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Halawa N, Armstrong M, Fancy S, Abidi S. Clozapine-induced myocarditis and subsequent rechallenge: a narrative literature review and case report. J Can Acad Child Adolesc Psychiatry 2023; 32:e252-e263. [PMID: 38034406 PMCID: PMC10686227] [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] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/03/2023] [Indexed: 12/02/2023]
Abstract
Clozapine is an antipsychotic medication that has been proven effective for the management of treatment-resistant schizophrenia (TRS). For some patients, it is the only medication that can improve disease burden and quality of life. Clozapine comes with various potentially serious adverse effects which may dissuade physicians from prescribing it despite its well-documented efficacy. One of these adverse effects is clozapine-induced myocarditis (CIM). Due to these risks, patients who undergo a clozapine rechallenge after CIM require close monitoring. Myocardial damage can be reversible if CIM is promptly identified, and clozapine is discontinued appropriately. The gold-standard for diagnosing myocarditis is an endomyocardial biopsy but there are no clear recommendations for how to use less invasive screening assessments to monitor for CIM during a clozapine rechallenge. This review article aims to increase awareness of CIM and provide guidance on monitoring and management. The accompanying case report presents a proposed strategy, including biomarkers that were used to identify inflammation and cardiac injury which guided the treatment of an adolescent patient who had a successful clozapine rechallenge. Further research is necessary to validate the proposed monitoring protocol and to further advance guidance for clinicians.
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Affiliation(s)
- Nadine Halawa
- Adjunct Faculty and Lecturer, Department of Pharmacy, Dalhousie University; Clinical Pharmacy Specialist, IWK Child and Adolescent Mental Health and Addictions Program, Halifax, Nova Scotia
| | | | - Sarah Fancy
- Assistant Professor, Department of Psychiatry, Dalhousie University; Staff Psychiatrist, IWK Garron Centre for Child and Adolescent Mental Health, Halifax, Nova Scotia
| | - Sabina Abidi
- Associate Professor, Department of Psychiatry, Dalhousie University; Associate Chief, Division of Child and Adolescent Psychiatry IWK Mental Health and Addictions Program; Head, IWK Youth Psychosis Program, Halifax, Nova Scotia
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2
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Mavragani A, Johnson Emberly D, Jeffrey J, Hundert A, Pakkanlilar O, Abidi S, Bagnell A, Brennan M, Campbell LA, Clark S, Bradley K, Ross O. Implementation of a Knowledge Management System in Mental Health and Addictions: Mixed Methods Case Study. JMIR Form Res 2023; 7:e39334. [PMID: 36745489 PMCID: PMC9941906 DOI: 10.2196/39334] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/22/2022] [Accepted: 11/21/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mental health and addictions (MHA) care is complex and individualized and requires coordination across providers and areas of care. Knowledge management is an essential facilitator and common challenge in MHA services. OBJECTIVE This paper aimed to describe the development of a knowledge management system (KMS) and the associated processes in 1 MHA program. We also aimed to examine the uptake and use, satisfaction, and feedback on implementation among a group of pilot testers. METHODS This project was conducted as a continuous quality-improvement initiative. Integrated stakeholder engagement was used to scope the content and design the information architecture to be implemented using a commercially available knowledge management platform. A group of 30 clinical and administrative staff were trained and tested with the KMS over a period of 10 weeks. Feedback was collected via surveys and focus groups. System analytics were used to characterize engagement. The content, design, and full-scale implementation planning of the KMS were refined based on the results. RESULTS Satisfaction with accessing the content increased from baseline to after the pilot. Most testers indicated that they would recommend the KMS to a colleague, and satisfaction with KMS functionalities was high. A median of 7 testers was active each week, and testers were active for a median of 4 days over the course of the pilot. Focus group themes included the following: the KMS was a solution to problems for staff members, functionality of the KMS was important, quality content matters, training was helpful and could be improved, and KMS access was required to be easy and barrier free. CONCLUSIONS Knowledge management is an ongoing need in MHA services, and KMSs hold promise in addressing this need. Testers in 1 MHA program found a KMS that is easy to use and would recommend it to colleagues. Opportunities to improve implementation and increase uptake were identified. Future research is needed to understand the impact of KMSs on quality of care and organizational efficiency.
