bluuebunny/crossref_metadata_2025_split huggingface dataset:
Les Réponses des Clients Souffrant de Troubles Psychiatriques et de Toxicomanie et Fréquentant des Ressources Pour Les Personnes Itinérantes Sont-Elles Valides?
Authors: Bonin Jean-Pierre , Fournier Louise , Blais Régis , Perreault Michel , White Noé Djawn 
Published: July 2017

Objectif: Vérifier la validité des réponses autodéclarées de clients souffrant de troubles mentaux et de toxicomanie et fréquentant des ressources pour personnes itinérantes de Québec et de Montréal quant à leur utilisation des services. Méthode: Comparer les données autodéclarées relatives à l'utilisation des services provenant d'une vaste enquête de santé auprès de la clientele de ressources pour personnes itinérantes (Fournier, 2001) avec des données administratives du Québec en matière de santé (MED-ÉCHO et RAMQ). Résultats: Les analyses démontrent des taux de concordance de modérés à élevés entre les réponses autodéclarées et les données officielles. La plupart des items analysés présentent des coefficients de corrélation intraclasse significatifs et modérés pour les hospitalisations générales et psychiatriques et l'utilisation de médicaments psychiatriques, et significatifs mais faibles pour les hospitalisations en santé physique. Les caractéristiques des participants, comme les troubles mentaux, le statut domiciliaire et la consommation de substances ne semblent pas avoir d'effet sur la validité des réponses données. Conclusions: Les réponses des personnes présentant des problèmes de santé mentale, de statut domiciliaire et de consommation de substances concernant l'utilisation des services de santé s'avèrent généralement valides. Les réponses autodéclarées de ces personnes semblent donc être une source de données généralement fiable et peu coûteuse lors de recherches sur l'utilisation des services ou tout autre domaine.
No-Suicide Agreements: Current Practices and Opinions in a Canadian Urban Health Region
Authors: Page Stacey A , King Michael C 
Published: July 2017

Objective: To determine the extent to which no-suicide agreements (NSAs)—one method of intervening with people at risk of suicide—are used by a population of outpatient mental health therapists in a Canadian urban health region, and to describe therapists' perceptions and practices surrounding their use. Method: The survey was mailed to 516 therapists, including psychiatrists, psychologists, nurses, social workers, and occupational therapists. Results: Completed surveys were returned by 312 therapists (response rate = 60.5%). NSAs were used by 83%, although 43% had no formal training in their use. Among those who had used NSAs, 31% reported having had at least one patient attempt or complete suicide while an agreement was in place. Therapists from nonmedical disciplines were most likely to have used these agreements. Most therapists believed NSAs communicated care and concern to patients. Respondents were divided in their perceptions of whether NSAs afforded liability protection in the event of a patient suicide. Contextual factors associated with the perceived degree of suicide risk, the patient–therapeutic relationship influenced a therapist's use of NSAs. Most therapists attempted to have patients admitted to hospital if the patient refused to enter into an NSA. Conclusions: Use of NSAs is prevalent in this population of outpatient psychotherapists, suggesting that these therapists believe they are a useful intervention in the management of suicidal patients. Practitioners might benefit from increased formal training opportunities in the use and legal implications of NSAs.
Toward a Hippocratic Psychopharmacology
Authors: Ghaemi S Nassir 
Published: July 2017

Objective: To provide a conceptual basis for psychopharmacology. Method: This review compares contemporary psychopharmacology practice with the Hippocratic tradition of medicine by examining the original Hippocratic corpus and modern interpretations (by William Osler and Oliver Wendell Holmes). Results: The Hippocratic philosophy is that only some, not all, diseases should be treated and, even then, treatments should enhance the natural healing process, not serve as artificial cures. Hippocratic ethics follow from this philosophy of disease and treatment. Two rules for Hippocratic medicine are derived from the teachings of Osler (treat diseases, not symptoms) and Holmes (medications are guilty until proven innocent). The concept of a diagnostic hierarchy is also stated explicitly: Not all diseases are created equal. This idea helps to avoid mistaking symptoms for diseases and to avoid excessive diagnosis of comorbidities. Current psychopharmacology is aggressive and non-Hippocratic: symptom-based, rather than disease oriented; underemphasizing drug risks; and prone to turning symptoms into diagnoses. These views are applied to bipolar disorder. Conclusions: Contemporary psychopharmacology is non-Hippocratic. A proposal for moving in the direction of a Hippocratic psychopharmacology is provided.
Alcohol Factors in Suicide Mortality Rates in Manitoba
Authors: Mann Robert E , Zalcman Rosely Flam , Rush Brian R , Smart Reginald G , Rhodes Anne E 
Published: July 2017

