bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroimaging in Attention-Deficit Hyperactivity Disorder: Beyond the Frontostriatal Circuitry
Authors: Cherkasova Mariya V , Hechtman Lily 
Published: January 2017

Objectives: To review the findings of structural and functional neuroimaging studies in attention-deficit hyperactivity disorder (ADHD), with a focus on abnormalities reported in brain regions that lie outside the frontostriatal circuitry, which is currently believed to play a central role in the pathophysiology of ADHD. Methods: Relevant publications were found primarily by searching the MEDLINE and PubMed databases using the keywords ADHD and the abbreviations of magnetic resonance imaging (MRI), functional MRI, positron emission tomography, and single photon emission computed tomography. The reference lists of the articles found through the databases were then reviewed for the purpose of finding additional articles. Results: There is now substantial evidence of structural and functional alterations in regions outside the frontostriatal circuitry in ADHD, most notably in the cerebellum and the parietal lobes. Conclusions: Although there is compelling evidence suggesting that frontostriatal dysfunction may be central to the pathophysiology of ADHD, the neuroimaging findings point to distributed neural substrates rather than a single one. More research is needed to elucidate the nature of contributions of nonfrontostriatal regions to the pathophysiology of ADHD.
Frequency and Correlates of Gambling Problems in Outpatients with Major Depressive Disorder and Bipolar Disorder
Authors: Kennedy Sidney H , Welsh Brenda R , Fulton Kari , Soczynska Joanna K , McIntyre Roger S , O'Donovan Claire , Milev Roumen , le Melledo Jean-Michel , Bisserbe Jean-Claude , Zimmerman Mark , Martin Neasa 
Published: January 2017

Objective: To investigate the frequency of gambling in people who have been diagnosed with major depressive disorder (MDD) or bipolar disorder (BD). Secondary objectives were to examine: sex differences in the rates of gambling behaviour, the temporal relation between onset of mood disorders and problem gambling, psychiatric comorbidities associated with problem gambling, and the influences of problem gambling on quality of life. Method: People (aged 18 years and older) who met criteria for lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision-defined MDD or BD I or II, and were confirmed by the Mini International Neuropsychiatric Interview, were enrolled. Participants were recruited from 5 sites in Canada and 1 in the United States. Prevalence of past-year problem gambling was assessed with the Canadian Problem Gambling Index. Associated comorbidities with problem gambling are presented. Results: A total of 579 participants were enrolled (female: n = 379, male: n = 200). Prevalence of problem gambling did not differ significantly between the MDD (12.5%) and the BD (12.3%) groups. There was a significant difference in the prevalence of problem gambling between males (19.5%) and females (7.8%) in the BD group (χ2 = 8.695, df = 1, P = 0.003). Among people meeting criteria for problem gambling, the mood disorder was the primary onset condition in 71% of cases. People with a mood disorder with comorbid current panic disorder (OR = 1.96; 95% CI 1.02 to 3.75), obsessive-compulsive disorder (OR = 1.86; 95% CI 1.01 to 3.45), specific phobia (OR = 2.36; 95% CI 1.17 to 4.76), alcohol dependence (OR = 5.73; 95% CI 3.08 to 10.65), or lifetime substance dependence (OR = 2.05; 95% CI 1.17 to 3.58), had significantly increased odds of problem gambling. Problem gambling across MDD and BD populations was also associated with lower quality of life ratings. Conclusion: These results reaffirm a higher prevalence of gambling both in BD and in MDD populations, compared with previously published community samples. Our study also identifies risk factors for gambling behaviours within these populations.
Improving Reliability of the Assessment of the Life Course of Schizophrenia
Authors: Thompson Angus H , Newman Stephen C , Orn Helene , Bland Roger C 
Published: January 2017

