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Erskine HE, Maravilla JC, Wado YD, Wahdi AE, Loi VM, Fine SL, Li M, Ramaiya A, Wekesah FM, Odunga SA, Njeri A, Setyawan A, Astrini YP, Rachmawati R, Hoa DTK, Wallis K, McGrath C, Shadid J, Enright ME, Blondell SJ, Lawrence D, Fisher PW, Whiteford HA, Vinh ND, Wilopo SA, Kabiru CW, Blum RW, Scott JG. Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study. Lancet 2024; 403:1671-1680. [PMID: 38588689 DOI: 10.1016/s0140-6736(23)02641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam. METHODS As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs. FINDINGS Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam). INTERPRETATION NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries. FUNDING The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company.
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Affiliation(s)
- Holly E Erskine
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Joemer C Maravilla
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines
| | | | - Amirah Ellyza Wahdi
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Vu Manh Loi
- Institute of Sociology, Vietnam Academy of Social Sciences, Hanoi, Viet Nam
| | - Shoshanna L Fine
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mengmeng Li
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Astha Ramaiya
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Frederick Murunga Wekesah
- African Population and Health Research Center, Nairobi, Kenya; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Anne Njeri
- African Population and Health Research Center, Nairobi, Kenya
| | - Althaf Setyawan
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yufan Putri Astrini
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rizka Rachmawati
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Krystina Wallis
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Cartiah McGrath
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Jamileh Shadid
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Meaghan E Enright
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Sarah J Blondell
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - David Lawrence
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Prudence W Fisher
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nguyen Duc Vinh
- Institute of Sociology, Vietnam Academy of Social Sciences, Hanoi, Viet Nam
| | - Siswanto Agus Wilopo
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Robert Wm Blum
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - James G Scott
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, QLD, Australia
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DeSerisy M, Wolf AD, Hoffman J, Moritz EK, Fisher PW, Albano AM, Margolis AE. Modified Approaches to Treating Anxiety for Children With Visual-Spatial Problems: A Strengths-Based Perspective. J Am Acad Child Adolesc Psychiatry 2024; 63:12-16. [PMID: 37121394 DOI: 10.1016/j.jaac.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/26/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
Anxiety disorders are common and impairing1 and affect as many as 30% of youth with2 and without3 neurodevelopmental disorders. Nonverbal learning disability (NVLD) is an understudied neurodevelopmental disorder with an estimated prevalence of 3% in North American children and adolescents.4 Although definitions of NVLD vary, all include a core deficit of difficulty with visual-spatial processing. Importantly, anxiety is also a common psychiatric comorbidity for youth with NVLD, affecting roughly one-third of these youth.4,5 In youth with neurodevelopmental disorders, treatment is often sought or received for comorbid conditions (eg, anxiety, attention-deficit/hyperactivity disorder) or associated impairments, rather than for the symptoms or core deficits of the neurodevelopmental disorder itself.6 Considerable work has examined the adaptation of anxiety disorder treatments for children with attention-deficit/hyperactivity disorder7 and autism.8 Comparatively little work has explored treatment approaches for children with NVLD. Given the overlap of anxiety symptoms and visual-spatial problems in NVLD,9,10 herein we consider how these cognitive problems might interfere with patients' abilities to engage with common treatment approaches.
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Affiliation(s)
- Mariah DeSerisy
- Mailman School of Public Health, Columbia University Irving Medical Center, New York; New York State Psychiatric Institute, New York
| | - Amie D Wolf
- Brooklyn Learning Center, Brooklyn, New York
| | | | | | - Prudence W Fisher
- Brooklyn Learning Center, Brooklyn, New York; Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Anne Marie Albano
- Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Amy E Margolis
- New York State Psychiatric Institute, New York; Vagelos College of Physicians and Surgeons, Columbia University, New York.
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3
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Amsalem D, Fisch CT, Wall M, Choi CJ, Lazarov A, Markowitz JC, LeBeau M, Hinds M, Thompson K, Fisher PW, Smith TE, Hankerson SH, Lewis-Fernández R, Dixon LB, Neria Y. Anxiety and Depression Symptoms Among Young U.S. Essential Workers During the COVID-19 Pandemic. Psychiatr Serv 2023; 74:1010-1018. [PMID: 37042105 DOI: 10.1176/appi.ps.20220530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVE Emerging cross-sectional data indicate that essential workers in the COVID-19 era face increased mental health risks. This study longitudinally examined clinical symptoms of generalized anxiety disorder, depression, and posttraumatic stress disorder (PTSD) among U.S. essential workers, including health care workers and workers in indispensable occupations such as manufacturing, food industry, construction, transportation, hospitality, and emergency services, during the COVID-19 pandemic. The authors anticipated high symptom levels and greater symptom severity among women versus men and among younger adults compared with older adults. Analyses also explored the association between COVID-19 vaccination status and clinical symptoms. METHODS This four-wave online survey study assessed clinical symptoms in a convenience sample of 4,136 essential workers at baseline and 14, 30, and 90 days between August and December 2021. Symptoms of anxiety, depression, and PTSD were measured with the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Primary Care PTSD Screen instruments, respectively. RESULTS At every time point, 74%-78% of respondents reported symptoms of anxiety and depression, which were highest among younger adults (ages 18-22 years), females, and transgender respondents. Vaccinated participants had slightly higher symptom levels than unvaccinated respondents. Rates of clinical symptoms did not change significantly over time. CONCLUSIONS Essential workers consistently reported symptoms of generalized anxiety, depression, or PTSD, especially younger adult, female, and transgender participants. The overwhelming and unprecedented nature of the COVID-19 pandemic underscores the need to offer mental health care to essential workers, especially those in these subgroups. Employers and administrators should support and proactively encourage employees to access care when needed.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Chana T Fisch
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Melanie Wall
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - C Jean Choi
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Amit Lazarov
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - John C Markowitz
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Mariah LeBeau
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Melissa Hinds
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Kip Thompson
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Prudence W Fisher
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Thomas E Smith
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Sidney H Hankerson
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Roberto Lewis-Fernández
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Lisa B Dixon
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
| | - Yuval Neria
- New York State Psychiatric Institute and Department of Psychiatry (Amsalem, Fisch, Wall, Choi, Markowitz, LeBeau, Hinds, Thompson, Fisher, Lewis-Fernández, Dixon, Neria) and Vagelos College of Physicians and Surgeons (Amsalem, Wall, Markowitz, Thompson, Fisher, Smith, Lewis-Fernández, Dixon, Neria), Columbia University, New York City; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith); Department of Population Health Sciences and Policy and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (Hankerson)
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4
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Amsalem D, Wall M, Lazarov A, Markowitz JC, Fisch CT, LeBeau M, Hinds M, Liu J, Fisher PW, Smith TE, Hankerson S, Lewis-Fernández R, Dixon LB, Neria Y. Brief Video Intervention to Increase Treatment-Seeking Intention Among U.S. Health Care Workers: A Randomized Controlled Trial. Psychiatr Serv 2023; 74:119-126. [PMID: 36097721 DOI: 10.1176/appi.ps.20220083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Many health care workers avoid seeking mental health care, despite COVID-19-related increases in risk of psychopathology. This study assessed the effects of two versions (distinguished by the race of the protagonist) of a brief social contact-based video on treatment-seeking intention and stigma toward mental health services among U.S. health care workers. METHODS Participants (N=1,402) were randomly assigned to view a 3-minute video in which a Black or White female nurse described struggles with COVID-19-related anxiety and depression, barriers to care, and how therapy helped, or to view a control video unrelated to mental health. Half of the participants receiving the intervention watched the same video (i.e., booster) again 14 days later. Treatment-seeking intention and treatment-related stigma were assessed at baseline, postintervention, and 14- and 30-day follow-ups. RESULTS Both intervention videos elicited an immediate increase in treatment-seeking intention in the intervention groups (p<0.001, effect size [ES]=21%), with similar effects among those who watched the booster video (p=0.016, ES=13%) and larger effects among those who had never sought treatment (p<0.001, ES=34%). The increased effects were not sustained 14 days after the initial video or at 30-day follow-up. The results showed an immediate reduction in stigma, but with no booster effect. The race of the protagonist did not influence outcomes. CONCLUSIONS This easily administered intervention could increase the likelihood of care seeking by proactively encouraging health care workers with mental health challenges to pursue treatment. Future studies should examine whether the inclusion of linkable referrals to mental health services helps to increase treatment-seeking behavior.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Melanie Wall
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Amit Lazarov
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - John C Markowitz
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Chana T Fisch
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Mariah LeBeau
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Melissa Hinds
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Jun Liu
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Prudence W Fisher
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Thomas E Smith
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Sidney Hankerson
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Roberto Lewis-Fernández
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Lisa B Dixon
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
| | - Yuval Neria
- New York State Psychiatric Institute, New York City (Amsalem, Wall, Markowitz, Fisch, LeBeau, Hinds, Liu, Fisher, Hankerson, Lewis-Fernández, Dixon, Neria); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Amsalem, Wall, Markowitz, Liu, Fisher, Smith, Hankerson, Lewis-Fernández, Dixon, Neria); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); New York State Office of Mental Health, Albany (Smith)
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5
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Rosing T, Malka M, Brafman D, Fisher PW. A qualitative study of equine-assisted therapy for Israeli military and police veterans with PTSD-impact on self-regulation, bonding and hope. Health Soc Care Community 2022; 30:e5074-e5082. [PMID: 35852225 DOI: 10.1111/hsc.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/09/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Equine-assisted therapy (EAT) is an increasingly popular form of treatment for people suffering from post-traumatic stress disorder (PTSD) who, for one reason or another, find psychotherapy and other traditional treatment approaches unsuitable or unhelpful. However, the concomitant growth of research in the field is yet to engage with key factors relating to EAT; specifically, there are few studies considering the phenomenological perspective of patients, and the embodied knowledge deriving from the lived experience of PTSD patients who participated in EAT-based intervention programmes. Based on a qualitative-phenomenological study, interviews were conducted with 12 PTSD patients who had completed an EAT-based intervention programme. From these, three main themes characterising the meanings they gave to participation in an EAT-based treatment programme were identified: the ability to relax (self-regulation); establishing a relationship (bonding) and transformation and hope for the future. The findings of this study point to a process whereby participation in an EAT-based treatment programme facilitates the ability to cope with PTSD symptoms in a way that bridges the patient's emotional, social and spiritual-existential dimensions. The findings suggest that EAT can contribute to the healing process of veterans suffering from PTSD.