Objective: To identify alcohol-related factors that influence mortality rates from suicide. Method: We examined the impact of per capita consumption of total alcohol, spirits, beer, and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total, male and female suicide mortality rates in Manitoba during 1976 to 1997. Time series analyses with autoregressive integrated moving average modelling were applied to total, male and female suicide rates. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines. Results: Total alcohol consumption, and consumption of beer, spirits, and wine individually, were significantly and positively related to female suicide mortality rates. Spirits and wine were positively related to total and male mortality rates. AA membership rates were negatively related to total and female suicide rates. Unemployment rates were positively related to male and total suicide rates. Conclusions: The data confirm the important relations between per capita consumption measures and suicide mortality rates. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and alcohol abuse treatment can exert beneficial effects observable at the population level.
Suicide in Newfoundland and Labrador: A Linkage Study Using Medical Examiner and Vital Statistics Data
Authors: Edwards Nicole , Alaghehbandan Reza , MacDonald Don , Sikdar Khokan , Collins Kayla , Avis Simon 
Published: July 2017

Objective: To examine suicide epidemiology in Newfoundland and Labrador from 1997 to 2001. Method: Data from the Office of the Chief Medical Examiner (CME) were linked with data derived from the Canadian Vital Statistics Death Database. Ninety-five percent confidence intervals (CI) were calculated to assess variation of rates. We used the chi-square test to compare categorical data. Results: The CME recorded 225 suicide deaths, compared with 187 in the Canadian Vital Statistics Death Database. Most deaths not coded as suicide in the national database were coded as accidental. Using the CME data, the overall suicide rate was 9.5/100 000, aged 10 years and older. The rate among males (15.8/100 000, 95%CI, 10.7 to 20.8) was almost 5 times that of females (3.3/100 000; 95%CI, 1.0 to 5.5). Age-standardized rates decreased over the study period, from 10.9 to 8.0/100 000; however, the difference was not significant. The proportionate mortality ratio for suicide deaths was highest among those aged 10 to 19 years (20.0%) and decreased with age. The suicide rate was highest among those aged 50 to 59 years. The rate for unpartnered individuals (17.0/100 000, 95%CI, 10.7 to 23.0) was significantly higher, compared with partnered individuals (5.1/100 000; 95%CI, 2.5 to 7.8). Males used more violent methods than females. Suicide was significantly higher in Labrador (27.7/100 000, 95%CI, 18.4 to 37.0), an area with a higher Aboriginal population, compared with the island of Newfoundland (8.5/100 000, 95%CI, 7.3 to 9.7). Psychiatric illness was the most common predisposing factor. Conclusions: Suicide deaths are highest among males, unpartnered individuals, and individuals with psychiatric disorders.
Lithium Treatments: Single and Multiple Daily Dosing
Authors: Ljubicic Dulijano , Letica-Crepulja Marina , Vitezic Dinko , Bistrovic Ivana Ljubicic , Ljubicic Rudolf 
Published: July 2017

