bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining Anxious Depression: Going beyond Comorbidity
Authors: Silverstone Peter H , von Studnitz Erica 
Published: January 2017

Objective: Since publication of the DSM-IV, there remains a group of patients with depression and anxiety symptoms who are not well classified. We therefore wanted to determine more accurately the type of patients best described by the term “anxious depression.” We also wanted to review the literature to assess the most appropriate treatment(s) for these patients. Method: We surveyed the medical literature published after 1994 for all articles containing the relevant terms and assessed all possible articles in detail to determine those relevant to the diagnosis and those that involved relevant clinical studies. Results: The term anxious depression can encompass 3 groups of patients: those with comorbid major depressive disorder (MDD) and an anxiety disorder, those with MDD but with subthreshold anxiety symptoms, and those with subthreshold depressive and subthreshold anxiety symptoms (also called mixed anxiety and depressive disorder). Conclusions: Based upon our literature review, we believe that the term anxious depression should only be used for the second group; that is, those patients with an MDD and subthreshold anxiety symptoms. From our literature review to determine the most appropriate treatment for this group of patients, it appears likely that drugs inhibiting the reuptake of both noradrenaline and serotonin may have greater clinical utility than single-action drugs such as the selective serotonin reuptake inhibitors (SSRIs). However, it is also clear that much more research needs to be undertaken in this important patient group so that we can better understand its prevalence, clinical features, and treatment.
Risk of Weight Gain Associated with Antipsychotic Treatment: Results from the Canadian National Outcomes Measurement Study in Schizophrenia
Authors: McIntyre Roger S , Trakas Kostas , Lin Daryl , Balshaw Robert , Hwang Pieway , Robinson Kimberly , Eggleston Andrew 
Published: January 2017

Background: Antipsychotic-induced weight gain occurs in a substantial percentage of treated persons. There remains a paucity of naturalistic data that describe relative weight-gain liability with the available novel atypical antipsychotics (NAPs). This investigation describes comparative NAP-induced weight gain in a prospective naturalistic cohort of persons with schizophrenia and related psychotic disorders. Methods: The Canadian National Outcomes Measurement Study in Schizophrenia (CNOMSS) is an ongoing prospective, longitudinal, naturalistic study involving 32 academic and community sites across Canada. Persons with DSM-IV–defined schizophrenia, schizophreniform or schizoaffective disorder, and psychosis not otherwise specified were consecutively enrolled. The overarching objectives of this initiative were to collect and compare global effectiveness, tolerability, safety, and humanistic outcomes in persons receiving commercially available NAPs in Canada. This analysis reports only weight change with the respective NAPs. Other outcomes were reported in separate companion papers. Results: A spectrum of weight-gain liability was noted with quetiapine (QUE) (mean 7.55 kg, SD 9.20; P = 0.28), olanzapine (OLZ) (mean 3.72 kg, SD 0.56; P = 0.15), and risperidone (RIS) (mean 1.62 kg, SD 7.72; P = 0.43). Categorically defined weight gain (that is, over 7% of baseline weight) was observed in 55.6% of QUE patients, 24.1% of OLZ patients, and 23.7% of RIS patients. Adjusting for demographic and disease-specific confounding factors, QUE patients had greater odds of gaining over 7% of their baseline weight, compared with RIS patients (odds ratio [OR] 3.62; 95%CI, 1.02 to 12.83; P = 0.05). No statistical difference was detected between OLZ patients and RIS patients for over 7% of baseline weight (OR 1.54; 95%CI, 0.63 to 3.75; P = 0.12) or over 10% weight gain (OR 1.44; 95%CI, 0.50 to 4.13; P = 0.58). Conclusion: Clinicians are reminded to monitor anthropometric and metabolic parameters in all NAP-treated persons. Clinically significant differences in weight gain liability exist among the available NAPs.
Suicide Attempts and Associated Factors in Newfoundland and Labrador, 1998–2000
Authors: Alaghehbandan Reza , Gates Kayla D , MacDonald Don 
Published: January 2017

