bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residents-as-Teachers Programs in Psychiatry: A Systematic Review
Authors: Dewey Charlene M , Coverdale John H , Ismail Nadia J , Culberson John W , Thompson Britta M , Patton Cynthia S , Friedland Joan A 
Published: January 2017

Objectives: Because psychiatry residents have important roles as teachers and significant opportunities to contribute to medical student education, we set out to: identify all randomized control trials (RCT) for residents' teaching skills programs in psychiatry and to identify the efficacy of those interventions for improving teaching skills; identify the strengths and weaknesses of the available studies across medical disciplines; and identify currently available methods for enhancing residents' teaching skills for residents training in psychiatry. Methods: The published English-language literature was searched using PubMed, Social Sciences Index, and PsycINFO databases, with key search words including: residents, teaching skills, residents as teachers, psychiatry, and assessments. Both RCT and controlled, nonrandomized trials of residents' teaching programs directed to enhance residents' teaching skills were selected and critically appraised. Results: Of 13 trials identified and reviewed, most included residents in internal medicine. Only one included psychiatry residents and assessed their ability to teach interviewing skills to medical students. Along with other studies, this study demonstrated improvement in residents' teaching skills. Overall, interventions and outcome measures were heterogeneous while the quality of methodologies varied. Five studies were of higher quality, representing examples of quality educational research. Several described group differences, blinding, good follow-up, and use of valid, reliable tools. Conclusions: Only one trial exists that incorporated psychiatry residents. Significant opportunity to advance educational research in this field exists. Psychiatry residency program directors should incorporate high-quality methodologies and can benefit from the findings of trials in other disciplines.
Psychiatric Education and Simulation: A Review of the Literature
Authors: McNaughton Nancy , Ravitz Paula , Wadell Andrea , Hodges Brian D 
Published: January 2017

Objectives: Simulation methodologies are integral to health professional education at all levels of training and across all disciplines. This article reviews the literature on simulation in psychiatric education and explores recent innovations and emerging ethical considerations related to teaching and evaluation. Method: The authors searched the MEDLINE, ERIC, and PsycINFO databases from 1986 to 2006 using multiple search terms. A detailed manual search was conducted of Academic Psychiatry, Academic Medicine, and Medical Education. Literature indirectly relevant to the search parameter was also included. Results: Of the more than 5000 articles retrieved from the literature on simulation and health professional education, 72 articles and books used the terms simulation and standardized patients or role play and psychiatry education. Of the more than 900 articles on objective structured clinical examinations (OSCE), 24 articles related specifically to psychiatry OSCEs. Conclusions: Live simulation is used in teaching, assessment, and research at all levels of training in psychiatric education. Simulated and standardized patients are useful and appropriate for teaching and assessment and are well accepted at both undergraduate and post-graduate level. There is also an important place for role play. Further research is needed regarding the implications of different simulation technologies in psychiatry.
Discontinuation of Lithium Augmentation in Geriatric Patients with Unipolar Depression: A Systematic Review
Authors: Ross James 
Published: January 2017

Objective: Lithium is an augmentation strategy for unipolar depression in geriatric populations. This review outlines the evidence in the literature regarding risk of relapse when lithium is discontinued in geriatric patients. Method: Articles were selected based on selection criteria for relevance and design quality (original studies, French or English, patients older than 65 years, patients with an episode of major depressive disorder, meeting DSM-III or greater criteria, and patients who had been successfully treated to remission with lithium augmentation of an antidepressant, then withdrawn from lithium augmentation treatment). Results: Three articles were found. Overall rate of relapse could not be clearly established but a rate of 50% relapse over about 6 months follow-up could be surmised from the study results. Conclusions: There is a risk of relapse in elderly patients whose lithium augmentation treatment for unipolar depression is discontinued. More studies with a randomized control trial design are required to provide more definitive information on this topic.
Suicidal Ideators without Major Depression—Whom are We Not Reaching?
Authors: Rhodes Anne E , Bethell Jennifer 
Published: January 2017