Objective: To review the feasibility and effectiveness of single daily dosing of lithium in patients with affective disorder and to discuss advantages and disadvantages of this schedule of administration. Method: A comprehensive search of the literature was conducted using a combination of electronic databases and a search of reference lists and relevant journals. English-language articles were selected for the review if they discussed the issues comparing multiple and single daily dosing schedules of lithium. Results: We found 9 comparative studies. Single daily dosing of lithium causes transient higher peak lithium concentrations; however, no comparative study revealed a significant difference in side effects between multiple and single daily dosing groups. Numerous reports concluded that taking lithium in a single dose prevents, or at least limits, the increase in urine output (and the reduction of osmolality) and subsequent thirst. There is no evidence that a single lithium dosing schedule preserves glomerular function. Conclusion: According to the presented data, it could be reasonable to use lithium as a single evening dose in patients who can tolerate this schedule because no studies have suggested any benefit from administration of multiple daily doses. Possible advantages of single daily dosing, especially in improved compliance, could not be veiled by disadvantages of transient and mild postabsorptive side effects.
Prevention Inherent in Services for Women with Schizophrenia
Authors: Seeman Mary V 
Published: July 2017

Objective: Effective care to women with serious mental illness provides an opportunity for prevention of mental health problems in their offspring. The objective of this study is to outline the preventive possibilities of a service targeted to women with schizophrenia. Method: An analysis of recently published literature on women suffering from schizophrenia, focusing on intervention. Results: Genetic counselling, prenatal care, prevention of obstetrical complications, substance abuse reduction, appropriate antipsychotic treatment, parenting support, safety issues, quality of life, ethics, cultural competence, and advocacy are components of a comprehensive service to women with schizophrenia. Conclusions: These components improve maternal health and, by also ensuring fetal and neonatal health, are potentially preventive against schizophrenia in the second generation.
Effect of Olanzapine and Risperidone on Subjective Well-Being and Craving for Cannabis in Patients with Schizophrenia or Related Disorders: A Double-Blind Randomized Controlled Trial
Authors: van Nimwegen Lonneke J , de Haan Lieuwe , van Beveren Nico JM , van der Helm Mischa , van den Brink Wim , Linszen Don 
Published: July 2017

Objective: To examine whether subjective well-being and craving for cannabis were different in patients with schizophrenia or related disorders treated with either olanzapine or risperidone. Method: A 6-week, double-blind, randomized trial of olanzapine and risperidone was carried out in 128 young adults with recent onset schizophrenia or related disorders. Primary efficacy measures were the mean baseline-to-endpoint change in total scores on the Subjective Well-Being under Neuroleptics scale, the Obsessive–Compulsive Drug Use Scale, the Drug Desire Questionnaire, and the cannabis use self-report. An analysis of covariance was used to test between-group differences. Results: Estimated D2 receptor occupancy did not differ between olanzapine ( n = 63) and risperidone ( n = 65). Similar improvements in subjective well-being were found in both groups. In the comorbid cannabis-using group ( n = 41, 32%), a similar decrease in craving for cannabis was found in both treatment conditions. Conclusions: Both olanzapine and risperidone were associated with improved subjective well-being. No evidence was found for a differential effect of olanzapine or risperidone on subjective experience or on craving for cannabis in dosages leading to comparable dopamine D2 occupancy. Objectif: Examiner si le bien-être subjectif et l'état de manque de cannabis étaient différents chez les patients souffrant de schizophrénie ou de troubles connexes traités à l'olanzapine ou à la rispéridone.
Comparing the Clinical Presentation of First-Episode Psychosis across Different Migrant and Ethnic Minority Groups in Montreal, Quebec
Authors: van der Ven Elsje , Bourque François , Joober Ridha , Selten Jean-Paul , Malla Ashok K 
Published: July 2017

