bluuebunny/crossref_metadata_2025_split huggingface dataset:
Absence of Oligoclonal IgG Bands and Anti-Achr Antibodies in the Cerebrospinal Fluid of Patients with Myasthenia Gravis
Authors: Kapinas K. , Tzartos S. , Kokkas B. , Divanoglou D. , Tsolaki M. , Anogiannakis G. , Kazis A. 
Published: January 2017

Myasthenia gravis (MG) is a neuromuscular disorder in which antibodies are directed against the nicotinic acetylcholine receptor (AChR) at the neuromuscular junction. Some investigators describe the existence of oligoclonal IgG bands and anti-AChR antibodies in the cerebrospinal fluid (CSF) of MG patients while other refuse it. This study was performed in 15 patients with clinical and electrophysiological diagnosis of MG. Oligoclonal IgG bands (OCB) and antibodies to the AChR from human skeletal muscle were determined in the serum and the CSF of the above MG patients. The last one was done in order to investigate any possible central nervous system (CNS) involvement. It was found that all the MG patients who had a high titre of anti- AChR antibodies in the serum (mean titre 29.2±24.3 nM, range 1.8 to 62 nM) did not present OCB and anti-AChR antibodies in their CSF. On the same time, in a group of 10 patients with a definite multiple sclerosis it was found that eight of them presented OCB in their CSF while the results were negative in another group of 10 patients without evidence of CNS disease. The last two groups served as control groups. Our findings are in accordance with the concept that MG is a pure neuromuscular disorder.
Diabetic Polyneuropathy and the Genetics of Signal Transduction. Evidence of Association with Cytosolic Low Molecular Weight Phosphotyrosine-Phosphatase
Authors: Antonacci E. , Bottini N. , Gloria-Bottini F. , Amante A. , Lucarini N. 
Published: January 2017

We have studied 263 subjects with non-insulin-dependent diabetes mellitus (NIDDM) and have found a highly significant interaction between cytosolic low molecular weight phosphotyrosine phosphatase (cLMWPTP) and RhE genotypes concerning their effects on polyneuropathy. A discriminant analysis has revealed two distinct clusters of subjects with neuropathy differing for both cLMWPTP and RhE genotypes. A high glycemic level is present in one cluster only, suggesting that genetic variability of signal transduction may have an important role especially in patients developing neuropathy in spite of a satisfactory metabolic control of diabetes.
Staff Feelings and Patient Diagnosis
Authors: Holmqvist Rolf 
Published: January 2017

Objective: To assess the associations between staff feelings toward patients and the patients' diagnoses, in view of the fact that clinical reports of such associations have not been corroborated by systematic research. Method: At 24 psychiatric units, 143 patients were assessed according to their personality organization, and staff feelings toward these patients were followed for 5 years. The feelings were reported on a feeling checklist twice yearly, and outcome was assessed as the effect size at year 5, using ratings on Kernberg's structural model complemented with ratings on Strauss-Carpenter's function scale. Results: The study showed that it was possible, using discriminant analyses, to separate diagnostic groups by the different feelings that they evoked in the staff. Patients with borderline personality organization (BPO) evoked fewer relaxed and more aggressive feelings, in contrast to patients with psychotic personality organization (PPO). In contrast to patients with neurotic personality organization (NPO), who evoked feelings of sympathy and helpfulness, PPO patients evoked more feelings of insufficiency and disappointment. A stepwise discriminant analysis of reactions to patients with positive treatment outcome separated the 3 personality organizations with 2 functions using only 2 feelings, “relaxed” and “objective.” The feeling relaxed separated the NPO patients from the BPO patients, and the feeling objective separated the PPO patients from the other groups. The patients' diagnoses accounted for larger proportions of variance in feelings for the patients with positive outcome. Conclusion: The results implied that the patients' different personality organizations evoked different staff feelings in this treatment context and that positive treatment outcome was associated with more pronounced and clear-cut staff reactions.
Déficit en théorie de l'esprit dans la schizophrénie: Relecture clinique et revue des arguments expérimentaux
Authors: Sarfati Yves 
Published: January 2017

