bluuebunny/crossref_metadata_2025_split huggingface dataset:
Les Propriétés Psychométriques De La Version Française Du Modified Mini-Mental State (3Ms) Avec Des Patients âgés Suivis En Psychiatrie Gŕriatrique
Authors: Cappeliez Philippe , Quintal Marie , Blouin Mariette , Gagne Serge , Bourgeois Anne , Finlay Michel , Robillard ET Andree 
Published: January 2017

Objectif: Cette recherche étudie les propriétés psychométriques de la version française du Modified Mini-Mental State (SMS), un instrument de dépistage de la démence, avec un échantillon de patients suivis en psychiatrie gériatrique. Méthode: Les sujets (N = 94; 63 ans à 92 ans) sont des patients externes référés à un service hospitalier de psychiatrie gériatrique. Outre le 3MS, une batterie de tests portant sur le fonctionnement cognitif et la Symptomatologie dépressive a été administrée. Résultats: Le coefficient de fidélité test-retest s'élève à 0,87 pour un sous-échantillon de 35 sujets. Une analyse factorielle de type exploratoire révèle 4 facteurs qui rendent compte de 63,2 % de la variance. Des scores-seuils de 79 à 80 (avec scolarisation ⩾ 8 ans) et de 71 à 72 (avec scolarisation ⩽ 7 ans) offrent la meilleure combinaison sensibilité/spécificité, soit respectivement 0,80 et 0,96. Conclusions: Cette étude soutient les qualités psychométriques de la version française du 3MS pour l'utilisation avec des patients suivis en psychiatrie gériatrique, en proposant des seuils qui tiennent compte du niveau d'éducation. Elle souligne l'influence des variables sociodémographiques sur les performances au test.
Psychiatric Practice for the Coming Decade
Authors: Goldbloom David S , Garfinkel Paul E 
Published: January 2017

Objective: To identify important trends and themes that will affect psychiatric training and practice. Method: Selective literature review and reflections by the authors. Results: Three principal themes are elucidated relating to empiricism and integration, accountability and collaboration, and training and the public trust. Conclusions: There must be debate and action on these and other themes to maintain the relevance of psychiatry to its changing context.
Competency Assessments: Perceptions at Follow-up
Authors: Carlin Kathleen , Silberfeld Michel , Deber Raisa B , Lowy Frederick 
Published: January 2017

Objectives: To report on the perceptions of assessment of competency and its consequences on a group of clients and significant others at follow-up. Methods: Ninety-five interviews were conducted using a carefully developed semistructured telephone interview of 24 clients and 71 family/caregivers, representing the perceptions of about 80 clients. Results: There was general satisfaction in the competency assessment process. There was a perception that interests and rights were protected. Clients were seen to be less involved in all spheres of decision making rergardless of capacity outcome. Clients and families were satisfied with how decisions were made. Conclusions: Follow-up study of competency assessment does not support the conclusions previously drawn based on court record studies that assessments are deleterious and frequently result in violations of rights.
Syndrome De Capgras: ÉVolution Des Hypotheses
Authors: Debruille Jacques B , Stip Et Emmanuel 
Published: January 2017

Objectif: Retracer l'évolution des hypothèses concernant le syndrome de Capgras. Méthodes: Les données consistent en un peu plus de 60 études publiées entre 1866 et 1994 qui ont été sélectionnées en fonction de leur caractère novateur et de leur pertinence quant à la description clinique du syndrome, et quant aux interprétations psychodynamiques, neurologiques et neuropsychologiques. Résultats: Deux temps principaux, se chevauchant partiellement, peuvent être dégagés dans l'évolution des hypothèses touchant aux mécanismes du syndrome. Le 1er, débutant dès 1923, se caractérise par la prédominance des interprétations psychodynamiques. Le 2e, issu de la constatation de dysfonctionnements organiques dans un pourcentage élevé de cas, s'en différencie par la survenue d'interprétations d'ordre neurologiques, et par quelques hypothèses mixtes. Conclusions: Au total cette revue permet de mettre en évidence la grande diversité des points de vue concernant le syndrome. Elle servira de base à l'étude suivante qui vise à montrer que la mise à l'épreuve expérimentale de chacun des points de vue est possible.
Suicide in Old Age: A Tragedy of Neglect
Authors: Duckworth Geoffrey , McBride Hazel 
Published: January 2017