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Affiliation(s)
| | | | - Jennifer Jeffrey
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Amos Hundert
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | | | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Maureen Brennan
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Sharon Clark
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Kristina Bradley
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Olivia Ross
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
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Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, Lovas D, Alda M, Pavlova B, Uher R. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychol Med 2023; 53:559-566. [PMID: 34140050 DOI: 10.1017/s0033291721001951] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 11/07/2022]
Abstract
BACKGROUND Offspring of parents with major mood disorders (MDDs) are at increased risk for early psychopathology. We aim to compare the rates of neurodevelopmental disorders in offspring of parents with bipolar disorder, major depressive disorder, and controls. METHOD We established a lifetime diagnosis of neurodevelopmental disorders [attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, communication disorders, intellectual disabilities, specific learning disorders, and motor disorders] using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version in 400 participants (mean age 11.3 + s.d. 3.9 years), including 93 offspring of parents with bipolar disorder, 182 offspring of parents with major depressive disorder, and 125 control offspring of parents with no mood disorder. RESULTS Neurodevelopmental disorders were elevated in offspring of parents with bipolar disorder [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.23-4.47, p = 0.010] and major depressive disorder (OR 1.87, 95% CI 1.03-3.39, p = 0.035) compared to controls. This difference was driven by the rates of ADHD, which were highest among offspring of parents with bipolar disorder (30.1%), intermediate in offspring of parents with major depressive disorder (24.2%), and lowest in controls (14.4%). There were no significant differences in frequencies of other neurodevelopmental disorders between the three groups. Chronic course of mood disorder in parents was associated with higher rates of any neurodevelopmental disorder and higher rates of ADHD in offspring. CONCLUSIONS Our findings suggest monitoring for ADHD and other neurodevelopmental disorders in offspring of parents with MDDs may be indicated to improve early diagnosis and treatment.
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Affiliation(s)
- L Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Rempel
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - E Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - D Lovas
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - B Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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Patterson VC, Tibbo PG, Stewart SH, Town J, Crocker CE, Ursuliak Z, Lee S, Morrison J, Abidi S, Dempster K, Alexiadis M, Henderson N, Pencer A. A multiple baseline trial of adapted prolonged exposure psychotherapy for individuals with early phase psychosis, comorbid substance misuse, and a history of adversity: A study protocol. Front Psychol 2022; 13:1012776. [PMID: 36578677 PMCID: PMC9791093 DOI: 10.3389/fpsyg.2022.1012776] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background Adversity is prevalent among people with psychotic disorders, especially those within the first 5 years of a psychotic disorder, called early phase psychosis. Although adversity can lead to many negative outcomes (e.g., posttraumatic stress symptoms), very few treatments for adversity-related sequelae have been tested with individuals with psychotic disorders, and even fewer studies have specifically tested interventions for people in early phase psychosis. Furthermore, people who misuse substances are commonly excluded from adversity treatment trials, which is problematic given that individuals with early phase psychosis have high rates of substance misuse. For the first time, this trial will examine the outcomes of an adapted 15-session prolonged exposure protocol (i.e., PE+) to observe whether reductions in adversity-related psychopathology occurs among people with early phase psychosis and comorbid substance misuse. Methods This study will use a multiple-baseline design with randomization of participants to treatment start time. Participants will complete baseline appointments prior to therapy, engage in assessments between each of the five therapy modules, and complete a series of follow-up appointments 2 months after the completion of therapy. Primary hypothesized outcomes include clinically significant reductions in (1) negative psychotic symptoms measured using the Positive and Negative Syndrome Scale, (2) adversity-related sequelae measured using the Trauma Symptom Checklist-40, and (3) substance use frequency and overall risk score measured with the Alcohol, Smoking, and Substance Involvement Screening Test. We also anticipate that clinically significant reductions in hopelessness and experiential avoidance, measured with the Beck Hopelessness Scale and Brief Experiential Avoidance Questionnaire, the theorized mechanisms of change of PE+, will also be observed. A secondary outcome is a hypothesized improvement in functioning, measured using the Clinical Global Impression and Social and Occupational Functioning Assessment scales. Discussion The results of this treatment trial will contribute to the advancement of treatment research for individuals in early phase psychosis who have current substance misuse and a history of adversity, and the findings may provide evidence supporting the use of hopelessness and experiential avoidance as mechanisms of change for this treatment. Clinical trial registration Clinicaltrials.gov, NCT04546178; registered August 28, 2020, https://clinicaltrials.gov/ct2/show/NCT04546178?term=NCT04546178&draw=2&rank=1.
