bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Updated Review of the Optimal Lithium Dosage Regimen for Renal Protection
Authors: Carter Lorie , Zolezzi Monica , Lewczyk Andrea 
Published: January 2017

Objective: Despite several decades of research, there is still uncertainty regarding the optimal lithium dosage regimen associated with a decreased risk of renal effects, such as polyuria, in patients with bipolar affective disorder. We present an updated review of the literature to provide an informed dosing regimen recommendation for prescribers. Method: Major databases MEDLINE and Embase were searched using terms, such as lithium, drug administration schedule, dose–response relationship, once daily, twice daily, and sustained release. In addition, the bibliographies of related publications were manually searched. Results: A total of 20 trials were included. Some trials showed a reduction in urine volume with single daily dosing (SDD), while others showed no change. The only trial evaluating patients newly started on lithium found a reduction in urinary frequency with SDD after 21 days. Trials examining renal biopsy results found that multiple daily doses were associated with more pathologic damage to the kidneys. SDD regimens were generally well tolerated, and no reduction in efficacy was noted in any of the trials. Conclusions: The available evidence is contradictory as to whether SDD of lithium reduces polyuria; however, no trial has demonstrated any downfall of SDD in terms of prophylactic efficacy or adverse effects. Given the added benefits of SDD, such as improved compliance, we recommend patients newly started on lithium should be converted to a SDD of lithium at bedtime once an appropriate daily dose is determined.
Social Network Intervention in Patients with Schizophrenia and Marked Social Withdrawal: A Randomized Controlled Study
Authors: Terzian Emanuela , Tognoni Gianni , Bracco Renata , De Ruggieri Edoardo , Ficociello Rita Angela , Mezzina Roberto , Pillo Giuseppe 
Published: January 2017

Objective: To evaluate the efficacy and feasibility of actions intended to implement or improve patients' social network within the Italian National Health Service community mental health services. Methods: We conducted a randomized clinical trial through a network of 47 community mental health services on patients with a diagnosis in the schizophrenia spectrum (F20 in the International Classification of Diseases, 10th Revision), who were young (aged younger than 45 years), and with a poor social network (less than 5 relationships). In addition to routine treatments, for the experimental group, the staff identified possible areas of interest for individual patients and proposed social activities taking place outside the services' resources and with members of the community. The main outcome was an improvement in the patients' social network; secondary end points were clinical outcome, abilities of daily living, and work. Results: One- and 2-year outcomes of 345 and 327, respectively, of the 357 patients randomized were analyzed by intention-to-treat. A social network improvement was observed at year 1 in 25% of the patients allocated to routine treatment and in 39.9% of those allocated to the experimental arm (OR 2.0, 95% CI 1.3 to 3.1; adjusted OR 2.4, 95% CI 1.4 to 3.9). The difference remained statistically significant at year 2. No significant differences emerged for any of the other end points. However, patients with 1 or more other areas of improvement at year 1 and 2 showed a statistically significant social network improvement. Conclusions: The activation of social networks as an activity integrated with standard psychiatric care is practicable, without added economic and organizational costs, and appears to produce an effect persisting well beyond its implementation.
Nonmedical Use of Prescription Medication among Adolescents Using Drugs in Quebec
Authors: Roy Élise , Nolin Marc-Antoine , Traoré Issouf , Leclerc Pascale , Vasiliadis Helen-Maria 
Published: January 2017

