bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptoms Defined by Parents' and Teachers' Ratings in Attention-Deficit Hyperactivity Disorder: Changes with Age
Authors: Öncü Bedriye , Öner Özgür , Öner Pınar , Erol Neşe , Aysev Ayla , Canat Saynur 
Published: July 2017

Objective: To determine whether Child Behavior Checklist/4–18 (CBCL) and Teacher Report Form (TRF) scores of children and adolescents with a first-time diagnosis of attention-deficit hyperactivity disorder (ADHD) are different and whether there is a similar difference in normal control subjects. Method: We analyzed the CBCL and TRF scores of 146 patients (124 boys and 22 girls, aged 6 to 18 years; mean age 11.0 years, SD 3.6). We analyzed the same scores for 274 age and sex-matched control subjects recruited from a nationally representative sample. Results: Subjects with ADHD had significantly higher CBCL and TRF scores than control subjects. Age was significantly correlated with scores on the CBCL and TRF subscales Social Withdrawal, Somatic Complaints, and Internalization Problems; with scores on the CBCL subscale Attention Problems; and with scores on the TRF subscale Anxiety–Depression. In the group with ADHD, age was negatively correlated with scores on the CBCL and TRF subscale Externalizing Problems and with scores on the TRF subscale Aggressive Behavior. In the control group, the only significant correlation was between age and the CBCL subscale Somatic Complaints score. Conclusions: These results indicate that underdiagnosis of ADHD in childhood may cause the emergence of greater internalization problems in adolescence. attention-deficit hyperactivity disorder
Somatization Disorder: A Practical Review
Authors: Mai François 
Published: July 2017

Objective: This paper reviews the present state of knowledge on the etiology, prevalence, diagnosis, and treatment of somatization disorder (SD). Method: A comprehensive review of the literature on SD is described under the above headings. Results: SD is a common condition that is not well managed by many physicians. Patients with SD get caught between the cracks of the health care system, with expensive consequences. SD is a psychiatric disorder, but patients are reluctant to see and be treated by psychiatrists. They frequently are managed by nonpsychiatric physicians who have limited understanding of the condition. Cognitive-behavioural therapy (CBT) is the most efficacious treatment in SD, although antidepressants and supportive psychotherapy also have a role for some patients. Conclusions: A cadre of clinicians with training in the theory and practice of CBT for SD is required. They need to be based both in the community and in tertiary health care centres, where most patients with this condition are located.
Sexual Medicine: Why Psychiatrists Must Talk to Their Patients about Sex
Authors: Stevenson Ronald WD 
Published: July 2017

Objective: To review the prevalence of sexual concerns and the relevance of this area to psychiatrists and to present evidence supporting the need for psychiatrists to routinely include a sex-function inquiry in the assessment of their patients. Method: A review of the recent literature was undertaken. Conclusions: Sex is a fundamental quality-of-life issue. Sexual problems are extremely prevalent among the general population and even more so among persons with psychiatric or medical illness. There are at least 9 reasons why all physicians, perhaps psychiatrists especially, should make inquiry into sexual behaviours and response a routine part of caring for each patient.
Design and Feasibility of a New Cognitive-Behavioural Therapy Course Using a Longitudinal Interactive Format
Authors: Lau Mark A , Dubord Greg M , Parikh Sagar V 
Published: July 2017