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Affiliation(s)
- Thom Rosing
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Menny Malka
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Dorit Brafman
- School of Social Work, Ariel University, Hamada, Ariel, Israel
- Therapeutic riding and Canine Institute (ngo), Derech Halord Tel Mond, Tel Mond, Israel
| | - Prudence W Fisher
- Clinical Psychiatric Social Work (in Psychiatry), Columbia University, New York City, New York, USA
- New York State Psychiatric Institute, New York City, New York, USA
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6
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Amsalem D, Wall M, Lazarov A, Markowitz JC, Fisch CT, LeBeau M, Hinds M, Liu J, Fisher PW, Smith TE, Hankerson S, Lewis-Fernández R, Neria Y, Dixon LB. Destigmatising mental health treatment and increasing openness to seeking treatment: randomised controlled trial of brief video interventions. BJPsych Open 2022; 8:e169. [PMID: 36111611 PMCID: PMC9534926 DOI: 10.1192/bjo.2022.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite an elevated risk of psychopathology stemming from COVID-19-related stress, many essential workers stigmatise and avoid psychiatric care. This randomised controlled trial was designed to compare five versions of a social-contact-based brief video intervention for essential workers, differing by protagonist gender and race/ethnicity. AIMS We examined intervention efficacy on treatment-related stigma ('stigma') and openness to seeking treatment ('openness'), especially among workers who had not received prior mental healthcare. We assessed effectiveness and whether viewer/protagonist demographic concordance heightened effectiveness. METHOD Essential workers (N = 2734) randomly viewed a control video or brief video of an actor portraying an essential worker describing hardships, COVID-related anxiety and depression, and psychotherapy benefits. Five video versions (Black/Latinx/White and male/female) followed an identical 3 min script. Half the intervention group participants rewatched their video 14 days later. Stigma and openness were assessed at baseline, post-intervention, and at 14- and 30-day follow-ups. Trial registration: NCT04964570. RESULTS All video intervention groups reported immediately decreased stigma (P < 0.0001; Cohen's d = 0.10) and increased openness (P < 0.0001; d = 0.23). The initial increase in openness was largely maintained in the repeated-video group at day 14 (P < 0.0001; d = 0.18), particularly among viewers without history of psychiatric treatment (P < 0.0001; d = 0.32). Increases were not sustained at follow-up. Female participants viewing a female protagonist and Black participants viewing a Black protagonist demonstrated greater openness than other demographic pairings. CONCLUSIONS Brief video-based interventions improved immediate stigma and openness. Greater effects among female and Black individuals viewing demographically matched protagonists emphasise the value of tailored interventions, especially for socially oppressed groups. This easily disseminated intervention may proactively increase care-seeking, encouraging treatment among workers in need. Future studies should examine intervention mechanisms and whether linking referrals to psychiatric services generates treatment-seeking.
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Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Melanie Wall
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Israel
| | - John C Markowitz
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Chana T Fisch
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Mariah LeBeau
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Melissa Hinds
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Jun Liu
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Prudence W Fisher
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Thomas E Smith
- Columbia University Vagelos College of Physicians & Surgeons, New York, and New York State Office of Mental Health, NY, USA
| | - Sidney Hankerson
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Roberto Lewis-Fernández
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Yuval Neria
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Lisa B Dixon
- Department of Psychiatry, New York State Psychiatric Institute, and Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
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7
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU). Methods Data come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Bailey Holmes Spencer
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research Center, New York City, New York, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
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8
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Fisher PW, Reyes-Portillo JA, Riddle MA, Litwin HD. Systematic Review: Nonverbal Learning Disability. J Am Acad Child Adolesc Psychiatry 2022; 61:159-186. [PMID: 33892110 DOI: 10.1016/j.jaac.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/18/2021] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To summarize the current state of the research literature on nonverbal learning disability (NVLD), including criteria used to define NVLD in research contexts and the quality of the extant research; and to determine what research can tell us about ways in which NVLD is distinct from DSM neurodevelopmental disorders and typical development. METHOD A systematic search of 7 databases was conducted to identify research on NVLD published through February 2019. Criteria used to define NVLD were extracted from identified studies and sorted by category. Each study was assessed for risk of bias and rated "good," "fair," or "poor;" findings from studies rated good or fair were summarized. RESULTS A total of 61 articles (63 studies) met inclusion criteria. There was great heterogeneity in the criteria used to define NVLD. Deficits in visuospatial ability/intelligence was the most common criterion used, followed by discrepancy between verbal and nonverbal intelligence (VIQ>PIQ split of 10 or greater). All studies were cross-sectional and most included small, poorly described samples. Most studies focused on children and young adolescents. Eight studies were rated as good, 42 as fair, and 13 as poor. Review of results from the 50 good or fair studies suggest that there is sufficient evidence that youths with NVLD (as defined by significant deficits in visuospatial abilities) can be clearly differentiated from their typically developing peers, those with verbal learning disorders, and from other clinical groups (eg, individuals with high functioning autism). CONCLUSION A standard set of criteria for determining an NVLD diagnosis would greatly improve research studies and the possibility of inclusion in the DSM and the International Classification of Diseases.
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Affiliation(s)
- Prudence W Fisher
- Drs. Fisher, Reyes-Portillo, and Litwin are with New York State Psychiatric Institute and Columbia University Irving Medical Center, New York.