Objective: This study examined the epidemiology and associated factors for suicide attempts requiring hospitalization in the province of Newfoundland and Labrador. Method: We extracted data from the provincial hospital separation database. Outcome measures included incidence rates (IRs) of suicide attempts by age, sex, and geographical region of residence. We also analyzed sociodemographic data to determine associated factors. Results: A total of 978 patients who were hospitalized owing to suicide attempts were identified for 1998–2000, giving an overall IR of 68.7 per 100 000 person-years (P-Y). The age-specific rate for people aged 15 to 19 years was much greater, at 143.0 per 100 000 P-Y. The overall female-to-male ratio was 1.3, with an attempted suicide rate of 76.1 per 100 000 P-Y for female patients and 60.3 per 100 000 P-Y for male patients ( P = 0.001). Labrador (210.2 per 100 000 P-Y), a region with a high Aboriginal population, had a higher rate of suicide attempts, compared with the island portion of the province (59.0 per 100 000 P-Y) ( P < 0.001). More than 70% of hospitalizations were associated with psychiatric diagnosis. Poisoning was the most frequent method of attempting suicide. Higher IRs of suicide attempts were found among people who were divorced or separated and among those who were less educated ( P < 0.001). Conclusions: Suicide attempt represents a significant public health concern in the province, particularly in Labrador. An increased risk of suicide attempts was associated with single status, female sex, younger age (teen or young adult), and low educational level during the index attempt. Further research is needed to explicate these findings and increase our understanding of attempted suicide.
L'évaluation normalisée et clinique des mécanismes de défense: Revue critique de 6 outils quantitatifs
Authors: Soultanian Charlotte , Dardennes Roland , Mouchabac Stéphane , Guelfi Julien Daniel 
Published: January 2017

Contexte: Le concept de mécanisme de défense (MD) remonte aux fondements de la psychanalyse et en constitue un des piliers théoriques. Plus récemment, en raison de l'introduction de cette notion dans une rubrique expérimentale des classifications catégorielles, les MD sont devenus un nouveau champ à explorer dans le domaine de la recherche et de la communication scientifique. L'augmentation du nombre d'études prenant en compte les MD est allée de pair avec l'élaboration d'échelles d'évaluation clinique plus utilisables que les tests projectifs. Il n'existe à notre connaissance aucune analyse comparative de ces outils. Objectif: Nous décrivons dans un premier temps le mode d'utilisation et les qualités métrologiques des échelles les plus récentes. Nous proposons ensuite les avantages et les limites de ces instruments d'évaluation clinique. Ce travail vise à aider les cliniciens chercheurs dans le choix de l'outil le plus adapté à leur protocole. Méthode: Nous présentons les outils suivants au moyen d'une revue de la documentation: Defense Mechanism Inventory, Defense Mechanism Profile, Defense Style Questionnaire (DSQ), Defense Mechanism Rating Scale, Life Style Index, Response Evaluation Measure. Conclusion: L'utilisation des échelles cliniques comprend de nombreuses limites liées au concept de MD. Néanmoins, leur faisabilité et leur validité en justifient l'emploi. Les avantages du DSQ ressortent du fait de ses nombreuses qualités; néanmoins les spécificités des autres instruments restent à considérer en fonction des protocoles envisagés.
Correlates of Methylphenidate Use in Canadian Children: A Cross-Sectional Study
Authors: Charach Alice , Cao Hongmei , Schachar Russell , To Teresa 
Published: January 2017

Objectives: This study aimed to estimate the prevalence of methylphenidate (MPH) use among Canadian children aged 2 to 11 years, from 1994–1995 to 1998–1999 and to identify sociodemographic, child, and parent–family correlates are identified. Methods: Cross-sectional data collections from the National Longitudinal Survey of Children and Youth (NLSCY) for 1994–1995, 1996–1997, and 1998–1999 were used and samples weighted up to population levels ( n = 17 814 in 1994–1995, 13 575 in 1996–1997, and 18 980 in 1998–1999). Logistic regression identified correlates of parent-reported MPH use in each time period. Results: MPH use by Canadian children increased from 1.33% (95% confidence interval [CI], 1.17% to 1.50%) in 1994–1995 to 1.60% (95%CI, 1.42% to 1.78%) in 1998–1999. Use among school children aged 6 to 11 years increased from 1.94% (95%CI, 1.68% to 2.20%) in 1994–1995 to 2.42% (95%CI, 2.14% to 2.71%) in 1998–1999. Use of MPH increased among girls, from 0.52% (95%CI, 0.32% to 0.67%) in 1994–1995 to 0.97% (95%CI, 0.77% to 1.17%) in 1998–1999. For a child with parent-reported hyperactivity, the odds ratios for using MPH were 6.30 (95%CI, 4.94 to 8.90) in 1994–1995 and 12.54 (95%CI, 9.74 to 16.16) in 1998–1999. Age 6 to 11 years, male sex, and absence of parental alcohol use were significant correlates of MPH use in all time periods. Parental smoking correlated with MPH use in 1994–1995 and in 1998–1999. Conclusions: Less than 2% of Canadian children used MPH between 1994 and 1999. Some increase in use occurred among school-aged children and girls. Parent-reported hyperactivity was the most important correlate of MPH use.
Androgen Treatment of Depressive Symptoms in Older Men: A Systematic Review of Feasibility and Effectiveness
Authors: Shamlian Nathalie T , Cole Martin G 
Published: January 2017

