bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major Depression and Injury Risk
Authors: Patten Scott B , Williams Jeanne VA , Lavorato Dina H , Eliasziw Misha 
Published: January 2017

Objective: Cross-sectional epidemiologic studies have inconsistently reported associations between injuries and depressive symptoms. The significance of these findings remains unclear. Major depressive episodes (MDEs) may increase the risk of injury and injuries may increase the risk of MDEs. Longitudinal data are needed to distinguish between these possibilities. Method: Data from the Canadian National Population Health Survey (NPHS) were used in this analysis. The NPHS is a prospective study based on a representative sample of household residents in Canada. Injuries were evaluated using self-report items. MDE was assessed using the Composite International Diagnostic Interview-Short Form for major depression. Results: During each round of interviews, an association between MDE and injuries was evident. In longitudinal analyses a bidirectional association was found. MDEs increased the risk of injury (adjusted hazard ratio [HR] 1.6, 95% CI 1.3 to 2.0) and injury increased the risk of MDEs (adjusted HR 1.4, 95% CI 1.1 to 1.8). Conclusions: Injury prevention efforts may benefit from consideration of MDE as an injury determinant. For example, particular occupational or recreational activities may have a higher risk of injury during depressive episodes. Improved access to mental health resources in clinical settings where injuries are treated may also be valuable. However, additional studies are necessary to confirm these observations and to develop evidence-based interventions.
Use of School-Based Health Centres for Mental Health Support in Cape Breton, Nova Scotia
Authors: Szumilas Magdalena , Kutcher Stan , LeBlanc John C , Langille Donald B 
Published: January 2017

Objective: To determine whether students with self-reported needs for mental health support used school-based health centres (SBHCs) for this purpose. Method: A secondary analysis was conducted on self-reported data collected from 1629 high school students from Cape Breton, Nova Scotia. Descriptive statistics and logistic regression analyses were employed to determine the influence of sex, grade, sexual orientation, socioeconomic status (SES), school performance, social involvement, and health risk-taking behaviours on need for mental health support and use of SBHC for that purpose. Results: One-half of surveyed students reported needs for mental health support. Risk for depression was the most commonly reported indicator of need. Only 13% of students visited a SBHC nurse for mental health support, and 4 times as many females than males used the SBHC for this purpose (20.4%, compared with 5.3%, P < 0.001). There was a significantly increased likelihood of use of SBHC for mental health support, given the presence of a greater number of need factors. Multivariate logistic regression determined that female sex (OR 5.57, 95% CI 3.07 to 10.09), lower SES factor (OR 1.19, 95% CI 1.11 to 1.28), sexual health risk-taking behaviours (OR 1.72, 95% CI 1.28 to 2.31), and suicidal behaviour (OR 1.83, 95% CI 1.48 to 2.27) were significantly associated with the use of SBHCs for mental health support. Conclusions: Substantial need for mental health support and significant unmet need were observed. In particular, male students underused the services relative to their self-reported need. Implications for SBHCs and directions for future research are discussed.
La SUMD (Scale to Assess Unawareness of Mental Disorder): Validation et adaptation française dans une population de patients souffrant de schizophrénie
Authors: Raffard Stéphane , Trouillet Raphaël , Capdevielle Delphine , Gely-Nargeot Marie-Christine , Bayard Sophie , Larøi Franck , Boulenger Jean-Philippe 
Published: January 2017