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Affiliation(s)
- Victoria C. Patterson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Philip G. Tibbo
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada,Mental Health and Addictions, IWK Health, Halifax, NS, Canada
| | - Sherry H. Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Joel Town
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Candice E. Crocker
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Zenovia Ursuliak
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Siranda Lee
- Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Jason Morrison
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, IWK Health, Halifax, NS, Canada
| | - Kara Dempster
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Maria Alexiadis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Neal Henderson
- Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada
| | - Alissa Pencer
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Mental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada,Mental Health and Addictions, IWK Health, Halifax, NS, Canada,*Correspondence: Alissa Pencer,
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Pavlova B, Bagnell A, Cumby J, Vallis EH, Abidi S, Lovas D, Propper L, Alda M, Uher R. Sex-Specific Transmission of Anxiety Disorders From Parents to Offspring. JAMA Netw Open 2022; 5:e2220919. [PMID: 35819786 PMCID: PMC9277490 DOI: 10.1001/jamanetworkopen.2022.20919] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Although anxiety disorders are known to run in families, the relative contribution of genes and environment is unclear. Patterns of sex-specific transmission of anxiety may point to different pathways in how parents pass anxiety disorders down to their children; however, the association of parent and offspring sex with the transmission of anxiety disorders has not been previously studied. OBJECTIVE To examine whether the transmission of anxiety from parents to children is sex specific. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional family study recruited participants from the general population (enriched for familial risk of mood disorders) in Nova Scotia, Canada, from February 1, 2013, to January 31, 2020. EXPOSURES Anxiety disorder in the same-sex or opposite-sex parent. MAIN OUTCOMES AND MEASURES Semistructured interviews were used to establish lifetime diagnoses of anxiety disorder in parents and offspring. The association between anxiety disorder in the same-sex or opposite-sex parent and anxiety disorders in the offspring was tested with logistic regression. RESULTS A total of 398 offspring (203 female offspring with a mean [SD] age of 11.1 [3.7] years and 195 male offspring with a mean [SD] age of 10.6 [3.1] years) of 221 mothers and 237 fathers participated in the study. Anxiety disorders in the same-sex parent (odds ratio [OR], 2.85; 95% CI, 1.52-5.34; P = .001) were associated with increased rates of anxiety disorders in the offspring, whereas anxiety disorders in the opposite-sex parent (OR, 1.51; 95% CI, 0.81-2.81; P = .20) were not. Sharing a household with a same-sex parent without anxiety was associated with lower rates of offspring anxiety (OR, 0.38; 95% CI, 0.22-0.67; P = .001), but the presence of an opposite-sex parent without anxiety was not (OR, 0.96; 95% CI, 0.56-1.63; P = .88). CONCLUSIONS AND RELEVANCE In this cross-sectional study of families, an association between the same-sex parent's anxiety disorder and anxiety disorders in offspring suggests an environmental mechanism, such as modeling. Future studies should establish whether treating parents' anxiety may protect their children from developing an anxiety disorder.
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Affiliation(s)
- Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jill Cumby
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Emily Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - David Lovas
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
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Ghroubi S, Jelassi O, Abidi S, Trabelsi E, Ben Ayed H, Chlif M, Elleuch MH. Association between isokinetic abdominal muscle strength, pelvic floor muscle strength and stress urinary incontinence severity. Prog Urol 2022; 32:727-734. [PMID: 35697554 DOI: 10.1016/j.purol.2022.04.005] [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] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 04/03/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Studies have shown that there is co-activation between abdominal and pelvic floor muscles (PFM) in physiological conditions. This study aimed to assess pelvic floor and isokinetic trunk flexors function in non-active incontinent women, and to investigate the association between the strength of these muscle groups and the severity of stress urinary incontinence (SUI). METHODS A cross-sectional study was carried out. Twenty-five incontinent women were enrolled after one-hour pad test results and compared to twenty asymptomatic women. The severity of SUI was determined by the Pad test and Urinary Distress Inventory, Short Form (UDI-6). PFM function was assessed using the modified Oxford Scale, intra-vaginal PFM electromyography, and PFM endurance according to the PERFECT scheme. Trunk flexors strength was assessed using a Cybex Norm II dynamometer. RESULTS Incontinent women had a weaker PFM and isokinetic abdominal muscle strength compared to continent women (P<0,05). SUI severity was negatively correlated with PFM strength (r=-0,620, P=0,001), isokinetic trunk flexors strength (r=-0,605, P=0,001), and PFM endurance (r=-0,561, P=0,003) in incontinent women. A positive correlation between PFM function and isokinetic trunk flexors strength was found in incontinent women (r=0,488, P=0,013). CONCLUSION Non-active incontinent women had weaker pelvic floor muscles and isokinetic trunk flexors strength compared to continent ones. The positive correlation found between these two muscle groups may be explained by their synergic activity. These findings suggest that the severity of SUI could be related not only to PFM strength but also to abdominal muscle weakness. Further research is needed to recommend abdominal wall training as an alternative method to treat SUI. LEVEL OF PROOF 3.