Objective: To determine the feasibility and effectiveness of androgen treatment of depressive symptoms in older men. Method: We searched MEDLINE, PsycINFO, Eric, HealthStar, and the Cochrane Database of Systematic Reviews for potentially relevant articles. The bibliographies of relevant articles were searched for additional references and experts were consulted. Seventeen reports (8 open and 12 randomized trials; 3 articles reported studies of 2 designs) met the following inclusion criteria: original investigation; published in English or French, use of acknowledged criteria or scale for depression, and open or randomized trial of androgen treatment. Four criteria assessed study validity: randomization, double blinding, comparability of treatment and control groups at baseline, and description of dropouts. We abstracted, tabulated, and compared information from each article. Results: Most studies had methodological limitations. With regard to feasibility, there were few reported withdrawals due to adverse events. With regard to effectiveness, 6 of 8 open trials had positive results, and 5 of 12 randomized trials had positive results, although 1 was equivocal. However, testosterone was combined with antidepressant medication in 3 of these positive randomized trials. Only 2 open trials enrolled subjects whose mean age was 60 years or over. One had positive results, and the other had negative results. Conclusion: Androgen therapy may be feasible in the short term, but there is little evidence that it is an effective treatment for depressive symptoms in older men.
Demographic Characteristics of Participants in Studies of Risk Factors, Prevention, and Treatment of Postpartum Depression
Authors: Ross Lori E , Campbell Vashti LS , Dennis Cindy-Lee , Blackmore Emma Robertson 
Published: January 2017

Objectives: Metaanalyses have found that sociodemographic variables are not strong predictors of postpartum depression. However, no studies have systematically examined the extent to which the samples used in published research on postpartum depression have included sufficiently diverse samples of women to merit this conclusion. The objectives of this study were to examine the demographic characteristics of participants in previously published studies and to document existing gaps in the current literature. Method: We extracted age, ethnicity, relationship status, and socioeconomic status of 51 453 participants from 143 studies previously selected for systematic literature reviews. Results: Few studies reported complete demographic data; however, existing data indicate that participants were predominantly aged 25 to 35 years, white, partnered, and of mid- or high-socioeconomic status. Conclusions: To assess the external validity of the findings, improved reporting of demographic characteristics is required in publications related to postpartum depression. Additional research is needed to understand postpartum depression among understudied populations. Objectifs: Les méta-analyses ont révélé que les variables sociodémographiques ne sont pas des prédicteurs fiables de la dépression postpartum. Cependant, aucune étude n'a examiné systématiquement la mesure dans laquelle les échantillons utilisés dans les études publiées de la dépression postpartum incluaient des échantillons suffisamment diversifiés de femmes pour arriver à cette conclusion. Les objectifs de la présente étude étaient d'examiner les caractéristiques démographiques des participantes à des études déjà publiées et à documenter les écarts existant dans la documentation actuelle. Méthode: Nous avons extrait l'âge, l'origine ethnique, l'état relationnel et le statut socio-économique de 51 453 participantes à 143 études préalablement sélectionnées pour des revues systématiques de la documentation. Résultats: Peu d'études ont présenté des données démographiques complètes; cependant, les données existantes indiquent que les participantes étaient majoritairement âgées de 25 à 35 ans, blanches, en couple, et de statut socio-économique moyen à élevé. Conclusions: Une meilleure présentation des caractéristiques démographiques est nécessaire dans les publications liées à la dépression postpartum pour évaluer la validité externe des résultats. Il faut plus de recherche pour comprendre la dépression postpartum chez les populations sous-étudiées.
The Evolving Understanding of Major Depression Epidemiology: Implications for Practice and Policy
Authors: Patten Scott B , Bilsker Dan , Goldner Elliott 
Published: January 2017