| | - Jazmin A Reyes-Portillo
- Drs. Fisher, Reyes-Portillo, and Litwin are with New York State Psychiatric Institute and Columbia University Irving Medical Center, New York; Dr. Reyes-Portillo is also with Montclair State University, New Jersey
| | - Mark A Riddle
- Dr. Riddle is with The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hillary D Litwin
- Drs. Fisher, Reyes-Portillo, and Litwin are with New York State Psychiatric Institute and Columbia University Irving Medical Center, New York
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9
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Kreniske P, Mellins CA, Dolezal C, Morrison C, Shea E, Fisher PW, Kluisza L, Robbins RN, Nguyen N, Leu CS, Wiznia A, Abrams EJ. Predictors of Attempted Suicide Among Youth Living With Perinatal HIV Infection and Perinatal HIV-Exposed Uninfected Counterparts. J Acquir Immune Defic Syndr 2021; 88:348-355. [PMID: 34406984 PMCID: PMC8693508 DOI: 10.1097/qai.0000000000002784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents and young adults (AYA). AYA living with perinatally acquired HIV infection (AYALPHIV) are at higher risk of attempted suicide when compared with AYA who were perinatally HIV-exposed but uninfected (AYAPHEU). To inform interventions, we identified risk and protective factors of attempted suicide among AYALPHIV and AYAPHEU. SETTING Data were obtained from a longitudinal New York City-based study of AYALPHIV and AYAPHEU (n = 339; enrollment age 9-16 years) interviewed approximately every 12-18 months. METHOD Our main outcome was suicide attempt at any follow-up. The DISC was used to assess psychiatric disorder diagnoses and attempted suicide and the Child Depression Inventory to assess depressive symptoms. Psychosocial and sociodemographic risk factors were also measured. Analyses used backward stepwise logistic regression modeling. RESULTS At enrollment, 51% was female individuals, 49% Black, 40% Latinx, and 11% both Black and Latinx. Attempted suicide prevalence was significantly higher among AYALPHIV compared with AYAPHEU (27% vs 16%, P = 0.019), with AYALPHIV having 2.21 times the odds of making an attempt [95% confidence interval: (1.18 to 4.12), P = 0.013]. Higher Child Depression Inventory scores were associated with an increased risk of attempted suicide in both groups and the total sample. The presence of DISC-defined behavior disorder increased the risk of attempted suicide in the total sample and the AYALPHIV subgroup. Religiosity was protective of attempted suicide in AYALPHIV. CONCLUSIONS AYALPHIV had increased suicide attempts compared with AYAPHEU. Religiosity was protective in AYALPHIV. Highlighting a need for prevention of early mental health challenges was associated with risk.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Claude Ann Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Eileen Shea
- Department of Psychiatry, Mental Health Data Science, Columbia University Medical Center, New York, NY
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Nadia Nguyen
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Cheng-Shiun Leu
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY; and
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
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10
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Fisher PW, Lazarov A, Lowell A, Arnon S, Turner JB, Bergman M, Ryba M, Such S, Marohasy C, Zhu X, Suarez-Jimenez B, Markowitz JC, Neria Y. Equine-Assisted Therapy for Posttraumatic Stress Disorder Among Military Veterans: An Open Trial. J Clin Psychiatry 2021; 82. [PMID: 34464523 DOI: 10.4088/jcp.21m14005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: As veterans have high rates of posttraumatic stress disorder (PTSD) and historically poor treatment outcomes and high attrition, alternative treatments have gained much popularity despite lack of rigorous research. In this study, a recently developed and manualized 8-session group Equine-Assisted Therapy for PTSD (EAT-PTSD) was tested in an open trial to assess its preliminary feasibility, acceptability, and outcomes for military veterans. Methods: The study was conducted from July 2016 to July 2019. Sixty-three treatment-seeking veterans with PTSD enrolled. PTSD diagnosis was ascertained using the Structured Clinical Interview for DSM-5, Research Version (SCID-5-RV) and confirmed using the Clinician-Administered PTSD Scale (CAPS-5). Mean age was 50 years, and 23 patients (37%) were women. Clinician and self-report measures of PTSD and depression were assessed at pretreatment, midtreatment, and posttreatment and at a 3-month follow-up. An intent-to-treat analysis and a secondary analysis of those who completed all 4 clinical assessments were utilized. Results: Only 5 patients (8%) withdrew from treatment, 4 before midtreatment and 1 afterward. Posttreatment assessment revealed marked reductions in both clinician-rated and self-reported PTSD and depression symptoms, which persisted at 3-month follow-up. Specifically, mean (SD) CAPS-5 scores fell from 38.6 (8.1) to 26.9 (12.4) at termination. Thirty-two patients (50.8%) showed clinically significant change (≥ 30% decrease in CAPS-5 score) at posttreatment and 34 (54.0%) at follow-up. Conclusions: Manualized EAT-PTSD shows promise as a potential new intervention for veterans with PTSD. It appears safe, feasible, and clinically viable. These preliminary results encourage examination of EAT-PTSD in larger, randomized controlled trials. Trial Registration: ClinicalTrials.gov identifier: NCT03068325.
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Affiliation(s)
- Prudence W Fisher
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,First authors-equal contribution
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,First authors-equal contribution.,Corresponding author: Amit Lazarov, PhD, Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032
| | - Ari Lowell
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Shay Arnon
- New York State Psychiatric Institute, New York, New York
| | - J Blake Turner
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Maja Bergman
- New York State Psychiatric Institute, New York, New York
| | - Matthew Ryba
- New York State Psychiatric Institute, New York, New York
| | - Sara Such
- New York State Psychiatric Institute, New York, New York
| | | | - Xi Zhu
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Benjamin Suarez-Jimenez
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - John C Markowitz
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Yuval Neria
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York
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11
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Lugo-Candelas C, Corbeil T, Wall M, Posner J, Bird H, Canino G, Fisher PW, Suglia SF, Duarte CS. ADHD and risk for subsequent adverse childhood experiences: understanding the cycle of adversity. J Child Psychol Psychiatry 2021; 62:971-978. [PMID: 33289088 PMCID: PMC8169708 DOI: 10.1111/jcpp.13352] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with adverse childhood experiences (ACEs) are more likely to develop Attention-Deficit/Hyperactivity Disorder (ADHD). The reverse relationship - ADHD predicting subsequent ACEs - is vastly understudied, although it may be of great relevance to underserved populations highly exposed to ACEs. METHODS Participants were 5- to 15-year-olds (48% females) with (9.9%) and without ADHD (DSM-IV criteria except age of onset) in a longitudinal population-based study of Puerto Rican youth. In each wave (3 yearly assessments, W1-3), ten ACEs (covering parental loss and maladjustment and child maltreatment) were examined, plus exposure to violence. Logistic regression models examined ADHD (including subtypes) and subsequent risk for ACEs. Also considered were interactions by age, sex, number of W1 ACEs, and recruitment site. RESULTS Children with W1 ADHD were more likely to experience subsequent adversity (OR: 1.63; 95% CI: 1.12-2.37) accounting for child age, sex, public assistance, maternal education, site, disruptive behavior disorders, and W1 ACEs. Inattentive (OR: 2.00; 95% CI: 1.09-3.66), but not hyperactive/impulsive or combined ADHD, predicted future ACEs. CONCLUSIONS ADHD predicts subsequent risk for ACEs, and the inattentive presentation may confer the most risk. Inattentive presentations could pose a bigger risk given differences in symptom persistence, latency to access to treatment, and treatment duration. The present study suggests a pathway for the perpetuation of adversity, where bidirectional relationships between ADHD and ACEs may ensnare children in developmental pathways predictive of poor outcomes. Understanding the mechanism underlying this association can help the development of interventions that interrupt the cycle of adversity exposure and improve the lives of children with ADHD.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Thomas Corbeil
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Melanie Wall
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Jonathan Posner
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Hector Bird
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, PR,USA
| | - Prudence W. Fisher
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | | | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
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12
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Zhu X, Suarez-Jimenez B, Zilcha-Mano S, Lazarov A, Arnon S, Lowell AL, Bergman M, Ryba M, Hamilton AJ, Hamilton JF, Turner JB, Markowitz JC, Fisher PW, Neria Y. Neural changes following equine-assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study. Hum Brain Mapp 2021; 42:1930-1939. [PMID: 33547694 PMCID: PMC7978114 DOI: 10.1002/hbm.25360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/09/2021] [Accepted: 01/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background While effective treatments for posttraumatic stress disorder (PTSD) exist, many individuals, including military personnel and veterans fail to respond to them. Equine‐assisted therapy (EAT), a novel PTSD treatment, may complement existing PTSD interventions. This study employs longitudinal neuro‐imaging, including structural magnetic resonance imaging (sMRI), resting state‐fMRI (rs‐fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD. Method Nineteen veterans with PTSD completed eight weekly group sessions of EAT undergoing multimodal MRI assessments before and after treatment. Clinical assessments were conducted at baseline, post‐treatment and at 3‐month follow‐up. Results At post‐treatment patients showed a significant increase in caudate functional connectivity (FC) and reduction in the gray matter density of the thalamus and the caudate. The increase of caudate FC was positively associated with clinical improvement seen immediately at post‐treatment and at 3‐month follow‐up. In addition, higher baseline caudate FC was associated with greater PTSD symptom reduction post‐treatment. Conclusions This exploratory study is the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD. The findings suggest that EAT may target reward circuitry responsiveness and produce a caudate pruning effect from pre‐ to post‐treatment.
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Affiliation(s)
- Xi Zhu
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Neuroscience Department, University of Rochester, Rochester, New York, USA
| | | | - Amit Lazarov
- Department of Psychiatry, Columbia University, New York, New York, USA.,School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shay Arnon
- New York State Psychiatric Institute, New York, New York, USA
| | - Ari L Lowell
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Memphis Veterans Administration Medical Center, Memphis, Tennessee, USA
| | - Maja Bergman
- New York State Psychiatric Institute, New York, New York, USA
| | - Matthew Ryba
- New York State Psychiatric Institute, New York, New York, USA
| | | | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, Tucson, Arizona, USA
| | - J Blake Turner
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - John C Markowitz
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Prudence W Fisher
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
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13
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Barbe MF, Hilliard B, Fisher PW, White AR, Delany SP, Iannarone VJ, Harris MY, Amin M, Cruz GE, Popoff SN. Blocking substance P signaling reduces musculotendinous and dermal fibrosis and sensorimotor declines in a rat model of overuse injury. Connect Tissue Res 2020; 61:604-619. [PMID: 31443618 PMCID: PMC7036028 DOI: 10.1080/03008207.2019.1653289] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose/Aim: Substance P-NK-1R signaling has been implicated in fibrotic tendinopathies and myositis. Blocking this signaling with a neurokinin 1 receptor antagonist (NK1RA) has been proposed as a therapeutic target for their treatment.Materials and Methods: Using a rodent model of overuse injury, we pharmacologically blocked Substance P using a specific NK1RA with the hopes of reducing forelimb tendon, muscle and dermal fibrogenic changes and associated pain-related behaviors. Young adult rats learned to pull at high force levels across a 5-week period, before performing a high repetition high force (HRHF) task for 3 weeks (2 h/day, 3 days/week). HRHF rats were untreated or treated in task weeks 2 and 3 with the NK1RA, i.p. Control rats received vehicle or NK1RA treatments.Results: Grip strength declined in untreated HRHF rats, and mechanical sensitivity and temperature aversion increased compared to controls; these changes were improved by NK1RA treatment (L-732,138). NK1RA treatment also reduced HRHF-induced thickening in flexor digitorum epitendons, and HRHF-induced increases of TGFbeta1, CCN2/CTGF, and collagen type 1 in flexor digitorum muscles. In the forepaw upper dermis, task-induced increases in collagen deposition were reduced by NK1RA treatment.Conclusions: Our findings indicate that Substance P plays a role in the development of fibrogenic responses and subsequent discomfort in forelimb tissues involved in performing a high demand repetitive forceful task.
