bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preferential Aggregation of Obsessive—Compulsive Spectrum Disorders in Schizophrenia Patients with Obsessive—Compulsive Disorder
Authors: Poyurovsky Michael , Fuchs Camil , Faragian Sarit , Kriss Victoria , Weisman Gregory , Pashinian Artashez , Weizman Ronit , Weizman Abraham 
Published: January 2017

Objective: To validate a complex association between schizophrenia and obsessive–compulsive disorder (OCD). Method: We used the Structured Clinical Interview for DSM-IV Axis I disorders to compare the rate of OCD spectrum and additional Axis I disorders in 100 patients who met criteria for both schizophrenia and OCD, non-OCD schizophrenia ( n = 100), and OCD ( n = 35). Results: There was a robust between-group difference in the number of patients with one or more OCD spectrum disorders (schizo-obsessive n = 30, compared with schizophrenia n = 8; P = 0.001), that is, higher rates of body dysmorphic (8% compared with 0%) and tic (16% compared with 4%) disorders. No difference was revealed in affective, anxiety, and substance use disorders. We found comparable rates of OCD spectrum disorders in the schizo-obsessive and OCD groups (30% and 42.8%, respectively; P = 0.32). Conclusion: Preferential aggregation of OCD spectrum disorders in the schizo-obsessive group supports this unique clinical association. Whether a schizo-obsessive interface represents comorbidity or a specific subtype of schizophrenia warrants further investigation.
The Incidence of Methylphenidate Use by Canadian Children: What is the Impact of Socioeconomic Status and Urban or Rural Residence?
Authors: Brownell Marni D , Mayer Teresa , Chateau Daniel 
Published: January 2017

Objective: To examine socioeconomic, demographic, and behavioural factors that influence the incidence of methylphenidate use among children aged 4 to 13 years. Method: A total of 11 316 children, aged 2 through 11 years, from Cycle 1 (1994–95) of the National Longitudinal Survey of Children and Youth were followed up 2 years later in Cycle 2 (1996–97). The outcome measure was methylphenidate use in Cycle 2. Individual-level explanatory variables included sex, age, socioeconomic status (SES), mother's age at birth of child, lone-parent family status, parental working status, and hyperactivity-impulsivity and inattention probabilities. Area-level explanatory variables included income and rural or urban residence. We used hierarchical linear modelling to examine individual- and area-level factors that predicted methylphenidate use. Results: The strongest predictors of methylphenidate use were behavioural: children with high hyperactive-impulsive and (or) inattention behaviours in 1994, compared with children low on these behaviours, were 4.5 to 6 times more likely to use methylphenidate 2 years later. SES remained a significant predictor of the incidence of methylphenidate use, even when other significant predictors were held constant, with lower SES being associated with higher use. Area-level income also predicted methylphenidate use. Conclusion: Even when children with similar behavioural symptoms and demographic characteristics were compared, socioeconomic factors had a significant impact on incidence of methylphenidate use.
Cost-Effectiveness of Memantine Compared with Standard Care in Moderate-to-Severe Alzheimer Disease in Canada
Authors: Gagnon Micheline , Rive Benoît , Hux Margaret , Guilhaume Chantal 
Published: January 2017

Objective: To conduct a cost-effectiveness analysis comparing the addition of memantine to standard care (that is, without acetylcholinesterase inhibitors) with standard care alone in moderate-to-severe Alzheimer disease (AD) in Canada. Methods: A 2-year Markov model estimated clinical effects in terms of quality-adjusted life years (QALYs) and time in complete dependence as well as societal costs in four 6-month cycles. Health states were defined by AD severity assessed with the Mini-Mental State Examination (moderate = 10 to 19; severe < 10), by level of dependence in activities of daily living, and by death. Transition probabilities were estimated by combining data of patients with moderate-to-severe AD from all relevant clinical trials. QALYs were estimated from a UK epidemiologic study. The initial distribution and use of medical and support services for each health state was obtained from the Canadian Study on Health and Aging with current estimates of frequency of use and unit prices applied. Results: Compared with standard care, the memantine strategy saved more than 1 month of complete dependence and produced 0.03 additional QALYs, with no additional cost. Probabilistic sensitivity analyses give an 83.3% chance that memantine treatment is cost-neutral, an 89.5% chance of its being cost-effective if the decision maker is willing to pay $20 000 for a QALY, and a 96.2% chance with a willingness to pay $100 000 per QALY. Robustness of results was confirmed through 1-way and scenario-based sensitivity analyses. Conclusions: Our evaluation found that memantine monotherapy produced relevant health benefit, compared with standard care alone, with no additional costs. Results are consistent with other economic evaluations of memantine conducted in Europe and the United States.
Pathological Gambling and the Psychiatric Emergency Service
Authors: Chaput Yves , Lebel Marie-Josée , Labonté Edith , Beaulieu Lucie , Paradis Michel 
Published: January 2017

