bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relation between Perceived Need for Mental Health Treatment, DSM Diagnosis, and Quality of Life: A Canadian Population-Based Survey
Authors: Sareen Jitender , Stein Murray B , Campbell Darren W , Hassard Thomas , Menec Verena 
Published: July 2017

Objectives: Prevalence estimates of mental disorders were designed to provide an indirect estimate of the need for mental health services in the community. However, recent studies have demonstrated that meeting criteria for a DSM-based disorder does not necessarily equate with need for treatment. The current investigation examined the relation between self-perceived need for mental health treatment and DSM diagnosis, with respect to quality of life (QoL) and suicidal ideation. Methods: Data came from an Ontario population-based sample of 8116 residents (aged 15 to 64 years). The University of Michigan Composite International Diagnostic Interview was used to diagnose mood, anxiety, substance use, and bulimia disorder according to DSM-III-R criteria. We categorized past-year help seeking for emotional symptoms and (or) perceiving a need for treatment without seeking care as self-perceived need for treatment. We used a range of variables to measure QoL: self-perception of mental health status, a validated instrument that measured well-being, and restriction of activities (current, past 30 days, and long-term). Results: Independent of subjects' meeting criteria for a DSM-III-R diagnosis, self-perceived need for treatment was significantly associated with poor QoL (on all measures) and past-year suicidal ideation. Conclusions: Self-perceived need for mental health treatment, in addition to DSM diagnosis, may provide valuable information for estimating the number of people in the population who need mental health services. The relation between self-perceived need for treatment and objective measures of treatment need requires future study.
Troubles dépressifs majeurs et urgences psychiatriques: Une étude naturaliste concernant la place des interventions de crise
Authors: Damsa Cristian , Lazignac Coralie , Cailhol Lionel , Di Clémente Thierry , Haupert Joëlle , Pull Charles 
Published: July 2017

Objectif: Le but de cette étude rétrospective a été de mesurer l'effet de l'introduction du modèle d'intervention de crise dans le service d'urgences d'un hôpital général, sur le nombre d'hospitalisations et de suivis ambulatoires des patients souffrant d'un trouble dépressif majeur. Méthode: L'étude porte sur l'ensemble des patients présentant un trouble dépressif majeur (critères du DSM IV) qui ont consulté le service d'urgences psychiatriques d'un hôpital général durant 2 périodes de 8 mois: avant (425 patients) et après (436 patients) l'introduction des interventions de crise. Résultats: Après l'introduction des interventions de crise, on constate une diminution significative du taux d'hospitalisations volontaires (de 17,9 % à 12,4 %), ainsi qu'une augmentation du nombre des suivis psychiatriques ambulatoires (de 82,1 % à 86,2 %). La présence d'un trouble de personnalité limite (borderline) a été associée avec une plus grande diminution du taux d'hospitalisations (27,8 % contre 38,2 %), tandis que le nombre d'hospitalisations des patients souffrant d'un trouble dépressif avec des caractéristiques psychotiques n'a pas diminué après l'introduction des interventions de crise. Les interventions de crise ont été plus efficaces pour les femmes. Conclusions: Ces résultats suggèrent l'intérêt des interventions de crise aux urgences psychiatriques pour améliorer la prise en charge des patients souffrant d'un trouble dépressif majeur, en favorisant la solution de rechange du suivi ambulatoire multimodal plutôt qu'une hospitalisation en milieu psychiatrique.
Frequency and Adequacy of Depression Treatment in a Canadian Population Sample
Authors: Esposito Eleonora , Wang Jian Li , Adair Carol E , Williams Jeanne VA , Dobson Keith , Schopflocher Donald , Mitton Craig , Newman Stephen , Beck Cynthia , Barbui Corrado , Patten Scott B 
Published: July 2017