Objective: This report describes the design and feasibility of conducting a unique longitudinal supervision course incorporating both therapist and patient evaluation measures in teaching cognitive-behavioural therapy (CBT) to a group of mental health practitioners. Method: We designed a 10-session longitudinal supervision course to teach CBT by applying key continuing medical education (CME) principles. Each session consisted of 30 minutes of didactics and demonstrations followed by 90 minutes of group case supervision. Course participants were mental health practitioners who treated patients from their own practice; most of the patients suffered from a depressive and (or) anxiety disorder. We assessed therapists for CBT skill acquisition at the beginning and at the end of the course, using the Cognitive Therapy Scale (CTS). We assessed patients' symptoms weekly, using the Beck Depression Inventory, the Beck Anxiety Inventory, and the Clinical Global Impression scale. Results: A total of 34 participants enrolled in three 10-session courses. Most participants submitted audiotapes for rating at the beginning and end of the course, and most submitted patient symptom information. Conclusions: This course shows promise as an effective way to teach complex skills in CBT to mental health providers. In limited samples, the course showed clear improvement in therapist adherence to CBT and in patients' clinical outcomes. Future research is required to validate the potential benefit of this CME intervention for mental health practitioners treating patients with mood and anxiety disorders.
Bipolar Disorder: It's All in Your Mind? The Neuropsychological Profile of a Biological Disorder
Authors: Malhi Gin S , Ivanovski Belinda , Szekeres Viktoria , Olley Amanda 
Published: July 2017

Objective: To compare and contrast the neuropsychological profile of the 3 phases of bipolar disorder (BD) to achieve a better definition of BD and to identify potential state and trait deficits. Methods: We conducted a search for English-language papers published in journals from 1965 onward, using the following terms in Medline and Embase: neuropsychology or neuropsychological and BD, depression, mania, and euthymia. We scrutinized suitable subheadings and retrieved familiar papers and literature. Results: We initially identified more than 100 articles and then excluded reviews and papers that did not directly administer neuropsychological tests. This left 27 papers, which we further examined and the findings of which we tabulated and discussed. Cognitive and executive functioning deficits were found, including set-shifting, verbal fluency, planning, attention, and memory. Conclusions: The neuropsychological deficits found in bipolar depression, mania or hypomania, and euthymia provide important insights into the pathophysiology of BD and may, in future studies, form the basis of clinically meaningful subtypes.
Impact of Culture on Depressive Symptoms of Elderly Chinese Immigrants
Authors: Lai Daniel WL 
Published: July 2017

Objectives: The impact of culture on mental health has been inadequately researched. This study examines the effect of cultural factors on the depressive symptoms reported by elderly Chinese immigrants in Canada. Method: Data from 1537 elderly Chinese immigrants who took part in a cross-sectional multisite survey on the health and well-being of older Chinese-Canadians were used. Participants were identified through telephone screening of randomly selected telephone numbers listed with Chinese surnames. A structured questionnaire was used to conduct face-to-face interviews. A Chinese version of the 15-item Geriatric Depression Scale was used to assess depressive symptoms. Results: Close to one-quarter of the elderly Chinese immigrants reported having at least a mild level of depressive symptoms. Having more cultural barriers and a higher level of identification with Chinese cultural values resulted in a higher probability of being depressive. Conclusions: The importance of the sociocultural determinants of mental health is demonstrated. The health delivery system should be more sensitive to the unique ethnic and cultural differences of older immigrants.
Command Hallucinations among Asian Patients with Schizophrenia
Authors: Lee Theresa MY , Chong Siow Ann , Chan Yiong Huat , Sathyadevan Gangaharan 
Published: July 2017

Objectives: The impact of command hallucinations on patients and the determinants of patients' compliance with them are still poorly understood. The extant literature is also divided on their association with violence. This study aimed to establish the prevalence of command hallucinations and to identify the factors that affect compliance with the commands, together with patients' coping methods. Methods: We recruited 50 consecutive male and 50 consecutive female schizophrenia inpatients who reported hearing voices in the 6 months prior to admission. We interviewed these patients, using a semistructured questionnaire. We collected information on the contents of their auditory hallucinations and their coping methods. Results: Of the patients, 53 (53%) reported command hallucinations. Of these 53 patients, 58% were women and 48% were men; 62% reported complying with the commands. They were also more likely to comply with nonviolent commands. A history of self-harm predicted compliance. Those patients who did not comply with the commands adopted various methods of coping, of which praying was the most common. Conclusion: Command hallucinations are common in patients with schizophrenia. Patients with a history of self-harm need closer monitoring because they may be more likely to comply with these hallucinations. Assessment should also include the patient's own coping strategies, which can be incorporated into the treatment.
Psychotic Disorders Clinic and First-Episode Psychosis: A Program Evaluation
Authors: Archie Suzanne , Wilson Jane Hamilton , Woodward Kevin , Hobbs Heather , Osborne Shelley , McNiven Jean 
Published: July 2017