Objective: To explore differences in severity and nature of symptoms of first-episode psychosis (FEP) according to ethnic group and migrant status. Method: We administered rating scales to assess positive and negative symptoms, as well as general psychopathology, to 301 consecutive patients presenting with an FEP within a defined catchment area in Montreal, Quebec, classified according to ethnicity and migrant status. Symptom scores of Euro-Canadian patients without a recent history of migration, that is, the reference group ( n = 145), were compared with those of African and Afro-Caribbean ( n = 39), Asian ( n = 27), Central and South American ( n = 15), Middle Eastern and North African ( n = 24), and European and North American ( n = 39) patients. Results: Except for referral source, there were no significant differences between ethnic groups on any demographic variables. The African and Afro-Caribbean group had a higher level of negative symptoms (especially alogia) and general psychopathology scores on the Positive and Negative Syndrome Scale (especially, uncooperativeness, preoccupation, and poor attention), compared with the reference group. Ethnic groups did not differ on the Scale for the Assessment of Positive Symptoms scores. Conclusions: A comparison of FEP patients from different ethnic groups and native-born Euro-Canadians revealed no significant differences in the nature of positive symptoms at first presentation or in age at onset, suggesting that there was no evidence for the hypothesis that ethnic minorities are misdiagnosed as psychotic. Increased severity of negative symptoms and general psychopathology, specifically among the black ethnic minority group, may have implications for the role of ethnicity for the treatment and outcome of the initial episode of psychotic disorders.
Perceived Relational Evaluation as a Predictor of Self-Esteem and Mood in People with a Psychotic Disorder
Authors: Norman Ross M G , Windell Deborah , Lynch Jill , Manchanda Rahul 
Published: July 2017

Objective: There is evidence that social support predicts self-esteem and related moods for people with psychotic disorders. However, there has been little investigation of relative importance of specific components of social support. Evidence from social psychology suggests that perceived relational evaluation (PRE) or the extent to which people see others as valuing them, is a particularly important determinant of self-esteem and mood. Our study compared the importance of PRE and other types of social support, in predicting self-esteem and depressive mood, anxiety, and anger-hostility in a sample of patients in an early intervention program for psychotic disorders. Method: One hundred and two patients of the Prevention and Early Intervention Program for Psychoses in London, Ontario, completed measures of PRE, appraisal, tangible and general emotional social support, self-esteem, and mood. In addition, ratings of positive and negative symptoms were completed for all participants. Results: In general, perceived relational value was the most important predictor of self-esteem and mood. These relations were not a result of confounding with positive or negative symptoms. Conclusions: PRE appears to be a particularly important aspect of social support in predicting self-esteem and mood states. Possible implications of these findings and future research directions are discussed.
Conformance to Evidence-Based Treatment Recommendations in Schizophrenia Treatment Services
Authors: Addington Donald , McKenzie Emily , Smith Harvey , Chuang Henry , Boucher Stephen , Adams Beverly , Ismail Zahinoor 
Published: July 2017

Objective: To assess quality of health care provided in a representative Canadian mental health service using conformance to evidence-based treatment recommendations, and to examine differences from published US results. Method: We used a cross-sectional cohort design involving a randomly selected sample of patients diagnosed with schizophrenia attending 1 of 3 mental health clinics in 1 Canadian regional health system. The sample size was calculated to detect differences with the US sample. Conformance criteria were based on a published protocol. Data were collected using patient interviews and a structured review of health records. Conformance to 9 key Schizophrenia Patient Outcomes Research Team recommendations was assessed. Results: Conformance ranged between 58% and 90% for pharmacological recommendations, and 0% to 81% for psychosocial recommendations. No patients who met criteria for assertive case management had been referred to an assertive case management team. Significant differences in conformance rates to some treatment recommendations were found between Canadian and published US results. Conclusions: It proved possible to assess health care quality using process measures of conformance to treatment recommendations. Conformance to clinical recommendations for pharmacotherapy is higher than for psychosocial therapies. The absence of barriers to access for pharmacological therapies likely enhances the higher conformance to these recommendations. Limited or variable access to psychosocial services, specifically assertive community treatment, likely negatively affects conformance to psychosocial treatment recommendations. Methodological limitations preclude drawing conclusions on comparisons between Canadian and US services.
Is Mental Health in the Canadian Population Changing over Time?
Authors: Simpson Keith R S , Meadows Graham N , Frances Allen J , Patten Scott B 
Published: July 2017