Objective: Population-based data about depression treatment are largely restricted to estimates of the frequency of antidepressant (AD) use. Such frequencies are difficult to interpret in the absence of information about dosages, reasons for taking the medications, and participation in nonpharmacologic treatment. The objective of this study was to describe the pattern of treatment for major depression (MD) in Alberta. Method: Telephone survey methods were employed. Random digit dialing was used to select a sample of 3345 household residents aged 18 to 64 years in Alberta. A computer-assisted telephone interview that included the Mini Neuropsychiatric Diagnostic Interview and questions about pharmacotherapy and psychotherapy was administered. Estimates were weighted for design features and population demographics. Results: The point prevalence of MD was 4.4% (95% confidence interval [CI], 3.4% to 5.5%), and the overall prevalence of current AD use was 7.4% (95%CI, 6.2% to 8.6%). The ADs taken most commonly, serotonin-specific reuptake inhibitors, were taken at therapeutic dosages 87.4% of the time. Most (80.7%) of those taking ADs reported taking them for more than 1 year. The frequency of receiving counselling, psychotherapy, or talk therapy was 3.9% overall and 14.3% in respondents with MD. However, most of these subjects were unable to name the type of counselling they were receiving. Conclusions: When compared with previous estimates, these results suggest continued progress in the delivery of evidence-based care to the population. There is room for additional improvement, especially in the provision of nonpharmacologic treatment.
Epidemiology of Chronic Pain with Psychological Comorbidity: Prevalence, Risk, Course, and Prognosis
Authors: Tunks Eldon R , Crook Joan , Weir Robin 
Published: July 2017

Objective: To review the relation between chronic pain and psychological comorbidities, and the influence on course and prognosis, based on epidemiologic and population studies. Method: We present a narrative overview of studies dealing with the epidemiology of chronic pain associated with mental health and psychiatric factors. Studies were selected that were of good quality, preferably large studies, and those that dealt with prevalences, course and prognosis of chronic pain, risk factors predicting new pain and comorbid disorders, and factors that affect health outcomes. Results: Chronic pain is a prevalent condition, and psychological comorbidity is a frequent complication that significantly changes the prognosis and course of chronic pain. In follow-up studies, chronic pain significantly predicts onset of new depressions, and depression significantly predicts onset of new chronic pain and other medical complaints. Age, sex, severity of pain, psychosocial problems, unemployment, and compensation are mediating factors in course and prognosis. Conclusion: In assessment of chronic pain, the evidence from epidemiologic studies makes it clear that chronic pain can best be understood in the context of psychosocial factors.
Lifestyle Characteristics of Psychiatric Outpatients
Authors: Chuang Henry T , Mansell Craig , Patten Scott B 
Published: July 2017

Objective: To describe lifestyle characteristics and associated health issues among psychiatric outpatients in 3 diagnostic categories: schizophrenia, bipolar disorder, and anxiety and (or) depression. Method: A series of patients ( n = 182) attending 3 outpatient mental health clinics in Calgary were administered a set of items and instruments to assess: social support, dietary habits, substance use, exercise, and recreational pursuits. In addition, clinical and laboratory parameters including body mass index (BMI) and lipid and glucose levels were compared when available. Results: Satisfaction with social support was comparable across the 3 diagnostic categories. About two-thirds reported predominantly sedentary routine daily activities. No significant differences in fatty food intake were identified, or for other dietary habits. There were no significant differences between diagnostic groups and total cholesterol, and high-density lipoprotein or low-density lipoprotein levels. According to their BMI, 74% of the entire sample could be described as overweight and 38% as obese; again, differences between the 3 diagnostic categories were not observed. Conclusion: Unhealthy lifestyle issues are not restricted to any specific diagnostic group. These data identify a compelling need to develop ameliorative intervention strategies for psychiatric outpatients; however, we could not identify a basis for targeting such interventions specifically in relation to diagnosis.
The Effect of Study Design on the Reporting of Mortality Due to Colorectal Cancer in Adults with Mental Illness in Nova Scotia
Authors: Kisely Stephen , Campbell Leslie Anne , Cox Martha 
Published: July 2017