Background: There is growing recognition that people presenting with psychotic symptoms for the first time need specialized treatment. The Hamilton Health Sciences Corporation, McMaster Hospital, offers one such program, the Psychotic Disorders Clinic (PDC); it addresses some of the problems posed by long waiting lists, lack of family interventions, and long-term hospitalizations. The PDC is affiliated with the Department of Psychiatry and Behavioural Neurosciences at McMaster University. The program's goals are to provide comprehensive outpatient care and early interventions for persons in the early stages of illness and, consequently, to improve symptom control and functioning and reduce hospitalizations. Key service components include providing low dosages of antipsychotics, offering specialized family education, and supporting return to school and work settings. Objectives: This study compared outcomes before and after enrolment in the PDC to determine whether first-episode patients achieved improved symptom control and functioning and fewer hospitalizations. Method: For a 12-month period, we followed 40 patients, aged between 16 and 45 years, who experienced their first episode of psychotic illness between 1997 and 2000. Prospective longitudinal data were collected at baseline, 3, 6, and 12 months. Outcome measures included symptoms, global functioning, employment rates, duration of untreated psychosis, and number of bed-days. Results: Of the patients, 37 completed the study at 6 months, and 31 at 12 months. Over the 12 months, significant improvements occurred in psychiatric symptoms ( P < 0.001), global functioning ( P < 0.001), and the mean number of hospital bed-days ( P < 0.001). Conclusions: It is feasible for small outpatient services to provide early intervention strategies and obtain good outcomes among first-episode patients.
Perceived Quality of Life in Patients with Bipolar Disorder. Does Group Psychoeducation Have an Impact?
Authors: Michalak Erin E , Yatham Lakshmi N , Wan Dante DC , Lam Raymond W 
Published: July 2017

Objective: A large body of research has now accumulated concerning quality of life (QoL) for patients with major depressive disorder, both in terms of describing levels of well-being and in terms of assessing the impact of treatment interventions. However, there is little information concerning QoL for patients with bipolar disorder (BD), and there is relatively little published evidence concerning the effectiveness of psychological interventions for BD. We aimed to assess the impact of a time-limited psychoeducation (PE) group therapy upon perceived QoL among patients with BD. Method: Participants were patients ( n = 57) with BD type I or II who were clinically described as euthymic or mildly symptomatic. Treatment intervention was a standardized, 8-week group PE course delivered in a mood disorders program in British Columbia, Canada. Using retrospective chart review and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), we assessed QoL at baseline and at 8 weeks. Results: Mean baseline Q-LES-Q scores were 56%, representing moderate impairment in QoL. Group PE was associated with a 5-point increase in Q-LES-Q scores (where higher scores indicate better QoL). Examination of the questionnaire's subscales revealed that 2 domains (that is, physical functioning and general satisfaction) increased significantly following PE, with the remaining domains showing nonsignificant trends toward improved functioning. Multivariate analysis indicated that only one factor (having had a recent episode of depression) significantly predicted pre- and posttreatment Q-LES-Q scores. Conclusion: Patients with BD continue to show impaired QoL even when clinically euthymic. Although preliminary, our results show that group PE is associated with improved QoL in this population, both in terms of general satisfaction and in relation to levels of physical functioning. The use of PE as an adjunct to pharmacotherapy in BD should be further studied with particular emphasis on characterizing the effects of treatment intervention on perceived QoL.
Difficult-to-Engage Patients: A Specific Target for Time-Limited Assertive Outreach in a Swiss Setting
Authors: Bonsack Charles , Adam Laurence , Haefliger Thomas , Besson Jacques , Conus Philippe 
Published: July 2017