Objective: Pathological gambling (PG) has been associated with several negative mental health outcomes. We attempted to assess the impact of PG at the level of the psychiatric emergency service (PES). Methods: In a first trial, clinical and demographic data were acquired from patients visiting the PES of a major university teaching hospital in downtown Montreal from July 1, 1996, to December 31, 2000. In a second trial, data were simultaneously acquired for a 2-year period in the above PES and in 3 others, beginning in September 2002. Results: In the first trial, from 2000 onward, the number of visits by PG patients to the PES increased by over 50%. In the second trial, the high level of PES use observed from 2000 onward in the first trial was similarly observed at all 4 PESs. The clinical and demographic characteristics of these patients were typical of help-seeking PG patients. They were, however, significantly less likely to be frequent users of the PES or to be hospitalized. Conclusion: Although still manageable, the clinical impact of PG on the PES increased significantly during the course of this study.
Psychosocial Rehabilitation and Psychiatry: What are the Boundaries?
Authors: Bachrach Leona L 
Published: January 2017

Objectives: 1. To examine the conceptual underpinnings of psychosocial rehabilitation and underscore its essential relationship to the practice of psychiatry. 2. To explore and dispel some misunderstandings and myths that practitioners in each field sometimes carry about the other. Method: Literature review and observation. Results: Psychiatry and psychosocial rehabilitation's shared emphasis on the biopsychosocial nature of mental illness forms a compelling basis for cooperative enterprise. Conclusions: Mentally ill persons are best served when the disciplines of psychiatry and psychosocial rehabilitation come together in a common cause.
Alcohol, Drugs and Gambling in the Ontario Adult Population, 1994
Authors: Smart Reginald G , Ferris Jacqueline 
Published: January 2017

Objective: To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems. Method: Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models. Results: The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking. Conclusions: The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possiblity of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.
Undue Mood Elevation in Unipolar Patients following Cessation of Lithium Augmentation Treatment: Implications for the Understanding of Mood Disorders
Authors: Hoaken Pcs , Hoaken Peter 
Published: January 2017

Objective: The precipitation of hypomania or mania in some patients with apparent unipolar (UP) depression by the use of antidepressants, lithium augmentation, or antidepressant withdrawal has been described in the literature. However, only 4 cases have been reported where undue mood elevation in UP patients followed lithium termination. To add to the literature, we report 2 cases where mood elevation followed cessation of lithium augmentation treatment. Method: Observations were continued on 2 patients receiving an antidepressant plus lithium augmentation after cessation of the lithium treatment. Result: There was undue mood elevation in these patients immediately following lithium termination. Conclusion: This observation supports the view that there is extensive vulnerability to bipolar disorder among patients with multiple depressions.
Ecg Changes in Pediatric Patients on Tricyclic Antidepressants, Desipramine, and Imipramine
Authors: Johnson Amanda , Giuffre R Michael , O'malley Keiran 
Published: January 2017

Objective: To determine if there is an altered pattern of cardiac electrical activity in children treated with tricyclic antidepressants, desipramine, or imipramine, which may predispose these patients to sudden death. Methods: All patients in a child psychiatry practice from 1989 to 1993 in Calgary, Alberta, treated with desipramine or imipramine with both pre- and post-treatment electrocardiograms (ECGs) were included in the study (n = 21; ages 8 to 17 years). Thirty-six blinded post-treatment ECGs were analysed for interval measurement and compared to the pretreatment ECGs. Results: Drug dosages ranged from 25 mg to 125 mg per day and treatment duration ranged from 1 to 49 months. Seven of 21 patients were concurrently receiving an antipsychotic medication (pericyazine). The maximal increase in PR, and QRS, and QT interval changes were 40 msec and 70 msec, respectively, with most patients demonstrating no significant changes in the ECG intervals. The QT interval was corrected for heart rate (QTC). No significant arrhythmias or tachycardias were observed. ECG interval changes were not related to drug dosage, age, treatment duration or plasma levels. Conclusions: No consistent pattern of ECG interval changes including the QTC interval was observed in children on desipramine and imipramine.
Key Features of Maltreatment of the Infirm Elderly in Home Settings
Authors: Mendonca James D , Velamoor Varadaraj R , Sauve Danielle 
Published: January 2017