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Affiliation(s)
- MF Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - B Hilliard
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - PW Fisher
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - AR White
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - SP Delany
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - VJ Iannarone
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - MY Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - M Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - GE Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - SN Popoff
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
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14
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Blank MS, Turner JB, Fisher PW, Guthrie EB, Whitaker AH. The Need for a Clinically Useful Schema of Social Communication. J Am Acad Child Adolesc Psychiatry 2020; 59:1198-1200. [PMID: 33126991 DOI: 10.1016/j.jaac.2020.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/18/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022]
Abstract
The recent Translations article by Bishop et al.1 draws much-needed attention to social communication (SC) in autism spectrum disorder (ASD) and to the need in autism research for treatment-sensitive measures of this key domain. In this context, the authors define SC ability as "the appropriate use and modulation of verbal and nonverbal behaviors during interactions with others"1(p. 555). "Appropriate" is defined relative to normative behaviors for developmental age and language level based on parent report. This stirred us to share our concern that clinicians, too, need ways to assess SC. Historically, observation of a patient's SC has not been part of the routine psychiatric mental status examination (MSE); clinicians lack even a common basic vocabulary for describing this vital domain. The DSM-52 does not explicitly define SC or distinguish it from social interaction (SI) or language, important terms also used in the criteria for ASD. All three terms are used interchangeably and inconsistently across the literature. Here we offer a definition of SC, distinguish it from SI and language, and propose a schema, or conceptual model, for observing and documenting an impression of a patient's SC.
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Affiliation(s)
- Marion S Blank
- Mojo Learning Inc., Las Vegas, Nevada, and (retired) Columbia University, New York
| | - J Blake Turner
- Columbia University Vagelos College of Physicians and Surgeons, New York, and the New York State Psychiatric Institute
| | - Prudence W Fisher
- Columbia University Vagelos College of Physicians and Surgeons, New York, and the New York State Psychiatric Institute
| | - Elisabeth B Guthrie
- Columbia University Vagelos College of Physicians and Surgeons, New York, and the New York State Psychiatric Institute
| | - Agnes H Whitaker
- Columbia University Vagelos College of Physicians and Surgeons, New York, and the New York State Psychiatric Institute.
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15
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Arnon S, Fisher PW, Pickover A, Lowell A, Turner JB, Hilburn A, Jacob-McVey J, Malajian BE, Farber DG, Hamilton JF, Hamilton A, Markowitz JC, Neria Y. Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings. Mil Med 2020; 185:e557-e564. [PMID: 32034416 PMCID: PMC7282489 DOI: 10.1093/milmed/usz444] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking empirical support, a manual, and a standardized protocol. Our team of experts in EAT and PTSD developed an eight-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to two pilot groups of military veterans to assess initial effects. MATERIALS AND METHODS We describe the development of the treatment manual, which was used with two pilot groups of veterans. Protocol safety, feasibility, and acceptability were assessed by reported adverse events, treatment completion rates, and self-rated patient satisfaction. Preliminary data on PTSD, depressive, and anxiety symptoms and quality of life were collected pretreatment, midpoint, post-treatment, and at 3-month follow up. RESULTS No adverse events were recorded. All patients completed treatment, reporting high satisfaction. Preliminary data showed decreases in clinician-assessed PTSD and depressive symptoms from pre to post-treatment and follow-up (medium to large effect sizes, d = .54-1.8), with similar trends across self-report measures (d = 0.72-1.6). In our pilot sample, treatment response and remission varied; all patients showed some benefit post-treatment, but gains did not persist at follow-up. CONCLUSIONS This article presents the first standardized EAT protocol. Highly preliminary results suggest our new manualized group EAT-PTSD appears safe, well-regarded, and well-attended, yielding short-term benefits in symptomatology and quality of life if unclear length of effect. Future research should test this alternative treatment for PTSD more rigorously.
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Affiliation(s)
- Shay Arnon
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Prudence W Fisher
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Alison Pickover
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Ari Lowell
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - J Blake Turner
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Anne Hilburn
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Jody Jacob-McVey
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
- EquiSense Solutions LLC, 33 West 93rd Street, 3B, New York, NY 10025
| | | | - Debra G Farber
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
| | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, 8649 E Woodland Road, Tucson, AZ 85749
| | - Allan Hamilton
- Department of Surgery, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724
| | - John C Markowitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Yuval Neria
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
- Department of Epidemiology, Columbia University Irving Medical Center, 722 West 168th Street, New York, NY 10032
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Reyes-Portillo JA, McGlinchey EL, Toso-Salman J, Chin EM, Fisher PW, Mufson L. Clinician Experience and Attitudes Toward Safety Planning with Adolescents at Risk for Suicide. Arch Suicide Res 2019; 23:222-233. [PMID: 29624113 DOI: 10.1080/13811118.2018.1456382] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined clinician experiences and attitudes toward safety planning in a large urban pediatric psychiatry department serving primarily Latino youth. A total of 46 clinicians completed a survey assessing their experience with and attitudes toward safety planning with adolescents at-risk for suicide. The majority of clinicians were female (78%), non-Latino White (54%), and aged 30-39 (52%). Clinicians' attitudes were largely positive (M = 3.69 SD = 0.47, Range = 2.42-4.42). However, many clinicians (n = 24) were not convinced that safety planning reduces the imminent risk of suicidal behavior in patients. This study provides more depth to our understanding of the way in which safety planning is perceived by clinicians.
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17
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Lowell A, Lopez-Yianilos A, Ryba M, Arnon S, Suarez-Jimenez B, Lazarov A, Fisher PW, Markowitz JC, Neria Y. A University-Based Mental Health Center for Veterans and Their Families: Challenges and Opportunities. Psychiatr Serv 2019; 70:159-162. [PMID: 30497324 DOI: 10.1176/appi.ps.201800356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Military Family Wellness Center at Columbia University Irving Medical Center provides cost-free, confidential mental health services to military service members, veterans, and their families in a nongovernmental setting, with an emphasis on addressing gaps in available care. Partnerships with academic institutions and collaboration with veteran organizations, regional stakeholders, and local Veterans Administration centers facilitate cross-site referrals, enhance knowledge and expertise, and advance shared goals. This article describes the development of these relationships, focusing on key priorities, barriers overcome, and lessons learned. Future directions are discussed.
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Affiliation(s)
- Ari Lowell
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Andrea Lopez-Yianilos
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Matthew Ryba
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Shay Arnon
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Benjamin Suarez-Jimenez
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Amit Lazarov
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Prudence W Fisher
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - John C Markowitz
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Yuval Neria
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
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18
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Krasner AJ, Turner JB, Feldman JF, Silberman AE, Fisher PW, Workman CC, Posner JE, Greenhill LL, Lorenz JM, Shaffer D, Whitaker AH. ADHD Symptoms in a Non-Referred Low Birthweight/Preterm Cohort: Longitudinal Profiles, Outcomes, and Associated Features. J Atten Disord 2018; 22:827-838. [PMID: 26700791 PMCID: PMC4919227 DOI: 10.1177/1087054715617532] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study's objective is to differentiate possible ADHD syndromes on the basis of symptom trajectories, prognosis, and associated clinical features in a high-risk cohort. METHOD Latent class analysis of inattentive (IA) and hyperactive-impulsive (HI) symptoms in 387 non-disabled members of a regional low birthweight/preterm birth cohort who were evaluated for ADHD at 6, 9, and 16 years. Adolescent functional outcomes and other clinical features were examined across the classes. RESULTS Three latent classes were identified: unaffected (modest IA and HI symptom prevalences at six, remitting by nine), school age limited (relatively high IA and HI symptom prevalences at six and nine, declining by 16), and persistent inattentive (high IA and HI prevalences at six and nine, with high IA levels persisting to 16). The persistent inattentive class was distinctively associated with poor functioning, motor problems, other psychiatric disorders, and social difficulties as indexed by a positive screen for autism spectrum disorder at 16. CONCLUSION These findings differentiate a potential persistent inattentive syndrome relevant to ADHD evaluation and treatment.