Objective: To determine the prevalence and factors associated with nonmedical use of prescription medication (NMUPM) among adolescents who use drugs (ages 12 to 17 years) in Quebec. Method: Secondary data analyses were carried out with data from a 6-month study, namely, the 2010–2011 Quebec Health Survey of High School Students—a large-scale survey that sought to gain a better understanding of the health and well-being of young Quebecers in high school. Bivariate and multivariate logistic regression analyses were conducted to study NMUPM among adolescents who use drugs, according to sociodemographic characteristics, peer characteristics, health indicators (anxiety, depression, or attention-deficit disorder [ADD] with or without hyperactivity), self-competency, family environment, and substance use (alcohol and drug use) factors. Results: Among adolescents who had used drugs in the previous 12 months, 5.4% (95% Cl 4.9% to 6.0%) reported NMUPM. Based on multivariate analyses, having an ADD (adjusted odds ratio [AOR] 1.47; 95% CI 1.13 to 1.91), anxiety disorder (AOR 2.14; 95% CI 1.57 to 2.92), low self-esteem (AOR 1.62; 95% CI 1.26 to 2.08), low self-control (AOR 1.95; 95% CI 1.55 to 2.45), low parental supervision (AOR 1.43; 95% CI 1.11 to 1.83), regular alcohol use (AOR 1.72; 95% CI 1.36 to 2.16), and polysubstance use (AOR 4.09; 95% CI 3.06 to 5.48) were associated with increased odds of reporting NMUPM. Conclusions: The observed prevalence of NMUPM was lower than expected. However, the associations noted with certain mental health disorders and regular or heavy use of other psychoactive substances are troubling. Clinical implications are discussed.
A Participant's Observations: Preparing DSM-IV
Authors: Shaffer David 
Published: January 2017

Objective: To provide an overview of the process of creating the DSM-IV from a participant's perspective. Method: Narrative review. Results: In its attempt to address the perceived weaknesses of both the content and development of the DSM-III and DSM-III-R, the DSM-IV development was based on commissioned reviews for sets of diagnoses, especially designed field trials and a transparent decision-making process. Conclusions: Nosology is an ambitious and complicated enterprise. Classification systems must evolve as new empirical evidence is presented. Many of the obstacles faced by the DSM-IV work groups, therefore, may be moot for those formulating DSM-V. The DSM-IV development process was carefully planned, and the profession is indebted to the American Psychiatric Association (APA) for its initiative and effort in producing this system.
The Use of Selective Serotonin Reuptake Inhibitors in Young Children with Pervasive Developmental Disorders: Some Clinical Observations
Authors: Awad George A 
Published: January 2017

Objective: To study the effects of a new group of psychotropic medications, the selective serotonin reuptake inhibitors (SSRIs), on some symptoms of young children (under 7 years old) with pervasive developmental disorders (PDD). Method: Open clinical trial. Results: Medications produced positive results in half the children, particularly those with obsessional, repetitive, and anxiety symptoms. The medication was discontinued in half the children: one-quarter for worsening of symptoms and the other quarter for doubtful side effects. Conclusions: SSRIs may have a role to play in ameliorating some symptoms of PDD. Further studies with standardized measurements, however, are needed to elucidate which children and what symptoms could benefit from which medication.
Utilisation de «l'arrêt des pensées» dans le traitement d'un trouble obsessionnel-compulsif chez une fillette de neuf ans
Authors: Frare Paola , Lebel Alain 
Published: January 2017

Objectif: L'utilisation d'une approche pharmacocomportementale, ayant recours aux techniques modifiées d'exposition et prévention de la réponse et d'arrêt des pensées, dans le traitement d'un trouble obsessionnel-compulsif chez une fillette de 9 ans. Méthode: Le diagnostic du trouble obsessionnel-compulsif (TOC) a été posé selon les critères du DSM-IV. La patiente a été rencontrée pendant 15 séances durant lesquelles la clomipramine a été introduite et les techniques modifiées d'exposition et prévention de la réponse et d'arrêt des pensées ont été utilisées successivement. Le suivi s'est prolongé sur plus d'un an et demi après la fin de la thérapie. Résultats: L'apprentissage et l'utilisation des techniques comportementales ont été faciles pour la patiente et nous avons observé une disparition rapide, complète et soutenue de la symptomatologie obsessionnelle-compulsive. Conclusion: L'utilisation de l'approche pharmacocomportementale dans le traitement du TOC chez les jeunes enfants demeure limitée. Des techniques utilisées chez l'adulte légèrement modifiées pour les adapter à l'enfant représentent à notre avis une avenue thérapeutique à explorer.
Psychopathology in Adolescent Mothers and its Effects on Mother—Infant Interactions: A Pilot Study
Authors: Cassidy Beverley , Zoccolillo Mark , Hughes Susan 
Published: January 2017