Objectifs: Cet exposé de synthèse se propose de réunir, de confronter et de commenter les arguments cliniques et expérimentaux plaidant en faveur de l'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie. Méthode: Après la définition du terme « théorie de l'esprit », suit une revue qui se veut exhaustive de la documentation concernant l'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie. Les différents arguments cliniques ou expérimentaux sont présentés en huit chapitres, et suivis d'une synthèse de la question. Résultats: L'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie est convaincante, surtout au vu des expériences les plus récentes. Ce déficit cognitif permettrait d'expliquer la présence de certains signes schizophréniques comme le délire d'influence ou de référence, les troubles de l'adaptation sociale ou les signes de désorganisation dans le champ de la communication. Le rôle de l'ambiguïté des situations, du niveau intellectuel et du traitement est discuté. Conclusions: Le déficit en théorie de l'esprit est une voie de recherche récente dans le domaine de la schizophrénie, susceptible de répercussions cliniques. Les modèles explicatifs et les paradigmes expérimentaux doivent être perfectionnés pour pouvoir déterminer plus précisément le rôle d'un tel déficit dans la survenue des symptômes.
Inpatient Treatment of Severe Disruptive Behaviour Disorders with Risperidone and Milieu Therapy
Authors: Ad-Dab'bagh Yasser , Greenfield Brian , Milne-Smith Jennifer , Freedman Hyman 
Published: January 2017

Objectives: To evaluate the therapeutic impact of adding risperidone to milieu therapy of latency-aged inpatients with severe disruptive disorders. Methods: The charts of 90 latency-aged patients consecutively admitted to a psychiatry ward were reviewed retrospectively. Fifteen of these patients received 0 risperidone treatment, were nonpsychotic, and did not suffer from pervasive developmental disorder (12 male, 3 female; mean age 9.99 years, SD 1.76). Their scores on the Children's Global Assessment Scale (CGAS) were compared at admission, before risperidone treatment, and at discharge. Results: All subjects were diagnosed with a disruptive behavioural disorder. Ten (66.67%) had additional learning difficulties, and 13 (86.7%) had pathological personality traits. The characteristics of the sample suggested borderline pathology or multiple complex developmental disorder. Following a mean of 38 days after admission (SD 22.3), the patients received risperidone for a mean of 46 days (SD 28.2) before being discharged. The mean maintenance dose of risperidone was 1.27 mg daily (SD 0.36). Mean CGAS scores increased from admission (21.9, SD 7.0) to before risperidone treatment (26.8, SD 7.6, P < 0.0001) and to discharge (50.3, SD 5.3, P < 0.0001). Only 2 patients had documented side effects. Conclusions: Low-dose risperidone used adjunctively to milieu therapy led to statistically and clinically significant additional improvement in the functioning of hospitalized latency-aged children with severe behavioural disorders. Low-dose risperidone is a safe and effective adjunct to milieu therapy for treating this population in inpatient settings. Prospective randomized controlled trials are needed to confirm these findings.
Natural Disasters and Service Delivery to Individuals with Severe Mental Illness—Ice Storm 1998
Authors: McMurray Lisa , Steiner Warren 
Published: January 2017

Objective: To review the literature on the responses of individuals with severe mental illness (SMI) to natural disasters, to describe the impact of the 1998 Ice Storm on a group of SMI patients, and to describe the steps taken at a Canadian university teaching hospital to ensure the ongoing provision of mental health services throughout the crisis. Method: Published articles describing the impact of natural disasters on SMI populations, as well as service provision to these patients, are reviewed. Service use at the Montreal General Hospital (MGH) Department of Psychiatry is described. A questionnaire about the impact of the ice storm was administered to a group of patients in an assertive community treatment program. Results: Service use during this natural disaster was consistent with that described in the literature, in that these patients were no more likely to be admitted or to visit the emergency room during the crisis. Continuous mental health service delivery may have contributed to this positive outcome. This service delivery was provided by ensuring staff access to information, by securing the physical safety of both staff and patients, and by taking a flexible, outreach-oriented approach to service delivery. Conclusions: SMI patients who have ongoing access to psychiatric services in disaster situations tend to cope well. A flexible, proactive, assertive approach to service delivery during the crisis situation will help to ensure that needs for care will be met.
Who Develops Severe or Fatal Adverse Drug Reactions to Selective Serotonin Reuptake Inhibitors?
Authors: Dalfen Ariel K , Stewart Donna E 
Published: January 2017