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Affiliation(s)
- Aaron J. Krasner
- Columbia University, New York, NY, USA,Yale University, New Haven, CT, USA
| | - J. Blake Turner
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Prudence W. Fisher
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | | | - Jonathan E. Posner
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Laurence L. Greenhill
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | | | - David Shaffer
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Agnes H. Whitaker
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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Matte B, Rohde LA, Turner JB, Fisher PW, Shen S, Bau CHD, Nigg JT, Grevet EH. Reliability and Validity of Proposed DSM-5 ADHD Symptoms in a Clinical Sample of Adults. J Neuropsychiatry Clin Neurosci 2016; 27:228-36. [PMID: 26067434 DOI: 10.1176/appi.neuropsych.13060137] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The DSM-5 ADHD and Disruptive Behaviors Work Group proposed two major changes for diagnosis of attention deficit hyperactivity disorder (ADHD) in adults: (1) inclusion of four new impulsivity symptoms and (2) reduction in the number of symptoms required for assigning an ADHD diagnosis. In this case-control study, the performance of these modifications was assessed in a clinical sample of 133 adult subjects (68 ADHD cases and 65 non-ADHD control subjects). The proposed new impulsivity symptoms for adults do not improve ADHD diagnosis enough to overcome potential negative effects of changing the criteria. However, fewer symptoms than the six-of-nine threshold required by DSM-IV provided the best cutoff point for identifying adults who are impaired.
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Affiliation(s)
- Breno Matte
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Luis Augusto Rohde
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - J Blake Turner
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Prudence W Fisher
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Sa Shen
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Claiton H D Bau
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Joel T Nigg
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
| | - Eugenio H Grevet
- From the ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre (BM, LAR, CHDB, EHG), and Dept. of Genetics, Instituto de Biociências (CHDB), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (LAR); Columbia University/New York State Psychiatric Institute, New York, NY (JBT, PWF, SS); and Dept. of Psychiatry, Oregon Health and Sciences University, Portland, OR (JTN)
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20
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Roberts RE, Fisher PW, Turner JB, Tang M. Estimating the burden of psychiatric disorders in adolescence: the impact of subthreshold disorders. Soc Psychiatry Psychiatr Epidemiol 2015; 50:397-406. [PMID: 25358512 DOI: 10.1007/s00127-014-0972-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE We examine the impact of including subthreshold disorders on estimating psychiatric morbidity burden in adolescents. To more fully understand this burden it is important to focus on both full syndrome and subthreshold disorders and the impairment associated with each, since evidence suggests prevalence of subthreshold disorders is substantial as is impairment. METHODS Data were analyzed from a probability sample of 4,175 youths 11-17 years of age. We examine the prevalence of DSM-IV disorders (FS) and subthreshold (SUB) disorders, with and without impairment. Diagnostic categories examined were anxiety, mood, attention deficit hyperactivity disorder, disruptive, and substance use disorders in the past year. RESULTS The prevalence of any FS disorders was 16.1 and 42.3 % for SUB. The combined prevalence was 58.4 %. By requiring impairment, the prevalence of any FS in the past year dropped to 8 % and for SUB to 15.7 %, with a combined overall rate of 23.7 %. For FS disorders, 49.6 % met criteria for moderate to severe impairment, compared to 37.8 % for SUB. One in four adolescents had either an FS or SUB disorder with impairment. CONCLUSION The results indicate that SUB disorders constitute a major public health burden in terms of psychiatric morbidity among adolescents. Given their substantial impairment and their high prevalence, consideration should be given to including SUB disorders in estimates of the public health burden psychiatric morbidity. Doing so would provide a more accurate estimate of psychiatric morbidity.
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Affiliation(s)
- Robert E Roberts
- UTHealth School of Public Health, University of Texas Health Science Center, San Antonio Regional Campus, 7411 John Smith Drive, Suite 1100, San Antonio, TX, 78229, USA,
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Neugebauer R, Turner JB, Fisher PW, Yamabe S, Zhang B, Neria Y, Gameroff M, Bolton P, Mack R. Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls. ACTA ACUST UNITED AC 2014. [DOI: 10.1037/a0035240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Canino GJ, Fisher PW, Alegria M, Bird HR. Assessing Child Impairment in Functioning in Different Contexts: Implications for Use of Services and the Classification of Psychiatric Disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojmp.2013.21006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Galanter CA, Hundt SR, Goyal P, Le J, Fisher PW. Variability among research diagnostic interview instruments in the application of DSM-IV-TR criteria for pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry 2012; 51:605-21. [PMID: 22632620 DOI: 10.1016/j.jaac.2012.03.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 03/13/2012] [Accepted: 03/27/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The DSM-IV-TR criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and validity, but vary in how they incorporate DSM-IV-TR criteria for pediatric BD. METHOD We examined DSM-IV-TR criteria and the descriptive text for a manic episode and the mania sections of six commonly used pediatric diagnostic research interviews focusing on the following: interpretation of DSM-IV-TR, recommendations for administration, and scoring methods. RESULTS There are differences between the DSM-IV-TR manic episode criteria and descriptive text. Instruments vary in several ways including in their conceptualization of the mood criterion, whether symptoms must represent a change from the child's usual state, and whether B-criteria are required to co-occur with the A-criterion. Instruments also differ on recommendations for administration and scoring methods. CONCLUSIONS Given the differences between DSM-IV-TR manic episode criteria and explanatory text, it is not surprising that there is considerable variation between diagnostic instruments based on DSM-IV-TR. These differences likely lead to dissimilarities in subjects included in BD research studies and inconsistent findings across studies. The field of child psychiatry would benefit from more uniform methods of assessing symptoms and determining pediatric BD diagnoses. We discuss recommendations for changes to future instruments, interviews, assessment, and the DSM-5.
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Affiliation(s)
- Cathryn A Galanter
- State University of New York Downstate and the Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA.
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Angold A, Erkanli A, Copeland W, Goodman R, Fisher PW, Costello EJ. Psychiatric diagnostic interviews for children and adolescents: a comparative study. J Am Acad Child Adolesc Psychiatry 2012; 51:506-17. [PMID: 22525957 PMCID: PMC3336098 DOI: 10.1016/j.jaac.2012.02.020] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 01/27/2012] [Accepted: 02/27/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). METHOD Roughly equal numbers of males and females of white and African American ethnicity, aged 9 to 12 and 13 to 16 years, were recruited from primary care pediatric clinics. Participants (N = 646) were randomly assigned to receive two of the three interviews, in counterbalanced order. Five modules were used: any depressive disorder, anxiety disorders, oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder. At two sessions about 1 week apart, parent and child completed one of two interviews plus five screening questionnaires. RESULTS When interviewed with the DAWBA, 17.7% of youth had one or more diagnoses, compared with 47.1% (DISC) and 32.4% (CAPA). The excess of DISC diagnoses was accounted for by specific phobias. Agreement between interview pairs was 0.13 to 0.48 for DAWBA-DISC comparisons, 0.21 to 0.61 for DISC-CAPA comparisons, and 0.23 to 0.48 for CAPA-DAWBA comparisons. DAWBA-only cases were associated with higher parent-report questionnaire scores than DISC/DAWBA cases, but equivalent child-report scores. CONCLUSIONS The DAWBA is shorter and cases were probably more severe, making it a good choice for clinical trials, but the user cannot examine the data in detail. The DISC and CAPA are similar in length and training needs. Either would be a better choice where false-negative results must be avoided, as in case-control genetic studies, or when researchers need to study individual symptoms in detail.
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Affiliation(s)
- Adrian Angold
- Department of Psychiatry and Behavioral Sciences, Box 3454 Duke University Medical School, Durham, NC 27710, USA.
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DeVylder JE, Alexander N, Fisher PW. A consultation service to support participants in psychiatric research. Psychiatr Serv 2012; 63:291-2. [PMID: 22388535 DOI: 10.1176/appi.ps.20120p291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Whitaker AH, Feldman JF, Lorenz JM, McNicholas F, Fisher PW, Shen S, Pinto-Martin J, Shaffer D, Paneth N. Neonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders. ACTA ACUST UNITED AC 2011; 68:742-52. [PMID: 21727256 DOI: 10.1001/archgenpsychiatry.2011.62] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Infants born prematurely are at risk for a perinatal encephalopathy characterized by white and gray matter injuries that affect subsequent cortical development and neural connectivity and potentially increase risk for later psychiatric disorder. OBJECTIVE To determine the relation of perinatal brain injury, as detected by neonatal head ultrasound, to psychiatric disorders in adolescents who were born prematurely. DESIGN Prospective cohort. SETTING Community. PARTICIPANTS Adolescent survivors of a population-based low-birth-weight (<2000 g; 96% preterm; born 1984-1987) cohort (n = 1105) screened as neonates with serial head ultrasounds. Neonatal head ultrasound abnormalities were categorized as either (1) germinal matrix and/or intraventricular hemorrhage or (2) parenchymal lesions and/or ventricular enlargement. Of 862 eligible survivors, 628 (72.9%) were assessed at age 16 years. The sample consisted of 458 nondisabled survivors assessed in person. Main Outcome Measure Adolescent current and lifetime psychiatric disorders assessed with parent report on the Diagnostic Interview Schedule for Children-IV. RESULTS Compared with no abnormality, germinal matrix/intraventricular hemorrhage increased risk for current major depressive disorder (odds ratio, 2.7; 95% confidence interval, 1.0-6.8) and obsessive-compulsive disorder (9.5; 3.0-30.1). Parenchymal lesions/ventricular enlargement increased risk for current attention-deficit/hyperactivity disorder-inattentive type (odds ratio, 7.6; 95% confidence interval, 2.0-26.5), tic disorders (8.4; 2.4-29.6), and obsessive-compulsive disorder (7.6; 1.39-42.0). Parenchymal lesions/ventricular enlargement were not related to lifetime attention-deficit/hyperactivity disorder-inattentive type, but all other relations were similar for lifetime disorders. Control for other early risk factors did not alter these relations. Most of these relations persisted with control for concurrent cognitive or motor problems. CONCLUSION In preterm infants, 2 distinct types of perinatal brain injury detectable with neonatal head ultrasound selectively increase risk in adolescence for psychiatric disorders in which dysfunction of subcortical-cortical circuits has been implicated.