Objectives: To describe individuals who reported suicidal ideation but neither met the criteria for major depression (MD) nor were in contact with mental health services in the previous year. Method: Data were drawn from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Conducted in 2002, the CCHS 1.2 was a cross-sectional population-based survey of 36 984 Canadian household residents aged 15 years or more. First, we described the individuals who reported suicidal ideation, were without MD, and were not in contact with mental health services ( n = 584) as well as their nonsuicidal counterparts ( n = 31 382) based on various demographic and health status variables. Second, to analyse whether these same variables are associated with mental health service contact(s) among suicidal individuals without MD, we compared those who were in contact with mental health services ( n = 209) to those who were not ( n = 584). Results: Almost one-half (47.9%) of the suicidal ideators were without both MD and a mental health service contact in the previous year. Individuals in this group were younger and exhibited greater morbidity than their nonsuicidal counterparts (without MD or mental health service contact) but did not differ by sex. Although male and female respondents were equally represented among the suicidal ideators without MD, male respondents were less likely to contact mental health services. Such contact was more likely among female respondents and individuals with an anxiety disorder. Conclusions: These findings underscore the need for further research evaluating early intervention programs that succeed in capturing suicidal youths, particularly male youths.
Changes over Time in Physical Activity and Psychological Distress among Older Adults
Authors: Cairney John , Faulkner Guy , Veldhuizen Scott , Wade Terrance J 
Published: January 2017

Objective: While previous research has established that regular involvement in physical activity (PA) is associated with better mental health in old age, the socio-cognitive factors that mediate the association have only been partially tested. We examined whether changes in PA are associated with changes in distress during a 6-year period, and whether this association is mediated by changes in global self-esteem, mastery, and physical health status. Method: A residualized regression technique was used to examine changes over time in a national longitudinal survey of adults aged 65 years and older ( n = 1327). Results: There is a significant association between change in PA and change in distress. Separately, physical health status accounted for 30% of the explained variance of the longitudinal relation between PA and distress, while global self-esteem and mastery accounted for 39%. Combined, they accounted for 50% of the explained variance of PA on distress. Conclusion: These findings highlight the importance of psychosocial factors in the relation between PA and distress. Results suggest that PA interventions focused on improving mastery or self-worth, as well as physical fitness, may yield the greatest benefit in alleviating psychological distress.
Demonstrating Adherence to Guidelines for the Treatment of Patients with Borderline Personality Disorder
Authors: Kolla Nathan J , Links Paul S , McMain Shelley , Streiner David L , Cardish Robert , Cook Michele 
Published: January 2017

Objective: To describe the development and implementation of General Psychiatric Management (GPM), a dynamically informed psychotherapeutic and case management approach along with symptom-targeted pharmacological interventions for the treatment of borderline personality disorder (BPD), derived from the American Psychiatric Association's (APA) guidelines for treating BPD. Method: Clinician adherence to GPM was assessed using the General Psychiatric Management Adherence Scale (GPMAS), which measured the amount of emphasis accorded to therapeutic tools and strategies during individual therapy sessions. GPMAS surveys were completed by 9 different therapists every 6 weeks during 1 year for 50 patients. Results: GPMAS displayed excellent internal consistency and good-to-excellent test–retest reliability. The convergence between patient- and therapist-rated sessions was excellent. Mean levels of emphasis were significantly greater for GPM interventions than prohibited ones across all time points. The mean number of prescribed psychotropic medications was 2.3, and the most frequently prescribed class of medication was antidepressants, followed by neuroleptics. Conclusions: From these results, we conclude that the clinicians were adherent to the outlined protocol and that the GPMAS is a valuable measure for demonstrating adherence to therapies based on the APA guidelines.
Effet du formulaire de consentement verbal sur le taux de participation à un sondage téléphonique
Authors: Jacques Christian , Ladouceur Robert , Baillargeon Lucie , Fournier Patricia-Maude 
Published: January 2017

Objectif: Cette étude a pour but d'évaluer l'effet du formulaire de consentement sur le taux de participation à un sondage téléphonique portant sur les jeux de hasard et d'argent. Méthode: Quatre conditions comportant chacune un formulaire de consentement différent ont été testées. Dans la première condition, le formulaire de consentement satisfait globalement aux exigences des comités d'éthique universitaires, alors que les deuxième et troisième conditions excluent certains éléments. Enfin, le formulaire de consentement de la quatrième condition correspond à l'introduction généralement utilisée par les firmes de sondage privées. Résultats: Les résultats montrent que peu importe l'allègement du formulaire exigé par les comités d'éthique universitaire, le texte d'introduction des firmes privées permet d'obtenir le meilleur taux de participation. Par contre, les participants ayant reçu une introduction similaire à celle employée par les firmes de sondage auraient souhaité être mieux informés en début d'entrevue. Conclusion: La discussion soulève la délicate position dans laquelle se trouve la recherche universitaire, qui veut à la fois satisfaire aux exigences éthiques et réaliser des recherches valides et représentatives.
Cigarette Smoking, Stages of Change, and Major Depression in the Canadian Population
Authors: Khaled Salma M , Bulloch Andrew , Exner Derek V , Patten Scott B 
Published: January 2017