Objective: To investigate the incidence and treatment of depression in geriatric suicide. Method: All coroners' records, autopsy and police reports for suicide victims aged 65+ in Ontario (n = 543) over 3 years were examined. Results: Over 80% of the elderly who committed suicide received no psychiatric referral. Of the sample, 87% were untreated while only 13% received antidepressants. Tricyclics, which are lethal in overdose, were the drugs of choice. None of the sample was treated with the safer specific serotonin reuptake inhibitors (SSRIs). Females were 3 times as likely to be treated as were males, and those seeing psychiatrists were 4 times more likely to be treated with antidepressants than those seeing general practitioners (GPs). The physically ill were rarely treated. Conclusions: These findings suggest that early geropsychiatric assessment and vigorous treatment could prevent many suicides in old age.
Occurrence and Effects of Personality Disorders in Depression: Are They the Same in the Old and Young?
Authors: Agbayewa M Oluwafemi 
Published: January 2017

Objectives: To determine the frequency and effects of personality disorders on episodes of depression in elderly and young inpatients. Personality disorders are common and may affect the prognosis of Axis I disorders. Methods: Clinical records of 89 elderly inpatients and a matched comparison group of 119 young inpatients were reviewed to confirm the diagnosis of a major depressive episode according to the DSM-III-R criteria. The frequency of personality disorder diagnoses in the 2 groups was determined. Within each group, severity, functioning, and treatment were compared between those with and without personality disorders. Results: Personality disorders were diagnosed more frequently in the young (40.3%) than in the elderly (27%). Both rates were similar to previous reports. Cluster C disorders were the most common personality disorders found in the elderly, compared to cluster B disorders in the young. Personality disorder in the young was associated with longer episodes of depression (P = 0.035) and poorer family relations (P < 0.001); whereas in the elderly, personality disorder was associated with more severe episodes (P = 0.014). Conclusions: These findings suggest that the frequency and effects of personality disorders on the depressed patient may differ according to age.
Readiness to Stop Smoking in Schizophrenia
Authors: Addington Jean , el-Guebaly Nady , Addington Donald , Hodgins David 
Published: January 2017

Objective: To assess the motivation and readiness to change of individuals with schizophrenia prior to developing a smoking cessation program. Method: Smoking history, nicotine dependence, readiness to stop smoking, and interest in a smoking cessation group were assessed in 60 schizophrenia outpatients who smoked. Results: The majority were interested in attending a smoking cessation group and appeared to be appropriately motivated. Conclusions: Smoking cessation groups for a schizophrenia population may be a worthwhile endeavour. Current measures of motivation and readiness to change may be useful to identify those who are most likely to succeed.
Childhood Antecedents of Self-Destructiveness in Borderline Personality Disorder
Authors: Dubo Elyse D , Zanarini Mary C , Lewis Ruth E , Williams Amy A 
Published: January 2017

Objective: To assess the relationship between lifetime patterns of self-destructive behaviour and various parameters of childhood abuse and neglect in patients with borderline personality disorder (BPD) compared with other personality disorder (OPD) controls. Method: The subjects were 42 inpatients with the diagnosis of BPD and 17 OPD controls. Lifetime patterns of self-destructive behaviour were assessed using the Lifetime Borderline Symptom Index. Childhood experiences were assessed using a semistructured interview by raters who were blind to diagnosis. Results: Chronic self-destructive behaviour discriminated patients with BPD from OPD controls. In the borderline group, parental sexual abuse was significantly related to suicidal behaviour and both parental sexual abuse and emotional neglect were significantly related to self-mutilation. Conclusion: Both parental sexual abuse and emotional neglect appear to play a role in the etiology of self-destructive behaviour in BPD. The results highlight the importance of considering the effects of sexual abuse within its environmental context and suggest that the etiology of borderline symptoms is likely multifactorial.
Bipolar Disorder: From Families to Genes
Authors: Alda Martin 
Published: January 2017

