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Abstract
Bipolar disorders (BDs) are recurrent and sometimes chronic disorders of mood that affect around 2% of the world's population and encompass a spectrum between severe elevated and excitable mood states (mania) to the dysphoria, low energy, and despondency of depressive episodes. The illness commonly starts in young adults and is a leading cause of disability and premature mortality. The clinical manifestations of bipolar disorder can be markedly varied between and within individuals across their lifespan. Early diagnosis is challenging and misdiagnoses are frequent, potentially resulting in missed early intervention and increasing the risk of iatrogenic harm. Over 15 approved treatments exist for the various phases of bipolar disorder, but outcomes are often suboptimal owing to insufficient efficacy, side effects, or lack of availability. Lithium, the first approved treatment for bipolar disorder, continues to be the most effective drug overall, although full remission is only seen in a subset of patients. Newer atypical antipsychotics are increasingly being found to be effective in the treatment of bipolar depression; however, their long term tolerability and safety are uncertain. For many with bipolar disorder, combination therapy and adjunctive psychotherapy might be necessary to treat symptoms across different phases of illness. Several classes of medications exist for treating bipolar disorder but predicting which medication is likely to be most effective or tolerable is not yet possible. As pathophysiological insights into the causes of bipolar disorders are revealed, a new era of targeted treatments aimed at causal mechanisms, be they pharmacological or psychosocial, will hopefully be developed. For the time being, however, clinical judgment, shared decision making, and empirical follow-up remain essential elements of clinical care. This review provides an overview of the clinical features, diagnostic subtypes, and major treatment modalities available to treat people with bipolar disorder, highlighting recent advances and ongoing therapeutic challenges.
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Affiliation(s)
- Fernando S Goes
- Precision Medicine Center of Excellence in Mood Disorders, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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2
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Miozzo R, Eaton W, Bienvenu OJ, Samuels J, Nestadt G. Psychiatric comorbidity in the Baltimore ECA follow-up study: the matrix approach. Soc Psychiatry Psychiatr Epidemiol 2023; 58:141-151. [PMID: 34820686 PMCID: PMC11100458 DOI: 10.1007/s00127-021-02184-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/31/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Psychiatric comorbidity is defined as the joint occurrence of two or more mental or substance use disorders. Widespread psychiatric comorbidity has been reported in treatment and population-based studies. The aim of this study was to measure the extent and impact of psychiatric comorbidity in a cohort of the Baltimore Epidemiologic Catchment Area study. METHODS We examined the comorbidity burden of 16 mental disorders in a cohort of 847 participants using both established and novel analytical approaches The Comorbidity to Diagnosis Inflation Ratio (CDIR), is a statistical instrument that quantifies impact of pairwise comorbid associations, both on the whole sample, as well as on each specific disorder. RESULTS Most anxiety disorders had substantial co-occurrence with each other, as well as with Major Depressive Disorder (MDD). In addition, mood disorders had a high degree of comorbidity with Alcohol Dependence (AD). The CDIR for the whole sample was 1.32, indicating a ratio of 132 comorbidities per 100 diagnoses. The conditions with high sample prevalence were relatively less comorbid than the low prevalence conditions. Obsessive Compulsive Disorder had a comorbidity burden that was 89% greater than the overall sample. CONCLUSION Anxiety disorders are highly interrelated, as well as highly comorbid with depression. The comorbidity phenomenon is linked to the differential prevalence of the analyzed conditions. Comorbidity frequency (most prevalent comorbid condition) appears mutually exclusive to comorbidity burden (most widely interrelated condition). While AD and MDD were the most frequently diagnosed disorders; low prevalence conditions as OCD and GAD were the most widely interrelated.
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Affiliation(s)
- Ruben Miozzo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA.
- Graduate Training Program in Clinic Investigation, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Meyers Primary Care Institute, Worcester, MA, 01605, USA.
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
| | - William Eaton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA
- Graduate Training Program in Clinic Investigation, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 624 North Broadway, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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3
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Karam E, Kovess Masfety V. We share more attributes than we think: the crucial input of epidemiology. World Psychiatry 2022; 21:475-476. [PMID: 36073691 PMCID: PMC9453892 DOI: 10.1002/wps.21012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Elie Karam
- WPA Section on Epidemiology and Public Health,Institute for Development, Research, Advocacy and Applied Care (IDRAAC)BeirutLebanon,Department of Psychiatry and Clinical Psychology, Faculty of MedicineUniversity of BalamandBeirutLebanon,Department of Psychiatry and Clinical PsychologySt. George Hospital University Medical CenterBeirutLebanon
| | - Vivianne Kovess Masfety
- WPA Section on Epidemiology and Public Health,Laboratoire de Psychopathologie et Processus de SantéParis UniversityParisFrance,Department of PsychiatryMcGill UniversityMontrealCanada
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Abstract
BACKGROUND The use of older data and references is becoming increasingly disfavored for publication. A myopic focus on newer research risks losing sight of important research questions already addressed by now-invisible older studies. This creates a 'Groundhog Day' effect as illustrated by the 1993 movie of this name in which the protagonist has to relive the same day (Groundhog Day) over and over and over within a world with no memory of it. This article examines the consequences of the recent preference for newer data and references in current publication practices and is intended to stimulate new consideration of the utility of selected older data and references for the advancement of scientific knowledge. METHODS Examples from the literature are used to exemplify the value of older data and older references. To illustrate the recency of references published in original medical research articles in a selected sample of recent academic medical journals, original research articles were examined in recent issues in selected psychiatry, medicine, and surgery journals. RESULTS The literature examined reflected this article's initial assertion that journals are emphasizing the publication of research with newer data and more recent references. CONCLUSIONS The current valuation of newer data above older data fails to appreciate the fact that new data eventually become old, and that old data were once new. The bias demonstrated in arbitrary policies pertaining to older data and older references can be addressed by instituting comparable treatment of older and newer data and references.
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Affiliation(s)
- Barry A Hong
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX, USA
| | - David E Pollio
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX, USA
- Center for Scientific Review, National Institutes of Health, Washington, DC, USA
| | - Dana L Downs
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel W Coyne
- John T. Milliken Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Carol S North
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Patient Health Questionnaire (PHQ-9): A depression screening tool for people with epilepsy in Vietnam. Epilepsy Behav 2021; 125:108446. [PMID: 34839244 DOI: 10.1016/j.yebeh.2021.108446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Depression is a common mental disorder in people with epilepsy. Depression has a negative impact on medical and surgical treatment of epilepsy thus affecting the quality of life. Despite its high prevalence, depression has been under-recognized and treated improperly. It may also lead to missed work, increased healthcare system utilization, and higher direct medical costs. OBJECTIVES This study aimed to evaluate the accuracy of the Vietnamese Patient Health Questionnaire (PHQ-9) as a screening tool for depression in people with epilepsy. METHODS This cross-sectional study was conducted prospectively at epilepsy clinic at Nguyen Tri Phuong hospital, Ho Chi Minh City, Viet Nam from December 2019 to March 2020. A total of 91 adult people with epilepsy were recruited. After completing the Vietnamese PHQ-9 questionnaires, each participant was interviewed in a structured clinical interview for DSM-5 (SCID-5) to establish a diagnosis of major depressive disorder. The diagnostic accuracy of the PHQ-9 was assessed using diagnostic efficiency statistics compared with the gold standard structured interview. RESULTS The prevalence of major depression in this sample was 25.3%. The areas under receiver operating characteristic (ROC) curve index of PHQ-9 had an estimated value of 0.91. The PHQ-9 at a cutoff point of 8 had the great overall balance of sensitivity (87.0%) and specificity (82.4%). At the cutoff point of 10, PHQ-9 had a higher specificity of 94.1%, but a lower sensitivity of 78.0%. CONCLUSIONS The Vietnamese version PHQ-9 is an efficient and valid screening tool for depression in people with epilepsy in clinic settings.
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Carstensen LL. Socioemotional Selectivity Theory: The Role of Perceived Endings in Human Motivation. THE GERONTOLOGIST 2021; 61:1188-1196. [PMID: 34718558 DOI: 10.1093/geront/gnab116] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 11/14/2022] Open
Abstract
Socioemotional selectivity theory (SST) is a theory of life-span development grounded in the uniquely human ability to monitor time. SST maintains that the approach of endings-whether due to aging or other endings such as geographic relocations and severe illness-elicits motivational changes in which emotionally meaningful goals are prioritized over exploration. Research guided by SST has informed preferences, social networks, and emotional experience and led to the discovery of the positivity effect in cognitive processing. This article, based on my 2015 Robert W. Kleemeier Award Lecture, describes the development of SST and its related program of empirical research.