Objective: Mental health in populations may be deteriorating, or it may be improving, but there is little direct evidence to support either possibility. Our objective was to examine secular trends in mental health indicators from national data sources. Methods: We used data (1994–2008) from the National Population Health Survey and from a series of cross-sectional studies (Canadian Community Health Survey) conducted in 2001, 2003, 2005, and 2007. We calculated population-weighted proportions and also generated sex-specifc, age-standardized estimates of major depressive episode prevalence, distress, professionally diagnosed mood disorders, antidepressant use, self-rated perceived mental health, and self-rated stress. Results: Major depression prevalence did not change over time. No changes in the frequency of severe distress were seen. However, there were increases in reported diagnoses of mood disorders and an increasing proportion of the population reported that they were taking antidepressants. The proportion of the population reporting that their life was extremely stressful decreased, but the proportion reporting poor mental health did not change. Conclusions: Measures based on assessment of symptoms showed no evidence of change over time. However, the frequency of diagnosis and treatment appears to be increasing and perceptions of extreme stress are decreasing. These changes probably reflect changes in diagnostic practice, mental health literacy, or willingness to report mental health concerns. However, no direct evidence of changing mental health status was found.
Prevalence and Frequency of Mental Health Care Provided by General Practitioners: Differences between 2 National Data Sources for the Same Population
Authors: Palin JoAnne L , Goldner Elliot M , Koehoorn Mieke , Hertzman Clyde 
Published: July 2017

Objective: Estimates from Canada's first national mental health surveillance initiative- which is based on diagnostic codes in administrative health care utilization databases- indicate that the proportion of Canadians who receive mental health care is more than twice as high as reported in Canada's national mental health survey. Our study examines and clarifies the nature and extent of differences between 2 predominant types of data that are used for mental health services research and planning. Method: A person-by-person data linkage was conducted between the Canadian Community Health Survey: Mental Health and Well-Being and administrative health care utilization records (British Columbia Ministry of Health Services-Medical Services Plan, and Hospital Discharge Abstract Database) within a universal-access, publically funded health care system, to examine the level of agreement between the data sources and respondent characteristics associated with agreement ( N = 2378). Results: The prevalence of mental health care from general practitioners (GPs) was higher in administrative data (19.3%; 95% CI 17.7% to 20.9%) than survey data (8.5%; 95% CI 7.5% to 9.8%). Agreement between prevalence estimates from the 2 data sources was associated with age, mental health characteristics, and the number of GP visits. The median number of visits per person was significantly higher in the survey data. Conclusions: GPs saw more than twice as many patients for mental health issues according to administrative data, compared with survey data; however, the number of visits per patient was higher in survey data.
Common and Unique Risk Factors and Comorbidity for 12-Month Mood and Anxiety Disorders among Canadians
Authors: Meng Xiangfei , D'Arcy Carl 
Published: July 2017

Objective: To explore the common and unique risk factors for mood and anxiety disorders. What sociodemographic, psychological, and physical risk factors are associated with mood and anxiety disorders and their comorbidities? What is the impact of multiple risk factors? Method: Data from the Canadian Community Health Survey: Mental Health and Well-Being were analyzed. Appropriate sampling weights and bootstrap variance estimation were employed. Multiple logistic regression was used to estimate odds ratios and confidence intervals. Results: The annual prevalence of any mood disorder was 5.2%, and of any anxiety disorder 4.7%. Major depressive episode was the most prevalent mood and anxiety disorder (4.8%), followed by social phobia, panic disorder, mania, and agoraphobia. Among people with mood and anxiety disorders, 22.4% had 2 or more disorders. Risk factors common to mood and anxiety disorders were being young, having lower household income, being unmarried, experiencing greater stress, having poorer mental health, and having a medical condition. Unique risk factors were found: major depressive episode and social phobia were associated with being born in Canada; panic disorder was associated with being Caucasian; lower education was associated with panic and agoraphobia; and poor physical health was associated with mania and agoraphobia. People who were young, unmarried, not fully employed, and had a medical condition, greater stress, poorer self-rated mental health, and dissatisfaction with life, were more likely to have a comorbid mood and (or) anxiety disorder. As the number of common risk factors increases, the probability of having mood and anxiety disorders also increases. Conclusions: Common and unique risk factors exist for mood and anxiety disorders. Risk factors are additive in increasing the likelihood of disease.