Background: Genetic factors are known to contribute to the etiology of bipolar illness, but the actual genetic mechanisms remain to be clarified. Methods: This paper reviews the research undertaken to establish the genetic basis of bipolar illness and to elucidate the nature of its genetic predisposition. Results: The presented findings suggest that bipolar affective disorder is a heterogeneous condition characterized by a complex relationship between the genetic susceptibility and the clinical presentation. Linkage studies have generated promising and replicated findings on chromosomes 18 and 21. Conclusion: In spite of the methodological difficulties inherent in the genetic study of psychiatric disorders, recent investigations have made important advances and promise to identify specific susceptibility genes.
A Cross-Sectional Study of Private Psychiatric Practices under a Single-Payer Health Care System
Authors: Anderson Keith , Catterson Alistair , Gaudet Michael , Gautam Mamta , Kerr Peter J , Pecher Marina , Waiser David , Kaji Junko , Fava Maurizio 
Published: January 2017

Objectives: To examine current concerns that in the Canadian single-payer mental health care system, the “rich worried well” (that is, wealthy individuals who are worried yet mentally well) may overuse psychiatric services, while low-income, uninsured mentally ill individuals may remain undertreated. The current study focuses on the mental health care in the Canadian region of Ottawa-Carleton, where a single-payer system provides universal access to mental health services, to assess how psychiatric services are provided by psychiatrists in private practice. Method: One hundred and seven private psychiatrists working in the region of Ottawa-Carleton completed a questionnaire which contained questions about the sociodemographic characteristics and background of the psychiatrists themselves and which asked the psychiatrists specific questions about the sociodemographic status, diagnosis, and treatment of each patient seen on November 10, 1994. Results: Approximately 93% of the patients seen met criteria for one or more Axis I disorders, of which mood and anxiety disorders were the most common. Wealthier patients were relatively underrepresented among the patients treated by the private psychiatrists. In addition, we found no significant differences in the distribution of Axis I, Axis II, and Axis III disorders between patients earning below $30 000 per year compared with patients earning above $60 000 per year. Conclusions: Our results suggest that outpatient psychiatric care delivered by private psychiatrists in a Canadian single-payer system targets primarily individuals with major psychiatric disorders and does not seem to favour “the worried well.” Larger epidemiological studies with independent assessments of psychiatric populations are necessary to confirm our findings.
Is Mr Pac Man Eating Our Children? A Review of the Effect of Video Games on Children
Authors: Emes Craig E 
Published: January 2017

Objective: To provide mental health professionals with an up-to-date review of the literature regarding the effects of playing video games on the well-being of children. Method: A computerized literature search of MEDLINE and PSYCHINFO of all articles written in English from 1966 to 1996 was performed. The various studies are organized into different sections. Results: Playing video games is associated with a variety of physical effects including increased metabolic and heart rate, seizures, and tendinitis. Aggressive behaviour may result from playing video games, especially among younger children. There is no direct relationship between psychopathology or academic performance and playing video games. Conclusions: Video games have some adverse effects, but they are also valuable learning tools. Research about the role of video games is inadequate. The data are also limited by the lack of long-term studies and inconsistent findings.
The Relationship of Endogenous Cortisol to Psychiatric Disorder: A Review
Authors: Kiraly Stephen J , Ancill Raymond J , Dimitrova Gergana 
Published: January 2017

