bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Somatic Symptoms on Beck Depression Inventory Scores in Hospitalized Postmyocardial Infarction Patients
Authors: Delisle Vanessa C , Abbey Susan E , Beck Aaron T , Dobson Keith S , Dozois David J A , Grace Sherry L , Stewart Donna E , Ziegelstein Roy C , Thombs Brett D 
Published: January 2017

Objective: The Beck Depression Inventory (BDI) has been used more than any other self-report questionnaire in research on depression in cardiovascular disease. However, no studies have examined whether BDI scores may be influenced by somatic symptoms common after myocardial infarction (Ml) that may overlap with symptoms of depression. The objective of this study was to examine whether BDI scores of post-MI patients may be influenced by somatic symptoms that commonly occur after MI, but may not be related to depression. Method: Post-MI patients and psychiatric outpatients were matched on BDI cognitive-affective symptom scores, sex, and age, and their BDI somatic symptom scores were compared using independent samples t tests. Results: Somatic symptoms accounted for 57% of BDI total scores for 296 post-MI patients (mean total BDI = 8.8), compared with 50% for 296 matched psychiatric outpatients (mean total BDI = 7.6). Overall, BDI somatic scores of post-MI patients were 1.3 points higher than for psychiatric outpatients (95% CI 0.68 to 1.82; P < 0.001), equivalent to 14% of total scores of post-MI patients. Conclusions: The relative influence of somatic symptoms on BDI total scores was higher for post-MI patients than for psychiatric outpatients matched on cognitive-affective scores, sex, and age. This finding stands in contrast to that from a previous study that used similar methods and sample comparisons and found that post-MI and psychiatric outpatients did not differ in their endorsement of somatic symptoms on the BDI-II. The BDI-II may be preferable to the BDI in post-MI patients.
Synthesis through Simulation: Insights on the Epidemiology of Mood and Anxiety Disorders in Canada
Authors: Patten Scott B , Lin Elizabeth , Martens Patricia J , Stiff David , Smetanin Paul , Adair Carol E 
Published: January 2017

Objective: Prevalence estimates for mood and anxiety disorders in Canada are available, but various methodological approaches have produced inconsistent results. Simulation studies involve careful examination of available data by an expert modelling team working together with subject matter experts. Simulation can integrate datasets and literature-based estimates from various sources into a coherent mathematical representation of the underlying total population epidemiology. Methods: Supported by the Mental Health Commission of Canada, a simulation modelling project for mental disorders in Canada was recently undertaken. The modelling was carried out by RiskAnalytica using their Life at Risk platform. Specification and calibration of the model occurred in consultation with national and international experts. Results: To reconcile estimates of incidence and prevalence, recall bias needed to be represented in the model. This suggests that the population prevalence of mood and anxiety disorders has been underestimated by population surveys and may explain a discrepancy observed in the age-specific prevalence in population surveys as compared with studies using administrative data. The number of Canadians with mood and anxiety disorders is projected to increase in upcoming decades as a result of population growth, but, based on conservative assumptions, an increased prevalence proportion is not anticipated. Conclusions: Simulation models can act as a platform for economic analyses and epidemiologic projections and can support the rapid exploration of what-if scenarios, thereby informing policy decisions. This first national-level simulation provides a high level overview of mood and anxiety disorder epidemiology in Canada.
Inégalités de santé des troubles de l'humeur selon la défavorisation matérielle et sociale du quartier de résidence
Authors: Vanasse Alain , Courteau Josiane , Lesage Alain , Fleury Marie-Josée , Grégoire Jean-Pierre , Moisan Jocelyne , Lauzier Sophie , Bergeron Claude 
Published: January 2017

