structures; decline in individual self-worth; reliance on ethnospecific social agencies that are not designed or funded for formal mental health care; lack of services that combine ethnoracial, geriatric, and psychiatric care; inadequacy and unacceptability of interpreter services; reluctance of seniors and families to acknowledge mental health problems for fear of rejection and stigma; lack of appropriate professional responses; and inappropriate referral patterns. Conclusions: There is a clear need for more mental health workers from ethnic backgrounds, especially appropriately trained psychiatrists, and for upgrading the mental health service capacity of frontline agencies through training and core funding. Active community education programs are necessary to counter stigma and improve knowledge of mental disorders and available services. Mainstream services require acceptable and appropriate entry points. Mental health services need to be flexible enough to serve changing populations and to include services specific to ethnic groups, such as providing comprehensive care for seniors.
The Feasibility of a Mental Health Curriculum in Elementary School
Authors: Lauria-Horner Bianca A , Kutcher Stan , Brooks Sarah J 
Published: January 2017

Objective: To establish the feasibility and short-term impact of implementing a novel curriculum in a linguistically and geographically isolated francophone community to enhance elementary schoolchildren's (Grades 1 to 7; n = 158) knowledge and attitudes regarding mental health. Methods: The project team developed a curriculum that covered expected emotional development, depression, anxiety disorders, and attention-deficit hyperactivity disorder to be delivered by the school's usual teachers. Committee members led focused discussions (Grades 1 to 7) and administered evaluation questionnaires (Grades 4 to 7) surveying students' knowledge and attitudes before and after implementation. Results: Teachers were enthusiastic about the project. Parents were initially skeptical, but post hoc interventions by school staff secured participation consent for 98% of the students. Baseline data (Grades 4 to 7) revealed little knowledge and some negative attitudes regarding mental illnesses; postprogram data indicated improved knowledge and suggested improved attitudes. Conclusions: The project was made feasible by the high degree of involvement of local community members. Children's (Grades 4 to 7) mental health awareness and understanding was enhanced by the curriculum. Effects on help-seeking behaviour and case identification have yet to be assessed.