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Affiliation(s)
- Agnes H Whitaker
- Division of Adolescent and Child Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA.
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Haas AP, Eliason M, Mays VM, Mathy RM, Cochran SD, D'Augelli AR, Silverman MM, Fisher PW, Hughes T, Rosario M, Russell ST, Malley E, Reed J, Litts DA, Haller E, Sell RL, Remafedi G, Bradford J, Beautrais AL, Brown GK, Diamond GM, Friedman MS, Garofalo R, Turner MS, Hollibaugh A, Clayton PJ. Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. J Homosex 2011; 58:10-51. [PMID: 21213174 PMCID: PMC3662085 DOI: 10.1080/00918369.2011.534038] [Citation(s) in RCA: 557] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.
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Affiliation(s)
- Ann P Haas
- American Foundation for Suicide Prevention, New York, New York 10005, USA.
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Abstract
OBJECTIVE This article presents the 12-month prevalence estimates of specific mental disorders, their social and demographic correlates, and service use patterns in children and adolescents from the National Health and Nutrition Examination Survey, a nationally representative probability sample of noninstitutionalized US civilians. METHODS The sample includes 3042 participants 8 to 15 years of age from cross-sectional surveys conducted from 2001 to 2004. Data on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, version IV, a structured diagnostic interview administered by lay interviewers to assess psychiatric diagnoses of children and adolescents. RESULTS Twelve-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined disorders in this sample were 8.6% for attention-deficit/hyperactivity disorder, 3.7% for mood disorders, 2.1% for conduct disorder, 0.7% for panic disorder or generalized anxiety disorder, and 0.1% for eating disorders. Boys had 2.1 times greater prevalence of attention-deficit/hyperactivity disorder than girls, girls had twofold higher rates of mood disorders than boys, and there were no gender differences in the rates of anxiety disorders or conduct disorder. Only approximately one half of those with one of the disorders assessed had sought treatment with a mental health professional. CONCLUSION These data constitute a first step in building a national database on mental health in children and adolescents.
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Affiliation(s)
- Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland 20892, USA.
| | - Jian-Ping He
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Debra Brody
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Prudence W. Fisher
- New York State Psychiatric Institute, Columbia University, New York, New York
| | - Karen Bourdon
- Epidemiology Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Doreen S. Koretz
- Office of the Provost, Harvard University, Cambridge, Massachusetts
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Abstract
OBJECTIVE This article presents the 12-month prevalence estimates of specific mental disorders, their social and demographic correlates, and service use patterns in children and adolescents from the National Health and Nutrition Examination Survey, a nationally representative probability sample of noninstitutionalized US civilians. METHODS The sample includes 3042 participants 8 to 15 years of age from cross-sectional surveys conducted from 2001 to 2004. Data on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, version IV, a structured diagnostic interview administered by lay interviewers to assess psychiatric diagnoses of children and adolescents. RESULTS Twelve-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined disorders in this sample were 8.6% for attention-deficit/hyperactivity disorder, 3.7% for mood disorders, 2.1% for conduct disorder, 0.7% for panic disorder or generalized anxiety disorder, and 0.1% for eating disorders. Boys had 2.1 times greater prevalence of attention-deficit/hyperactivity disorder than girls, girls had twofold higher rates of mood disorders than boys, and there were no gender differences in the rates of anxiety disorders or conduct disorder. Only approximately one half of those with one of the disorders assessed had sought treatment with a mental health professional. CONCLUSION These data constitute a first step in building a national database on mental health in children and adolescents.
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Affiliation(s)
- Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland 20892, USA.
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Bugelski PJ, Capocasale RJ, Makropoulos D, Marshall D, Fisher PW, Lu J, Achuthanandam R, Spinka-Doms T, Kwok D, Graden D, Volk A, Nesspor T, James IE, Huang C. CNTO 530: molecular pharmacology in human UT-7EPO cells and pharmacokinetics and pharmacodynamics in mice. J Biotechnol 2007; 134:171-80. [PMID: 18242752 DOI: 10.1016/j.jbiotec.2007.12.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Accepted: 12/10/2007] [Indexed: 11/30/2022]
Abstract
CNTO 530 is a 58 kD antibody Fc domain fusion protein, created using Centocor's MIMETIBODY platform, that contains two EMP1 sequences as a pharmacophore. CNTO 530 has no sequence homology with EPO but acts as a novel erythropoietin receptor agonist. In UT-7(EPO) cells, CNTO 530 caused protein phosporylation of the erythropoietin receptor associated signaling pathway (Jak2, STAT5, AKT and ERK1/2). CNTO 530 also rescued these cells from apoptosis and mediated proliferation. In mice, pharmacokinetic analysis showed that CNTO 530 was slowly cleared from circulation with a t(1/2) approximately 40 h. Pharmacodynamic analysis in mice showed that a single sc dose of CNTO 530 caused a long-lived stimulation of erythropoiesis that translated into increases in red blood cell counts and hemoglobin values that were maintained for at least 28 d. In conclusion, CNTO 530 is a long-lived EPO-R agonist that stimulates erythropoiesis in a manner similar to epoetin-alpha. These data suggest that CNTO 530 may be an effective treatment of anemia in humans.
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Affiliation(s)
- P J Bugelski
- Centocor Research and Development, Radnor, PA 19087, United States.
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Abstract
INTRODUCTION Audit of inguinal hernia repair is important in view of the magnitude of the problem and the fact that it is a common operation often performed by surgical trainees. Due to the disparity of the results of various workers with regard to the rate of complications, individual surgeons have been advised to audit their patients' outcomes. METHOD Retrospective audit was performed, of all the inguinal hernias repaired between 1997 and 2003 inclusive, at two rural hospitals in northern Scotland, under a single consultant. Data were gathered from a hospital database and by means of postal questionnaire specifically aimed at wound complications, recurrence and chronic groin pain. RESULTS One hundred and sixty-three inguinal hernias were repaired during this period. One hundred and fifty-eight questionnaires were sent to patients ascertained to be living at the time of audit initiation with a response from 129 (86%). At a mean follow-up of 4.34 years, no recurrences were noted and eight patients complained of chronic groin pain of whom only three (1.5%) were experiencing moderate to severe pain. The results achieved by senior house officers were comparable to those obtained by the senior surgeon. CONCLUSION The incidence of recurrence of hernia after open mesh repair of inguinal hernias is very low. Excellent outcomes can be obtained for inguinal hernia even at remote and rural hospitals in the hands of both experienced and trainee surgeons
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Affiliation(s)
- S R Menakuru
- Department of General Surgery, Caithness General Hospital, Wick, KW1 5NS, UK
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Abstract
OBJECTIVE Despite available depression treatments, only one fourth to one third of depressed adolescents are receiving care. The problem of underdiagnosis and underreferral might be redressed if assessment of suicidality and depression became a more formal part of routine pediatric care. Our purpose for this study was to explore the feasibility and acceptability of implementing adolescent depression screening into clinical practice. METHODS In this study we implemented a 2-stage adolescent identification protocol, a first-stage pen-and-paper screen and a second-stage computerized assessment, into a busy primary care pediatric practice. Providers tracked the number of eligible patients screened at both health maintenance and urgent care visits and provided survey responses regarding the burden that screening placed on the practice and the effect on patient/parent-provider relationships. RESULTS Seventy-nine percent of adolescent patients presenting for health maintenance visits were screened, as were the majority of patients presenting for any type of visit. The average completion time for the paper screen was 4.6 minutes. Providers perceived parents and patients as expressing more satisfaction than dissatisfaction with the screening procedures and that the increased time burden could be handled. All providers wished to continue using the paper screen at the conclusion of the protocol. CONCLUSIONS Instituting universal systematic depression screening in a practice with a standardized screening instrument met with little resistance by patients and parents and was well perceived and accepted by providers.
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Affiliation(s)
- Rachel A Zuckerbrot
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, New York, New York, USA.