Objectif: Comparer la prévalence des troubles de l'humeur (TH) au Québec en 2006 et, chez les patients souffrant de TH, comparer l'utilisation des services de santé et des médicaments, la mortalité et morbidité selon le sexe et le niveau de défavorisation matérielle et sociale du quartier de résidence. Identifier les sous-groupes de personnes utilisant en plus grande proportion les services de santé et étant plus à risque de morbidité et mortalité. Méthode: Analyse secondaire des données médico-administratives gérées par la Régie de l'assurance maladie du Québec. La cohorte est constituée des personnes adultes ayant reçu un diagnostic de TH et résidant au Québec en 2006. Les variables sont: consultation d'un médecin, réclamation d'un médicament, consultation pour abus de substances ou d'alcool, consultation à l'urgence, hospitalisation pour trouble mental et décès. Les types de quartiers de résidence sont définis par le croisement des quintiles de défavorisation matérielle et sociale de Pampalon. Résultats: La prévalence de TH en 2006 était de 3,06 % (177 850 patients), celle des femmes étant 1,7 fois celle des hommes. Les résultats démontrent une prévalence de TH ainsi qu'une mortalité et morbidité plus importantes dans les quartiers matériellement et socialement défavorisés. Les jeunes hommes représentent également un sous-groupe particulièrement vulnérable pour plusieurs des variables étudiées. Conclusion: Les politiques publiques visant à améliorer les conditions matérielles (revenu, instruction, chômage) et à briser l'isolement social exerceraient une influence importante sur la santé mentale de la population. Une attention particulière devrait être portée à la population des jeunes hommes dans l'élaboration de programmes de santé publique.
The Impact of Memantine and Cholinesterase Inhibitor Initiation for Alzheimer Disease on the Use of Antipsychotic Agents: Analysis Using the Régie de l'Assurance Maladie du Québec Database
Authors: Lachaine Jean , Beauchemin Catherine , Crochard Anne , Bineau Sébastien 
Published: January 2017

Objective: Patients with Alzheimer disease (AD) show a high incidence of behavioural and psychological symptoms of dementia, which often lead to the prescription of antipsychotics. Our study sought to assess the impact of the initiation of memantine or cholinesterase inhibitors (ChEls) on the use of antipsychotics. Method: A retrospective cohort study was conducted using data from the Quebec provincial health plan database. Patients included in our study had received a diagnosis of AD and were initial users of memantine or ChEls. The proportion of patients who used antipsychotics was estimated using prescription data dating back to 1 year before and to 1 year after the first prescription of memantine or ChEls. The difference between the slopes corresponding to the periods pre- and postmemantine or ChEls was analyzed using an interrupted time series design. Results: The percentage of antipsychotic users increased by 118.3% before and by 68.3% after initiation of a ChEl, and increased by 68.6% before and by 7.0% after initiation of memantine. Antipsychotic trends pre- and post-ChEl initiation were not statistically different ( P = 0.89), while a statistical difference was observed when comparing the antipsychotic trends pre- and postmemantine initiation ( P < 0.001). Conclusions: The initiation of memantine, unlike ChEls, has a notable stabilization effect on the prescription of antipsychotics in patients with AD.
The Impact of the Type of Insurance Plan on Adherence and Persistence with Antidepressants: A Matched Cohort Study
Authors: Assayag Jonathan , Forget Amélie , Kettani Fatima-Zohra , Beauchesne Marie-France , Moisan Jocelyne , Blais Lucie 
Published: January 2017

Objective: To compare adherence to, and persistence with, antidepressants (AD) in Quebec patients who are covered by private and public drug insurance. Method: A matched cohort study was conducted using prescription claims databases: reMed, a medication data registry for Quebec residents covered by private drug insurance, and Régie de l'assurance maladie du Québec database for Quebec residents with public drug insurance. Patients were aged 18 to 64 years and filled at least 1 prescription for an AD in monotherapy between December 2007 and September 2009 (194 privately and 2055 publicly insured patients). Adherence over 1 year was estimated using the proportion of prescribed days covered (PPDC). The difference in mean PPDC between patients with private and public drug insurance was estimated with linear regression. Persistence was compared between the groups with a Cox regression model. Results: The PPDC was 86.4% (95% CI 83.3% to 89.5%) in privately insured and 82.2% (95% CI 78.5% to 85.9%) in publicly insured patients and the adjusted mean difference was 5.1 % (95% CI 1.6% to 8.6%). Persistence was 51.0% in the private group and 19.7% in the public group at 1 year ( P < 0.001); the adjusted hazard ratio was 0.49 (95% CI 0.30 to 0.79). Conclusion: Better adherence and persistence were observed in privately insured patients. Adherence difference may be due to lower copayment among privately insured patients. L'effet du type de régime d'assurance sur l'observance des antidépresseurs et la persistance: une étude de cohorte appariée
Trouble bipolaire à début précoce: Validation par les études de mélange et les biomarqueurs
Authors: Geoffroy Pierre Alexis , Etain Bruno , Jamain Stéphane , Bellivier Frank , Leboyer Marion 
Published: January 2017