Objective: To ascertain the risk factors associated with the development of severe and fatal adverse drug reactions (ADRs) or intentional overdoses by patients on selective serotonin reuptake inhibitors (SSRIs). Methods: We undertook a data analysis of Health Canada's database of Adverse Drug Reactions to SSRIs from 1986 to 1996, as well as a literature review. Results: Among the complete ADR reports in the SSRI database, there were no sex differences in occurrences of all ADRs (n = 1011), severe ADRs (n = 295), drug–drug interactions (n = 312), deaths (n = 87), or intentional overdoses (n = 79), when sex differences in prescription practices were considered. There were no differences in ADR rates among different SSRIs. The most common cause of death among patients taking SSRIs was intentional overdose (n = 65, 74.7%). This was reported in 47 (72.3%) women and 18 (27.7%) men. The most common drugs taken with SSRIs in patients who died of intentional overdoses were benzodiazepines, tricyclic antidepressants (TCAs), narcotics, alcohol, and diphenhydramine. Patients who had severe or fatal ADRs were more likely to be taking an SSRI with 2 or more other drugs, including alcohol. Drug combinations that included another CYP-450 drug were especially problematic. A total of 129 cardiovascular ADRs were reported, most of which were severe. These included rhythm disturbances, blood pressure perturbations, and chest pain or angina. Cardiovascular ADRs most often occurred with concomitant drug use of benzodiazepines, TCAs, histamine H2 antagonists, lithium, and calcium channel blockers. There were 3 deaths from malignant neuroleptic syndrome unassociated with intentional overdose. Conclusions: SSRIs are relatively safe when their widespread use is compared with the prevalence of ADRs. SSRIs may, however, be associated with ADRs, and even death, following intentional overdose or when taken with 2 or more other drugs or alcohol (particularly another drug metabolized by CYP-450). Physicians prescribing SSRIs need to consider drug-drug interactions and carefully monitor patients with severe affective disorders, comorbid medical conditions (especially cardiovascular disease), alcohol abuse, or a history of overdosing.
Attention-Deficit Hyperactivity Disorder in Manitoba Children: Medical Diagnosis and Psychostimulant Treatment Rates
Authors: Brownell Marni D , Yogendran Marina S 
Published: January 2017

Objective: To describe physicians' diagnosis rates for attention-deficit hyperactivity disorder (ADHD) for children in the province of Manitoba and to describe the rate of psychostimulant medication use by these children. Methods: This descriptive study reviewed the computerized administrative records of physician visits and prescriptions dispensed to examine a population-based, cross-sectional cohort of children diagnosed with ADHD or prescribed stimulant medication, or both. We found 4787 children with a diagnosis of ADHD over a 24-month period or a prescription for stimulant medication over a 12-month period, or both. Rates were calculated by age, sex, region of residence, neighbourhood income level, and physician specialty. Results: Among Manitoba children, 1.52% received a medical diagnosis of ADHD and 0.89% received stimulant medication. Regionally, diagnosis rates for ADHD varied almost 4-fold, and over 8-fold for medications prescribed. Urban areas had higher rates than did rural areas, regardless of physician specialty. Diagnosis and prescription rates varied according to physician specialty, with the highest rates found among pediatricians. An income gradient was evident in rural areas, with rates of ADHD diagnosis and medication prescribed increasing with increased neighbourhood income level. Conclusions: The pattern of regional variation found in this study suggests that the diagnosis and treatment of ADHD in Manitoba are influenced strongly by the practice styles of local physicians.
Lamotrigine: A Review of Clinical Studies in Bipolar Disorders
Authors: Zerjav-Lacombe S , Tabarsi E 
Published: January 2017