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Menakuru SR, Mazumdar S, Fisher PW. Prognostic significance of alarm symptoms in patients with gastric cancer (Br J Surg 2005; 92: 840-846). Br J Surg 2005; 93:122. [PMID: 16370022 DOI: 10.1002/bjs.5298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
[structure: see text] Bioassay-guided fractionation of the plant Acacia aulacocarpa, guided by a bioassay for Tie2 tyrosine kinase activity, yielded the novel triterpene 3,21-dioxo-olean-18-en-oic acid (1) as the first naturally occurring non-protein inhibitor of Tie2 kinase. The structure of 1 was assigned by analysis of spectral data. In addition to its activity as an inhibitor of Tie2 kinase, compound 1 also shows modest activity against a variety of cultured mammalian cells.
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Affiliation(s)
- B N Zhou
- Department of Chemistry, M/C 0212, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
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Nuttall ME, Pendrak I, Emery JG, Nadeau DP, Fisher PW, Nicholson TA, Zhu Y, Suva LJ, Kingsbury WD, Gowen M. Antagonism of oestrogen action in human breast and endometrial cells in vitro: potential novel antitumour agents. Cancer Chemother Pharmacol 2001; 47:437-43. [PMID: 11391860 DOI: 10.1007/s002800000259] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE There is a need to find novel oestrogen receptor (ER) ligands that antagonize oestrogen action in the reproductive tissues and would therefore have therapeutic potential in oestrogen-dependent tumours. We tested novel ER ligands in both breast and endometrial cells to profile agonism/antagonism in these oestrogen target reproductive tissues. METHODS Novel analogues of the ER antagonist ICI 182,780 were synthesized and tested for their ability to inhibit gene expression dependent on oestrogen response elements (ERE) in human breast (MCF-7) and endometrial (Ishikawa) cell lines. This activity was correlated with inhibition of oestrogen-induced cell proliferation and ER binding. RESULTS The sulphide analogue (compound 1) and sulphone analogue (compound 2) had no intrinsic ERE-dependent agonism in either breast cancer or endometrial cells in culture. All three compounds dose-dependently inhibited ERE-mediated oestrogen agonism. Moreover, these ER ligands inhibited oestrogen-stimulated proliferation of breast cancer and endometrial cells. ICI 182,780, compound 1 and compound 2 were all able to bind both isoforms of the ER (ER alpha and ER beta). In endometrial cells, the relative binding to ER beta correlated with the ERE-dependent antioestrogenic effect of these ligands, suggesting that in this tissue this receptor is the predominant isoform that determines antioestrogenic activity. CONCLUSIONS The ability of these analogues of ICI 182,780 to inhibit oestrogen-stimulated transcriptional activity and cell proliferation suggests that these agents, in particular the sulphone analogue, have therapeutic potential in the treatment of breast cancer without exhibiting the unwanted oestrogenic effects in the endometrium.
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Affiliation(s)
- M E Nuttall
- Department of Bone and Cartilage Biology, SmithKline Beecham Pharmaceuticals, 709 Swedeland Road, King of Prussia, Pennsylvania 19406, USA.
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Lucas CP, Zhang H, Fisher PW, Shaffer D, Regier DA, Narrow WE, Bourdon K, Dulcan MK, Canino G, Rubio-Stipec M, Lahey BB, Friman P. The DISC Predictive Scales (DPS): efficiently screening for diagnoses. J Am Acad Child Adolesc Psychiatry 2001; 40:443-9. [PMID: 11314570 DOI: 10.1097/00004583-200104000-00013] [Citation(s) in RCA: 292] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To derive and test a series of brief diagnosis-specific scales to identify subjects who are at high probability of meeting diagnostic criteria and those who may safely be spared more extensive diagnostic inquiry. METHOD Secondary data analysis of a large epidemiological data set (n = 1,286) produced a series of gate and contingent items for each diagnosis. Findings were replicated in a second retrospective analysis from a residential care sample (n = 884). The DISC Predictive Scales (DPS) were then used prospectively as a self-report questionnaire in two studies, in which parents (n = 128) and/or adolescents (n = 208) had subsequent diagnostic interviewing with the Diagnostic Interview Schedule for Children or the Schedule for Affective Disorders and Schizophrenia for School-Age Children. RESULTS All analyses showed that gate item selection was valid and that any missed cases were due solely to inconsistent reports on the same questions. Screening performance of the full scales was shown to be good, and substantial reductions in scale length were not associated with significant changes in discriminatory power. CONCLUSIONS The DPS can accurately determine subjects who can safely be spared further diagnostic inquiry in any diagnostic area. This has the potential to speed up structured diagnostic interviewing considerably. The full DPS can be used to screen accurately for cases of specific DSM-III-R disorders.
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Affiliation(s)
- C P Lucas
- Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, USA.
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Nuttall ME, Stroup GB, Fisher PW, Nadeau DP, Gowen M, Suva LJ. Distinct mechanisms of action of selective estrogen receptor modulators in breast and osteoblastic cells. Am J Physiol Cell Physiol 2000; 279:C1550-7. [PMID: 11029302 DOI: 10.1152/ajpcell.2000.279.5.c1550] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Raloxifene and idoxifene are selective estrogen receptor modulators (SERMs) that exhibit tissue-specific agonist or antagonist properties via interactions with the estrogen receptor (ER). Both compounds are similarly osteoprotective in the ovariectomized rat in vivo as assessed by measurement of bone mineral density, urinary pyridinium cross-links, and serum osteocalcin, suggesting a similar mechanism of action. However, we have identified a fundamental difference in this mechanism via the estrogen response element (ERE) in osteoblast-like cells. With the use of ERE-luciferase reporter constructs, raloxifene, like the complete ER-antagonist ICI-182780, acts as an antagonist via the ERE in osteoblastic cells. In contrast, idoxifene, like 17beta-estrogen itself and 4-OH-tamoxifen, acts as an agonist in osteoblastic cells via an ER/ERE-mediated mechanism. Both ICI-182780 and raloxifene inhibited the ERE-dependent agonist activity of 17beta-estradiol and idoxifene in osteoblastic cells. In contrast, in breast cells, raloxifene, idoxifene, 4-OH-tamoxifen, and ICI-182780 had no agonist activity and, indeed, raloxifene and idoxifene were potent antagonists of ERE-mediated 17beta-estradiol action, indicating an ERE-dependent mode of action in these cells. Although these SERMs exhibit a similar antagonist activity profile in breast cells, they can be distinguished mechanistically in osteoblastic cells.
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Affiliation(s)
- M E Nuttall
- Department of Bone and Cartilage Biology, SmithKline Beecham Pharmaceuticals, King of Prussia, Pennsylvania 19406, USA.
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Nuttall ME, Fisher PW, Suva LJ, Gowen M. The selective oestrogen receptor modulators idoxifene and raloxifene have fundamentally different cell-specific oestrogen-response element (ERE)-dependent/independent mechanisms in vitro. Eur J Cancer 2000; 36 Suppl 4:S63-4. [PMID: 11056323 DOI: 10.1016/s0959-8049(00)00230-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Idoxifene and raloxifene are selective oestrogen receptor modulators (SERMs) that by definition exhibit tissue-specific agonist or antagonist properties via interactions with the oestrogen receptor (ER). Idoxifene acts as an oestrogen agonist in osteoblastic cells via an ER/ERE-mediated mechanism. In contrast, raloxifene is an antagonist via the ERE in osteoblastic cells. Like the pure antagonist ICI 182,780, raloxifene inhibited the potent agonist activity of both 17beta-oestradiol and idoxifene through the ERE whereas idoxifene had no effect on the agonist activity of 17beta-oestradiol via the ERE. In breast cancer cells, both raloxifene and idoxifene were potent antagonists of ERE-mediated 17beta-oestradiol action suggesting an ERE-dependent mechanism of action for both ligands in these cells. Therefore, these SERMs exhibit cell-specific ERE-dependent and -independent mechanisms of action.
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Affiliation(s)
- M E Nuttall
- Department of Bone and Cartilage Biology, SmithKline Beecham Pharmaceuticals, UW2109, 709 Swedeland Road, PO Box 1539, King of Prussia, PA 19406, USA.