Objectifs: Le trouble bipolaire (TB) est une maladie multifactorielle de présentation clinique hétérogène, en particulier au niveau de l'âge de début (ADD). La pertinence d'un tel indicateur a été discutée et il est proposé dans les futures classifications nosographiques. Méthode: Nous avons effectué la synthèse systématique des études de mélange de distributions (ou dites d'admixture) ainsi que les biomarqueurs du TB à début précoce (TBDP). Résultats: Plusieurs arguments cliniques montrent que le TBDP est un sous-groupe cliniquement homogène qui présente des caractéristiques sévères et récurrentes. Huit études de mélange ont démontré l'existence de trois sous-groupes de patients souffrant du TB selon l'ADD (précoce, intermédiaire, et tardif) avec deux valeurs seuils de 21 (21,33 ans [ET 1,41]) et 35 ans (34,67 ans [ET 5,52]). Le sous-groupe du TBDP est caractérisé par: un taux plus élevé de tentatives de suicide, des cycles rapides, des mésusages d'alcool et drogues, des symptômes psychotiques et des comorbidités anxieuses. Des données génétiques, biologiques, d'imagerie et cognitives peuvent être considérées comme étant des marqueurs possibles de validité externe du TBDP. L'ajout de l'ADD dans les algorithmes de décision thérapeutique pourrait être intéressant même si le niveau de preuve est à consolider. Conclusion: La fréquence importante du TBDP (44,80 %) devrait pousser les cliniciens à une plus grande vigilance afin qu'ils apportent des stratégies préventives, un diagnostic et un traitement précoce à ces patients au tableau clinique particulièrement sévère. Cette pertinence clinique fait que le prochain DSM-5 devrait inclure l'ADD en tant que caractéristique du TB.
Effects of Age and Subtype on Emotional Recognition in Children with Anxiety Disorders: Implications for Cognitive-Behavioural Therapy
Authors: Lee Trevor Changgun , Dupuis Annie , Jones Emily , Guberman Carly , Herbert Monique , Manassis Katharina 
Published: January 2017

Objective: It remains unclear whether an anxiety diagnosis is associated with children's emotional recognition. We considered children's age and types of primary anxiety diagnosis, which have been neglected, to elucidate this relationship. Methods: Sixty-three referred children with anxiety disorder(s) and 59 volunteer children without anxiety disorder(s), aged between 6 and 11 years, were presented with animated characters, displaying a range of simple and complex emotions, for identification. Statistical analyses examined identification accuracy based on presence or absence of anxiety disorder, age, and types of primary diagnoses. Results: Children with anxiety disorder(s) as a group performed comparably to children without anxiety disorder(s) in identifying emotions ( z = −0.72, P = 0.47). In both groups, accuracy for disgust increased significantly each year of age ([anxiety group] OR 2.6; 95% CI 1.6 to 4.3, P < 0.001, [control group] OR 2.1; 95% CI 1.3 to 3.3, P = 0.002). When primary anxiety types were considered, while controlling for age, children with separation anxiety disorder (SAD) showed deficits in overall emotional recognition, compared with children with other subtypes or without anxiety ( P = 0.004). Further regression analyses showed that children with generalized anxiety disorder (GAD) presented significantly lower accuracy than children without anxiety disorder(s) at a young age, but the deficit disappeared with increased age. Conclusion: Children with anxiety disorder(s) as a group may not appear to be impaired in emotional recognition. However, when age and subtypes are considered, children with SAD and young children with GAD appear to have difficulty, compared with children without anxiety disorder(s).
A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with other Treatments
Authors: Cuijpers Pim , Berking Matthias , Andersson Gerhard , Quigley Leanne , Kleiboer Annet , Dobson Keith S 
Published: January 2017

Objective: No recent meta-analysis has examined the effects of cognitive-behavioural therapy (CBT) for adult depression. We decided to conduct such an updated meta-analysis. Methods: Studies were identified through systematic searches in bibliographical databases (PubMed, PsycINFO, Embase, and the Cochrane library). We included studies examining the effects of CBT, compared with control groups, other psychotherapies, and pharmacotherapy. Results: A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower ( g = 0.53) than for lower-quality studies ( g = 0.90). The difference between high- and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone ( g = 0.49). Conclusions: There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy.
Omega-3 Fatty Acid Supplementation in Adolescents with Borderline Personality Disorder and Ultra-High Risk Criteria for Psychosis: A Post Hoc Subgroup Analysis of a Double—Blind, Randomized Controlled Trial
Authors: Amminger G Paul , Chanen Andrew M , Ohmann Susanne , Klier Claudia M , Mossaheb Nilufar , Bechdolf Andreas , Nelson Barnaby , Thompson Andrew , McGorry Patrick D , Yung Alison R , Schäfer Miriam R 
Published: January 2017