Objective: This article reviews published studies on the use of lamotrigine in the treatment of bipolar disorder (BD). Method: We performed a Medline search to identify the literature data base available on double-blind, open-label studies and case series on the use of lamotrigine to treat BD. Results: Three double-blind studies, 3 open-label studies, and 2 case series have been conducted to date (n = 401 patients). Most patients were either nonresponders or partial responders to other mood stabilizers. Overall, 50% to 83% of the patients responded to lamotrigine; doses in the studies ranged from 50 to 400 mg daily. Switching to mania while on 200 mg of lamotrigine or more was extremely rare, and there were no reports of serious adverse effects during the study periods. Conclusion: Lamotrigine is proving to be an effective agent in the treatment of BD and may be useful for patients who have not responded to other mood stabilizers.
A Family Study of Juvenile Obsessive—Compulsive Disorder
Authors: Reddy P Srinivas , Reddy YC Janardhan , Srinath S , Khanna S , Sheshadri SP , Girimaji SR 
Published: January 2017

Objectives: To determine whether juvenile obsessive–compulsive disorder (OCD) is familial and whether the rate of Tourette syndrome (TS) and tic disorders is higher among relatives of patients with OCD than among relatives of controls subjects. Method: We assessed first-degree relatives of 35 juvenile OCD probands (aged 16 years or less) and 34 matched, psychiatrically unaffected control subjects, using the Diagnostic Interview for Children and Adolescents–Revised (DICA-R) (unpublished), a Questionnaire for tic disorders, the Children's Version of Leyton's Obsessional Inventory (CV-LOI), and the Children's Version of the Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Similarly, we assessed adult relatives, using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Leyton's Obsessional Inventory (LOI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and a Questionnaire for tic disorders. The diagnoses were determined by consensus, using DSM-III-R criteria. We calculated age-corrected morbid risk, using Weinberg's method. Results: The morbid risk for OCD among the relatives of OCD probands was 4.96%, while none of the relatives of unaffected control subjects had OCD. We did not diagnose TS in any of the relatives of either OCD probands or control subjects. We diagnosed chronic motor tic disorders in only 1 of the relatives of OCD probands, while none of the relatives of control subjects had any tic disorder. Conclusion: Most juvenile cases of OCD are nonfamilial and unrelated to tic disorders, while only a few are familial. There is a need to re-examine the issue of familiality in cases of OCD, as well as its relation to TS, using larger community samples to better understand the hypotheses of familial transmission and comorbidity with tic disorders.
The Effect of Divalproex Sodium on Viral Load: A Retrospective Review of HIV-Positive Patients with Manic Syndromes
Authors: Maggi Julie D , Halman Mark H 
Published: January 2017

Objective: In vitro studies report that valproic acid causes an increase in HIV-1 replication. This retrospective study examines a sample of patients with HIV disease and behavioural disturbances, for which the treatment of choice is divalproex sodium (DVP), to determine whether DVP causes an increase in HIV-1 replication. Method: A chart and database review identified 15 patients with HIV disease presenting with either 1) mania or hypomania or 2) dementia with mania or with hypomania or behavioural disturbances. HIV-1 viral load was compared before and after mood stabilizer initiation. Results: Eleven patients started therapy with DVP, and 4 patients declined treatment with a mood stabilizer. Nine of the 11 patients taking DVP were also receiving antiretroviral therapy. HIV-1 viral load did not increase in 6 of the 9 patients who had measurements between 1 week and 3.5 months after DVP initiation. No follow-up was available for the other 3 patients. Of the 2 patients receiving DVP but not antiretroviral medication, 1 had an increase of 0.17 log in HIV-1 viral load at 4 months. No follow-up record was available for the second patient. The 4 patients not taking DVP were all on antiretroviral therapy; viral loads in 2 of them remained nondetectable over 3 to 4 months, and 1 had an increase of 0.32 log in HIV-1 viral load at 3 months. No follow-up record was available for the fourth patient. Conclusions: These preliminary data suggest that, in the presence of effective antiretroviral therapy, HIV-1 viral load appears not to be adversely affected by the administration of DVP. The results for the patients receiving DVP in the absence of antiretroviral medication remain indeterminate. Further prospective study is required.
Occupational Effects of Stalking
Authors: Abrams Karen M , Robinson Gail Erlick 
Published: January 2017