Objective: Assertive community treatment (ACT) failed to develop in Europe, and its efficacy is debated. In Lausanne, Switzerland, ACT focuses on difficult-to-engage patients and aims to facilitate linkage with outpatient care through time-limited interventions. This study aimed to evaluate the applicability and efficiency of time-limited ACT. Methods: We retrospectively assessed social, clinical, and functional outcomes and motivation for treatment in 75 consecutively seen subjects treated between 2000 and 2002. Results: With 70% of the interventions lasting less than 6 months, we observed significant improvement in most clinical and social problems, in collaboration, in motivation for treatment, and in social network support, despite high baseline levels of clinical and social problems. The number of hospitalizations decreased significantly. Conclusions: Time-limited ACT is a useful treatment for difficult-to-engage patients with severe clinical and social problems, and it facilitates linkage to care. This narrower target for ACT may facilitate its implementation in Europe.
Small Signal, Big Noise: Performance of the CIDI Depression Module
Authors: Kurdyak Paul A , Gnam William H 
Published: July 2017

Objectives: With the release of data from the Canadian Community Health Survey: Mental Health and Weil-Being (Cycle 1.2), researchers have, for the first time, information on several psychiatric disorders from a nationally representative sample of Canadians residing in households. This survey used the Composite International Diagnostic Interview (CIDI) to identify persons with one or more psychiatric disorders. In this paper, our primary purpose was to evaluate the evidence supporting the validity of the CIDI—that is, the extent to which the depression diagnoses generated by the CIDI reflect true cases of depression. Method: We conducted a critical review of the CIDI, focusing on the depression module. Results: Reliability studies indicate that the CIDI performs reliably, as measured by interrater reliability. However, the use of different versions of the CIDI and the occasional exclusion of the Depression module from studies suggest that the reliability of the CIDI Depression module remains unconfirmed. The most critical issue in regard to the CIDI's performance is that clinical samples are used to test validity. A clinical sample has a higher prevalence of depression than a community sample. Conclusion: The results generated by the CIDI in a community setting likely will have a high false-positive rate, resulting in a falsely elevated prevalence rate. Given the widespread application of the CIDI internationally, addressing the outstanding concerns about validity with proper validation studies should become an international priority.
Neural Correlates of Sad Feelings in Schizophrenia with and without Blunted Affect
Authors: Stip Emmanuel , Fahim Cherine , Liddle Peter , Mancini-Marïe Adham , Mensour Boualem , Bentaleb Lahcen Ait , Beauregard Mario 
Published: July 2017

Objective: There have been reports that patients with schizophrenia have decreased activity in the prefrontal cortex during emotion processing. However, findings have been confounded by sample nonspecificity and explicit cognitive task interference with emotion processing. We aimed to further investigate this by examining the ventrolateral prefrontal cortex (VLPFC) activation in response to the passive viewing of sad film excerpts. Methods: We presented film excerpts depicting sad and neutral social situations to 25 schizophrenia patients (14 with blunted affect [BA+] and 11 without blunted affect [BA-]) in an implicit perception task to evoke prefronto-limbic activity illustrated by blood oxygenation level–dependent functional magnetic resonance imaging. Results: A random-effects analysis (2-sample t test) using statistical parametric mapping indicated that BA+ patients differed from BA–patients at a 0.05 level ( P corrected for multiple comparisons). Consistent with our a priori hypothesis, BA–patients (relative to BA+ patients) showed significant activation in the right VLPFC. An exploratory analysis revealed the following loci of activation: caudate nucleus, VLPFC, middle prefrontal cortex, medial prefrontal cortex, anterior cingulate cortex, and anterior temporal pole in the BA–group; and hippocampus, cerebellum, anterior temporal pole, and midbrain in the BA+ group. Conclusions: We observed not only hypofrontality in the BA+ group but also dysfunctional circuitry distributed throughout the brain. The temporal and midbrain activation seen in the BA+ group may indicate that these brain regions were working harder to compensate for inactivation in other regions. These distributed dysfunctional circuits may form the neural basis of blunted affect through impairment of emotion processing in the brain that prevents it from processing input efficiently and producing output effectively, thereby leading to symptoms such as blunted affect.
Childhood Separation Anxiety and Separation Events in Women with Agoraphobia with or without Panic Disorder
Authors: Peter Helmut , Brückner Eva , Hand Iver , Rufer Michael 
Published: July 2017