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Affiliation(s)
- Laura L Carstensen
- Department of Psychology, Stanford University, Stanford, California, USA.,Center on Longevity, Stanford University, Stanford, California, USA
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Boddu VK, Rebello A, Chandrasekharan SV, Rudrabhatla PK, Chandran A, Ravi S, Unnithan G, Menon RN, Cherian A, Radhakrishnan A. How does "locus of control" affect persons with epilepsy? Epilepsy Behav 2021; 123:108257. [PMID: 34425327 DOI: 10.1016/j.yebeh.2021.108257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/24/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Locus of control (LOC) is the degree to which people believe that they have control over the outcome of events in their lives. A person's locus can be internal, external, or chance. A person with internal locus of control believes that one can control one's own life. A person with external locus of control believes that his life is controlled by external factors or people over which he has no influence. A person with chance locus of control believes that fate, chance, or luck controls his own life. The aim of the current study was to determine the health locus of control, anxiety, and depression levels in persons with epilepsy (PWE) and to assess whether locus of control has relation to anxiety, depression, and seizure control. METHODS Patients aged 18 years or older with a history of epilepsy for at least 1 year were recruited from the outpatient epilepsy clinic or from the inpatient epilepsy monitoring unit at SCTIMST, Trivandrum from January 2019 to May 2020. Patients filled the questionnaire form consisting of demographic data, age of onset of seizures, present seizure control, and the current antiepileptic drugs. The Hospital Anxiety and Depression (HAD) scale was used to estimate the level of anxiety and depression in these patients. The Form-C of the Multidimensional Health Locus of Control (MHLC) scale was used to evaluate the health locus of control. Healthy controls aged 18 years or older and free of any chronic disease or psychiatric illness were also recruited. They were asked to fill the questionnaire forms with basic demographic data. HAD scale was used to estimate the level of anxiety and depression and form-C of MHLC was used to evaluate the health locus of control in the healthy controls. The mean scores of anxiety, depression, and locus of control were compared between the two groups. RESULTS A total of 170 participants were recruited which consisted of 100 PWE and 70 healthy controls. The mean anxiety and depression scores were 8.13(SD = 4.23) and 5.85(SD = 3.66) in the PWE group and 6.75(SD = 3.39) and 4.14(SD = 2.96) in the control group, respectively. The mean internal, external, and chance LOC scores were 24.95(SD = 10.92), 26.94(SD = 4.96), and 24.41(SD = 6.46) in the PWE group; and 29.44(SD = 5.62), 26.53(SD = 5.79), and 19.9(SD = 7.13) in the control group, respectively. Persons with epilepsy had higher chance LOC scores and lower internal LOC scores compared to controls (p = 0.00003, p < 0.00001 respectively). There were no differences in the external LOC scores between the two groups (p = 0.620). Persons with epilepsy with some level of anxiety had lower internal LOC scores compared to patients with no anxiety (p = 0.04). PWE with poor seizure control had higher external LOC score and lower internal LOC scores which however did not reach statistical significance. Persons with epilepsy with poor seizure control had higher anxiety and depression scores. CONCLUSIONS Persons with epilepsy had low perceptions of internal and strong perceptions of chance health locus of control. This means that PWE feel that luck plays an important role in their disease control. This information is important in the counseling of persons with epilepsy.
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Affiliation(s)
- Vijay Kumar Boddu
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Alex Rebello
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Soumya V Chandrasekharan
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Pavan Kumar Rudrabhatla
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Anuvitha Chandran
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Swathy Ravi
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Gopeekrishnan Unnithan
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ramshekhar N Menon
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ajith Cherian
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ashalatha Radhakrishnan
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
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Hudson D, McCrary S, Murugan V, Gerassi L, Proctor EK. Documenting Behavioral Health Needs in an Urban Setting. Front Public Health 2021; 9:493884. [PMID: 34527648 PMCID: PMC8435602 DOI: 10.3389/fpubh.2021.493884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Most local communities lack the capacity to conduct behavioral health needs assessments. The purpose of this paper is to describe a mixed-methods approach to estimate the behavioral health needs in St. Louis, MO. Data were drawn from multiple sources including local and state government prevalence estimates, medical records, and key informant interviews. The most prevalent behavioral conditions were depression, alcohol, and drug abuse. Priority populations were residents with co-occurring disorders, youth transitioning into the adult behavioral system, and homeless individuals with behavioral health needs. Treatment rates for behavioral health conditions were low, relative to identified needs. There are significant provider shortages and high staff turnover, which extend wait times, diminish the quality of care, and contribute to the use of emergency departments for behavioral health care. The data and methods described in this paper could be helpful to other municipalities that are looking to conduct behavioral health needs assessments.
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Affiliation(s)
- Darrell Hudson
- Brown School at Washington University in St. Louis, St. Louis, MI, United States
| | - Stacey McCrary
- Brown School at Washington University in St. Louis, St. Louis, MI, United States
| | - Vithya Murugan
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MI, United States
| | - Lara Gerassi
- School of Social Work, University of Wisconsin-Madison, Madison, WI, United States
| | - Enola K Proctor
- Brown School at Washington University in St. Louis, St. Louis, MI, United States
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Greene MC, Yangchen T, Lehner T, Sullivan PF, Pato CN, McIntosh A, Walters J, Gouveia LC, Msefula CL, Fumo W, Sheikh TL, Stockton MA, Wainberg ML, Weissman MM. The epidemiology of psychiatric disorders in Africa: a scoping review. Lancet Psychiatry 2021; 8:717-731. [PMID: 34115983 PMCID: PMC9113063 DOI: 10.1016/s2215-0366(21)00009-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
This scoping review of population-based epidemiological studies was done to provide background information on the prevalences and distribution of psychiatric disorders in Africa for calls to broaden diversity in psychiatric genetic studies. We searched PubMed, EMBASE, and Web of Science to retrieve relevant literature in English, French, and Portuguese from Jan 1, 1984, to Aug 18, 2020. In 36 studies from 12 African countries, the lifetime prevalence ranged from 3·3% to 9·8% for mood disorders, from 5·7% to 15·8% for anxiety disorders, from 3·7% to 13·3% for substance use disorders, and from 1·0% to 4·4% for psychotic disorders. Although the prevalence of mood and anxiety disorders appears to be lower than that observed in research outside the continent, we identified similar distributions by gender, although not by age or urbanicity. This review reveals gaps in epidemiological research on psychiatric disorders and opportunities to leverage existing epidemiological and genetic research within Africa to advance our understanding of psychiatric disorders. Studies that are methodologically comparable but diverse in geographical context are needed to advance psychiatric epidemiology and provide a foundation for understanding environmental risk in genetic studies of diverse populations globally.
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Affiliation(s)
- M Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Tenzin Yangchen
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Thomas Lehner
- New York Genome Center, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Patrick F Sullivan
- Center for Psychiatric Genomics, Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Carlos N Pato
- Institute for Genomic Health, SUNY Downstate, Health Science University, Brooklyn, NY, USA
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Lidia C Gouveia
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Chisomo L Msefula
- Pathology Department, College of Medicine, University of Malawi, Chichiri, Blantyre, Malawi
| | - Wilza Fumo
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Taiwo L Sheikh
- Department of Psychiatry, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Melissa A Stockton
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA.
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Ismail L, Materwala H, Al Kaabi J. Association of risk factors with type 2 diabetes: A systematic review. Comput Struct Biotechnol J 2021; 19:1759-1785. [PMID: 33897980 PMCID: PMC8050730 DOI: 10.1016/j.csbj.2021.03.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetes is the leading cause of severe health complications and one of the top 10 causes of death worldwide. To date, diabetes has no cure, and therefore, it is necessary to take precautionary measures to avoid its occurrence. The main aim of this systematic review is to identify the majority of the risk factors for the incidence/prevalence of type 2 diabetes mellitus on one hand, and to give a critical analysis of the cohort/cross-sectional studies which examine the impact of the association of risk factors on diabetes. Consequently, we provide insights on risk factors whose interactions are major players in developing diabetes. We conclude with recommendations to allied health professionals, individuals and government institutions to support better diagnosis and prognosis of the disease.