Objective: This study assessed adolescent maternal psychopathology and its relation to the quality of mother–infant interactions. Method: Twenty-one mother-infant pairs recruited from an adolescent medicine clinic were assessed for socio-demographic background, psychosocial adversity, conduct disorder, alcohol or substance dependence, and depression. Dyads were videotaped during free play and their interactions rated using the Crittenden Child–Adult Relational Experimental (CARE) Index. Results: A large proportion of mothers exhibited psychopathology. Severity of maternal depression correlated positively with maternal controllingness and infant difficulty. Severity of maternal antisocial history correlated positively with maternal unresponsiveness and infant passivity. Conclusion: Though preliminary, this work suggests that adolescent maternal depression and antisocial history have different effects on the quality of mother–infant interactions. Researchers and clinicians interested in adolescent parenting should consider psychopathology as a contributing variable to the quality of mother–infant interactions.
Prevention concerning Mental Health: The Adolescent's Perspective
Authors: Villeneuve Claude , Bérubé Huguette , Ouellet Rejeanne , Delorme André 
Published: January 2017

Objective: To examine several subjective components of adolescents' behaviour concerning mental illness prevention. Method: Adolescents' knowledge, their attitudes and subjective norms, as well as their thoughts about how they would concretely handle a psychological problem were measured. A self-administered questionnaire was completed by 438 male and female adolescents in grades 8 and 11. Results: Gender and age differences were revealed: girls and older adolescents were more attuned to prevention. Further, the influence on young people of peers and parents was also apparent. Conclusion: Adolescents perceive prevention concerning mental health as important.
Building Curriculum for Training in Community Child Psychiatry
Authors: Leverette John , Froese Arthur , DiNicola Vincenzo 
Published: January 2017

Objective: To present a practical approach to curriculum design for community-based care in child psychiatry. Method: A design template is presented, steps for a curriculum review are derived from it, and as an example, a small academic division's program is reviewed. Results: The division's curriculum was developed according to the template, resulting in an enhanced focus and improved coverage of topics through a combination of experiential and didactic teaching. Conclusion: The suggested format is considered applicable to child psychiatric training programs of all sizes and offers an opportunity to review or initiate the teaching of community child psychiatry.
Research Productivity among PhD Faculty Members and Affiliates Responding to the Canadian Association of Professors of Psychiatry and Canadian Psychiatric Association Survey
Authors: Atkinson Mark , el-Guebaly Nady 
Published: January 2017

Objective: This survey endeavours to assess the research productivity of PhD degree holders affiliated with Canadian academic departments of psychiatry. Method: A questionnaire was adapted to suit the Canadian milieu and was distributed to a target population of 2484, of whom 345 were nonmedical PhDs. Results: Out of 861 respondents, 148 indicated that they held a PhD degree only— a response rate of 42.9% for that subgroup. PhD respondents engaged in significantly more research activities than MDs. Their fields of research activity differed according to amount of time spent in research activities. Few gender differences were observed. Conclusions: The recruitment of sole PhD holders is an indicator of the current research needs of departments and of the dearth of candidates for these positions among MDs.
Screening Patients with Mental Retardation for Polydipsia
Authors: Hayfron-Benjamin Jonathan , Peters Claudia A , Woodhouse Rosamund A 
Published: January 2017

Objectives: To determine whether caregiver responses to a screening question are a reliable method of identifying polydipsia (excessive water drinking) in institutionalized residents with mental retardation. To review the etiology, acute and chronic clinical manifestations, and care of polydipsia and water intoxication. Method: This paper presents an assessment of interrater reliability for a screening question for polydipsia using responses of primary caregivers of preidentified polydipsia cases (n = 32) and matched controls (n = 33) in a large Canadian institution for developmentally handicapped adults. A chart review of all cases of identified water intoxication is also provided. The behavioural outcomes of preventive measures for water intoxication are described. Results: The screening instrument was reliable, having a κ (interrater reliability) of 0.73. Several case descriptions illustrate typical presentations of water intoxication in this population. Conclusions: Polydipsia is reliably identified by caregiver responses to a screening question. It should be screened for regularly to ensure appropriate care to prevent important acute and chronic complications.
Psychiatric Morbidity in HIV Patients
Authors: Khouzam Hani Raoul , Donnelly Nancy J , Ibrahim Nabil F 
Published: January 2017