Objectives: Epidemiologic studies have confirmed that major depression (MD) is an extremely common condition, but also one that is associated with an unexpectedly broad spectrum of morbidity. It is no longer a tenable position to regard MD as being a simple indicator of treatment need, nor is a one-size-fits-all approach to treatment likely to be an effective guide to health care delivery. The objective of this commentary is to explore the implications of these new epidemiologic findings for policy and practice in Canada. Method: This paper is a selective review and commentary. Results: Whereas the acute and long-term treatment needs of a subset of individuals with MD have received much attention in the literature, the needs of other groups have not. A sizable proportion of individuals with episodes meeting the Diagnostic and Statistical Manual of Mental Disorders-fourth edition definition in community populations may not need the intensive treatment emphasized by current Canadian practice guidelines. The strategy of watchful waiting may have a role in primary care. On the policy front, guided and perhaps self-guided management strategies deserve greater emphasis than they have received. Stepped-care strategies are an appealing option, but how best to effectively implement these in the Canadian context is unclear. Conclusions: The spectrum of morbidity among individuals with MD in community populations is much wider than has been previously appreciated. The health system should respond with an appropriate spectrum of services, but many questions remain about how to facilitate this.
Patient Sex as Moderator of Effects of Transference Interpretation in a Randomized Controlled Study of Dynamic Psychotherapy
Authors: Ulberg Randi , Johansson Paul , Marble Alice , Høglend Per 
Published: January 2017

Objective: To examine whether men and women respond differentially to brief dynamic psychotherapy, with or without transference interpretations. Method: Data from the First Experimental Study of Transference Interpretation were used. Patients ( n = 100) were randomized to receive 2 different dynamic psychotherapies during 1 year, with either a moderate level of transference interpretations or no transference interpretations. We used the following outcome measures: the Psychodynamic Functioning Scales, Inventory of Interpersonal Problems-Circumplex Version, Global Assessment of Functioning (GAF), and total mean score of Symptom Checklist-90-Revised (Global Severity Index [GSI]). Change was assessed using linear-mixed models. Results: On average, men and women responded equally across treatments. The moderator analyses, using the 2 secondary outcome measures, GAF and GSI, demonstrated that women responded better to therapy with transference interpretations, compared with men, whereas men responded better to therapy without transference interpretations, compared with women. When the moderator sex was combined with the moderator quality of object relations (QOR), a strong effect emerged: men with high QOR showed a large negative effect of transference interpretations, and women with low QOR showed a large positive effect. Conclusions: In terms of symptom change, women responded better to therapy with transference interpretations, while men responded better to therapy without transference interpretations. Patient sex showed moderator effects over and above the moderator effects of QOR.
An Examination of DSM-IV Borderline Personality Disorder Symptoms and Risk for Death by Suicide: A Psychological Autopsy Study
Authors: McGirr Alexander , Paris Joel , Lesage Alain , Renaud Johanne , Turecki Gustavo 
Published: January 2017

Objective: To clarify whether certain Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), borderline personality disorder (BPD) symptoms are more prevalent among people who die by suicide, and thereby better predict suicide risk. Method: A psychological autopsy method with best informants was used to investigate DSM-IV BPD symptoms and suicide risk among people who died by suicide and met criteria for BPD ( n = 62), and BPD control subjects ( n = 35). Results: BPD symptoms in people who died by suicide were less likely to include affective instability and paranoid ideation–dissociative symptoms. The negative association between paranoid ideation–dissociative symptoms and suicide was independent of all other BPD symptoms, Cluster B comorbidity, and alcohol dependence. Conclusions: We found that discrete DSM-IV BPD symptoms differentiate people with BPD who die by suicide and those who do not. People with BPD who go on to die by suicide appear to constitute a specific subgroup of those who meet criteria for BPD, characterized by different general clinical presentation, but also by different characteristics within BPD.
Factors Associated with Not Seeking Professional Help or Disclosing Intent Prior to Suicide: A Study of Medical Examiners' Records in Nova Scotia
Authors: Kisely Stephen , Campbell Leslie Anne , Cartwright Jennifer , Bowes Matthew J , Jackson Lois 
Published: January 2017