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Nuttall ME, Nadeau DP, Fisher PW, Wang F, Keller PM, DeWolf WE, Goldring MB, Badger AM, Lee D, Levy MA, Gowen M, Lark MW. Inhibition of caspase-3-like activity prevents apoptosis while retaining functionality of human chondrocytes in vitro. J Orthop Res 2000; 18:356-63. [PMID: 10937621 DOI: 10.1002/jor.1100180306] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Apoptosis was induced in a human chondrocyte cell line, T/C 28a4, by treatment with various stimuli, including camptothecin, tumor necrosis factor-alpha, staurosporine, okadaic acid, and reduced serum conditions. All stimuli induced a cytosolic DEVDase activity, coincident with apoptosis. Caspase activities in the lysates were characterized and quantitated with peptide cleavage profiles. To confirm that the results were not related to the immortalized nature of the cell line, primary human chondrocytes also were shown to undergo apoptosis under similar conditions, which resulted in increased cytosolic DEVDase activity. There was little or no caspase-1 (interleukin-1beta-converting enzyme) or caspase-8-like activity in the apoptotic cells. In all cases, the irreversible nonselective caspase inhibitor, Z-VAD-FMK, and the caspase-3-selective inhibitor, Ac-DMQD-CHO, inhibited DEVDase activity and apoptosis, whereas the caspase-1-selective inhibitor, Ac-YVAD-CHO, had no effect. Human chondrocytes were stably and transiently transfected with a type-II collagen gene (COL2A1) regulatory sequence driving a luciferase reporter as a specific marker of chondrocyte gene expression. Treatment of the cells with camptothecin or tumor necrosis factor-alpha plus cycloheximide significantly inhibited COL2A1 transcriptional activity. Significantly, cotreatment with Z-VAD-FMK or Ac-DMQD-CHO maintained COL2A1-reporter gene activity, indicating that the prevention of apoptosis by caspase-3 inhibition was sufficient to maintain cell functionality as assessed by the retention of type-II collagen promoter activity.
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Affiliation(s)
- M E Nuttall
- Department of Bone and Cartilage Biology, SmithKline Beecham Pharmaceuticals, King of Prussia, Pennsylvania 19406, USA.
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Motson RW, Fisher PW. A new technique for laparoscopic resection of a submucosal tumor on the posterior wall of the gastric fundus. Surg Endosc 2000; 14:205-6. [PMID: 10656964 DOI: 10.1007/s004649900103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Neugebauer R, Wasserman GA, Fisher PW, Kline J, Geller PA, Miller LS. Darryl, a cartoon-based measure of cardinal posttraumatic stress symptoms in school-age children. Am J Public Health 1999; 89:758-61. [PMID: 10224991 PMCID: PMC1508733 DOI: 10.2105/ajph.89.5.758] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This report examines the reliability and validity of Darryl, a cartoon-based measure of the cardinal symptoms of posttraumatic stress disorder (PTSD). METHODS We measured exposure to community violence through the reports of children and their parents and then administered Darryl to a sample of 110 children aged 7 to 9 residing in urban neighborhoods with high crime rates. RESULTS Darryl's reliability is excellent overall and is acceptable for the reexperiencing, avoidance, and arousal subscales, considered separately. Child reports of exposure to community violence were significantly associated with child reports of PTSD symptoms. CONCLUSIONS Darryl possesses acceptable psychometric properties in a sample of children with frequent exposure to community violence.
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Affiliation(s)
- R Neugebauer
- Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, NY 10032, USA
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Huang YC, Fisher PW, Nozik-Grayck E, Piantadosi CA. Hypoxia compared with normoxia alters the effects of nitric oxide in ischemia-reperfusion lung injury. Am J Physiol 1997; 273:L504-12. [PMID: 9316483 DOI: 10.1152/ajplung.1997.273.3.l504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Because both the biosynthesis of nitric oxide (NO.) and its metabolic fate are related to molecular O2, we hypothesized that hypoxia would alter the effects of NO. during ischemia-reperfusion (IR) in the lung. In this study, buffer-perfused lungs from rabbits underwent either normoxic IR (AI), in which lungs were ventilated with 21% O2 during ischemia and reperfusion, or hypoxic IR (NI), in which lungs were ventilated with 95% N2 during ischemia followed by reoxygenation with 21% O2. Lung weight gain (WG) and pulmonary artery pressure (Ppa) were monitored continuously, and microvascular pressure (Pmv) was measured after reperfusion to calculate pulmonary vascular resistance. We found that both AI and NI produced acute lung injury, as shown by increased WG and Ppa during reperfusion. In AI, where perfusate PO2 was > 100 mmHg, the administration of the NO. synthase inhibitor N-nitro-L-arginine methyl ester (L-NAME) before ischemia worsened WG and Ppa. Pmv also increased, suggesting a hydrostatic mechanism involved in edema formation. The effects of L-NAME could be attenuated by giving L-arginine and exogenous NO. donors before ischemia or before reperfusion. Partial protection was also provided by superoxide dismutase. In contrast, lung injury in NI at perfusate PO2 of 25-30 mmHg was attenuated by L-NAME; this effect could be reversed by L-arginine. Exogenous NO. donors given either before ischemia or before reperfusion, however, did not increase lung injury. NO. production was measured by quantifying the total nitrogen oxides (NOx) accumulating in the perfusate. The average rate of NOx accumulation was greater in AI than in NI. We conclude that hypoxia prevented the protective effects of NO on AI lung injury. The effects of hypoxia may be related to lower NO. production relative to oxidant stress during IR and/or altered metabolic fates of NO.-mediated production of peroxynitrite by hypoxic ischemia.
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Affiliation(s)
- Y C Huang
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
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Abstract
Pulmonary ischemia-reperfusion results in transient hypertension and edema formation. Implicated in this injury are partially reduced oxygen species including the highly reactive hydroxyl radical. We measured ischemia-reperfusion injury and hydroxyl radical production following 90 min of either air-ventilated, N2-ventilated, or nonventilated ischemia in an isolated rabbit lung preparation. We found that edema formation was independent of alveolar oxygen tension (PO2); all ischemic groups had similar edema formation, regardless of the type of ventilation. Weight gain was 37-50 g of fluid during 40 min of reperfusion. Production of hydroxyl radical, measured by nonenzymatic hydroxylation of salicylate, was influenced by PO2 with a significant increase after air-ventilated ischemia (P < 0.05) but not after N2-ventilated ischemia. Treatment with dimethylthiourea or superoxide dismutase reduced edema formation 60-80% after air (P < 0.05)- and N2 (P < 0.05)-ventilated ischemia, whereas treatment with catalase protected only N2-ventilated ischemia (P < 0.05). Our results implicate two distinct mechanisms by which partially reduced oxygen species may contribute to pulmonary ischemia-reperfusion injury. One is by a mechanism capable of generating hydroxyl radical at normal PO2; the second is from reactions active at low PO2, the products of which are metabolized readily by extracellular enzymatic scavengers. The precise mechanisms of oxidant generation are not clear, but the findings suggest that a complex oxidative injury occurs during ischemia-reperfusion.
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Affiliation(s)
- P W Fisher
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710
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Fisher PW, Shaffer D, Piacentini JC, Lapkin J, Kafantaris V, Leonard H, Herzog DB. Sensitivity of the Diagnostic Interview Schedule for Children, 2nd edition (DISC-2.1) for specific diagnoses of children and adolescents. J Am Acad Child Adolesc Psychiatry 1993; 32:666-73. [PMID: 8496131 DOI: 10.1097/00004583-199305000-00026] [Citation(s) in RCA: 193] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The sensitivity of the Diagnostic Interview Schedule for Children, second edition (DISC-2.1) was examined for certain "rare" disorders: eating disorders, major depressive episode, obsessive compulsive disorder, psychosis, tic disorders, and substance use disorders. METHOD Subjects recruited from specialized centers were interviewed with the DISC-2.1; the centers' diagnoses served as the criterion measure. RESULTS Overall the DISC showed good to excellent sensitivity (range = 0.73 to 1.0). Used alone, the DISC-P (parent interview) was generally more sensitive than the DISC-C (child interview). Areas for additional instrument revision were identified. Recommendations about informant choice by diagnosis are offered. CONCLUSIONS The strategy used in this study was useful for assessing the DISC's sensitivity for these disorders. Additional work examining specificity of the DISC remains to be done. The DISC should prove a useful adjunct in clinical settings given the ease and relatively low cost of administration.
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Affiliation(s)
- P W Fisher
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY
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Fisher PW, Currie RM, Churchill RJ. SARA Title III, Section 313--looking ahead. JAPCA 1988; 38:1376-9. [PMID: 3236039 DOI: 10.1080/08940630.1988.10466476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
Pregnant outbred albino mice (CD-1) received n-hexane once daily be gavage at doses up to 2.20 g/kg/day on days 6-15 of gestation. Other pregnant mice received higher hexane doses (up to 9.90 g/kg/day), employing a three times a day injection schedule. At the lower, once-daily doses only one dam died and no teratogenic effects occurred. Higher hexane doses (t.i.d.) were toxic: 2 of 25 dams treated with 2.83 g/kg/day, 3 of 34 treated with 7.92 g/kg/day and 5 of 33 treated with 9.90 g/kg/day died. At the 7.92 and 9.90 g/kg/day doses, the average fetal weight was significantly (p less than 0.05) reduced, but the incidence of malformations in treated and vehicle (cotton-seed oil) control groups did not differ significantly. Thus, n-hexane was not teratogenic even at doses toxic to the dam.
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Fisher PW. Destroying the whole-time option. Br Med J 1979; 2:554. [PMID: 497701 PMCID: PMC1596175 DOI: 10.1136/bmj.2.6189.554-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Fisher PW. New consultant contract. West J Med 1978. [DOI: 10.1136/bmj.1.6113.652-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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