bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence Studies of Substance-Related Disorders: A Systematic Review of the Literature
Authors: Somers Julian M , Goldner Elliot M , Waraich Paul , Hsu Lorena 
Published: July 2017

Objective: To present the results of a systematic review of literature published between January 1, 1980, and December 31, 2000, that reports epidemiologic estimates of substance-related disorders. Method: We conducted a literature search of substance-related epidemiologic studies, using medline and HealthSTAR databases and applying a set of predetermined inclusion and exclusion criteria to identify relevant studies. We extracted and analyzed prevalence and incidence data for heterogeneity. Results: A total of 19 prevalence studies of substance-related disorders met inclusion criteria for this review. Heterogeneity analyses revealed significant variability across 1-year and lifetime prevalence of both alcohol and other substance use disorders. The corresponding 1-year and lifetime pooled rates were 6.6 per 100 and 13.2 per 100, respectively, for alcohol use disorders and 2.4 per 100 and 2.4 per 100, respectively, for other substance use disorders. We observed variability among countries and also among regions within the same country. In contrast to other drug problems, alcohol use disorders were substantially more common, were more likely to occur among male subjects, and were more likely to be associated with abuse symptoms. For other drugs, dependence was consistently more prevalent than abuse. Conclusions: Studies using rigorous and comparable methodologies report significant variability in rates of alcohol and other substance use disorders. These data suggest that different policies and regional practices are associated with variability in rates of disorders. Policy-makers and health planners require regular, regionally sensitive estimates of prevalence rates to respond effectively to unique patterns of need in their constituencies.
Stress and Psychological Impact on SARS Patients during the Outbreak
Authors: Chua Siew E , Cheung Vinci , McAlonan Grainne M , Cheung Charlton , Wong Josephine WS , Cheung Erik PT , Chan Marco TY , Wong Teresa KW , Choy Khai M , Chu Chung M , Lee Peter WH , Tsang Kenneth WT 
Published: July 2017

Objective: To examine stress and psychological impact in severe acute respiratory syndrome (SARS) patients during the 2003 outbreak. SARS is a novel, highly infectious pneumonia, and its psychological impact is still unclear. Method: At the peak of the outbreak, SARS patients ( n = 79) and healthy control subjects ( n = 145) completed the Perceived Stress Scale (PSS) and documented a range of psychological responses. Groups were balanced for age, sex, education, and living circumstances. Results: Stress was significantly higher in SARS patients than in healthy control subjects. Stress correlated significantly with negative psychological effects. Of SARS patients, 39% ( n = 30) were infected health care workers; these individuals reported significantly more fatigue and worries about health than did other patients. Of patients, 25% ( n = 20) requested psychological follow-up. Conclusions: General stress and negative psychological effects are increased in SARS patients, particularly among infected health care workers. This may increase the risk of mood and stress-related disorders. Functional impairment is apparent in the postrecovery phase.
The Psychosocial Effects of Being Quarantined following Exposure to SARS: A Qualitative Study of Toronto Health Care Workers
Authors: Robertson Emma , Hershenfield Karen , Grace Sherry Lynn , Stewart Donna Eileen 
Published: July 2017

Objective: To examine the psychosocial effects on health care workers of being quarantined because of exposure to severe acute respiratory syndrome (SARS). Method: We used semistructured qualitative interviews. Results: We identified 3 major themes concerning psychosocial effects: loss, duty, and conflict. Conclusions: Quarantined workers experienced stigma, fear, and frustration. We highlight the need for clear and easily accessible information on dealing with infectious diseases. Practical advice on coping and stress management techniques for health care workers are needed in preparation for potential future outbreaks of infectious diseases. Information on author affiliations appears at the end of the article.
Preventing Postpartum Depression Part I: A Review of Biological Interventions
Authors: Dennis Cindy-Lee E 
Published: July 2017