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Affiliation(s)
- Leila Ismail
- Intelligent Distributed Computing and Systems Research Laboratory, Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, Abu Dhabi, 15551, United Arab Emirates
| | - Huned Materwala
- Intelligent Distributed Computing and Systems Research Laboratory, Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, Abu Dhabi, 15551, United Arab Emirates
| | - Juma Al Kaabi
- College of Medicine and Health Sciences, Department of Internal Medicine, United Arab Emirates University, Al Ain, Abu Dhabi 15551, United Arab Emirates
- Mediclinic, Al Ain, Abu Dhabi, United Arab Emirates
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Carlew AR, Fatima H, Livingstone JR, Reese C, Lacritz L, Pendergrass C, Bailey KC, Presley C, Mokhtari B, Cullum CM. Cognitive Assessment via Telephone: A Scoping Review of Instruments. Arch Clin Neuropsychol 2020; 35:1215-1233. [PMID: 33106856 PMCID: PMC7665291 DOI: 10.1093/arclin/acaa096] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Telephone-based cognitive assessment (TBCA) has long been studied but less widely adopted in routine neuropsychological practice. Increased interest in remote neuropsychological assessment techniques in the face of the coronavirus 2019 (COVID-19) pandemic warrants an updated review of relevant remote assessment literature. While recent reviews of videoconference-based neuropsychological applications have been published, no updated compilation of empirical TBCA research has been completed. Therefore, this scoping review offers relevant empirical research to inform clinical decision-making specific to teleneuropsychology. METHOD Peer-reviewed studies addressing TBCA were included. Broad search terms were related to telephone, cognitive, or neuropsychological assessment and screening. After systematic searching of the PubMed and EBSCO databases, 139 relevant articles were retained. RESULTS In total, 17 unique cognitive screening measures, 20 cognitive batteries, and 6 single-task measures were identified as being developed or adapted specifically for telephone administration. Tables summarizing the identified cognitive assessments, information on diagnostic accuracy, and comparisons to face-to-face cognitive assessment are included in supplementary materials. CONCLUSIONS Overall, literature suggests that TBCA is a viable modality for identifying cognitive impairment in various populations. However, the mode of assessment selected clinically should reflect an understanding of the purpose, evidence, and limitations for various tests and populations. Most identified measures were developed for research application to support gross cognitive characterization and to help determine when more comprehensive testing was needed. While TBCA is not meant to replace gold-standard, face-to-face evaluation, if appropriately utilized, it can expand scope of practice, particularly when barriers to standard neuropsychological assessment occur.
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Affiliation(s)
- Anne R Carlew
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Hudaisa Fatima
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Julia R Livingstone
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Caitlin Reese
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Laura Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Cody Pendergrass
- Mental Health Department, VA North Texas Health Care System, Dallas, TX 75216, USA
| | - Kenneth Chase Bailey
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Chase Presley
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Ben Mokhtari
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Colin Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
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Rush B, Tremblay J, Babor TF. Needs-Based Planning for Substance Use Treatment Systems: The New Generation of Principles, Methods, and Models. J Stud Alcohol Drugs Suppl 2020. [PMID: 30681943 PMCID: PMC6377024 DOI: 10.15288/jsads.2019.s18.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Brian Rush
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joël Tremblay
- Département de psychoéducation, UQTR/Centre universitaire de Québec, Québec, QC, Canada
| | - Thomas F Babor
- Department of Community Medicine & Health Care, UConn Health, Farmington, Connecticut
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Abstract
The last 40 years of JAMA Psychiatry are reviewed as a celebration of its achievements. The focus of this article is on the evolution of big data as reflected in key journal articles. The review begins in 1984 with the introduction of the Epidemiology Catchment Area (ECA) study and Freedman's editorial "Psychiatric Epidemiology Counts." The ECA study (N = 17 000), for the first time in a survey, used clinical diagnosis in 5 urban communities, thus linking research and care to population rates of psychiatric diagnosis. The review then traces the subsequent evolution of big data to 5 overlapping phases, other population surveys in the US and globally, cohort studies, administrative claims, large genetic data sets, and electronic health records. Each of these topics are illustrated in articles in JAMA Psychiatry. The many caveats to these choices, the historical roots before 1984, as well as the controversy around the choice of topics and the term big data are acknowledged. The foundation for big data in psychiatry was built on the development of defined and reliable diagnosis, assessment tools that could be used in large samples, the computational evolution for handling large data sets, hypothesis generated by smaller studies of humans and animals with carefully crafted phenotypes, the welcoming of investigators from all over the world with calls for broader diversity, open access and the sharing of data, and introduction of electronic health records more recently. Future directions as well as the opportunities for the complementary roles of big and little data are described. JAMA Psychiatry will continue to be a rich resource of these publications.
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Affiliation(s)
- Myrna M Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.,Mailman School of Public Health, Columbia University, New York, New York.,Division of Translational Epidemiology, New York State Psychiatric Institute, New York
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Hajek A, König HH. The moderating role of flexible goal adjustment in the link between pain and depressive symptoms: findings based on a nationally representative sample of older adults. Psychogeriatrics 2020; 20:602-607. [PMID: 32131145 DOI: 10.1111/psyg.12537] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/06/2020] [Accepted: 02/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pain is a frequent phenomenon in old age. It has been shown that increases in pain are longitudinally associated with depressive symptoms. This strong link can be attenuated by coping strategies like resilience. However, to date, there is a lack of longitudinal studies, based on nationally representative samples that have examined whether flexible goal adjustment moderates the relation between pain and depressive symptoms. Thus, the purpose of this study was to identify whether there is a longitudinal association between pain and depressive symptoms, and to examine whether flexible goal adjustment moderates this link. METHODS Longitudinal data (wave 3 and wave 4; 5582 observations) were taken from a sample (German Ageing Survey) which is nationally representative for middle-aged and older adults (40 years and over). A widely used pain measurement (single-item measure) served as the key independent variable. An instrument created by Brandstaedter and Renner was used to quantify flexible goal adjustment. The 15-item version of the Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. RESULTS Linear fixed effects regressions demonstrated that an increase in pain was associated with an increase in depressive symptoms (β = 0.42, P < 0.001). Moreover, flexible goal adjustment significantly moderated this association (β = -0.39, P < 0.01). With regard to potential confounders, an increase in depressive symptoms was associated with increasing age and worsening self-rated health. CONCLUSION The study findings showed that increasing pain leads to more depressive symptoms using a longitudinal approach. In addition, flexible goal adjustment moderated this link. Therefore, programs aiming at improving flexible goal adjustment may assist in avoiding an increase in depressive symptoms alongside pain increases among older adults.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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15
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Abstract
RésuméLes auteurs font la revue des études récentes concernant l’épidémiologie de la dépression. Les études épidémiologiques de la dépression dans la population générale sont difficiles à interpréter, du fait de différences dans l'identification des cas et de variations dans les procédures de diagnostic entre les études. Mais il y a eu un progrés considérable avec le récent développement des méthodes d’identifications de cas, fiables et valides, comme les RDC et le DSM-III. D’autres problémes méthodologiques concernent le choix de la population et le choix des différentes mesures du risque.Des données examinées, on peut tirer les estimations suivantes : la prévalence sur six mois de la dépression majeure est de 1% à 3% chez l’homme, et 3% à 5% chez la femme; la prévalence sur la vie entiere (proportion des sujets qui ont déjà présenté le trouble) est de 3% à 6% chez l’homme et 5% à 10% chez la femme. L’estimation du risque morbide (ou risque sur la vie entiére) est plus difficile. Le principal probléme provient de l’effet de cohorte de naissance: il semble que les taux de troubles affectifs majeurs sont en train d’augmenter dans les cohortes nées apres la Seconde Guerre mondiale.Aussi, les auteurs proposent une estimation des risques sur la vie entiére qui ne peut être que prudente: 6 à 10% chez l’homme, 12 à 20% chez la femme. Ils envisagent aussi l’épidemiologie de la dépression sous l’angle de la mortalité: les troubles affectifs sont associés non seulement à un haut risque de suicide mais aussi à une mortalité générale augmentée.
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Wiedemann G. Kleptomania: characteristics of 12 cases. Eur Psychiatry 2020; 13:67-77. [DOI: 10.1016/s0924-9338(98)80021-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/1997] [Accepted: 01/09/1998] [Indexed: 01/02/2023] Open
Abstract
SummaryA review of the literature showed that there is no good systematic study of a series of rigorously diagnosed “kleptomaniac” persons, other than those referred by the courts for expert opinions. This applies in particular to German-speaking and other European countries. We therefore report here on the phenomenology, demographics, psychopathology, family histories, treatment histories, behaviour therapy oriented analyses, and treatment results of 12 individuals meeting Diagnostic and Statistical Manual (DSM)-III-R criteria for kleptomania. All patients described an uncontrollable impulse to steal and a reduction in anxiety or tension during or after the act. All had at least one further psychiatric diagnosis. Although the kleptomaniac symptomatology did not seem to be part of these other disorders, the extent of stealing corresponded (positively or negatively) to other psychiatric symptoms such as depressive feelings, excessive urges to eat or migraine attacks. Microanalysis of the act of theft, as well as the preceding and following events (explored by applying behaviour therapy oriented analysis) showed intraindividually consistent, but inter-individually differing triggering factors. There was no evidence of correlation with obsessive-compulsive disorders, but some indications that kleptomania may be associated with affective disorders in terms of an “affective spectrum disorder”. According to a broader definition of “multi-impulsive-disorder” (analogous to Lacey and Evans or Fichter et al), one third of the patients might be diagnosed as “bi-impulsive disorder”. Eight of the 12 patients could be investigated at a mean follow-up time of 2 years after discharge showing favourable results. In conclusion, kleptomaniac behaviour seems to be multiconditionally caused and sustained.