Objectifs: L'objectif principal a été de mener la validation française de la Scale to Assess Unawareness of Mental Disorder (SUMD) auprès d'une population souffrant de schizophrénie. Méthode: Cent patients souffrant de troubles schizophréniques ont été inclus. Nos analyses statistiques ont évalué la fidélité inter-juges, la validité théorique, la validité convergente ou divergente. Finalement, une analyse factorielle exploratoire a été conduite. Résultats: Nos résultats montrent que la version francophone de la SUMD possède de bonnes qualités métrologiques. La fidélité inter-juges (CCI variant de 0,68 à 1,00) et la cohérence interne des facteurs (α de Cronbach > 0,70) sont satisfaisantes. La validité convergente ou divergente a été confirmée par des corrélations élevées entre les scores de la SUMD et le score G12 de l'échelle des syndromes positif et négatif (PANSS). Nous ne rapportons que peu de liens entre les scores de la SUMD et les variables cliniques. Enfin, nos analyses factorielles ACP confirment l'hypothèse de deux dimensions distinctes de l'insight (conscience, attribution) dans leurs aspects actuel et passé. Conclusion: La version française de la SUMD est une mesure fiable et valide de l'insight dans la schizophrénie. L'importance de mesurer l'insight et le développement d'interventions psychosociales afin d'améliorer l'insight des personnes souffrant de schizophrénie sont discutés.
Assessing the Prevalence of Nonmedical Prescription Opioid Use in the General Canadian Population: Methodological Issues and Questions
Authors: Fischer Benedikt , Nakamura Nadine , Ialomiteanu Anca , Boak Angela , Rehm Jürgen 
Published: January 2017

Objective: To assess the prevalence of nonmedical prescription opioid use (NMPOU) in the Canadian general adult population in the context of rising overall prescription opioid (PO) consumption and related problems in North America. Method: The prevalence of NMPOU was assessed as a multiitem construct in the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS; n = 16 672), an ongoing cross-sectional monthly random digit dialing telephone survey representative of the general Canadian population, aged 15 years and older. CADUMS data were collected between April and December of 2008 with a response rate of 43.5%. Results: About 22% of CADUMS respondents reported PO use in the last year, while 0.5% reported NMPOU during the same time frame. PO use was significantly higher among women than among men, and highest in the group aged 25 to 54 years. NMPOU was similar among men and women, and highest in the group aged 15 to 24 years. Conclusions: CADUMS data indicate an extremely low rate of NMPOU, especially given the levels of overall PO use, other PO-use related problems, and NMPOU levels estimated in the general US population where NMPOU has been assessed to be 10 times higher than in Canada. NMPOU survey item construction and response rates appear to strongly influence and potentially compromise NMPOU survey data. Existing NMPOU data and survey methods need to be validated for this important indicator in Canada, where increasing PO use and problem levels have been recognized as a significant and rising public health problem.
Prevalence of Pervasive Developmental Disorders among Children at the English Montreal School Board
Authors: Lazoff Tamara , Zhong Lihong , Piperni Tania , Fombonne Eric 
Published: January 2017

Objectives: The prevalence of pervasive developmental disorders (PDDs) has increased. There has been speculation regarding a role of thimerosal-containing vaccines (TCVs) in this trend. Our objectives were to determine prevalence rates of PDDs among school-aged children, and to evaluate the impact of discontinuation of thimerosal use in 1996 in routine childhood vaccines on PDD rates. Method: Children ( n = 23 635) attending kindergarten to Grade 11 were surveyed in 71 schools from the English Montreal School Board. For children with PDD, information was obtained about their diagnostic subtype, age, sex, grade, and school. Prevalence rates were calculated for the entire school population and for each grade. Prevalence rates were also compared for children born before or after 1996. Results: Students ( n = 187; male to female ratio: 5.4:1) with PDD were identified, corresponding to a prevalence of 79.1/10 000 (95% CI 67.8 to 90.4/10 000). The prevalence was 25.4, 43.6, 9.7, and 0.4 for autistic disorder, PDD not otherwise specified, Asperger syndrome, and childhood disintegrative disorder, respectively. During the study period, there was a significant linear increase in prevalence (OR 1.17 per year; 95% CI 1.12 to 1.23). The trend in prevalence of PDDs was unrelated to the discontinuation of TCVs. Conclusion: Our study provides additional evidence that the PDD rate is close to 1%. We estimate that at least 11 500 Canadian children aged 2 to 5 years suffer from a PDD. The reasons for the upward trend in prevalence could not be determined with our methods. Discontinuation of thimerosal use in vaccines did not modify the risk of PDD.
The Relation between Disease Severity and Cost of Caring for Patients with Alzheimer Disease in Canada
Authors: Herrmann Nathan , Tam Derrick Y , Balshaw Robert , Sambrook Robert , Lesnikova Nadia , Lanctôt Krista L ,   the Canadian Outcomes Study in Dementia (COSID) Investigators
Published: January 2017