Objective: This paper critically reviews the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a biological perspective. Methods: The criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care. Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003. Results: Seven studies that met criteria were examined. These studies focused on evaluating the preventive effect of antidepressant medication, estrogen and progesterone therapy, thyroid therapy, docosahexanoic acid, and calcium supplementation. Although some of these interventions have been examined rigorously for depression unrelated to childbirth, methodological study limitations render intervention efficacy equivocal for PPD; thus, there is limited strong evidence to guide practice or policy recommendations. Conclusions: Despite the recent upsurge of interest in this area, many questions remain unanswered, which has several implications for research.
The RCPSC Oral Examination: Patient Perceptions and Impact on Participating Psychiatric Patients
Authors: Tibbo Philip , Templeman Kelly 
Published: July 2017

Objective: To investigate patient perceptions and the impact of participating in the Royal College of Physicians and Surgeons of Canada (RCPSC) long case oral examination. Method: Immediately following the RCPSC exam, participating psychiatric patients completed a Participant Impact Questionnaire. We combined results for 2002 and 2003 from both the western and eastern sites. Results: Overall, there was a 93% response rate (132/142): 98% (65/66) for the western site and 88% (67/76) for the eastern site. Of the respondents, 94% said they would participate in the RCPSC oral exam again, if required. Most (92%) either agreed or strongly agreed that the exam was well organized; 76% either disagreed or strongly disagreed that the exam was stressful; only 9% agreed that they participated to earn extra money; and 82% strongly disagreed that they felt pressured by their psychiatrist to participate. Patients' written reasons for participating included, but were not limited to, helping to train future psychiatrists. We briefly discuss aspects of the use of real patients vs standardized patients in the RCPSC oral exam. Conclusion: Patients who participated in the RCPSC long case oral exam generally found this experience very positive. The exam did not appear to have a negative impact on patients.
Relation between Prenatal Maternal Mood and Anxiety and Neonatal Health
Authors: Misri Shaila , Oberlander Tim F , Fairbrother Nichole , Carter Diana , Ryan Deirdre , Kuan Annie J , Reebye Pratibha 
Published: July 2017

Objective: To examine the relation between the mood and anxiety of pregnant, psychiatrically treated women and neonatal health outcomes after birth. Method: We prospectively assessed 46 women treated with psychotropic medications for anxiety and depression during pregnancy. We compared measures of maternal mental health with infant outcomes, in particular, the outcomes of infants with symptoms of poor neonatal adaptation. Results: The mothers of babies who demonstrated poor neonatal adaptation reported higher levels of anxiety and depression at study entry than did the mothers of healthy babies. This relation was not related to the presence or absence of treatment with clonazepam, an anxiolytic used to treat symptoms of anxiety. Further, increased psychiatric comorbidity in the mother was associated with a greater likelihood of transient symptoms in the newborn. Conclusions: Despite psychiatric treatment, the intensity and degree of comorbid symptoms appear to be related to poor transient neonatal health outcome. Our data suggest that, in addition to the impact of pharmacologic factors, maternal psychiatric status influences infant outcomes.
Preparing Psychiatry Residents for the Certification Exam: A Survey of Residency and Exam Experiences
Authors: Crockford David , Holt-Seitz Alana , Adams Beverly 
Published: July 2017

Objective: To determine which methods best prepare psychiatry residents for the certification exam, and ultimately for practice, to facilitate appropriate residency program curriculum changes. Method: We sent an anonymous survey to all final year (that is, PGY5) Canadian university–affiliated psychiatry residents, regarding frequency and diversity of observed interviews, form of feedback delivery, research and other training experiences, self-perception of preparedness and knowledge base, and management strategies for exam anxiety 6 months before and immediately after the certification exam. Results: There was a 52% response rate. Residents from across Canada identified the following factors as enabling successful exam completion: regular mock orals supervised by Royal College examiners, clinical experience with exposure to a wide spectrum of pathologies, individual and group study time, and appropriate anxiety management. Preparation for the oral exam involving sample case vignettes with presentation and formulation skills training was considered to be essential but was identified as an area of educational and experiential weakness in some programs. Conclusions: To prepare psychiatry residents for successful completion of their certification exam, programs should incorporate regular mock orals observed by Royal College examiners throughout residency training (not just in PGY2 and PGY5). Programs should also incorporate training in case vignettes, training in oral exam skills, and teaching of anxiety-management strategies.
International Dosage Differences in Fluoxetine Clinical Trials
Authors: Patten Scott , Cipriani Andrea , Brambilla Paolo , Nosè Michela , Barbui Corrado 
Published: July 2017