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Polat A, Tiemeier H. Modern psychiatric epidemiology: the challenge of risk factor research. Eur Psychiatry 2020; 20:197-8. [PMID: 15935416 DOI: 10.1016/j.eurpsy.2004.09.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2004] [Accepted: 09/03/2004] [Indexed: 11/21/2022] Open
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Dhanju S, Kennedy SH, Abbey S, Katz J, Weinrib A, Clarke H, Bhat V, Ladha K. The impact of comorbid pain and depression in the United States: results from a nationally representative survey. Scand J Pain 2020; 19:319-325. [PMID: 30759071 DOI: 10.1515/sjpain-2018-0323] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/13/2019] [Indexed: 11/15/2022]
Abstract
Background and aims The co-morbidity between pain and depression is a target of interest for treatment. However most of the published literature on the topic has used clinical cohorts as the population of interest. The goal of this study was to use a nationally representative sample to explore how health outcomes varied across pain and depression status in a cohort sampled from the general US population. Methods This was a cross-sectional analysis of adults ≥18 years in the 2009-2010 National Health and Nutrition Examination Survey. The cohort was stratified into: no pain/depression, pain alone, depression alone, and pain with depression. The primary outcome was self-reported general health status, and secondary outcomes were healthcare visits, overnight hospital stays and functional limitation. Survey weighted logistic regression was used to adjust for potential confounders. Results The cohort consisted of 4,213 individuals, of which 186 (4.4%) reported concurrent pain and depression. 597 (14.2%) and 253 (6.0%) were classified with either pain or depression alone, respectively. The majority of individuals with co-morbid pain and depression reported poor health (65.1%, p<0.001) and were significantly more likely than those with neither condition to rate their health as poor after adjustment (OR: 7.77, 95% CI: 4.24-14.26, p<0.001). Those with pain only or depression only were also more likely to rate their health as poor, albeit to a lesser extent (OR: 2.21, 95% CI: 1.21-2.34, p<0.001; OR: 3.75, 95% CI: 2.54-5.54, p<0.001, respectively). A similar pattern was noted across all secondary outcomes. Most notably, those with co-morbid pain and depression were the most likely to endorse functional limitation (OR: 13.15, 95% CI: 8.00-21.61, p<0.001). Comparatively, a similar trend was noted amongst those with pain only or depression only, though with a reduced effect size (OR: 4.23, 95% CI: 3.12-4.77, p<0.001; OR: 5.13, 95% CI: 3.38-7.82, p<0.001). Conclusions Co-morbid pain and depression in the general population resulted in markedly worse outcomes versus isolated pain or depression. Further, the effect appears to be synergistic. Given the substantial burdens of pain and depression, future treatments should aim to address both conditions simultaneously. Implications As a result of the co-morbidity between pain and depression, patients presenting with either condition should increase the index of suspicion among clinicians and prompt screening for the reciprocal condition. Early intervention for co-morbid pain and depression has the potential to mitigate future incidence of chronic pain and major depression.
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Affiliation(s)
- Simranpal Dhanju
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Susan Abbey
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Joel Katz
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Psychology, York University, Toronto, ON, Canada
| | - Aliza Weinrib
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Psychology, York University, Toronto, ON, Canada
| | - Hance Clarke
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Venkat Bhat
- Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Karim Ladha
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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19
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Haeberlein K, Evans L, Champaigne B, Handal PJ. Differences in Distress and Utilization of Mental Health Services between 2005 and 2018: a Potential Trend? Psychiatr Q 2020; 91:11-19. [PMID: 31758300 DOI: 10.1007/s11126-019-09692-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined possible differences in self-reported psychological distress and need of treatment in two samples of well-educated adults, which were obtained from two larger studies that were conducted separately in 2005 and 2018. Psychological distress and need for treatment were reported using the Langner Symptom Survey, a psychometrically robust measure of nonspecific distress that provides validated cutoff scores for those in need of receiving mental healthcare services. Treatment utilization was examined through self-report in which respondents indicated whether they had never received treatment, previously received treatment, or were currently receiving treatment. Results suggested that a larger percentage of respondents from the 2018 sample reported current counseling (11.8%) compared to the 2005 sample (4.0%), and they were almost twice as likely to be classified as distressed and in need for treatment than their 2005 counterparts (51.9% compared to 33.2% in 2005; odds ratio = 2.17, 95% CI: 1.59-2.97). Implications for these findings are discussed at length.
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Affiliation(s)
| | - Luke Evans
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | | | - Paul J Handal
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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20
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Regier DA. Assessing Need for Mental Health Services. Psychiatry 2020; 83:161-165. [PMID: 32808911 DOI: 10.1080/00332747.2020.1767990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sullivan KJ, Liu A, Dodge HH, Andreescu C, Chang CCH, Ganguli M. Depression Symptoms Declining Among Older Adults: Birth Cohort Analyses From the Rust Belt. Am J Geriatr Psychiatry 2020; 28:99-107. [PMID: 31300193 PMCID: PMC6898763 DOI: 10.1016/j.jagp.2019.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To investigate potential birth cohort effects in depression symptoms in older adults. DESIGN Population-based prospective cohort. SETTING Small-town communities in Pennsylvania. PARTICIPANTS Three thousand two hundred and twenty seven older adults (average baseline age = 71.6) born between 1902 and 1941. MEASUREMENTS Four decade-long birth cohorts were the primary predictors in this study: 1902-1911, 1912-1921, 1922-1931, and 1932-1941. The outcome was symptoms of depression assessed at baseline and follow-up study visits using a modified Center for Epidemiologic Studies Depression Scale (mCES-D). The depression outcome was operationalized as: 1). A binary outcome of having greater than equal to 5 depression symptoms on the total mCES-D at any study visit, and 2). A continuous outcome of four factor-analyzed component scores of the mCES-D including depressed mood, anergia/hopelessness, withdrawal, and poor self-esteem. All analyses were jointly modeled with attrition and adjusted for age, sex, education, Mini Mental State Examination score, antidepressant medications, and total prescription medications. RESULTS Participants from more recently born cohorts were significantly less likely to have a study visit in which they reported greater than or equal to 5 depression symptoms, controlling for attrition. Specifically, in comparison to the 1902-1911 referent cohort, the 1912-1921 birth cohort was 43% less likely (odds ratio [OR] = 0.566, 95% confidence interval [CI]: 0.341-0.939), the 1922-1931 birth cohort was 63% less likely (OR = 0.0369, 95% CI: 0.215-0.632), and the 1932-1941 cohort was 79% less likely (OR = 0.205, 95% CI: 0.106-0.399). The cohort effect was most evident in the depressed mood and anergia/hopelessness symptom composites. CONCLUSION Reduced rates of depression symptoms observed in successive birth cohorts of older adults may reflect compression of morbidity or other secular trends.
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Affiliation(s)
- Kevin J Sullivan
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
| | - Anran Liu
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Hiroko H Dodge
- Michigan Alzheimer’s Disease Center, Department of Neurology, University of Michigan, Ann Arbor, MI,Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary Ganguli
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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22
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Södersten P, Brodin U, Zandian M, Bergh CEK. Verifying Feighner's Hypothesis; Anorexia Nervosa Is Not a Psychiatric Disorder. Front Psychol 2019; 10:2110. [PMID: 31607977 PMCID: PMC6756277 DOI: 10.3389/fpsyg.2019.02110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/30/2019] [Indexed: 12/17/2022] Open
Abstract
Mental causation takes explanatory priority over evolutionary biology in most accounts of eating disorders. The evolutionary threat of starvation has produced a brain that assists us in the search for food and mental change emerges as a consequence. The major mental causation hypothesis: anxiety causes eating disorders, has been extensively tested and falsified. The subsidiary hypothesis: anxiety and eating disorders are caused by the same genotype, generates inconsistent results because the phenotypes are not traits, but vary along dimensions. Challenging the mental causation hypothesis in Feighner et al. (1972) noted that anorexic patients are physically hyperactive, hoarding for food, and they are rewarded for maintaining a low body weight. In 1996, Feighner's hypothesis was formalized, relating the patients' behavioral phenotype to the brain mechanisms of reward and attention (Bergh and Södersten, 1996), and in 2002, the hypothesis was clinically verified by training patients how to eat normally, thus improving outcomes (Bergh et al., 2002). Seventeen years later we provide evidence supporting Feighner's hypothesis by demonstrating that in 2012, 20 out of 37 patients who were referred by a psychiatrist, had a psychiatric diagnosis that differed from the diagnosis indicated by the SCID-I. Out of the 174 patients who were admitted in 2012, most through self-referral, there was significant disagreement between the outcomes of the SCID-I interview and the patient's subjective experience of a psychiatric problem in 110 of the cases. In addition, 358 anorexic patients treated to remission scored high on the Comprehensive Psychopathological Rating Scale, but an item response analysis indicated one (unknown) underlying dimension, rather than the three dimensions the scale can dissociate in patients with psychiatric disorders. These results indicate that psychiatric diagnoses, which are reliable and valid in patients with psychiatric disorders, are less well suited for patients with anorexia. The results are in accord with the hypothesis of the present Research Topic, that eating disorders are not always caused by disturbed psychological processes, and support the alternative, clinically relevant hypothesis that the behavioral phenotype of the patients should be addressed directly.