Objective: Life course studies of schizophrenia that have used a 3-phase model (onset, course, and outcome) have had their use restricted owing to differences in definition and methodology. The purpose of this investigation was to describe life course data in mathematical terms and to compare the results with the findings from other life course studies. Method: The study population was comprised of 128 of 137 people who were first admitted for schizophrenia to 1 of the 2 mental hospitals in Alberta in 1963 and followed until 1997 or death. Patient evaluations were based on retrospective and contemporaneous information collected from the patients and hospital files, treatment records, and family members. Mathematically derived ratings were formulated for course, outcome, and onset (pre-admission years). The distribution of the resulting 8 life course types was compared with profiles drawn from other such studies reported in the literature. Results: The use of mathematical descriptions of onset, course, and outcome produced profiles that did not closely match the results of other investigations, largely owing to inconsistency across studies. Further, the present approach to outcome measurement produced results that were less favourable than those found in other studies. Conclusions: Studies on the life course of schizophrenia could be made more comparable by specifying mathematically expressed operational definitions of onset, course, and outcome. Nonetheless, the use of the term outcome can be questioned as it implies an assessment at a specific time rather than providing a summary statement of the quality of a life.
Schizophrenia and Cancer: In 2010 Do We Understand the Connection?
Authors: Bushe Chris J , Hodgson Richard 
Published: January 2017

Objective: In recent years, there has been a plethora of cancer mortality and incidence data reported in schizophrenia. Despite this, there has been little focus on cancer in schizophrenia guidelines. Additionally, there have been suggestions that schizophrenia may provide inherent protection against cancer. The goal of this review is to establish, using recent data, the incidence and mortality rates for cancer in schizophrenia. Method: We identified systematic reviews and meta-analyses and undertook a search using the Medical Subject Headings' entry terms schizophrenia and neoplasm. Results: Incidence and mortality rates for cancer in schizophrenia are increased, compared with relevant general populations. Data are not uniformly reported and cohort ages tend to be young for expected cancer incidence. Despite the young cohort ages, the incidence of the major cancers—lung and breast—are substantially increased. Confounders are often not measured in the epidemiologic databases. When lung cancer is adjusted for smoking rates, there appears to be a lower risk of lung cancer than expected providing some basis to support an inherently reduced risk of cancer. There may also be a dissonance between incidence and mortality rates that suggest a prejudice against either diagnosis or treatment of these vulnerable patients. Conclusion: A single definitive study of schizophrenia and cancer is unfeasible, and future research will lean heavily on systematic review and meta-analysis. Researchers should report cancer data to include age and follow-up data and cohort overlap. Cancer accounts for almost an equivalent mortality as cardiovascular disease.
The Relation between Adolescent Social Competence and Young Adult Delinquency and Educational Attainment among At-Risk Youth: The Mediating Role of Peer Delinquency
Authors: Stepp Stephanie D , Pardini Dustin A , Loeber Rolf , Morris Nancy A 
Published: January 2017

Objective: We examined trajectories of adolescent social competence as a resilience factor among at-risk youth. To examine potential mechanisms of this resilience process, we investigated the putative mediating effect of peer delinquency on the relation between adolescent social competence and young adult delinquency seriousness and educational attainment. Method: Participants ( n = 257) were screened to be at risk for antisocial behaviour at age 13 years. Data were derived from an ongoing longitudinal study of the development of antisocial and delinquent behaviour among inner-city boys, the Pittsburgh Youth Study. We used data collected from participants when aged 13 years until they were aged 25.5 years for our study. Results: Results indicated that boys with high levels of social competence decreased their involvement with deviant peers throughout adolescence, which, in turn, predicted less serious forms of delinquency in early adulthood. Social competence had a direct effect on educational attainment in early adulthood, as boys who developed social competencies in adolescence went further in school irrespective of their involvement with delinquent peers. Conclusions: Results suggest that promoting the development of social competencies and reducing involvement with delinquent peers will protect at-risk youth from engaging in serious delinquency in early adulthood while increasing their educational success.
Nonpharmacological Treatment of Alzheimer Disease
Authors: Ballard Clive , Khan Zunera , Clack Hannah , Corbett Anne 
Published: January 2017