Objective: International differences are thought to exist in dosages used by clinicians treating mood disorders. This study examined international dosage differences in antidepressant clinical trials, using a database formed and maintained as a component of a Cochrane review of comparative clinical trials of fluoxetine. Methods: This systematic review included 132 studies. A detailed set of methodological features and results were abstracted from the original publications and entered into an electronic database. Mean and maximum fluoxetine dosages were compared across countries. To evaluate the dosages of comparison medications, a defined daily dosage (DDD) ratio was calculated as the trial mean dosage divided by the DDD for that drug. Results: Both the maximum and mean dosages for fluoxetine and comparison medications were higher in trials conducted in the US (fluoxetine weighted mean dosage 49.18 mg; 95%CI, 41.30 to 57.05), compared with trials conducted in Europe (fluoxetine weighted mean dosage 29.98 mg; 95%CI, 25.28 to 34.68). Since most clinical trials were conducted in Europe or the US, we could not determine whether different dosages tended to be used in other regions. Conclusions: International differences in prescriber behaviour may influence, and in turn be influenced by, the conduct of clinical trials. It is difficult to reconcile such differences with the principles of evidence-based medicine.
Panic-Agoraphobic Spectrum and Light Sensitivity in a General Population Sample in Italy
Authors: Bossini Letizia , Martinucci Mirko , Paolini Katia , Castrogiovanni Paolo 
Published: July 2017

Objective: This study aimed to verify a possible correlation between panic symptoms and photosensitivity, not only in panic disorder (PD) but also in the panic-agoraphobic spectrum. Method: One hundred and sixty-nine healthy and drug-free subjects completed the Structured Clinical Interview for Panic-Agoraphobic Spectrum–Lifetime version (SCI-PAS-Lifetime) and the Photosensitivity Assessment Questionnaire (PAQ). Results: The SCI-PAS-Lifetime total score was positively correlated with the total score of the PAQ photophobia subdimension ( r = 0.44; P < 0.001); the SCI-PAS-Lifetime total score was not significantly correlated with the photophilia subdimension. As photophobia increased, we observed significant score increases in all SCI-PAS-Lifetime domains. Bivariate correlation showed higher coefficient correlation between the panic-like symptoms domain and photophobia ( r = 0.44; P < 0.001). Conclusions: A high total score in the SCI-PAS-Lifetime, which denotes more typical features of the spectrum, is associated with a higher level of light sensitivity and intolerance toward bright stimuli. This finding reflects clinical evidence that widely documents photophobic behaviours in subjects with PD and the importance of light stimuli exposure during the onset and course of such a disorder. Bright stimulation seems to be relevant both in PD diagnosed according to current DSM criteria and in the entire panic-agoraphobic spectrum, from nuclear elements of the disorder through subclinical states to the normal condition.
Psychiatric Risk Factors for Motor Vehicle Fatalities in Young Men
Authors: Dumais Alexandre , Lesage Alain D , Boyer Richard , Lalovic Aleksandra , Chawky Nadia , Ménard-Buteau Carole , Kim Caroline , Turecki Gustavo 
Published: July 2017