Objective: To identify contributory factors of elder abuse by caregivers in home settings. Method: Using a reliable instrument, visiting nurses rated observations symptomatic of abuse and neglect found in their current caseload of elderly patients. Their observations were also classified as related or unrelated to wilful maltreatment. Results: Regression analysis produced the following significant findings: 1. signs of poor physical care were found to be predictors of physical abuse; 2. signs of psychosocial distress and exploitation were identified as predictors of emotional abuse; 3. defensiveness and irritability shown by caregivers and strained family relationships, in general, were also associated with abuse. Conclusion: It appears that emotional abuse is more prevalent than, and not a necessary precursor of, physical abuse; however, reliable signs of impending or actual abuse of the elderly can be found in a home during visitation.
Physician Resource Variables and Their Impact on the Future Pool of Research Expertise among Psychiatrists: The Canadian Association or Professors of Psychiatry and Canadian Psychiatric Association Survey
Authors: El-Guebaly Nady , Atkinson Mark 
Published: January 2017

Objective: To assess the impact of the increased proportion of female psychiatrists and trainees, the rapid reduction of international medical graduates allowed in the country, and the expanding number of practitioners with subspecialization on the future pool of psychiatrist researchers in Canadian academic departments of psychiatry. Method: A questionnaire was adapted to suit the Canadian milieu and distributed to a target population of 2484, including a core of 522 full-time faculty. Results: Female psychiatrists responding to the questionnaire reported less research involvement overall than their male counterparts. International medical graduates with both undergraduate and residency training abroad reported more research interests than other graduate categories. Respondents training in a subspecialty showed no difference in research commitment. Conclusions: Concerted efforts must be made to recruit, support, and retain female researchers. Particular attention must be paid to developing research expertise among Canadian medical graduates. The trend towards subspecialization influences only the selection of research topic.
A Critical Review of Recovered Memories in Psychotherapy: Part I—Trauma and Memory
Authors: Paris Joel 
Published: January 2017

Objective: The theoretical basis of the use of recovered memories in psychotherapy will be critically examined. Method: Literature will be reviewed on the nature of normal memory, and on the relationship of trauma to memory. Results: Normal memories are surprisingly inaccurate. There is little evidence that normal memories can be repressed. There is no evidence that trauma makes repression more likely. Conclusions: “Recovery” of repressed memories is not consistent with the findings of empirical research.
Syndrome de Capgras: Perspectives ouvertes par la neuropsychologie cognitive
Authors: Debruille Jacques B , Stip Emmanuel 
Published: January 2017

Objectif: Examiner la façon dont certaines idées, émises quant à la Physiopathologie du syndrome de Capgras (1), ont été mises à l'épreuve par des tests neuropsychologiques. Méthodes: Les données consistent en une trentaine d'études sélectionnées pour leur pertinence quant aux étapes cérébrales du traitement des visages chez les patients schizophrènes, les patients atteints du syndrome de Capgras, et les sujets normaux. Résultats: L'étude de ces travaux montre: a) qu'en ce qui concerne les patients, les auteurs se sont focalisés sur l'étape de traitement correspondant à la reconnaissance des visages per se; b) mais que l'on peut également étudier l'étape correspondant aux connaissances et croyances relatives aux personnes et évaluer l'existence du clivage proposé par de nombreux psychodynamiciens. Conclusions: Les vues provenant du champ de la neuropsychologie, comme du champ psychodynamique peuvent donc être mises à l'épreuve. En offrant le moyen d'élaborer des prédictions testables dans des protocoles expérimentaux, les méthodes de la neuropsychologie cognitive permettront, in fine, le rejet des idées erronées et la démonstration des idées justes. Nous militons pour que les méthodes soient appliquées au syndrome de Capgras comme à chacun des symptômes de schizophrénie.
The Varied Outcomes of Schizophrenia
Authors: Davidson Larry , McGlashan Thomas H 
Published: January 2017