Objective: To provide an accessible source of clinical information related to the diagnosis and treatment of psychiatric morbidity associated with HIV infection. Method: A selective MEDLINE literature search was used to identify 225 relevant articles, 67 of which were selected for inclusion based upon the presence of psychiatric morbidity. Psychiatric morbidity was defined by the presence of a DSM-IV diagnostic code reflecting psychiatric illness. Results: HIV-infected patients have high rates of psychiatric morbidity. Conclusion: The psychiatric evaluation and treatment of psychiatric morbidity improve the quality of life of HIV and AIDS patients.
The Prevalence of Posttraumatic Stress Disorder in an Adolescent Inpatient Unit
Authors: Koltek Mark , Wilkes TCR , Atkinson Mark 
Published: January 2017

Objective: To examine the prevalence and comorbidity of posttraumatic stress disorder (PTSD) in an adolescent inpatient population. A 2-year retrospective chart study was conducted. Method: Computer-registered data of discharge records from 1993 and 1994 were recovered. Patients were grouped by diagnosis; frequency and chi-square statistical analyses were performed to ascertain the prevalence and the comorbidity of various diagnoses with PTSD. Results: A total of 187patients, 114 females and 73 males, with a mean age of 15 years were reviewed, and 42% (79) of all patients had a diagnosis of PTSD using DSM-III-R criteria. There were 54 females and 25 males with PTSD; however, gender effect was not clinically significant. Associated comorbidity reaching clinical significance included other anxiety disorders (P = 0.008) and depressive disorders (P = 0.003). Asthma was diagnosed as a significant clinical disorder (P = 0.05) comorbid with PTSD. PTSD diagnoses correlated strongly with a history of abuse (P = 0.0001). Conclusions: PTSD occurs frequently in adolescent inpatients and is commonly comorbid with other diagnostic presentations. These findings may affect the management of PTSD and prognosis for this population.
Suggestions for a Framework for an Empirically Based Classification of Personality Disorder
Authors: Livesley W John 
Published: January 2017

Background: The classification of personality disorder is one of the least satisfactory sections of contemporary psychiatric classification. Fundamental problems with current classifications include extensive diagnostic overlap, limited evidence of validity, and poor empirical support. Methods: Conceptual analysis and the results of empirical studies are used to propose a framework for organizing an empirically based classification. Results: First, personality disorder is a form of mental disorder and, therefore, should be classified as a single diagnostic entity on Axis I along with other mental disorders. A preliminary definition of personality disorder as a tripartite failure involving the self system, kinship relationships, and societal relationships is proposed. The evidence suggests that this definition can be translated into a reliable set of items. Second, the diagnosis of personality disorder should be separated from the assessment of clinically relevant personality traits. Given the consistent evidential support for a dimensional model of personality disorder, it is suggested that personality be coded on a set of trait dimensions selected to provide a systematic representation of the domain of behaviours represented by current diagnostic concepts. Third, given that personality traits are hierarchically organized, it is suggested that an axis for coding personality include basic or lower-order dimensions as the primary level of assessment and a few higher-order patterns to summarize information for some purposes. Conclusion: A preliminary list of 16 basic dispositional traits is proposed to describe the more specific components of personality disorder based, in part, on the convergence of evidence across studies: anxiousness, affective lability, callousness, cognitive dysregulation, compulsivity, conduct problems, insecure attachment, intimacy avoidance, narcissism, oppositionality, rejection, restricted expression, social avoidance, stimulus seeking, submissiveness, and suspiciousness. Three higher-order patterns were proposed: emotional dysregulation, dissocial behaviour, and inhibitedness, which may occur independently or in combination.
Does Childhood Trauma Cause Personality Disorders in Adults?
Authors: Paris Joel 
Published: January 2017