Background: Motor vehicle accident (MVA) fatalities are an important cause of death in young men. Psychiatric disorders have been shown to be risk factors for MVA, but only a few studies have investigated MVA fatalities. Method: A case–control study was carried out comparing 61 young male MVA fatalities in which the subject was the driver with an equal number of living male subjects matched for age (case by case with no more than 1 year's difference between case subjects and control subjects) with the accident group. We assessed both groups, using structured interviews and psychological autopsies. Results: Our results suggest that cluster B personality disorders (borderline and [or] antisocial) (OR 3.54; 95%CI, 1.38 to 16.01) and substance use disorders in the last 6 months (OR 4.33; 95%CI, 1.42 to 9.25) increased the risk of dying in MVAs. In addition, we observed an age effect, where differences in cluster B personality disorders and substance use disorders in the last 6 months were only significantly more prevalent in case subjects aged 26 years or over, compared with control subjects of the same age. Drivers under age 25 years appeared to be comparable with control subjects on all measures of psychopathology. Finally, this interaction between cluster B personality disorders and age over 26 years was the only significant predictor of car fatalities (adjusted OR 16.25; 95%CI, 1.67 to 158.10). Conclusion: Borderline and antisocial personality disorders in which impulsive-aggressive behaviours play a central role and substance use disorders appear to be risk factors for young male deaths in MVAs. Interestingly, this effect seems to be specific to MVA case subjects aged 26 years or over.
Long-Term Outcome of Patients with Schizophrenia: A Review
Authors: Jobe Thomas H , Harrow Martin 
Published: July 2017

Objective: To review empirical studies that assess outcome of patients with schizophrenia and evaluate the degree to which reported outcome is affected by research methodology, treatment variables, prognostic factors, epidemiologic factors, and patient resilience. Method: We reviewed studies that used control subjects and lasted for a decade or more, comparing them with respect to research methodology and choice of outcome variables. Results: Like other mental illnesses and medical illness in general, the natural course of schizophrenia showed itself to have a threefold division of mild, moderate, and severe. Although a great deal of variance in outcome occurred across the studies reviewed, schizophrenia is nevertheless a disorder with relatively poor outcome. Patients with schizophrenia consistently showed poorer courses and outcomes than patients with other psychotic and nonpsychotic psychiatric disorders. On the positive side, subgroups of schizophrenia patients had extended periods of recovery—some without the benefit of extensive mental health aftercare treatment—and patients with schizophrenia did not show a progressive downhill course. Conclusion: While documenting the heterogeneity in outcome and the generally poorer outcomes of patients with schizophrenia, the studies reviewed also alert us to the danger of suicide and early death in schizophrenia. In addition, they expose problems in clinical management and treatment and also help us anticipate the possibility of intervals or periods of recovery, some of which appear spontaneously and may be tied to individual patient factors such as resilience.
Ambulatory Use of Olanzapine and Risperidone: A Population-Based Study on Persistence and the Use of Concomitant Therapy in the Treatment of Schizophrenia
Authors: Cooper Dan , Moisan Jocelyne , Gaudet Michel , Abdous Belkacem , Grégoire Jean-Pierre 
Published: July 2017

Objective: To assess treatment discontinuation and concomitant use of other antipsychotics among individuals initiated on olanzapine or risperidone for the treatment of schizophrenia. Method: Using data from the Quebec health insurance plan and the Quebec database for hospitalization, we conducted a population-based cohort study of patients for whom a first claim for olanzapine or risperidone was submitted between 1 January 1997 and 31 August 1999. Included were 6405 patients with schizophrenia whom we followed from the date of the first claim for olanzapine or risperidone either to discontinuation date, end of eligibility for the drug plan, 365 days, date of moving out of the province, or date of death. We used Cox regression models to compute hazards ratios (HRs) of having the treatment discontinued and logistic regression models to compute odds ratios (ORs) among persisting patients of having any concomitant antipsychotic prescription. All models were adjusted for age, sex, schizophrenia disorder, comorbidity, region, beneficiary type, substance use disorder, and prior hospitalization for mental illness. Results: Compared with risperidone users ( n = 2718), discontinuation rates were lower for olanzapine users ( n = 3687; HR = 0.79; 95%CI, 0.74 to 0.84). The odds of receiving any concomitant antipsychotic prescription did not differ statistically between olanzapine and risperidone users (OR 0.85; 95%CI, 0.71 to 1.01). Conclusions: The study results suggest that new users of olanzapine were less likely to discontinue their initial treatment than were new users of risperidone, although discontinuation was high in both groups. Among those who persisted, concomitant use of other antipsychotics did not differ between olanzapine users and risperidone users.
Comprehensive Gene Expression Analysis in Bipolar Disorder
Authors: Kato Tadafumi , Kakiuchi Chihiro , Iwamoto Kazuya 
Published: July 2017