Objectives: To characterize the cost of caring for an outpatient in Canada with Alzheimer disease (AD) based on disease severity, and to describe how costs change with increases in disease severity. Method: Community-dwelling patients with mild-to-moderate AD were enrolled in a 3-year, naturalistic, observational study. Assessments included cognition (Mini Mental Status Examination), global ratings (Global Deterioration Scale [GDS]), and daily function (Functional Autonomy Measurement System) as part of the Canadian Outcomes Study in Dementia. Direct (medical and nonmedical) and indirect costs were collected using resource use questionnaires. Costs at baseline were compared with costs at follow-up and correlated with disease severity. Results: Total costs associated with treating AD were significantly higher with greater disease severity. The mean total cost to treat patients with very mild AD (GDS = 2) was $367 per month, compared with $4063 per month for patients with severe or very severe AD (GDS = 6). From baseline to follow-up, the greatest changes in cost were observed in the group of patients with the most severe AD as measured by all scales. The largest component of total cost was indirect costs at most severity levels, though medication costs contributed the most in patients with very mild AD. Significant independent contributors to cost were being female, having more impaired activities of daily living, and exhibiting more neuropsychiatric symptoms. Conclusions: Costs for treating a patient with AD were strongly associated with disease severity, even though none of the patients were institutionalized. Delaying the progression of AD may reduce indirect costs and burden to caregivers.
Canadian Youth Born Large or Small for Gestational Age and Externalizing and Internalizing Problems
Authors: Van Lieshout Ryan J , Boyle Michael H 
Published: January 2017

Objective: To determine if youth born large for gestational age (LGA; birth weight above the 95th percentile) or small for gestational age (SGA; less than the fifth percentile) are at an increased risk of developing symptoms of externalizing and internalizing problems. Method: Data on members of the Ontario Child Health Study aged 4 to 16 years were used to examine associations between LGA, SGA, and psychopathology. This sample consisted of 2923 youth about whom parent, teacher, and self-reported levels of internalizing and externalizing symptoms were available, and whose caregivers retrospectively reported birth weight and gestational age (GA). Psychopathology was assessed using the Diagnostic and Statistical Manual of Mental Disorders–oriented scales derived from the Child Behavior Checklist. Results: Multilevel linear regression analyses revealed that after adjustment for parental psychopathology, socioeconomic disadvantage, sex, age, maternal age, birth order, and child health and school performance, youth born LGA had higher scores on the self-reported externalizing scale (1.39, 95% CI 0.01 to 2.78), but not internalizing scale, compared with youth born at an appropriate weight for GA (10th to 90th percentile). Parent and teacher ratings generally supported these findings in direction but did not reach statistical significance. Youth and parents reported increased levels of externalizing and internalizing symptoms in youth born SGA, but these were not statistically significant. Conclusions: Youth born above the 95th percentile for GA manifest increased levels of externalizing symptoms. Given increasing rates of macrosomic births, further study is warranted to replicate and determine the clinical significance of these findings, the contribution of the antecedents of LGA to this risk and the extent to which this association may be causal.
Winning and Losing: An Evolutionary Approach to Mood Disorders and Their Therapy
Authors: Sloman Leon , Sturman Edward D , Price John S 
Published: January 2017