Objective: To describe the 12-month prevalence of major depression in relation to smoking status, nicotine dependence levels, commitment to quit, attempts to quit, and maintenance of smoking cessation in the Canadian general population. Method: Data from Public Use Microdata File of the Canadian Community Health Survey: Health and Well-Being were used. The Composite International Diagnostic Interview—Short Form (CIDI-SF) for major depression was used to assess depressive disorder status. The survey also included a smoking module. There were 49 249 respondents assessed by the CIDI-SF, of whom 10 236 were administered the smoking module. Analyses used appropriate measures to deal with survey design effects. Result: The prevalence of major depression was highest in current smokers, followed by ever smokers, former smokers, and was lowest in the never smokers. This pattern persisted after stratification for age and sex. For quitting, the prevalence of major depression was highest among people who tried to quit, followed by those who considered quitting, those who quit in the past year, and lowest among those who maintained their smoking cessation status for longer than 1 year. The prevalence of depression among those with a high nicotine dependence level, as assessed by the Fagerstrom Tolerance Questionnaire, was about twice that of people with a low nicotine dependence level. Conclusion: The strikingly high prevalence of major depression among current smokers who are young, trying to quit, and with high nicotine dependence levels in the general population indicates that further longitudinal exploration of this topic is urgently needed.
Prevalence and Correlates of 12-Month Prescription Drug Misuse in Alberta
Authors: Currie Cheryl L , Schopflocher Donald P , Wild T Cameron 
Published: January 2017

Objective: We examined the prevalence and correlates of prescription drug misuse (PDM) in a population-based sample of adults from Alberta. Methods: Data were collected from 3511 adults in Alberta aged 18 years and older in 2002 using a computer-aided telephone survey; the survey response rate was 57.4%. Results: The prevalence of 12-month PDM in Alberta was 8.2% in 2002. Opiates were the most frequently misused drug class, followed by sedatives, stimulants, and tranquilizers. Current disability was particularly associated with PDM. Odds of PDM were also elevated among adult students and adults with a high school diploma relative to adults with a post-secondary degree. Past-year problem gambling, illicit drug use, and alcohol use and dependence were each associated with PDM, while past-year binge drinking and daily smoking were not. Conclusions: Findings suggest PDM was an important public health concern in Alberta in 2002. Estimates suggest prescription use and misuse have increased substantially in Canada since that time. There is an urgent need for an ongoing assessment of this evolving problem so that effective prevention and therapeutic strategies can be developed.
La thérapie cognitivo-comportementale des psychoses en début d'évolution: étude ouverte en milieu clinique
Authors: Marois Marie-Josée , Gingras Nathalie , Provencher Martin D , Mérette Chantal , Émond Claudia , Bourbeau Julie , Jomphe Valérie , Roy Marc-André 
Published: January 2017

Objectif: Les résultats des méta-analyses concluent à l'efficacité de la thérapie cognitivo-comportementale des psychoses (TCCp) sur les symptômes persistants. Cependant, la validité externe reste à explorer. L'application de la TCCp aux psychoses débutantes (c'est-à-dire, les 5 premières années suivant le diagnostic) paraît particulièrement pertinente, compte tenu de l'effet possible sur l'évolution au long cours. Cependant, les quelques études ayant expérimenté la TCCp auprès de cette population ont eu des résultats décevants. Toutes ont introduit la thérapie en phase psychotique aiguë et la plupart ont effectué un nombre limité de séances. Ainsi, la présente étude ouverte d'implantation vise à évaluer l'efficience d'un programme de TCCp australien de 25 séances, introduit en phase stable, auprès de patients de Québec souffrant de psychoses débutantes. Méthode: Le programme Active Cognitive Psychotherapy for Early Psychosis a été offert à 20 patients âgés de 14 ans et plus, à raison d'une séance hebdomadaire pendant 6 mois. Résultats: Le taux d'acceptation était de 75 %, le taux moyen d'observance des séances de 84 %, et les participants étaient satisfaits du programme. Les analyses d'avant et d'après la TCCp rapportent des améliorations statistiquement significatives de la symptomatologie psychotique, lesquelles sont maintenues au suivi de 6 mois. L'autocritique est également améliorée de façon statistiquement significative après la TCCp. Conclusion: La TCCp semble applicable à nos milieux cliniques, notamment chez les adolescents. De plus, la posologie employée semble favoriser l'observance des rencontres.
Ten Years of Antipsychotic Prescribing to Children: A Canadian Population-Based Study
Authors: Alessi-Severini Silvia , Biscontri Robert G , Collins David M , Sareen Jitender , Enns Murray W 
Published: January 2017