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Affiliation(s)
- Per Södersten
- Karolinska Institutet, Mandometer Clinics, Huddinge, Sweden
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Antisocial personality and risks of cause-specific mortality: results from the Epidemiologic Catchment Area study with 27 years of follow-up. Soc Psychiatry Psychiatr Epidemiol 2019; 54:617-625. [PMID: 30506390 DOI: 10.1007/s00127-018-1628-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Little is known about the effect of antisocial personality disorder (ASPD) on the risks of cause-specific mortality in the community. This study aimed to close this gap by evaluating if ASPD increases risks of cause-specific mortality in population-based residential and institutionalized samples with 27 years of follow-up. METHODS Data were collected in four metropolitan sites as part of the Epidemiologic Catchment Area (ECA) study during 1979-1983. Records were linked to the National Death Index through the end of 2007. Cox proportional hazards models adjusted for propensity weights and sample weights were fitted to estimate the effect of ASPD on the hazard of dying. RESULTS 420 respondents with ASPD (median survival age 71.0 years) and 15,367 without ASPD (median survival age 84.6 years) were included in this study. Those with ASPD were more likely to die from all causes (HR = 4.46; 95% CI = 2.44-8.16), suicide (HR = 2.81; 95% CI = 1.03-7.65), malignant neoplasms (HR = 4.09; 95% CI = 2.66-6.28), chronic lower respiratory disease (HR = 5.67; 95% CI = 2.92-11.0), and human immunodeficiency virus infection (HR = 8.07; 95% CI = 2.03-32.1), but not from accidents (HR = 0.58; 95% CI = 0.17-1.93) or heart disease (HR = 1.09; 95% CI = 0.43-2.76). CONCLUSIONS Our findings demonstrate that antisocial personality disorder is a strong predictor of all-cause mortality, and cause-specific mortality. Early identification, treatment, and prevention of ASPD are important public mental health initiatives that could reduce premature mortality among this vulnerable population.
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A Cross-Sectional Study on the Prevalence and Risk Correlates of Mental Disorders: The GRANADΣP Study. J Nerv Ment Dis 2018; 206:716-725. [PMID: 30124573 DOI: 10.1097/nmd.0000000000000873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is a cross-sectional study of participants from a population census living in the province of Granada (Spain). A total of 1176 persons were contacted, 367 (31%) refused and 54 (6.7%) needed substitution. A final sample of 809 participants (response rate, 69.3%) were screened for mental disorder (MD) using the MINI International Neuropsychiatric Interview, a comprehensive interview validated to generate diagnoses compatible with ICD-10/DSM-4 criteria. Current (1-month) prevalence for any MD was 11.3% (95% confidence interval [CI], 9.7%-13.4%; affective 8.2%, anxiety 9.6%, psychotic 2.1%, addiction 1.8%, personality disorder 3.6%). Lifetime MD prevalence was 24.6% (95% CI, 21.6-27.6; affective 14.9%, anxiety 15.5%, psychotic 3.4%, addiction 4.4%, personality disorder 3.6%). Female sex was associated with MD, but this appeared partially due to higher levels of neuroticism among women. MD also correlated significantly with cannabis use, family history of MD, higher social adversity, higher suicide risk, poorer physical health, poorer cognitive performance, and personality problems.
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Akinhanmi MO, Biernacka JM, Strakowski SM, McElroy SL, Balls Berry JE, Merikangas KR, Assari S, McInnis MG, Schulze TG, LeBoyer M, Tamminga C, Patten C, Frye MA. Racial disparities in bipolar disorder treatment and research: a call to action. Bipolar Disord 2018; 20. [PMID: 29527766 PMCID: PMC6175457 DOI: 10.1111/bdi.12638] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity. METHODS For this paper, we reviewed the phenomenological differences between bipolar individuals of African and European ancestry in the context of diagnostic criteria and clinical factors that may contribute to a potential racial bias. RESULTS Published data show that bipolar persons of African ancestry, compared with bipolar persons of non-African ancestry, are more often misdiagnosed with a disease other than bipolar disorder (i.e. schizophrenia). Additionally, studies show that there are disparities in recruiting patients of African ancestry to participate in important genomic studies. This gap in biological research in this underrepresented minority may represent a missed opportunity to address potential racial differences in the risk and course of bipolar illness. CONCLUSION A concerted effort by the research community to increase inclusion of diverse persons in studies of bipolar disorder through community engagement may facilitate fully addressing these diagnostic and treatment disparities in bipolar individuals of African ancestry.
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Affiliation(s)
- Margaret O Akinhanmi
- Clinical and Translational ScienceMayo Clinic Graduate School of Biomedical SciencesRochesterMNUSA
| | - Joanna M Biernacka
- Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMNUSA,Department of Psychiatry & PsychologyMayo ClinicRochesterMNUSA
| | - Stephen M Strakowski
- Department of PsychiatryDell Medical SchoolThe University of Texas at AustinAustinTXUSA
| | - Susan L McElroy
- Lindner Center of HOPEMasonOHUSA,Department of Psychiatry and Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiOHUSA
| | - Joyce E Balls Berry
- Mayo Clinic Center for Clinical & Translational Science (CCaTS)RochesterMNUSA,Department of Health Sciences ResearchMayo ClinicRochesterMNUSA
| | | | - Shervin Assari
- Department of PsychiatryUniversity of MichiganAnn ArborMIUSA
| | | | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMUMunichGermany
| | - Marion LeBoyer
- Department of PsychiatryMondor HospitalUniversité Paris Est, AP‐HPCréteil, ParisFrance,Inser U955Institute for Biomedical Research Faculté de MédecineCréteil, Paris France
| | - Carol Tamminga
- Southwestern Department of PsychiatryUniversity of TexasDallasTXUSA
| | - Christi Patten
- Department of Psychiatry & PsychologyMayo ClinicRochesterMNUSA,Mayo Clinic Center for Clinical & Translational Science (CCaTS)RochesterMNUSA
| | - Mark A Frye
- Department of Psychiatry & PsychologyMayo ClinicRochesterMNUSA
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Abstract
I have been given a priceless opportunity to reflect on my career in the remarkably productive field of risk factors for depression. Psychological research on depression exploded in the early years of my work. I try to give an account of the choices and challenges, and reflect on the influences, some calculated and some serendipitous, that determined the paths I have followed. I focus mostly on the robust depression risk factors that have influenced my research, including dysfunctional cognitions, stressful life events and circumstances, parental depression, interpersonal dysfunction, and being female, and I cover some of what I did but also the influential work of others. This is a selective review of depression research in the past 40 or so years, noting some of the big developments that set the stage for the remarkable activity that continues today. In the conclusion, there is a brief statement of aspirations for future developments in our field.
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Affiliation(s)
- Constance Hammen
- Department of Psychology, University of California, Los Angeles, California 90095, USA;
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Muramatsu K, Miyaoka H, Kamijima K, Muramatsu Y, Tanaka Y, Hosaka M, Miwa Y, Fuse K, Yoshimine F, Mashima I, Shimizu N, Ito H, Shimizu E. Performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. Gen Hosp Psychiatry 2018; 52:64-69. [PMID: 29698880 DOI: 10.1016/j.genhosppsych.2018.03.007] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subjects (n = 284; male = 107, female = 177) had to return the questionnaires to their health care professional within 48 hours and undergo a diagnostic evaluation interview based on the Japanese version of M.I.N.I-Plus. RESULTS 93 patients were diagnosed as having major depressive disorder (MDD). In the J-PHQ-9, the optimal cutpoint ≥ 10 had sensitivity of 90.5% and specificity of 76.6%. As for the categorical algorithms, the sensitivity was 80.6%; specificity was 89.5%, and a positive likelihood ratio of 7.7. The Stratum-specific likelihood ratios (SSLRs) of the J-PHQ-9 scores of 0-9, 10-14, 15-19, and 20-27 for major depression were 0.10 (95% CI: 0.05-0.20), 1.67 (95% CI: 1.02-2.76), 5.41 (95% CI: 2.87-10.22), and 11.98 (95% CI: 5.39-26.63), respectively. The relationship between the severity of J-PHQ-9 and the MCS of SF-8 was significant (χ 2 = 85.72, df = 4, P ≤ 0.0001). CONCLUSIONS This study has validated the J-PHQ-9 as a useful tool for the assessment of MDD in primary care in Japan.