Objective: To investigate whether long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve functioning and psychiatric symptoms in young people with borderline personality disorder (BPD) who also meet ultra-high risk criteria for psychosis. Methods: We conducted a post hoc subgroup analysis of a double-blind, randomized controlled trial. Fifteen adolescents with BPD (mean age 16.2 years, [SD 2.1]) were randomized to either 1.2 g/day n-3 PUFAs or placebo. The intervention period was 12 weeks. Study measures included the Positive and Negative Syndrome Scale, the Montgomery–Åsberg Depression Rating Scale, and the Global Assessment of Functioning. Side effects were documented with the Udvalg for Kliniske Undersøgelser. Fatty acids in erythrocytes were analyzed using capillary gas chromatography. Results: At baseline, erythrocyte n-3 PUFA levels correlated positively with psychosocial functioning and negatively with psychopathology. By the end of the intervention, n-3 PUFAs significantly improved functioning and reduced psychiatric symptoms, compared with placebo. Side effects did not differ between the treatment groups. Conclusions: Long-chain n-3 PUFAs should be further explored as a viable treatment strategy with minimal associated risk in young people with BPD.
Protective Factors for Mental Disorders and Psychological Distress in Female, Compared with Male, Service Members in a Representative Sample
Authors: Mota Natalie P , Medved Maria , Whitney Debbie , Hiebert-Murphy Diane , Sareen Jitender 
Published: January 2017

Objective: Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations. Method: Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. Results: In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Conclusions: Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.
Antenatal Depression in a Multi-Ethnic, Community Sample of Canadian Immigrants: Psychosocial Correlates and Hypothalamic-Pituitary-Adrenal Axis Function
Authors: Peer Miki , Soares Claudio N , Levitan Robert D , Streiner David L , Steiner Meir 
Published: January 2017

Objectives: Immigrant women living in Canada present with higher rates of prenatal depressive symptomatology than Canadian-born women; however, the associated psychosocial correlates remain understudied. Antenatal depression and stress negatively affect maternal health and infant development, in part through changes in maternal hypothalamic–pituitary–adrenal (HPA) axis activity. We aimed to examine the factors associated with prenatal depressive symptoms, including altered HPA axis function, in an ethnically diverse community sample of Canadian immigrant women. Methods: Seventy-eight pregnant immigrant women were recruited from the community at 19 weeks' gestation and provided information on health, mood, stressful life events (SLEs), and social support. Fifty-seven of these women also provided saliva samples for measurement of the cortisol awakening response and nighttime cortisol levels. Results: Seventeen per cent of the sample had a high level of prenatal depressive symptoms, and these women reported more perceived stress, more somatic symptoms, lower social support, and were less often working or attending school during pregnancy. Controlling for wake time, parity, and region of origin, high levels of prenatal depressive symptoms were associated with elevated nighttime cortisol levels, whereas SLEs were not associated with any measures of HPA axis activity. Conclusions: High levels of prenatal depressive symptoms are common in immigrant women living in Canada, and are associated with identifiable factors. Preliminary evidence suggests a similar pattern of HPA axis activity characterizing depressive symptomatology in this subpopulation as previously seen in clinically depressed patients.
Diagnostic Stability of First-Episode Psychotic Disorders and Persistence of Comorbid Psychiatric Disorders over 1 Year
Authors: Pope Megan A , Joober Ridha , Malla Ashok K 
Published: January 2017

Objective: Diagnostic stability is an important indicator of the reliability and validity of psychiatric diagnoses and has implications in clinical practice and research. While several studies have investigated the diagnostic stability of first-episode psychosis (FEP) disorders, less is known about psychiatric comorbidity in FEP and the persistence of such comorbid conditions over time. Our study aimed to confirm the diagnostic stability of FEP disorders and determine the variation in persistence of comorbid substance use disorders (SUDs), mood disorders, and anxiety disorders over 1 year. Method: The Structured Clinical Interview for DSM-IV-TR Axis I Disorders—Patient Edition was conducted at first presentation and repeated after 1 year (or reconstructed) for 214 FEP patients at the Prevention and Early Intervention Program for Psychoses–Montreal. Results: Psychotic disorder diagnoses were retained by 76.2% of patients at 1 year, schizophrenia being the most stable diagnosis (92.1%). Most diagnostic shifts were to schizophrenia and schizophrenia spectrum disorders. Comorbid SUDs, anxiety disorders, and mood disorders persisted for 50.7%, 64.0%, and 16.7% of patients, respectively. Many new cases of each of these disorders also emerged at 1-year follow-up. Conclusions: These findings demonstrate the stability of primary psychotic disorder diagnoses and greater fluidity of comorbid psychiatric diagnoses, with anxiety disorders persisting as comorbid conditions more than mood disorders and SUDs. These results highlight the importance of repeating a structured diagnostic assessment longitudinally, especially for consideration of comorbid conditions.