Objective: This study aimed to investigate the association between separation anxiety and actual separation events during childhood in adult patients with agoraphobia with or without panic disorder (PD). Method: Forty-two women with agoraphobia with or without PD participated in long-term follow-ups after exposure-in-vivo treatment. We assessed separation anxiety and separation events from age 0 to 18 years, as well as adult separation from a spouse. Results: Childhood separation experiences (55%) and separation anxiety were significantly higher in patients than in healthy subjects, but both conditions were not associated with each other. Childhood separation anxiety was related to adult separation events. Conclusions: Retrospective measures of childhood separation anxiety appear to be confounded by adult separation events. Thus the conclusion of whether childhood anxiety is a consequence of actual childhood separation events cannot be drawn, owing to a lacking association between both ratings.
Suicidal Behaviours in a Population-Based Sample of French Youth
Authors: Fedorowicz Valérie J , Fombonne Eric 
Published: July 2017

Objectives: To estimate the prevalence of suicidal ideation and behaviours in a large, representative sample of French youth and to evaluate age and sex correlates. Method: We surveyed a large ( n = 1106) cohort of French adolescents and young adults, aged 15 to 26 years and diversified throughout France, using a mailed-in self-report questionnaire. Results: Lifetime prevalence rates for suicidal ideation, plans, and attempts were 47.2%, 14.8%, and 5.7%, respectively. Rates for female youth were higher than for male youth across the entire spectrum of suicide-related outcomes. Rates generally increased between the ages of 15 and 20 years and decreased after age 21. Conclusions: The findings suggest that suicidal thoughts and behaviours are widespread phenomena among adolescents and constitute a major public health issue.
Strengthening the Status of Psychotherapy for Personality Disorders: An Integrated Perspective on Effects and Costs
Authors: Bartak Anna , Soeteman Djøra I , Verheul Roel , Busschbach Jan JV 
Published: July 2017

Objective: Despite scientific evidence of effectiveness, psychotherapy for personality disorders is not yet fully deployed, nor is its reimbursement self-evident. Both clinicians and health care policy-makers increasingly rely on evidence-based medicine and health economics when determining a treatment of choice and reimbursement. This article aims to contribute to that understanding by applying these criteria on psychotherapy as a treatment for patients with personality disorder. Method: We have evaluated the available empirical evidence on effectiveness and cost-effectiveness, and integrated this with necessity of treatment as a moderating factor. Results: The effectiveness of psychotherapy for personality disorders is well documented with favourable randomized trial results, 2 metaanalyses, and a Cochrane review. However, the evidence does not yet fully live up to modern standards of evidence-based medicine and is mostly limited to borderline and avoidant personality disorders. Data on cost-effectiveness suggest that psychotherapy for personality disorders may lead to cost-savings. However, state-of-the-art cost-effectiveness data are still scarce. An encouraging factor is that the available studies indicate that patients with personality disorder experience a high burden of disease, stressing the necessity of treatment. Conclusions: When applying an integrated vision on outcome, psychotherapy can be considered not only an effective treatment for patients with personality disorder but also most likely a cost-effective and necessary intervention. However, more state-of-the-art research is required before clinicians and health care policy-makers can fully appreciate the benefits of psychotherapy for personality disorders. Considerable progress is possible if researchers focus their efforts on evidence-based medicine and cost-effectiveness research.