Objective: To report the prescribing of antipsychotics to the youth population of the Canadian province of Manitoba during the course of a decade. Methods: Use of antipsychotics in children and adolescents (aged 18 years or younger) was described using data collected from the administrative health databases of Manitoba Health and the Statistics Canada census between the fiscal years of 1999 and 2008. Results: The prevalence of antipsychotic use in this segment of the population increased with the introduction of the second-generation antipsychotics (SGAs) from 1.9 per 1000 in 1999 to 7.4 per 1000 in 2008. The male-to-female antipsychotic usage ratio increased from 1.9 to 2.7 as the male youth population represented the fastest-growing subgroup of antipsychotic users in the entire population of Manitoba. The total number of prescriptions also increased significantly despite the lack of approved indications in this population. Proportion of use remained equally split between high- and low-income users. More than 70% of antipsychotic prescriptions to children and adolescents were written by general practitioners. The most common diagnoses linked to antipsychotic use were attention-deficit hyperactivity disorder and conduct disorders. Use of antipsychotics in combination with methylphenidate increased from 13% to 43%. Conclusion: Extensive off-label use of SGAs has been observed in the youth population of Manitoba for treatment of aggressive behaviours across a range of diagnoses. It is important to monitor antipsychotic prescribing to children as more reports of significant adverse events associated with antipsychotics become available.
Educating Family Physicians to Recognize and Manage Depression: Where are We Now?
Authors: Gask Linda 
Published: January 2017

Objectives: To consider what the barriers are to effective depression education; to understand what attitudes, knowledge, and skills doctors need to acquire, and finally to examine what we currently know about effective ways of training family physicians (FPs) about depression. Methods: A narrative review of the published literature compiled from searching reviews and original articles was conducted using the following key words: education, training, attitudes, depression, and primary care. Further relevant articles were identified from reference lists. Results: The identified barriers are FPs' attitudes and confidence toward recognizing and managing depression, the way in which they conceptualize depression, and the difficulties they face in implementing change in the systems in which they work. We, as educators, can identify what FPs need to know, and this should include novel ways of organizing care. However, of key importance is the need to address how more effective interventions may be provided, recognizing that FPs may be starting from many different points on 3 differing continua of attitude, skills, and knowledge in relation to depression. Conclusions: We have to not only ensure that the content of what we teach is perceived as relevant to primary care but also review exactly how we go about providing it, using methods that will engage and stimulate doctors at differing stages of readiness to acquire new attitudes, skills, and knowledge about depression. However, we still need to find better ways of helping FPs to recognize and acknowledge their educational needs. Further research is also required to thoroughly evaluate these novel approaches to tailoring educational interventions.
Psychosocial Interventions for Bipolar Disorder and Coping Style Modification: Similar Clinical Outcomes, Similar Mechanisms?
Authors: Parikh Sagar V , Hawke Lisa D , Zaretsky Ari , Beaulieu Serge , Patelis-Siotis Irene , MacQueen Glenda , Young L Trevor , Yatham Lakshmi , Velyvis Vytas , Bélanger Claude , Poirier Nancy , Enright Jean , Cervantes Pablo 
Published: January 2017

Objective: To investigate changes in the use of coping styles in response to early symptoms of mania in cognitive-behavioural therapy (CBT), compared with psychoeducation, for bipolar disorder. Method: Data were drawn from a randomized controlled trial comparing CBT and psychoeducation. A subsample of 119 participants completed the Coping Inventory for the Prodromes of Mania and symptom assessments before treatment and 72 weeks later. Results: Both CBT and psychoeducation were associated with similar improvements in symptom burden. Both treatments also produced equivalent improvements in stimulation reduction and problem-directed coping styles, but no statistically significant change on the endorsement of help-seeking behaviours. A treatment interaction showed that a reduction in denial and blame was present only in the CBT treatment condition. Conclusions: CBT and psychoeducation have similar impacts on coping styles for the prodromes of mania. The exception to this is denial and blame, which is positively impacted only by CBT but which does not translate into improved outcome. Given the similar change in coping styles and mood burden, teaching patients about how to cope in adaptive ways with the symptoms of mania may be a shared mechanism of change for CBT and psychoeducation.
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.