Objective: To review the key nonpharmacological treatment approaches to the cognitive and functional symptoms of Alzheimer disease (AD). Methods: We searched and critically analyzed the most recent relevant literature pertaining to the nonpharmacological treatment of AD. Results: There is evidence from a modest number of well-conducted randomized controlled trials (RCTs) that various nonpharmacological approaches, including cognitive training, cognitive rehabilitation, and cognitive stimulation therapy (CST), confer modest but significant benefits in the treatment of cognitive symptoms in people with AD, and that there may be additive benefits in combination with cholinesterase inhibitor therapy. Cognitive rehabilitation also appears to result in functional benefits in AD. The modest number of RCTs focusing on cognitive training in AD is consistent with the results of larger cognitive training trials in healthy older people. However, there is no convincing evidence of any benefits associated with brain training games. Conclusion: An emerging evidence base indicates that different approaches to cognitive training and cognitive stimulation in people with AD confer modest but significant benefits. The best evidence base is for CST, although this approach is labour-intensive, and requires further evaluation of cost-effectiveness. There is currently no evidence that brain training games provide any significant benefit to people with AD.
The Pharmacoepidemiology of Antipsychotics for Adults with Schizophrenia in Canada, 2005 to 2009
Authors: Pringsheim Tamara , Lam Darren , Tano David S , Patten Scott B 
Published: January 2017

Objective: To describe the frequency and trends in the use of antipsychotics for adults with schizophrenia in Canada from 2005 to 2009. Methods: Analyses were performed on IMS Brogan's Canadian Disease and Therapeutic Index (CDTI). The CDTI is a national physician panel study consisting of a representative sample of physicians both geographically and by specialty. Weighting adjustments are made to estimate national drug recommendations. Quarterly, panel physicians record all therapeutic recommendations during a 2-day period, including patient age, sex, and indication. Antipsychotic recommendations were estimated using CDTI data in which schizophrenia was listed as the indication. Results: First-generation antipsychotic (FGA) recommendations for adults with schizophrenia increased by 38% between 2005 and 2009, from 329 380 to 454 960 recommendations. There were notable increases in recommendations for chlorpromazine, loxapine, zuclopenthixol, and flupentixol. Second-generation antipsychotic (SGA) recommendations increased to a much lesser extent (9%), which was mostly attributable to an increase in recommendations for clozapine. Drug recommendations for olanzapine decreased by 9%. Conclusion: The rate of increase of FGA use is now greater than that of SGAs. This may be due to data from recent comparative trials, which suggest that clinical efficacy, and the rate of neurological side effects is similar between FGAs and SGAs. The decreasing use of olanzapine may be due to metabolic adverse effects. The increased use of clozapine may be due to data on its superiority in patients who are treatment resistant.
Substances Used in Completed Suicide by Overdose in Toronto: An Observational Study of Coroner's Data
Authors: Sinyor Mark , Howlett Andrew , Cheung Amy H , Schaffer Ayal 
Published: January 2017

Objective: To identify the substances used by people who die from suicide by overdose in Toronto and to determine the correlates of specific categories of substances used. Method: Coroner's records for all cases of suicide by overdose in Toronto, Ontario, during a 10-year period (1998 to 2007) were examined. Data collected included demographic data, all substances detected, and those determined by the coroner to have caused death. Logistic regression analyses were used to examine demographic and clinical factors associated with suicide by different drug types. Results: There were 397 documented suicides by overdose (mean age 49.1 years, 50% female). Most substances detected were psychotropic prescription medications ( n = 245), followed by other prescription medications ( n = 143) and over-the-counter (OTC) medications ( n = 83). More than one-half of all suicides by overdose were determined to have only one specifc substance as the cause of death ( n = 206). In suicides where only one class of substance was present in lethal amounts, OTC medication ( n = 48), opioid analgesics ( n = 44), and tricyclic antidepressants ( n = 44) were most common. Conclusions: Suicides by overdose involved the use of different classes of substances, including psychotropic prescription medication, other prescription medications, as well as OTC medications. Physicians and pharmacists should be aware of commonly used prescription and OTC medications in overdose and exercise increased vigilance in prescribing or dispensing them to at-risk patients.
Second-Generation Antipsychotics for the Treatment of Disruptive Behaviour Disorders in Children: A Systematic Review
Authors: Pringsheim Tamara , Gorman Daniel 
Published: January 2017