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Affiliation(s)
- Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Japan.
| | - Hitoshi Miyaoka
- Department of Psychiatry, Kitasato University School of Medicine, Japan
| | | | | | - Yutaka Tanaka
- Niigata University Graduate School of Medicine and Dental Sciences, Japan
| | | | - Yusuke Miwa
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan
| | | | | | | | - Natsue Shimizu
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Hiroto Ito
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan
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O'Regan A, Cullen W, Hickey L, Meagher D, Hannigan A. Is problem alcohol use being detected and treated in Irish general practice? BMC FAMILY PRACTICE 2018; 19:30. [PMID: 29433442 PMCID: PMC5810014 DOI: 10.1186/s12875-018-0718-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/29/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The pattern of alcohol consumption in Ireland has serious societal and health consequences. General practice is well placed to screen for problem alcohol use and to carry out brief interventions. The aims of this study were to investigate the prevalence of documentation of problem alcohol use in patient records in Irish general practice, and to describe the documentation of its diagnosis and treatment. METHODS General practitioners (GPs) affiliated with an Irish medical school were invited to participate in the study. One hundred patients were randomly selected from each participating practice using the practice software and the clinical records were reviewed for evidence of problem alcohol use. The following was recorded: patient demographics, whether problem alcohol use was documented, whether they had an intervention, a psychotropic medication or if a referral was made. Descriptive statistics and an estimate of the prevalence were calculated using SPSS and SAS software. RESULTS Seventy one percent of the practices participated (n = 40), generating a sample of 3, 845 active patients. Only 57 patients (1.5%, 95% confidence interval 1 to 2%) were identified as having problem alcohol use in the previous two years. 29 (51%) of those with documented problem alcohol use were referred to other specialist services. 28 (49%) received a psychological intervention. 40 (70%) were prescribed psychotropic medications. CONCLUSION This is the first large scale study of patient records in general practice in Ireland looking at documentation of screening and treatment of problem alcohol use. It highlights the current lack of documentation of alcohol problems and the need to re-inforce positive attitudes among GPs in relation to preventive work.
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Affiliation(s)
- Andrew O'Regan
- Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
| | - Walter Cullen
- School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin, Ireland
| | - Louise Hickey
- Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - David Meagher
- Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Campion J, Checinski K, Nurse J, McNeill A. Smoking by people with mental illness and benefits of smoke-free
mental health services. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.108.005710] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Smoking is the largest single cause of preventable illness in the UK. Those
with mental health problems smoke significantly more and are therefore at
greater risk. The new Health Act (2006) will require mental health
facilities in England to be completely smoke-free by 1st July 2008. This
article reviews the current literature regarding how smoking affects both
the physical and mental well-being of people with mental health problems. It
also considers the effects of smoke-free policy in mental health
settings.
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Clark LA, Cuthbert B, Lewis-Fernández R, Narrow WE, Reed GM. Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC). Psychol Sci Public Interest 2017; 18:72-145. [DOI: 10.1177/1529100617727266] [Citation(s) in RCA: 333] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals—the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders—provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health’s Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems’ approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.
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Affiliation(s)
| | - Bruce Cuthbert
- Research Domain Criteria Unit, National Institute of Mental Health
| | | | - William E. Narrow
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine
| | - Geoffrey M. Reed
- Department of Mental Health and Substance Abuse, World Health Organization
- Global Mental Health Program, Columbia University Medical Center
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Longitudinal Cognitive Outcomes of Clinical Phenotypes of Late-Life Depression. Am J Geriatr Psychiatry 2017; 25:1123-1134. [PMID: 28479153 PMCID: PMC5600662 DOI: 10.1016/j.jagp.2017.03.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/15/2016] [Accepted: 03/24/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Late-life depression is associated with cognitive deficits and increased risk for cognitive decline. The purpose of the study was to determine whether clinical characteristics could serve as phenotypes informative of subsequent cognitive decline. Age at depression onset and antidepressant remission at 3 months (acute response) and 12 months (chronic response) were examined. METHODS In a longitudinal study of late-life depression in an academic center, 273 depressed and 164 never-depressed community-dwelling elders aged 60 years or older were followed on average for over 5 years. Participants completed annual neuropsychological testing. Neuropsychological measures were converted to z-scores derived from the baseline performance of all participants. Cognitive domain scores at each time were then created by averaging z-scores across tests, grouped into domains of episodic memory, attention-working memory, verbal fluency, and executive function. RESULTS Depressed participants exhibited poorer performance at baseline and greater subsequent decline in all domains. Early-onset depressed individuals exhibited a greater decline in all domains than late-onset or nondepressed groups. For remission, remitters and nonremitters at both 3 and 12 month exhibited greater decline in episodic memory and attention-working memory than nondepressed subjects. Three-month remitters also exhibited a greater decline in verbal fluency and executive function, whereas 12-month nonremitters exhibited greater decline in executive function than other groups. CONCLUSION Consistent with past studies, depressed elders exhibit greater cognitive decline than nondepressed subjects, particularly individuals with early depression onset, supporting the theory that repeated depressive episodes may contribute to decline. Clinical remission is not associated with less cognitive decline.
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Abstract
PURPOSE We aimed to systematically review recent publications (01/2014-03/2017) with longitudinal designs allowing for the assessment of the prospective risk of insomnia on new onset mental illness in key conditions: anxiety, depression, bipolar disorder, posttraumatic stress disorder, substance use disorders, and suicide. RECENT FINDINGS A literature yielded 1859 unique articles meeting search criteria were identified; 16 articles met all selection criteria and reviewed with some studies reporting on more than one mental health outcome. Overall, the review supports the hypothesis that insomnia is a predictor of subsequent mental illness. The evidence is strongest for an insomnia-depression relationship. The new studies identified and reviewed add to a modest number of publications supporting a prospective role of insomnia in new onset mental illness in three areas: anxiety disorders, bipolar disorder, and suicide. The few selected new studies focused on SUD were mixed, and no studies focused on PTSD were identified that met the selection criteria. Treatment of insomnia may also be a preventive mental health strategy.
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Zaleski M, Laranjeira RR, Marques ACPR, Ratto L, Romano M, Alves HNP, de Macedo Soares MB, Abelardino V, Kessler F, Brasiliano S, Nicastri S, Brunferntrinker Hochgraf P, de Paula Gigliotti A, Lemos T. Guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs (ABEAD) for diagnosis and treatment of psychiatric comorbidity with alcohol and other substance and dependence. Int Rev Psychiatry 2017; 29:254-262. [PMID: 28587553 DOI: 10.1080/09540261.2017.1285552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In recent years, several studies have been focused on the comorbidity of psychiatric disorders with alcohol and other substance dependence. In this context, the Brazilian Association of Studies on Alcohol and Other Drugs initiated a project to establish Brazilian Guidelines. The aim of this study was to review diagnostic and therapeutic criteria for the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological studies, animal testing and other forms of research are reviewed herein. The main psychiatric comorbidities are investigated and data published in the literature are reviewed, based on guidelines adopted by other countries. Epidemiological aspects, diagnostic criteria, integrated treatment and the organization of specialized service, as well as details regarding psychotherapy and pharmacological treatment are discussed. The guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs reinforce the importance of adequate diagnosis and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.
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Affiliation(s)
- Marcos Zaleski
- a Núcleo de Psiquiatria , Universidade Federal de Santa Catarina (UFSC) , Florianópolis , Brazil.,b Instituto de Psiquiatria de Santa Catarina , Florianópolis , Brazil
| | - Ronaldo Ramos Laranjeira
- c Unidade de Pesquisa em Álcool e Drogas (UNIAD) , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | | | - Lílian Ratto
- d Unidade de Álcool e Drogas da Santa Casa de Misericórdia de São Paulo , São Paulo , Brazil
| | - Marcos Romano
- c Unidade de Pesquisa em Álcool e Drogas (UNIAD) , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - Hamer Nastasy Palhares Alves
- c Unidade de Pesquisa em Álcool e Drogas (UNIAD) , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil
| | - Márcia Britto de Macedo Soares
- e Grupo de Estudos de Doenças Afetivas (GRUDA), Instituto de Psiquiatria , Hospital das Clinicas Faculdade de Medicina, Universidade de São Paulo (USP) , São Paulo , Brazil
| | - Valter Abelardino
- f Centro de Atendimento Médico e Social (CAMPS) - Clínica Vitao , Curitiba , Brazil
| | - Félix Kessler
- g Equipe de Álcool e Drogas , Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Sílvia Brasiliano
- h Programa de Atenção à Mulher Dependente Química (PROMUD), Instituto de Psiquiatria , Hospital das Clínicas Faculdade de Medicina, Universidade de São Paulo (USP) , São Paulo , Brazil
| | - Sérgio Nicastri
- i Programa Álcool e Drogas , Hospital Israelita Albert Einstein , São Paulo , Brazil
| | - Patrícia Brunferntrinker Hochgraf
- h Programa de Atenção à Mulher Dependente Química (PROMUD), Instituto de Psiquiatria , Hospital das Clínicas Faculdade de Medicina, Universidade de São Paulo (USP) , São Paulo , Brazil
| | - Analice de Paula Gigliotti
- j Setor de Dependência Química , Santa Casa do Rio de Janeiro , Rio de Janeiro , Brazil.,k Universidade Gama Filho , Rio de Janeiro , Brazil
| | - Tadeu Lemos
- a Núcleo de Psiquiatria , Universidade Federal de Santa Catarina (UFSC) , Florianópolis , Brazil.,b Instituto de Psiquiatria de Santa Catarina , Florianópolis , Brazil
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Fairman BJ, Hwang S, Alexandre PK, Gallo JJ, Eaton WW. Costs of substance use disorders from claims data for Medicare recipients from a population-based sample. J Subst Abuse Treat 2017; 77:174-177. [PMID: 28242082 PMCID: PMC5420335 DOI: 10.1016/j.jsat.2017.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/17/2017] [Accepted: 02/10/2017] [Indexed: 11/19/2022]
Abstract
Medicare spending is projected to increase over the next decade, including for substance use disorders (SUD). Our objective was to determine whether SUDs are associated with higher six-year Medicare costs (1999-2004) among participants in the Baltimore Epidemiologic Catchment Area (ECA) Study. Medicare claims data for the years 1999-2004 from the Centers for Medicare and Medicaid Services were linked to four waves of data from the Baltimore ECA cohort collected between 1981 and 2005 (n=566). A generalized linear model with a log link and gamma distribution was used to examine direct Medicare costs associated with SUD status. Medicare recipients with no history of SUD had mean six-year costs of $42,576. Those with a history of SUD based on both Baltimore ECA and Medicare data, or based on Medicare claims data alone, had significantly higher costs ($98,754 and $64,876, respectively). A history of SUD based solely on Baltimore ECA data alone had lower average costs ($25,491). Findings indicate that Medicare costs differ by source of SUD diagnosis when comparing treatment versus survey data. This may have future implications for projecting Medicare costs among SUD individuals as healthcare coverage expands under the Affordable Care Act.