Objective: To examine the relationship between trauma in childhood and personality disorders in adulthood. Method: A review of the literature was conducted. Results: The reported associations between trauma and personality pathology are illuminated by the following research findings: 1) personality is heritable; 2) only a minority of patients with severe personality disorders report childhood trauma; and 3) children are generally resilient, and traumatic experiences do not consistently lead to psychopathology. Conclusions: The role of trauma in the personality disorders is best understood in the context of gene–environment interactions.
Delusions and Self-Esteem
Authors: Bowins B , Shugar G 
Published: January 2017

Objective: To investigate the hypothesis that the content of delusions and hallucinations is significantly influenced by subjects ' global self-esteem and by 5 specific areas of self-esteem. Method: The delusions and hallucinations of 40 psychotic patients were assessed by 2 independent raters for content indicative of positive or negative self-esteem and for the extent to which the delusional content would be self-enhancing (or diminishing) and comforting (or discomforting) to the subject. These ratings were correlated with the results of self-esteem inventories completed by the subjects. Results: The content of delusions reflects both global self-esteem and self-regard. Conclusions: This study demonstrates that 2 specific personality factors, global self-esteem and self-regard, are reflected in the content of delusions and influence whether those delusions are experienced as comfortable (or uncomfortable) and enhancing (or diminishing). Delusional content is therefore consistent with patients ' views of themselves, and this may partially account for the persistence of delusions.
Autonomie Correlates of Antidepressant Treatment Using Heart-Rate Variability Analysis
Authors: Khaykin Yaariv , Dorian Paul , Baker Brian , Shapiro Colin , Sandor Paul , Mironov Dmitry , Irvine Jane , Newman David 
Published: January 2017

Objective: To assess the 24-hour temporal-domain heart-rate variability correlates of treatment with fluoxetine or doxepinfor depression. Method: A randomized evaluation of fluoxetine and doxepin measured a 50% change in the Hamilton Depression Rating Scale (HDRS) score as a response to therapy and was correlated with measures of standard deviation of the mean of all 5-minute segments of normal electrocardiographic R-R intervals (SDANN), standard deviation of all normal R-R intervals (SDNN), root mean square of successive differences in R-R intervals (r-MSSD), and percentage difference between adjacent normal R-R intervals that are greater than 50 msec (pNN50)from 24-hour electrocardiogram (ECG) tapes. Results: Ten out of 14 patients responded. Response was associated with an increase in SDANN of 17% (P < 0.05). Nonresponse was associated with a 17% decrease in SDANN and a 22% decrease in SDNN (both P < 0.05). No other measures correlated with therapeutic response. No heart-rate variability (HRV) differences between the 2 drug therapies were observed. Conclusion: Twenty-four-hour HRV measures may be useful in assessing response to antidepressant therapy.
Anxious Attachment and Self-Reported Depressive Symptomatology in Women
Authors: West Malcolm , Rose M Sarah , Verhoef Marja J , Spreng Sheila , Bobey Mary 
Published: January 2017

Objective: Lack of intimacy has been identified as an important provoking agent that increases the risk of depressive symptoms in women. This study precisely characterized lack of intimacy by assessing a woman's attachment style and investigated the specificity of association between depressive symptoms and an anxious attachment pattern. Method: Four hundred and twenty women participated in this cross-sectional study of depressive symptomatology and anxious attachment. All participants completed the following measures: a sociodemographic questionnaire, the Centre for Epidemiological Studies Depression Scale (CES-D), the Reciprocal Attachment Questionnaire, the Social Support Questionnaire, the Rosenberg Self-Esteem Scale, and the Global Assessment of Recent Stress Scale. Results: A score of 16 or above on the CES-D, which indicates the presence of depressive symptoms, was used to divide the sample into 2 groups: a depressed group (N = 129) and a nondepressed group (N = 291). We found that women in the depressive symptomatology group were more likely than women in the nondepressive symptomatology group to exhibit anxious attachment and adverse social and cognitive characteristics. Lower levels of self-esteem and higher levels of recent stress were also predictive of depressive symptomatology. Feared loss of the attachment figure and a lack of use of the attachment figure were independent predictors of depressive symptomatology in the same model. Conclusion: The feared loss of security associated with an attachment figure seems to be related to an increased likelihood of depressive symptoms.