Objective: Individual-level data from clinical settings lack information on people who did not seek professional help prior to suicide. We used records of the Nova Scotia Medical Examiner Service (NSMES) to compare people who had contact with a health professional prior to suicide with those who did not. Method: We linked data from the NSMES to routine administrative data of the province. Results: The NSMES recorded 108 suicides in Nova Scotia from January 1, 2006, to December 31, 2006; there were 90 male and 18 female suicide deaths. Mean and median age at death were 44.73 (SD 13.33) and 44 years, respectively. Patients aged 40 to 49 years made up one-third of the cases ( n = 35) and this was the decade of life with the highest number of suicides. This was also the group least likely to have suicidal intent recorded in the NSMES files (χ2 = 3.86, df = 1, P = 0.05). Otherwise, there were no significant differences between people who sought help, or disclosed intent, prior to suicide and people who did not. The samples in all cases were predominately male and single. Conclusions: People aged 40 to 49 years were the age group with the highest absolute number of suicides, but were the least likely to have suicidal intent recorded in the NSMES files. This finding merits further investigation. Medical examiner or coroner data may provide additional information not obtained elsewhere for the surveillance of suicide.
Childhood Maltreatment and Aggressive Behaviour in Violent Offenders with Psychopathy
Authors: Kolla Nathan J , Malcolm Charlotte , Attard Stephen , Arenovich Tamara , Blackwood Nigel , Hodgins Sheilagh 
Published: January 2017

Objective: To document experiences of childhood maltreatment among violent offenders with antisocial personality disorder (ASPD) distinguishing between those with and without the syndrome of psychopathy (+P and -P), and to determine whether maltreatment is associated with proactive and reactive aggression. Method: The sample included 10 violent offenders with ASPD+P, 15 violent offenders with ASPD+P, and 15 nonoffenders. All participants completed interviews with the same forensic psychiatrist focusing on physical, sexual, and emotional abuse prior to age 18 using the Early Trauma Inventory. Aggression was assessed using the Reactive-Proactive Questionnaire. Results: Violent offenders with ASPD+P reported significantly more severe childhood physical abuse, but not more sexual or emotional abuse, than violent offenders with ASPD-P and nonoffenders. Psychopathy Checklist'Revised (PCL-R) scores, but not childhood physical abuse, were associated with proactive aggression. Childhood physical abuse was associated with reactive aggression, as was an interaction term indicating that when both PCL-R scores and childhood physical abuse were high, so was reactive aggression. Conclusions: Among violent offenders, PCL-R scores were positively associated with proactive aggression, while experiences of childhood maltreatment were not. This finding concurs with previous studies of children and adults and suggests that proactive aggression may be a behavioural marker of psychopathic traits. By contrast, childhood physical abuse was associated with reactive aggression, even among violent offenders with high PCL-R scores. This latter finding suggests a strong influence of childhood physical abuse on the development of reactive aggression that persists over the lifespan.
Psychostimulant Prescriptions by Psychiatrists Higher Than Expected: A Self-Report Survey
Authors: Beck Charles , Silverstone Peter , Glor Kathleen , Dunn Joshua 
Published: January 2017

Objective: To survey Alberta psychiatrists on their prescribing of psychostimulants to adults. Method: A questionnaire was mailed to all 245 registered psychiatrists in Alberta. The respondents were requested to anonymously report, for the previous year, the number of adult patients to whom they prescribed pemoline, methylphenidate, amphetamines, or other psychostimulants for the treatment of adult attention-deficit hyperactivity disorder (ADHD), narcolepsy, unipolar depression, bipolar disorder, dementia, and other disorders. Results: The response rate was 93.9%; 88.7% treated adults. Of these, 46.6% prescribed psychostimulants to 1238 patients. The greatest proportion of prescriptions of psychostimulants was for adult ADHD, depression, and narcolepsy. Conclusions: Psychostimulants are more widely prescribed by psychiatrists than indicated in earlier studies and in recommendations for treatment.