Objective: To review variations in outcomes in schizophrenia across individual, historical, and cross-cultural boundaries, as well as within specific domains of functioning. Method: Research literature on the outcomes of schizophrenia appearing within the last 8 years was reviewed. Results: First, a review of follow-up studies published in the developed world suggests that heterogeneity in outcome across individuals with schizophrenia remains the rule, with affective symptoms, later and acute onset, and responsiveness to biological treatments predictive of good outcome. Negative symptoms are associated with poor outcome, cognitive impairments, and incapacity in social and work domains. Deterioration appears to occur within the first few months of onset if not already in the prodrome, with recent early-course studies finding longer duration of untreated psychosis associated with insidious onset, negative symptoms, social and work incapacity, and poor outcome. Second, a review of recent cross-cultural and historical studies provides evidence that outcome varies across time and place, schizophrenia having a more favourable outcome in the developing world and becoming a more benign disorder over the course of this century. Third, a review of studies of the domains of functioning within individuals identifies 4 relatively independent dimensions of depression and negative, psychotic, and disorganized symptoms. Cognitive deficits, which are associated with negative symptoms, also constitute a relatively stable dimension over time, showing neither marked deterioration nor improvement once established early in the course of disorder. Conclusions: The early appearance and stability over time of negative symptoms and cognitive impairments call for assertive intervention efforts early in the course of disorder to prevent chronicity and prolonged disability.
Who Applies to Regional Review Boards and What are the Outcomes?
Authors: Adams Susan J , Pitre Nancy L , Cieszkowski Rosa 
Published: January 2017

Objective: To determine the outcomes for patients following applications to regional review boards at an Ontario provincial psychiatric hospital for 1992 through 1994. Method: A retrospective casenote study examined frequency of readmission, time to next admission, status upon readmission, and episodes of dangerous behaviour perpetrated in the community for patients applying to review boards. Results: Over 3 years, 116 hearings took place to review various certificates. Only 57% of applications reached a hearing. Of those, 69% were confirmed and 31% rescinded. A small group of patients made multiple applications to the review board. Median time to next admission for patients who had certificates of involuntary admission rescinded by the review board was 14 days, compared with 53 days for those who remained in hospital until the time of planned discharge. Conclusion: Review boards consume considerable resources, serve only a small proportion of patients, and contribute to the “revolving door” phenomenon.
Epidemiology of Affective Disorders: A Review
Authors: Bland Roger C 
Published: January 2017

Objective: To review the epidemiology of affective disorders. Methods: This paper reviews recent studies, many of which have used standardized methodology and classification systems, and summarizes their major findings. It also presents trends with particular reference to major depression. Results: There have been major advances in the last 15 years, with many investigators using standard methods in different countries, cultures, and races. Rates of major depression are probably increasing, and both major depression and bipolar disorder are occurring at younger ages. Conclusions: Affective disorders present a major public health problem with poor recognition, diagnosis, and treatment. There is little coordinated action to reduce untreated morbidity despite the availability of reasonably safe, effective, and economical treatments and the established effectiveness of continuing education programs for providers.
Implications of Genetic Research for Child Psychiatry
Authors: Rutter Michael 
Published: January 2017

Objective: To review implications of genetic research in child psychiatry. Method: Key advances in quantitative and molecular genetics are noted and findings are summarized with respect to autism, attention-deficit hyperactivity disorder, oppositional defiant and conduct disorders, depression, schizophrenia, and Tourette's syndrome. Conclusions: Genetic findings will be helpful clinically in the elucidation of disordered brain processes, the understanding of nature–nurture interplay, diagnosis, genetic counselling, and pharmacotherapy.
Bipolar Disorder in Children and Adolescents: Current Challenges
Authors: Steele Margaret , Fisman Sandra 
Published: January 2017

Objective: To demonstrate the diagnostic and treatment challenges in juvenile-onset bipolar disorder. Method: Three case vignettes are outlined to demonstrate different bipolar presentations in children and adolescents. Results: These case examples illustrate important issues in the diagnosis and management of juvenile-onset bipolar disorder. These issues include diagnostic confusion with atypical initial presentation and the effect of developmental factors on symptom expression. The relationship among genetic risk, early affective instability, and the stress generated by affectively ill family members is complex and circular. Comorbidity with disruptive behaviour disorders, as well as anxiety disorders, is demonstrated by the cases discussed. Comorbid disorders may affect outcome and require separate treatment intervention. There is evidence for the prophylactic antimanic effect of lithium carbonate in children and adolescents, but its specificity as an antimanic agent is still uncertain. There is less evidence, at present, for effectiveness of other mood stabilizers in this age group, although sodium valproate may prove more effective in mixed mania and rapid cycling, which are so often seen with early-onset bipolar disorder. Conclusions: While the existence of juvenile-onset bipolar disorder is no longer in dispute, several outstanding issues related to diagnosis and long-term management remain. Careful prospective research will be necessary to sort out these issues definitively.