Objective: This case report and discussion describe the psychiatric and social consequences of being a stalking victim, with particular focus on its impact on the victim's occupation. Method: Data were gathered from the assessment and arbitration hearing of a female employee who lost her job while being stalked. Computerized literature searches were used to identify relevant papers from psychiatric and legal journals. Results: This case illustrates many of the common features of stalking. The female victim was harassed by a male after a failed intimate relationship. The victim suffered from depression, anxiety, guilt, shame, helplessness, humiliation, and posttraumatic stress disorder (PTSD). The stalking affected her psychological, interpersonal, and occupational functioning. Consequently, she was fired for poor work performance and poor attendance. Conclusion: Stalking may affect a victim's ability to work in several ways. The criminal behaviours often interfere directly with work attendance or productivity and result in the workplace becoming an unsafe location. Further, stalking may indirectly affect a person's ability to work through the many adverse emotional consequences suffered.
The Persistence of Folly: A Critical Examination of Dissociative Identity Disorder. Part I. The Excesses of an Improbable Concept
Authors: Piper August , Merskey Harold 
Published: January 2017

Objective: To examine the concept of dissociative identity disorder (DID). Method: We reviewed the literature. Results: The literature shows that 1) there is no proof for the claim that DID results from childhood trauma; 2) the condition cannot be reliably diagnosed; 3) contrary to theory, DID cases in children are almost never reported; and 4) consistent evidence of blatant iatrogenesis appears in the practices of some of the disorder's proponents. Conclusions: DID is best understood as a culture-bound and often iatrogenic condition.
Client and Community Services Satisfaction with an Assertive Community Treatment Subprogram for Inner-City Clients in Edmonton, Alberta
Authors: Chue Pierre , Tibbo Philip , Wright Evelyn , Van Ens Jelle 
Published: January 2017

Objectives: To evaluate client and agency satisfaction with a specific assertive community treatment subprogram, known as inner-city support, developed in Edmonton to target the inner-city population, and to determine the demographics and potential needs of this population. Method: Clients were administered questionnaires based on the Client Satisfaction Questionnaire and the Satisfaction With Life Scale. We also conducted a face-to-face interview. We contacted and similarly surveyed 18 community agencies. Results: The program was well received, although areas for improvements included dissemination of information and hours of operation. Clients also requested more input regarding the development of activities. Clients were predominantly male with a diagnosis of schizophrenia comorbid with substance abuse and antisocial personality disorders, a history of forensic contact, homeless, and dependent on social assistance. Conclusion: Among the population with serious and persistent mental illness, inner-city clients represent a particularly disadvantaged subpopulation that may benefit from specialized community programs.
Social Phobia among University Students and its Relation to Self-Esteem and Body Image
Authors: Izgiç Ferda , Akyüz Gamze , Doğan Orhan , Kuğu Nesim 
Published: January 2017

Objective: To demonstrate the prevalence of social phobia and its relation to body image and self-esteem. Method: Study participants were 1003 students recruited from Cumhuriyet University as a randomized sample. Subjects were administered the Diagnostic Interview Schedule-III-Revised (DIS-III-R) Social Phobia Scale, the Rosenberg Self-Esteem Scale, and the Multidimensional Body–Self Relations Questionnaire (MBSRQ). We analyzed the data, using Fisher's exact chi-square test. Results: Lifetime prevalence of social phobia among university students was 9.6% and past-year prevalence was 7.9%. Self-esteem was lower ( P < 0.05) among those with social phobia than among those without social phobia. Students with social phobia had lower scores on the MBSRQ than did those without social phobia ( P < 0.0001). Conclusions: The results show that persons with social phobia have lower self-esteem and more distorted body image than do those without social phobia.
Screening for Complicated Grief: When Less May Provide More
Authors: Piper William E , Ogrodniczuk John S , Weideman Rene 
Published: January 2017

Objective: This study aimed to discover screening questions for initial assessments of psychiatric outpatients to identify which patients are likely experiencing complicated grief (CG). Method: We examined the responses of 235 outpatients to questionnaire items. One set came from the Texas Revised Inventory of Grief (TRIG). This set represented events cited in clinical literature as indicators or risk factors for CG. Another set came from a factor analysis of items that define CG. We determined relations between items and CG, analyzed sensitivity and specificity, and compared the 2 sets of items. Results: The factor analysis items were superior. The 2 best items correctly identified nearly 90% of patients with and without CG. Conclusion: The items can be transformed into screening questions to be used in initial interviews.