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Affiliation(s)
- Brian J Fairman
- Health Behavior Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA.
| | - Seungyoung Hwang
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pierre K Alexandre
- Department of Management, Florida Atlantic University College of Business, Boca Raton, FL, USA
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Fountoulakis KN, Young A, Yatham L, Grunze H, Vieta E, Blier P, Moeller HJ, Kasper S. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines. Int J Neuropsychopharmacol 2017; 20:98-120. [PMID: 27815414 PMCID: PMC5408969 DOI: 10.1093/ijnp/pyw091] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/20/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity. METHODS The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines. RESULTS The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option. CONCLUSION The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Allan Young
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Lakshmi Yatham
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Heinz Grunze
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Eduard Vieta
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Pierre Blier
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Hans Jurgen Moeller
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
| | - Siegfried Kasper
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria
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36
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Pentin P, Sperry LD. Somatoform Disorders and Related Syndromes. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Takeuchi DT. Vintage Wine in New Bottles: Infusing Select Ideas into the Study of Immigration, Immigrants, and Mental Health. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:423-435. [PMID: 27803266 DOI: 10.1177/0022146516672050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The metaphor vintage wine in new bottles imagines how ideas from immigration studies, social psychology, and cultural sociology add novel insights about how the social context and social relationships of immigrant lives are linked to well-being. This article describes a few patterns in research studies that have addressed whether immigrants have higher or lower rates of mental health problems than their U.S.-born counterparts. It discusses a few past approaches to explain the differences in mental health outcomes. The article concludes with select concepts and tools from other sociological fields that may invigorate research on immigrants and their health and mental health.
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39
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Golding JM. Division of Household Labor, Strain, and Depressive Symptoms Among Mexican Americans and Non-Hispanic Whites. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.1990.tb00007.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article presents preliminary tests of the hypothesis that household labor serves as a source of strain and is indirectly associated with depressive symptoms. It also examines associations of gender and Mexican–American ethnicity with housework, household strain, and depressed mood. Respondents are 668 Mexican Americans and 394 non-Hispanic whites. Because respondents are randomly selected community residents and are married, average strain and depressive symptom levels are low. Results are consistent with the hypothesis that housework affects depressed mood indirectly, through household strain. Among women, housework is associated with an increased likelihood of household strain, which, in turn, is associated with depressive symptoms. Among men, housework is unrelated to household strain, but household strain is associated with depressed mood. Although ethnicity and gender are associated with household division of labor, with more traditional patterns among Mexican Americans, ethnicity does not modify associations among housework, household strain, and depressive symptoms.
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Ghanbari Jolfaei A, Ghadamgahi P, Ahmadzad-Asl M, Shabani A. Demographic and Diagnostic Features of 3147 Inpatients With Mood Disorders in Iran. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e2298. [PMID: 27822276 PMCID: PMC5097834 DOI: 10.17795/ijpbs-2298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 04/17/2016] [Accepted: 08/05/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess and compare demographic and diagnostic characteristics of inpatients with mood disorders in Iran. MATERIALS AND METHODS We collected the demographic, clinical, and treatment characteristics of patients, who were hospitalized during five years from April 2006 to March 2010, in Iran hospital of psychiatry, a residency training center to evaluate the general clinical picture of the disorder. RESULTS Overall, 95.3% of subjects had a diagnosis of bipolar I disorder (BID), 2.5% were diagnosed as bipolar II disorder (BIID) and 1.3% and 0.9% met the criteria for major depressive disorder (MDD) and bipolar not otherwise specified (NOS), respectively. Compared to patients with MDD and BIID, the onset of BID was at an earlier age (32.2 ± 1, 34.8 ± 1.5 and 29.9 ± 1.9 years old, respectively, P < 0.001). In addition, a number of admissions, mean duration of each admission and number of treatments with electro-convulsive therapy (ECT) were significantly higher in patients with BID. CONCLUSIONS Bipolar I disorder was the most common diagnosis for inpatients with mood disorders and a more severe course in BID may indicate more severe impairments that would result in more severe disabilities.
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Affiliation(s)
- Atefeh Ghanbari Jolfaei
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Pari Ghadamgahi
- Bipolar Disorders Research Group, Mental Health Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Masoud Ahmadzad-Asl
- Bipolar Disorders Research Group, Mental Health Research Center, Tehran Psychiatry Institute, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Amir Shabani
- Bipolar Disorders Research Group, Mental Health Research Center, Iran University of Medical Sciences, Tehran, IR Iran
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41
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Blazer D. The Three Cs of a Scientific Autobiography: Curiosity, Circumstance, and Colleagues. Am J Geriatr Psychiatry 2016; 24:943-948. [PMID: 27633898 DOI: 10.1016/j.jagp.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Dan Blazer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3003, Durham, NC 27710.
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The natural course of elevated levels of depressive symptoms in patients with vascular disease over eight years of follow-up. The SMART-Medea study. J Affect Disord 2016; 202:95-101. [PMID: 27259081 DOI: 10.1016/j.jad.2016.05.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/22/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Patients with cardiovascular disease have an increased risk for depression, and depression predicts poor prognosis in these patients, but the long-term course of depression is not known. We studied the natural course of elevated levels of depressive symptoms in patients with cardiovascular disease over eight years follow-up. METHODS Within the Second Manifestations of ARTerial disease - Memory, depression and aging (SMART-Medea) study, depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) in 690 patients (62±10 years) at baseline and bi-annually during 8 years follow-up. Natural course was described for symptom severity and course type (never, single episode, intermittent, and chronic) based on the cut-off point of ≥6 on the PHQ-9. Using multinomial regression analysis (reference: never depressed) we estimated age- and sex-adjusted odds ratios (OR) for the associations of demographic factors and vascular disease categories with course type. RESULTS Of the 690 patients, 60% was never depressed, 10% had a single episode, 19% had an intermittent and 11% a chronic course of depression. Increased risk for chronic course was observed for women (OR=3.42; 95% CI=1.98-5.90), those with younger age (OR=3.20; 95% CI=1.73-5.94), and for patients with cerebrovascular disease when compared to patients with coronary artery disease (OR=2.50; 95% CI=1.31-4.78). LIMITATIONS No information was available on clinical diagnosed major depressive disorder and/or clinical events during follow-up. CONCLUSIONS In patients with cardiovascular disease, an intermittent or chronic course of elevated levels of depressive symptoms is very common. Patients with cardiovascular disease may require more careful clinical monitoring and management of depressive symptoms.