Objective: The use of second-generation antipsychotics (SGAs) in youth has increased considerably. Increases are mainly attributable to treatment of disruptive behaviour disorders (DBDs). Our objective was to review the evidence regarding the efficacy of SGAs for DBDs in youth. Method: We performed a systematic review of all randomized controlled trials (RCTs) of SGAs and placebo for the treatment of DBDs in youth, focusing on efficacy data. Results: Eight RCTs in youth with DBDs were included. Five RCTs evaluated the use of risperidone in youth with the combination of subaverage-borderline IQ and disruptive behaviour-aggression. Single RCTs evaluated the use of risperidone for treatment-resistant aggression in attention-deficit hyperactivity disorder and for the treatment of conduct disorder (CD), and a single RCT evaluated the use of quetiapine for adolescent CD. The efficacy results of each of these studies are described. Conclusion: Four placebo-controlled studies support the short-term efficacy of low-dose risperidone in youth with a subaverage IQ. Placebo-controlled evidence is weak or nonexistent for SGAs other than risperidone, and is weak in youth with an average IQ. Multiple factors likely account for the disconnect between this limited evidence base and the frequent use of SGAs for DBDs in clinical practice. These include extrapolation from studies in youth with autism or a subaverage IQ to normally developing youth; ease of SGA titration and the mistaken perception that little monitoring is required; unavailability of psychosocial treatments; limited familiarity with other pharmacological options; clinical and cultural norms; and the influence of the pharmaceutical industry.
Electronic Media Use and Addiction among Youth in Psychiatric Clinic versus School Populations
Authors: Baer Susan , Saran Kelly , Green David A , Hong Irene 
Published: January 2017

Objective: Electronic media use is highly prevalent among today's youth, and its overuse in the general population has been consistently associated with the presence of psychiatric symptoms. In contrast, little information exists about electronic media use among youth with psychiatric disorders. Our study aims to compare patterns of television and computer and gaming station use among youth in psychiatric clinic and community-based school populations. Method: Surveys were completed by 210 youth and parents, from school ( n = 110) and psychiatric clinic ( n = 100) populations. Duration and frequency of television, video gaming, and nongaming computer activities were ascertained, along with addictive features of use. Descriptive and comparative analyses were conducted, with a statistical threshold of P < 0.05. Results: Quantitative and qualitative differences were identified between the patterns of use reported by the 2 groups. The mean reported daily duration of exposure to electronic media use was 6.6 hours (SD 4.1) for the clinic sample and 4.6 hours (SD 2.6) for the school sample (P < 0.01). Self-reported rates of addictive patterns related to computer and gaming station use were similar between the 2 populations. However, the clinically based sample favoured more violent games, with 29% reporting playing mature-rated games, compared with 13% reported by the school-based sample ( P = 0.02). Youth with externalizing disorders expended greater time video gaming, compared with youth with internalizing disorders ( P = 0.01). Conclusions: Clinically based samples of youth with mental illnesses spend more time engaged in electronic media activities and are more likely to play violent video games, compared with youth in the general population. Further research is needed to determine the long-term implications of these differences.
Age at Immigration to Canada and the Occurrence of Mood, Anxiety, and Substance Use Disorders
Authors: Patterson Beth , Kyu Hmwe Hmwe , Georgiades Katholiki 
Published: January 2017