Objective: To review recent findings by DNA microarray in bipolar disorder (BD). Method: A literature search was performed. Results: Comprehensive gene expression analysis in the brain, peripheral blood cells, and olfactory neuroepithelium would be a promising strategy for the research of BD. To date, alterations in glutamate receptors (GR), mitochondria-related genes, chaperone genes, oligodendrocyte genes, and markers of gamma amino butyric acidergic (GABAergic) neurons in postmortem brains are replicated by several different strategies. However, alterations in mitochondria-related genes are associated with agonal factors, sample pH, and effects of drugs. Analysis of blood cells showed altered endoplasmic reticulum stress pathway and other molecular cascades. Analysis of olfactory epithelium showed altered expression of genes associated with apoptosis. Conclusions: These findings warrant that comprehensive gene expression analysis by DNA microarray will be useful to identify the molecular cascades responsible for BD.
Epidemiologic Perspective on Chronic Pain Treatment
Authors: Tunks Eldon R , Weir Robin , Crook Joan 
Published: July 2017

Objective: To review the epidemiologic literature concerning psychosocial mediators of outcome in chronic pain. These factors deserve attention in the assessment and treatment of chronic pain by mental health professionals. Method: We reviewed literature dealing with epidemiologic perspectives on abuse, depression, addiction, employment, coping skills, and psychosocial problems. Treatments considered include analgesics, psychological rehabilitation, and prevention of disability. Results: Psychosocial factors such as abuse, mood disorder, employment handicap, poor coping skills, and other psychosocial problems are commonly found in chronic pain patients referred to clinics. Conclusion: Many psychosocial factors that can be identified in chronic pain sufferers are relevant to the professional skills of mental health professionals. These factors are determinants of prognosis, course, and outcome of chronic pain.
Expenditures on Mental Health and Addictions for Canadian Provinces in 2003/04
Authors: Jacobs Philip , Yim Rita , Ohinmaa Arto , Eng Ken , Dewa Carolyn S , Bland Roger , Block Ray , Slomp Mel 
Published: July 2017

Objective: To measure total public and private expenditures on mental health in each province. Method: Data for expenditures on mental health services were collected in the following categories: physician expenditures (general and psychiatrist fees for service and alternative funding), inpatient hospital (psychiatric and general), outpatient hospital, community mental health, pharmaceuticals, and substance abuse. Data for 2003/04 were collected from the Canadian Institute for Health Information (hospital inpatient and fees for service physicians), the individual provinces (pharmaceuticals, alternative physician payments, hospital outpatient, and community), and the Canadian Centre on Substance Abuse. Totals were expressed in terms of per capita and as a percentage of total provincial health spending. Results: Total spending on mental health was $6.6 billion, of which $5.5 billion was from public sources. Nationally, the largest portion of expenditures was for hospitals, followed by community mental health expenses and pharmaceuticals. This varied by province. Public mental health spending was 6% of total public spending on health, while total mental health spending was 5% of total health spending. Conclusions: Canadian public mental health spending is lower than most developed countries, and a little below the minimum acceptable amount (5%) stated by the European Mental Health Economics Network.