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Li J, Li Y, Zhang B, Shen X, Zhao H. Why depression and pain often coexist and mutually reinforce: Role of the lateral habenula. Exp Neurol 2016; 284:106-113. [PMID: 27554829 DOI: 10.1016/j.expneurol.2016.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/05/2016] [Accepted: 08/18/2016] [Indexed: 12/18/2022]
Abstract
The interrelation of depression and pain is increasingly coming under scrutiny. Although the lateral habenula (LHb) is widely implicated in the pathogenesis of depression and pain, its role in the interaction of depression and pain remains unknown. Thus, the aim of current study was to investigate the role of LHb in rat depression-pain comorbidity. Single extracellular firing recording and immunofluorescence methods were used to compare firing rates and c-Fos expression of the LHb neurons in normal and model rats. Following subcutaneous injection of formalin into the hind paw to simulate natural pain, we assessed pain behavior in rats subjected to the chronic, unpredictable mild stress procedure (CUMS, a model of depression). Pain sensitivity in the model rats was increased over that of controls. These rats showed a significant increase in the firing activity of LHb neurons compared with normal rats. Significantly, about 73% of neurons with high discharge frequency in LHb of model rats were pain-activated neurons (PANs), and the firing rates of PANs were inhibited by intraperitoneal injection of a tricyclic antidepressant, clomipramine. Immunofluorescence showed that the percentage of c-Fos positive cells in LHb was significantly increased in rats receiving CUMS alone, rats receiving pain stimulation alone, and rats receiving both CUMS and pain stimulation, but especially the last. The interaction effect was inhibited by injection of clomipramine. The LHb lesion can improve both depression-like behavior and pain sensitivity in depression model rats with pain. These suggest that hyperactivity of the LHb neurons contributes to depression-pain comorbidity in rats.
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Affiliation(s)
- Jicheng Li
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Yang Li
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Beilin Zhang
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Xiangfeng Shen
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Hua Zhao
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China.
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45
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Fantoni-Salvador P, Rogers R. Spanish Versions of the MMPI-2 and PAI: An Investigation of Concurrent Validity With Hispanic Patients. Assessment 2016. [DOI: 10.1177/107319119700400104] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Delivery of mental health services to Hispanic populations requires that assessment methods address the linguistic needs of their clientele. Toward this end, Spanish translations of two recent multiscale inventories (i.e., Minnesota Multiphasic Personality Inventory-2, MMPI, and Personality Assessment Inventory, PAI) were published in order to meet these needs. Unfortunately, the linguistic equivalence and criterion-based validation of these Spanish versions were not addressed prior to publication. We sought to take the first step in remedying this oversight by administering the MMPI-2 and PAI to 105 Hispanic patients for whom Spanish is the sole or preferred language. We employed a revised Spanish version of the Diagnostic Interview Schedule (DIS) as a criterion measure. By focusing on four common disorders (i.e., major depression, schizophrenia, anxiety disorders, and alcohol dependence), we examined the usefulness of codetypes and clinical elevations for establishing these disorders. Overall, we found moderate hit rates for the MMPI-2 ( N = .60, range from .46-.69) and moderate to high hit rates for the PAI ( M = .72, range from .57-.87). Correlations of selected scales with DIS symptoms varied widely and were generally in the low to moderate range. Finally, exploratory data suggested few within-minority differences on selected MMPI-2 and PAI scales when DIS symptoms were employed as covariates.
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46
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Essau CA, Conradt J, Petermann F. Frequency, Comorbidity, and Psychosocial Impairment of Depressive Disorders in Adolescents. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743558400154003] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The frequency, comorbidity, and psychosocial impairment of depressive disorders among adolescents was estimated from a survey of 1,035 students aged 12 to 17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Depressive disorders and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. A high proportion of our adolescents met the lifetime criteria for depressive disorders according to DSM-IV criteria, with a rate of 17.9%. Depressive disorders were significantly higher in females than in males. The rates for all of the disorders increased with age, with the greatest increase occurring mostly between the ages of 14 and 15; such increase was more prominent in females than in males. Our results imply the importance of identifying depressive disorders in adolescence and the need for preventive and intervention strategies.
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Burnam MA, Telles CA, Karno M, Hough RL, Escobar JI. Measurement of Acculturation in a Community Population of Mexican Americans. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2016. [DOI: 10.1177/07399863870092002] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 26-item acculturation measure was administered to a probability sample of 1245 adult Mexican Americans residing in Los Angeles. This measure demonstrated high internal reliability for the total sample and for specific sex, educational, and language groups. Construct validity was supported by showing acculturation scores predicted length of exposure to U.S. culture. Data suggested that, among first generation Mexican Americans, those who were younger and male acculturated more rapidly than those who were older and female. This sex difference, but not the age difference, could be explained by educational and employment experiences. Among later generation Mexican Americans, those who were younger again had higher acculturation levels, possibly due to age differences in education and employment, or to historical factors differentially effecting age cohorts.
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48
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Fudin J, Levasseur DJ, Passik SD, Kirsh KL, Coleman J. Chronic Pain Management with Opioids in Patients with Past or Current Substance Abuse Problems. J Pharm Pract 2016. [DOI: 10.1177/0897190003258507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Among patients who present to medical providers with chronic pain complaints, there is an elevated prevalence of illicit substance use and prescription misuse. For those with legitimate pain, this predicament potentiates the risk of being medically underserved or undertreated. Complicating factors include a lack of specificity and sensitivity to the issue of defining substance abuse or misuse in the health care setting. Irrespective of whether patients have histories of addiction, problematic behavior manifests during the course of chronic pain therapy, making a conceptualization of the nature and function of this behavior difficult. The objective of this article is to highlight known confounds in the assessment of “normal” pain-related vs. substance abuse behavior. Our aim is to offer important points to consider, a set of systematic guidelines to follow, and an armamentarium of essential tools to facilitate contingency management planning in the context of treating chronic pain with controlled substances.
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Affiliation(s)
- Jeffrey Fudin
- Interdisciplinary Pain Management and Primary Care Clinics (VAMC), Albany College of Pharmacy, and American Pharmaceutical Care Pain Consultants,
| | | | - Steven D. Passik
- Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentuck
| | - Kenneth L. Kirsh
- Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentuck
| | - John Coleman
- Drug Enforcement Administration: Law Enforcement and Office of Diversion Control
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Abstract
Associations of sexual assault history with reproductive and sexual symptoms were evaluated in 3,419 women randomly selected from two communities. Sexual assault was associated with excessive menstrual bleeding, genital burning, and painful intercourse (whether or not attributable to disease or injury), medically explained missing two menstrual periods, and medically unexplained dysmenorrhea, menstrual irregularity, and lack of sexual pleasure. Physically violent assaults and those committed by strangers were most strongly related to reproductive symptoms. Multiple assaults, assaults accomplished by persuasion, spouse assault, and completed intercourse were most strongly related to sexual symptoms. Assault was occasionally associated more strongly with reproductive symptoms among women with lower income or less education, possibly because of economic stress or differences in assault circumstances. Associations with unexplained menstrual irregularity were strongest among African American women; ethnic differences in reported circumstances of assault appeared to account for these differences.
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Zaninotto AL, Vicentini JE, Fregni F, Rodrigues PA, Botelho C, de Lucia MCS, Paiva WS. Updates and Current Perspectives of Psychiatric Assessments after Traumatic Brain Injury: A Systematic Review. Front Psychiatry 2016; 7:95. [PMID: 27378949 PMCID: PMC4906018 DOI: 10.3389/fpsyt.2016.00095] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/19/2016] [Indexed: 01/06/2023] Open
Abstract
Neuropsychological and psychiatric disorders represent a major concern and cause of disabilities after the trauma, contributing to worse recovery after traumatic brain injury (TBI). However, the lack of well-defined parameters to evaluate patient's psychiatric disorders leads to a wide range of diagnoses and symptoms. The aim of this study was to perform a review of literature in order to gather data of the most common scales and inventories used to assess and diagnose depression, anxiety, and posttraumatic stress disorder (PTSD) after TBI. We conducted a literature search via MEDLINE, PubMed, and Web of Science. We included reviews, systematic reviews, and meta-analysis studies, and we used the following keywords: "traumatic brain injury OR TBI," "depression OR depressive disorder," "anxiety," and "posttraumatic stress disorder OR PTSD." From 610 titles, a total of 68 systematic reviews or meta-analysis were included in the section "Results" of this review: depression (n = 32), anxiety (n = 9), and PTSD (n = 27). Depression after TBI is a more established condition, with more homogeneous studies. Anxiety and PTSD disorders have been studied in a heterogeneous way, usually as comorbidity with other psychiatric disorders. Some scales and inventories designed for the general community may not be appropriate for patients with TBI.
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Affiliation(s)
- Ana Luiza Zaninotto
- Laboratory of Neuromodulation, Center for Clinical Research Learning, Harvard Medical School (HMS), Charlestown, MA, USA
- Department of Neurology, School of Medicine, University São Paulo (USP-SP), São Paulo, Brazil
| | - Jessica Elias Vicentini
- Department of Neurology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Center for Clinical Research Learning, Harvard Medical School (HMS), Charlestown, MA, USA
| | | | - Cibele Botelho
- Department of Neurology, School of Medicine, University São Paulo (USP-SP), São Paulo, Brazil
| | | | - Wellingson Silva Paiva
- Department of Neurology, School of Medicine, University São Paulo (USP-SP), São Paulo, Brazil
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