Objective: To advance a new evolutionary model that examines the effects of winning and losing on mood and physiological variables. Previous studies have focused on the involuntary defeat strategy in de-escalating conflict. Here, we propose that there also exists an involuntary winning strategy (IWS) that is triggered by success and characterized by euphoria and increased self-confidence. It motivates efforts to challenge, and promotes reconciliation. Method: Previous studies are presented, including data on student athletes, demonstrating the impact of winning and losing on mood. Results: Winning is consistently shown to be related to physiological changes such as increased testosterone and serotonin levels in primates. It reliably leads to mood changes that serve to motivate winners to continue their competitive efforts. Conclusion: When the IWS functions optimally, success leads to success in an adaptive cycle. Over time, the initial differences between the winners and losers of agonistic encounters become magnified in a process known as difference amplification. As a result of assortative mating, the children of people who have entered into an adaptive cycle will inherit traits from both parents that will, in turn, give them an increased competitive advantage. In this manner, difference amplification could have accelerated human evolution by natural selection. Vignettes of clinical interventions are also used to illustrate therapeutic strategies designed to disrupt maladaptive cycles and promote adaptive behaviour.
Postdischarge Care for Depression in Ontario
Authors: Lin Elizabeth , Diaz-Granados Natalia , Stewart Donna E , Bierman Arlene S 
Published: January 2017

Objective: People hospitalized for depression are often discharged before the acute phase of their illness has resolved and need timely care transitions to prevent relapse. We examined 30-day postdischarge service use for Ontarians, aged 15 years or older, who were hospitalized for depression. We focused on a pattern consistent with guideline and policy directions: higher rates of physician visits, postdischarge, combined with lower rates of emergency department (ED) admissions or rehospitalization. Methods: Administrative data for the fiscal year of 2005 were used to identify hospitalizations for depression and subsequent physician visits, ED admissions, or readmissions for depression within 30 days, postdischarge. Sex, age, income, and geographic location were examined along with the relation between health care resources (beds, EDs, and physicians) and postdischarge service use. Results: Sixty-three percent of patients discharged for depression were followed, within 30 days, by a physician visit for depression. Twenty-five percent were either rehospitalized or visited an ED. Women and people from urban or high income areas were more likely to have postdischarge physician visits. Readmissions and ED visits were correlated with number of EDs, but postdischarge physician visits were not related to the number of general practitioners, family physicians, and psychiatrists in the local area. Conclusion: One-third of Ontarians hospitalized for depression did not receive recommended follow-up outpatient care within 30 days of discharge and one-quarter received follow-up through ED visits or readmissions, highlighting the need to improve coordination and integration across care settings for these patients. There are tested transitional and outpatient models that improve quality and outcomes of depression care that merit serious consideration.
The Association of Treatment of Depressive Episodes and Work Productivity
Authors: Dewa Carolyn S , Thompson Angus H , Jacobs Phillip 
Published: January 2017

Objective: About one-third of the annual $51 billion cost of mental illnesses is related to productivity losses. However, few studies have examined the association of treatment and productivity. The purpose of our research is to examine the association of depression and its treatment and work productivity. Methods: Our analyses used data from 2737 adults aged between 18 and 65 years who participated in a large-scale community survey of employed and recently employed people in Alberta. Using the World Health Organization's Health and Work Performance Questionnaire, a productivity variable was created to capture high productivity (above the 75th percentile). We used regression methods to examine the association of mental disorders and their treatment and productivity, controlling for demographic factors and job characteristics. Results: In the sample, about 8.5% experienced a depressive episode in the past year. The regression results indicated that people who had a severe depressive episode were significantly less likely to be highly productive. Compared with people who had a moderate or severe depressive episode who did not have treatment, those who did have treatment were significantly more likely to be highly productive. However, about one-half of workers with a moderate or severe depressive episode did not receive treatment. Conclusions: Our results corroborate those in the literature that indicate mental disorders are significantly associated with decreased work productivity. In addition, these findings indicate that treatment for these disorders is significantly associated with productivity. Our results also highlight the low proportion of workers with a mental disorder who receive treatment.
Responses to Mental Health Stigma Questions: The Importance of Social Desirability and Data Collection Method
Authors: Henderson Claire , Evans-Lacko Sara , Flach Clare , Thornicroft Graham 
Published: January 2017