Objective: Some studies suggest a higher case fatality from colorectal cancer (CRC) in psychiatric patients even though the incidence is no greater than in the general population. However, this finding is not universal and may be confounded by study design (for example, inception, compared with historical, cohort), mean cohort age, or delays in presentation with more advanced staging at diagnosis. We assessed how study design and cancer stage at presentation affected outcomes in psychiatric patients. Methods: A retrospective historical cohort of CRC presentations was used comparing psychiatric patients with control subjects. Psychiatric status was defined by either health service use or psychotropic prescription, and outcomes by logistic or Cox proportional hazards regression. Results: There were 3501 new presentations of CRC from 2001 to 2005. Psychiatric cases, as defned by in- or outpatient contacts, made up 15.9% ( n = 558) of patients with CRC. There was no association between psychiatric status and stage at presentation, surgical intervention, or mortality after adjusting for confounders. There was a reduced likelihood of resection, an indicator of curative treatment, when on a selective serotonin reuptake inhibitor or serotonin noradrenergic reuptake inhibitor ( n = 194; AOR 0.54; 95% CI 0.30 to 0.97) or antipsychotics ( n = 28; AOR 0.27; 95% CI 0.08 to 0.92). Conclusions: The association between psychiatric status and CRC may vary by study design and how psychiatric status is defined. These factors should be considered when interpreting any association between mental illness and cancer. As in studies of all-cause and cardiac mortality, historical cohorts of prevalent psychiatric cases may be less sensitive than inception cohorts of new patients, possibly because the excess of deaths is greatest within 7 years of initial presentation for a psychiatric disorder.
Diagnostic Criteria as Dysfunction Indicators: Bridging the Chasm between the Definition of Mental Disorder and Diagnostic Criteria for Specific Disorders
Authors: First Michael B , Wakefield Jerome C 
Published: July 2017

According to the introduction to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, each disorder must satisfy the definition of mental disorder, which requires the presence of both harm and dysfunction. Constructing criteria sets to require harm is relatively straightforward. However, establishing the presence of dysfunction is necessarily inferential because of the lack of knowledge of internal psychological and biological processes and their functions and dysfunctions. Given that virtually every psychiatric symptom characteristic of a DSM disorder can occur under some circumstances in a normally functioning person, diagnostic criteria based on symptoms must be constructed so that the symptoms indicate an internal dysfunction, and are thus inherently pathosuggestive. In this paper, we review strategies used in DSM criteria sets for increasing the pathosuggestiveness of symptoms to ensure that the disorder meets the requirements of the definition of mental disorder. Strategies include the following: requiring a minimum duration and persistence; requiring that the frequency or intensity of a symptom exceed that seen in normal people; requiring disproportionality of symptoms, given the context; requiring pervasiveness of symptom expression across contexts; adding specific exclusions for contextual scenarios in which symptoms are best understood as normal reactions; combining symptoms to increase cumulative pathosuggestiveness; and requiring enough symptoms from an overall syndrome to meet a minimum threshold of pathosuggestiveness. We propose that future revisions of the DSM consider systematic implementation of these strategies in the construction and revision of criteria sets, with the goal of maximizing the pathosuggestiveness of diagnostic criteria to reduce the potential for diagnostic false positives. Selon l'introduction du Manuel diagnostique et statistique des troubles mentaux (DSM), 5e édition, chaque trouble doit satisfaire à la définition d'un trouble mental, qui exige la présence de préjudice et de dysfonctionnement. Construire des ensembles de critères requérant un dommage est relativement simple. Cependant, établir la présence d'une dysfonction est nécessairement inférentiel en raison du manque de connaissances des processus psychologique et biologique internes ainsi que de leurs fonctions et dysfonctions. Étant donné qu'à peu près chaque caractéristique d'un symptôme psychiatrique d'un trouble du DSM peut se manifester dans certaines circonstances chez une personne fonctionnant normalement, les critères diagnostiques basés sur les symptômes doivent être construits de manière à ce que les symptômes indiquent une dysfonction interne, et qu'ils soient donc intrinsèquement pathosuggestifs.
Implementing a Continuum of Evidence-Based Psychosocial Interventions for People with Severe Mental Illness: Part 2—Review of Critical Implementation Issues
Authors: Briand Catherine , Menear Matthew 
Published: July 2017