Objectives: To focus on hypothalamic-pituitary-adrenal (HPA) axis activity, especially endogenous hypercortisolemia, to study its role in the maintenance of psychiatric illness, and to entertain the probability that the elderly are vulnerable. Method: Case presentation, clinical and research literature review, and theoretical discussion. Results: Clinical and research evidence overwhelmingly suggest that hypercortisolemia is toxic to the hippocampus. Some research supports the position that it can be a treatable perpetuating factor in a subset of affective disorders and psychoses. Pharmacological treatments to correct hypercortisolemia have been used by endocrinologists. Hypercortisolemic treatment-resistant and nontreatment-resistant psychoses and affective disorders have been successfully treated by a small number of researchers who remain interested in this subject. Data pertaining to geriatric psychoses may be germane but are sparse. Conclusions: It behooves us to research diagnostic methods pertaining to psychoses and affective disorders associated with hypercortisolemic states. Very little research is available, but we must be alert to the possibility that the elderly are more susceptible to cortisol endotoxicosis than the younger adult population. Without accurate diagnosis, we cannot take advantage of existing antiglucocorticoid strategies.
A Review of Functional Neuroimaging in Mood Disorders: Positron Emission Tomography and Depression
Authors: Kennedy Sidney H , Javanmard Mahan , Vaccarino Franco J 
Published: January 2017

Objective: To examine the progress of positron emission tomography (PET) as a tool for understanding the psychobiology of mood disorders, particularly major depression and bipolar disorder. Method: Review of the literature on functional imaging of mood disorders. Results: Functional imaging techniques have been used in psychiatric research as a noninvasive method to study the behaviour and function of the brain. Techniques used so far have involved the manipulation of emotion in healthy volunteers, the evaluation of depressed (unipolar and bipolar as well as secondary depression), manic, and normal subjects under resting and various activation conditions, such as cognitive activation, acute pharmacological challenge, and chronic thymoleptic treatments. As a result, functional imaging studies tend to support abnormalities in specific frontal and limbic regions. Conclusion: Different PET methods demonstrate consistent abnormalities in the prefrontal, cingulate, and amygdala regions. These findings are in agreement with past animal and clinical anatomical correlates of mood and emotions.
A Review of Continuation and Maintenance Electroconvulsive Therapy
Authors: Rabheru Kiran , Persad Emmanuel 
Published: January 2017

Background: Many patients with major psychiatric disorders who are severely ill, medication-resistant, or medication-intolerant respond more reliably and quickly to a course of electroconvulsive therapy (ECT). The management of such patients after successful treatment with ECT is of significant importance given the high rate of relapse and recurrence of these disorders. The unmet clinical need to maintain the mental health of these seriously ill patients at an optimal level has revived the interest in ECT as an alternative prophylactic treatment. Method: We review the historical background of ECT and the literature that supports its use as a prophylactic treatment in various disorders and special populations. A clinical summary outlining its efficacy, acceptability, risks, cost-effectiveness, and medicolegal aspects is followed by a guide for prescribing ECT for prophylactic reasons. Results: Continuation and maintenance ECT (C/MECT) has been found to be efficacious, safe, well tolerated, and cost-effective. Its greatest impact has been in reducing relapse, recurrence, and rehospitalization, particularly in the management of recurrent mood disorders in the elderly. The elderly are usually refractory or intolerant to pharmacotherapy but have a good response to ECT during the index episode. Parkinson's disease (PD), schizophrenia, and obsessive–compulsive disorder (OCD), as well as affective disorders coexisting with dementia, neurological disorder, or mental retardation, have also been reported to respond to C/MECT. The outcome depends greatly on rate of compliance. Cognitive risks of C/MECT need to be further studied because the literature to date consists mostly of case reports and anecdotal evidence. Controlled studies with well-defined outcome measurements are needed. Conclusions: When planning a rational approach to the care of patients with major pyschiatric disorders, clinicians should carefully consider ECT along with other alternatives.
Courts and Torts: The Psychiatrist Preparing for Trial
Authors: Hoffman Brian F 
Published: January 2017