Objective: To evaluate the impact on the general public of England's Time to Change program to reduce mental health-related stigma and discrimination using newly developed measures of knowledge and intended behaviour regarding people with mental health problems, and an established attitudes scale, and to investigate whether social desirability affects responses to the new measures and test whether this varies according to data collection method. Method: The Mental Health Knowledge Schedule (MAKS) and Reported and Intended Behaviour Scale (RIBS) were administered together with the 13-item version of the Marlowe-Crowne Social Desirability Scale to 2 samples (each n = 196) drawn from the Time to Change mass media campaign target group; one group was interviewed face to face, while the other completed the measures as an online survey. Results: After controlling for other covariates, interaction terms between collection method and social desirability were positive for each instrument. The social desirability score was associated with the RIBS score in the face-to-face group only (β = 0.35, 95% CI 0.14 to 0.57), but not with the MAKS score in either group; however, MAKS scores were more likely to be positive when data were collected face to face (β = 1.53, 95% CI 0.74 to 2.32). Conclusions: Behavioural intentions toward people with mental health problems may be better assessed using online self-complete methods than in-person interviews. The effect of face-to-face interviewing on knowledge requires further investigation.
Protective Associations of School Connectedness with Risk of Depression in Nova Scotia Adolescents
Authors: Langille Don , Rasic Daniel , Kisely Steve , Flowerdew Gordon , Cobbett Shelley 
Published: January 2017

Objective: To determine whether school connectedness demonstrated an independent protective association with risk of depression in students in grades 10 to 12 attending a high school in a rural community in southwestern Nova Scotia. Methods: Students at a high school in rural Nova Scotia participated in a self-completion survey in May 2009. Students were asked about a wide range of health-related factors to determine their needs for health services and promotion. Examining girls and boys separately, we used logistic regression to examine associations of an established measure of school connectedness with risk of depression as measured by the 12-item Center for Epidemiologic Studies Depression (CES-D) Scale, while including numerous potential confounding variables in our models. Results: The response rate was 95.2% among registered students present in class during the survey. Four hundred eight students (216 girls and 192 boys) completed both the CES-D12 and the School Connectedness Scale. Higher school connectedness was independently protective of risk of depression in girls (OR 0.85; 95% CI 0.78 to 0.93, P < 0.01) and in boys (OR 0.81; 95% CI 0.71 to 0.91, P < 0.01). Conclusions: Among adolescents in rural Nova Scotia, higher school connectedness has protective associations with risk of depression in both girls and boys, independent of a wide range of factors known to be associated with depression in adolescents. School may be a key place for helping adolescents to develop positive mental health.
Comparative Safety of Antipsychotics: Another Look at the Risk of Diabetes
Authors: Moisan Jocelyne , Turgeon Mélanie , Desjardins Olivier , Grégoire Jean-Pierre 
Published: January 2017

Objective: The association between the use of antipsychotics and diabetes mellitus (DM) is still unclear, as depicted by several conflicting reports. Our study aims to assess the risk of DM in new users of antipsychotics. Methods: Our nested case–control study used the Quebec Health Insurance Board databases. People in the source cohort were DM-free and had initiated an antipsychotic treatment. Subjects were cohort members who initiated an antidiabetic or had a diagnosis of DM during their follow-up period. Three variables were used to assess antipsychotic exposure: the antipsychotic used (any typical, clozapine, olanzapine, quetiapine, risperidone, or more than 1 drug); the number of 30-day periods of use; and antipsychotic use at index date (current or past). A paired multivariate logistic regression model was used to calculate adjusted odds ratios. Results: Among the 88 467 people included in the cohort, 6109 subjects with DM were identified and were matched to 61 090 control subjects. New users of quetiapine were less likely to develop DM than new users of typical antipsychotics (OR, 0.89; 95% CI 0.81 to 0.99). The risk of DM was not statistically different across the atypical antipsychotics. A longer exposure to any antipsychotic (for each 30-day period, OR 1.009; 95% CI 1.006 to 1.011) and current use of antipsychotics (OR 1.26; 95% CI 1.17 to 1.36) were associated with DM. Conclusion: These results suggest that metabolic parameters of people exposed to antipsychotics should be monitored, irrespective of the drug taken, among the drugs available at the time of analysis. Innocuité comparative des antipsychotiques: un autre regard sur le risque de diabète