Objective: In North America and internationally, efforts have been made to reduce the gaps between knowledge of psychosocial evidence-based practices (EBPs) and the delivery of such services in routine mental health practice. Part 2 of this review identifies key issues for stakeholders to consider when implementing comprehensive psychosocial EBPs for people with severe mental illness (SMI). Method: A rapid review of the literature was conducted. Searches were carried out in MEDLINE and PsycINFO for reports published between 1990 and 2012 using key words related to SMI, and psychosocial practices and implementation. The Consolidated Framework for Implementation Research (CFIR) was used to structure findings according to key domains and constructs known to influence the implementation process. Results: The CFIR allowed us to identify 17 issues reflecting more than 30 constructs of the framework that were viewed as influential to the process of implementing evidence-based psychosocial interventions for people with SMI. Issues arising at different levels of influence (intervention, individual, organizational, and system) and at all phases of the implementation process (planning, engagement, execution, and evaluation) were found to play important roles in implementation. Conclusion: The issues identified in this review should be taken into consideration by stakeholders when engaging in efforts to promote uptake of new psychosocial EBPs and to widen the range of effective psychosocial services available in routine mental health care.
Trauma Reactivation Plus Propranolol is Associated with Durably Low Physiological Responding during Subsequent Script-Driven Traumatic Imagery
Authors: Brunet Alain , Thomas Émilie , Saumier Daniel , Ashbaugh Andrea R , Azzoug Abdelmadjid , Pitman Roger K , Orr Scott P , Tremblay Jacques 
Published: July 2017

Objective: In a previous, double-blind, placebo-controlled study, patients with posttraumatic stress disorder (PTSD) showed lower physiological response during script-driven traumatic imagery 1 week after receiving a single dose of propranolol given after the retrieval of a traumatic memory. We hypothesized that this effect would extend beyond 1 week using a modified treatment approach. Method: Twenty-eight participants with PTSD read an account of their traumatic event once weekly for 6 consecutive weeks under the influence of open-label propranolol. One week and 4-months later, skin conductance, heart rate, and left corrugator electromyogram responses were measured while participants engaged in script-driven mental imagery of their traumatic event. Results from the 22 study participants were compared with results from treated and untreated participants in a previously published trial. Results: Most participants in our study were classified as non-PTSD cases at posttreatment and follow-up according to a psychophysiological discriminant function analysis. Posttreatment skin conductance and heart rate responses of the current (propranolol-treated) participants were lower than those of placebo participants from the previous study. No difference was observed between physiological responding measured posttreatment and at follow-up. Conclusions: Low physiological responding during script-driven traumatic imagery after treatment extends up to 4 months, demonstrating the durability of the treatment effect's. Limitations include the absence of a placebo-controlled group and lack of physiological baseline measures. Despite these limitations, results point to the need for future trials examining the clinical efficacy of trauma reactivation plus propranolol, as it has the potential to become a novel, cost- and time-effective treatment for PTSD.
Research-Track Programs for Residents in Psychiatry: A Review of Literature and a Report of 3 Canadian Experiences
Authors: Bhat Venkat , Leong KaWai , Lee Jonathan , Voineskos Daphne , Daskalakis Zafiris J , Lam Raymond W , Jollant Fabrice 
Published: July 2017