Objective: The process of migration and resettlement has been associated with increased risk for psychiatric illness. Our study sought to examine the association between age at immigration and risk for mood, anxiety, and substance use disorders (SUDs) among adult immigrants in Canada. Method: Data from the Canadian Community Health Survey: Mental Health and Well-Being, a cross-sectional study of psychiatric disorder conducted in 2002, was used to identify a representative sample of adult immigrants in Canada ( n = 4946). Logistic regression was used to examine the association between age at immigration (0 to 5 years, 6 to 17 years, and 18 years and older) and 12-month prevalence of mood and anxiety disorders, and SUDs. Results: Immigrants who arrived prior to age 6 years reported the highest risk for mood (OR 3.41; 95% CI 1.7 to 7.0) and anxiety disorders (OR 6.89; 95% CI 3.5 to 13.5), compared with those who immigrated at the age of 18 years or older, after adjusting for covariates, including duration of residence. Conclusions: Younger age at immigration was associated with increased risk of having a current mood disorder, anxiety disorder, or SUD. These findings speak to the importance of developing and evaluating targeted prevention programs for young immigrant children and adolescents.
Substance-Related Cravings and Relapses: Clinical Implications
Authors: el-Guebaly Nady , Hodgins David 
Published: January 2017

Objective: To review the implications of current research on clinical practice. Method: An examination of the literature over the last 10 years and the data from our own study group. Results: A synopsis of current psychobiological and psychological conceptual underpinnings of the nature and process of cravings and relapses among substance-dependent individuals is presented. The biopsychosocial dimensions of the clinical assessment of craving components, relapse patterns, and predictors, including relevant instruments, are explored. The panoply of management strategies for cravings and relapses encompasses cue exposure treatment techniques, relapse prevention approaches, anticraving and psychotropic medication, family involvement, and twelve-step programs. Conclusion: A clinician's familiarity with these strategies should contribute significantly to the transformation of the sense of failure engendered by a patient's relapse into a constructive challenge and opportunity.
Nicotine and Endogenous Opioids: Toward Specific Pharmacotherapy
Authors: Ismail Zahinoor , el-Guebaly Nady 
Published: January 2017

Objective: To address the theoretical framework behind opioid receptor antagonism for the treatment of nicotine abuse. The current literature is reviewed with a focus on opioid–nicotine interactions in animals and humans. Furthermore, previous studies addressing the effect of opioid antagonism on smoking behaviour are reviewed critically with a focus on suggestions and implications for future trials. Method: Computerized data bases and reference lists of existing articles were searched for prior publications in 3 areas: 1) the association between nicotine and endogenous opioids, 2) nicotine and reward, and 3) opioid antagonism in the treatment of nicotine use. Results: Nicotine affects the mesolimbic reward pathway postsynaptically via nicotinic cholinergic receptors and presynaptically via the central nervous system's (CNS) neurohumoral pathways. Thus nicotine results in the release of endogenous opioids that bind to μ receptors, which increases the release of dopamine along this pathway. Studies to date have shown mixed results on the effect of opioid antagonism on smoking behaviour. Conclusions: The role of opioid antagonism on smoking behaviour is unclear, despite the publication of 5 trials on the subject. Further trials of longer duration should be undertaken and use both longer-acting medications and those more specific to the μ receptor to further focus on the rewarding aspects of nicotine ingestion, thus addressing the craving for this drug. The development of adequate compounds has just begun, and psychiatrists can hope to have a more specific pharmacotherapy to address the cravings and short-term rewards of nicotine use.
Psychiatric Comorbidity in Pathological Gambling: A Critical Review
Authors: Crockford David Neil , el-Guebaly Nady 
Published: January 2017

Objective: To critically review the current literature on pathological gambling as regards the significant psychiatric comorbidities associated with it. Method: The authors synthesized information found via electronic searches (MEDLINE) and bibliographic-directed searches in over 60 publications. Results: Pathological gamblers frequently have comorbid substance use disorders. In addition, a subset appear to have comorbid antisocial personality disorder, but they represent a minority when compared with those people who have acquired their antisocial traits as a consequence of their gambling behaviour. A comorbidity with the mood disorders is probable, but methodological concerns and inconsistencies with the data prevent further delineation of this. Emerging research for other disorders possibly associated with pathological gambling is also reviewed. Conclusion: Pathological gambling is associated with significant psychiatric comorbidity. Recommendations for future research are described.