Objective: To outline how a psychiatric expert can do an impartial assessment and medicolegal report and then give an effective presentation in court that can sustain cross-examination. Methods: The legal principles of litigating emotional trauma are reviewed, including proving causation, characterizing emotional suffering, assessing disability, and determining a realistic prognosis. Results: Psychiatrists must understand the interplay of legal and psychiatric principles when they are asked to assess litigants who are suing for monetary compensation for a widening range of emotional injuries resulting from motor vehicle accidents, slips and falls, incest and sexual abuse of children, discrimination, unlawful dismissal, malpractice, human-made disasters, product liability, and intentional torts, to name a few. Conclusion: The psychiatrist can prepare his or her attitude, knowledge, and skills to give a presentation in court that will be credible, trustworthy, and dynamic. With adequate preparation, the psychiatric expert can bring an informed psychiatric perspective to the court that will have a significant impact on the outcome of the judicial deliberations.
Choking Incidents among Psychiatric Patients: Retrospective Analysis of Thirty-one Cases from the West Bologna Psychiatric Wards
Authors: Fioritti Angelo , Giaccotto Lucia , Melega Vittorio 
Published: January 2017

Objective: To determine the rate of choking incidents among the psychiatric population of 4 inpatient facilities, classifying the incidents according to their probable etiology. Method: All incidents recorded over 18 months were retrospectively analyzed for demographic variables, psychiatric and medical diagnoses, and drug therapy at the time of incident. Where possible, patients underwent psychiatric, neurological, and medical examination. Results: Thirty-one incidents were recorded involving 18 patients at a rate of one incident every 56.32 months' hospitalization per person. One case proved fatal, one patient died several weeks after the incident from aspiration pneumonia, and 5 patients needed reanimation or the Heimlich manoeuvre. Etiological classification showed that incidents due to bradykinetic dysphagia and “fast eating” were the most numerous, even among the fatal or grave cases. Conclusions: Various simple, effective preventive measures emerge from the study.
Severe Conduct Disorder—Some Key Issues
Authors: Werry John Scott 
Published: January 2017

Objective: To examine the state of knowledge about clinically severe conduct disorder and identify key issues. Method: This paper surveys the literature on conduct disorder and delineates and discusses the critical issues. Results: Conduct disorder is the subject of a vast and growing amount of research on taxonomy, correlates, etiology, outcome, management, and prevention. There are 2 distinctive types: childhood and adolescent onset. Comorbidity with other disorders is common. It remains a costly disorder, however, with a generally poor prognosis for the childhood-onset type. The validity of the separation of conduct and antisocial personality disorder is questionable. Conclusions: In view of its huge cost, chronicity, and generally poor outcome, childhood-onset or severe conduct disorder should be considered one of if not the major public health problems of our time, and resources for its study and management should reflect this. The disorder is poorly defined and inadequately studied in females.
Are There Injury-Prone Children? A Critical Review of the Literature
Authors: Wazana Ashley 
Published: January 2017

Objectives: To review the evidence of general injury and pedestrian injury studies to determine if there are child behavioural, emotional, developmental, or physical characteristics that put children at higher risk for injury and, if there are such proneness risk factors, to determine their importance relative to other risk factors. Methods: This paper critically assesses 11 general child injury studies and 6 child pedestrian injury studies that have examined variables of child proneness. Information on study design, source of data, magnitude and significance of the risk factors identified, and study limitations are presented in separate sections. Results: A critical review of the literature suggests that aggression is a consistent risk factor for general injuries but not for pedestrian injuries, hyperactivity is inconsistently associated with all types of injuries, and both a general measure of behaviour problems and a measure of unsafe behaviour were found to be significantly related to pedestrian injuries. A look at the pedestrian injury literature suggests that child risk factors make a consistent but minor contribution to injuries in comparison with environmental and social risk factors. Conclusions: We need to address the environmental and social risk factors by educating parents about the roles of home stressors, poor supervision, and high-risk exposure in child injuries and by adding our voice to the efforts to bring into effect engineering and legislative interventions.