Objectives: Clinician-scientists occupy an interesting position at the interface between science and care, and have a role to play in bridging the 2 valleys between fundamental and clinical research, and between clinical research and clinical practice. However, research training during medical residency for future clinician scientists is an important but challenging process. Our article, written by residents and directors of research-track (RT) programs, aimed at reviewing literature on RT programs for residents, and describing the organization of RT programs at 3 Canadian universities (the University of British Columbia, the University of Toronto, and McGill University). Methods: A systematic MEDLINE search was conducted for the review section. Psychiatry program directors in Canada were also contacted to provide information about potential RT programs. Results: Twenty articles were related to resident RT programs in medicine, including 6 in psychiatry. Moreover, 5 out of 16 Canadian programs were found to offer a formal RT program, of which 3 are described here. Most reviewed articles described the program organization, while only one provided an outcome assessment with evidence of increased scholarly activity following RT implementation. Conclusions: Our article sheds light on postgraduate programs aiming at facilitating the dual training of future clinician-scientists, and developed during the last 10 years. It also highlights the lack of outcome assessment, and the paucity of guidelines to organize these programs in relation to the national requirements.
Prevalence and Correlates of Mental Health Problems in Canadian Forces Personnel Who Deployed in Support of the Mission in Afghanistan: Findings from Postdeployment Screenings, 2009–2012
Authors: Zamorski Mark A , Rusu Corneliu , Garber Bryan G 
Published: July 2017

Objective: An important minority of military personnel will experience mental health problems after overseas deployments. Our study sought to describe the prevalence and correlates of postdeployment mental health problems in Canadian Forces personnel. Method: Subjects were 16 193 personnel who completed postdeployment screening after return from deployment in support of the mission in Afghanistan. Screening involved a detailed questionnaire and a 40-minute, semi-structured interview with a mental health clinician. Mental health problems were assessed using the Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist—Civilian Version. Logistic regression was used to explore independent risk factors for 1 or more of 6 postdeployment mental health problems. Results: Symptoms of 1 or more of 6 mental health problems were seen in 10.2% of people screened; the most prevalent symptoms were those of major depressive disorder (3.2%), minor depression (3.3%), and posttraumatic stress disorder (2.8%). The strongest risk factors for postdeployment mental health problems were past mental health care (adjusted odds ratio [AOR] 2.89) and heavy combat exposure (AOR 2.57 for third tertile, compared with first tertile). These risk groups might be targeted in prevention and control efforts. In contrast to findings from elsewhere, Reservist status, deployment duration, and number of previous deployments had no relation with mental health problems. Conclusions: An important minority of personnel will disclose symptoms of mental health problems during postdeployment screening. Differences in risk factors seen in different nations highlight the need for caution in applying the results of research in one population to another.
A Sex-Specific Comparison of Major Depressive Disorder Symptomatology in the Canadian Forces and the General Population
Authors: Erickson Julie , Kinley D Jolene , Bolton James M , Zamorski Mark A , Enns Murray W , Sareen Jitender 
Published: July 2017

Objective: To compare major depressive disorder (MDD) symptomatology within men and women in a large, representative sample of Canadian military personnel and civilians. Method: We used the Canadian Community Health Survey: Mental Health and Well-Being (Cycle 1.2 and Canadian Forces Supplement) ( n = 36 984 and n = 8441, respectively) to compare past-year MDD symptomatology among military and civilian women, and military and civilian men. Logistic regression models were used to determine differences in the types of depressive symptoms endorsed in each group. Results: Men in the military with MDD were at lower odds than men in the general population to endorse numerous symptoms of depression, such as hopelessness (adjusted odds ratio [AOR] 0.44; 99% CI 0.23 to 0.83) and inability to cope (AOR 0.53; 99% CI 0.31 to 0.92). Military women with MDD were at lower odds of thinking about their death (AOR 0.52; 99% CI 0.32 to 0.86), relative to women with MDD in the general population. Conclusion: Different MDD symptomatology among males and females in the military, compared with those in the general population, may reflect selection effects (for example, personality characteristics and patterns of comorbidity) or occupational experiences unique to military personnel. Future research examining the mechanisms behind MDD symptomatology in military personnel and civilians is required.