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Affiliation(s)
- S Ghroubi
- Department of Physical Medicine and Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia; Unité de Recherche de L'évaluation des Pathologies de L'appareil Locomoteur LR20ES09, Université du Sud, Sfax, Tunisia
| | - O Jelassi
- Department of Physical Medicine and Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia; Unité de Recherche de L'évaluation des Pathologies de L'appareil Locomoteur LR20ES09, Université du Sud, Sfax, Tunisia
| | - S Abidi
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - E Trabelsi
- Department of Physical Medicine and Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia; Unité de Recherche de L'évaluation des Pathologies de L'appareil Locomoteur LR20ES09, Université du Sud, Sfax, Tunisia
| | - H Ben Ayed
- Department of Preventive Medicine and Hospital Hygiene, Hedi Chaker University Hospital, Sfax, Tunisia
| | - M Chlif
- Sport Science Department, EA 3300 "APS and Motor Patterns: Adaptations-Rehabilitation", Picardie Jules Verne University, 80025 Amiens Cedex, France; Tunisian Research Laboratory Sport Performance Optimization, National Center of Medicine and Science in Sports, Tunis, Tunisia (CNMSS), Bp263, Avenue Med Ali Akid, 1004 El Menzah, Tunis, Tunisia
| | - M H Elleuch
- Department of Physical Medicine and Rehabilitation, Habib Bourguiba University Hospital, Sfax, Tunisia; Unité de Recherche de L'évaluation des Pathologies de L'appareil Locomoteur LR20ES09, Université du Sud, Sfax, Tunisia.
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7
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Shahid F, Farooqui Z, Alam T, Abidi S, Parwez I, Khan F. Thymoquinone supplementation ameliorates cisplatin-induced hepatic pathophysiology. Hum Exp Toxicol 2021; 40:1673-1684. [PMID: 33832332 DOI: 10.1177/09603271211003645] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hepatotoxicity is a major dose-limiting side effect of CP chemotherapy besides nephrotoxicity and gastrointestinal dysfunction. TQ, a principal Nigella sativa seed oil constituent, has been shown to improve hepatic functions in various in vivo models of acute hepatic injury. In view of this, the present study aimed to evaluate the effect of TQ against CP-induced hepatotoxicity. Rats were divided into four experimental groups; control, CP, CP+TQ and TQ. Animals in CP+TQ and TQ groups were administered TQ (1.5 mg/kg bwt, orally), with or without a single hepatotoxic dose of CP (6 mg/kg bwt, i.p.) respectively, for 14 days before and four days following the CP treatment. CP induced an upsurge in serum ALT and AST activities, indicating liver injury, as also confirmed by the histopathological findings. CP caused significant alterations in the activities of membrane marker enzymes, carbohydrate metabolic enzymes, and the enzymatic and nonenzymatic components of the antioxidant defense system. TQ supplementation ameliorated all these adverse biochemical and histological changes in CP-treated rats. Thus, TQ may have excellent scope for clinical applications in combating CP-induced hepatic pathophysiology.
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Affiliation(s)
- F Shahid
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Z Farooqui
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - T Alam
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - S Abidi
- Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - I Parwez
- Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - F Khan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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8
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Zwicker A, MacKenzie LE, Drobinin V, Bagher AM, Howes Vallis E, Propper L, Bagnell A, Abidi S, Pavlova B, Alda M, Denovan-Wright EM, Uher R. Neurodevelopmental and genetic determinants of exposure to adversity among youth at risk for mental illness. J Child Psychol Psychiatry 2020; 61:536-544. [PMID: 31749149 DOI: 10.1111/jcpp.13159] [Citation(s) in RCA: 20] [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: 10/10/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and lower cognitive ability have been linked with increased likelihood of exposure to adversity. We hypothesized that these associations may be partly due to genetic factors. METHODS We calculated polygenic scores for ADHD and intelligence and assessed psychopathology and general cognitive ability in a sample of 297 youth aged 5-27 years enriched for offspring of parents with mood and psychotic disorders. We calculated an adversity score as a mean of 10 indicators, including socio-economic disadvantage, childhood maltreatment and bullying. We tested the effects of polygenic scores, externalizing symptoms and IQ on adversity scores using mixed-effects linear regression. RESULTS Externalizing symptoms and general cognitive ability showed expected positive and negative relationships with adversity, respectively. Polygenic scores for intelligence were unrelated to adversity, but polygenic scores for ADHD were associated with adversity (β = 0.23, 95% CI 0.13 to 0.34, p < .0001). ADHD polygenic scores uniquely explained 4.0% of variance in adversity score. The relationship between polygenic scores for ADHD and adversity was independently significant among individuals with (β = 0.49, 95% CI 0.25 to 0.75, p < .0001) and without (β = 0.14, 95% CI 0.02 to 0.26, p = .022) ADHD. CONCLUSIONS A genetic score indexing liability to ADHD was associated with exposure to adversity in early life. Previously observed associations between externalizing symptoms, lower cognitive ability and adversity may be partially attributed to genetic liability to ADHD.
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Affiliation(s)
- Alyson Zwicker
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Lynn E MacKenzie
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Vladislav Drobinin
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Amina M Bagher
- Department of Pharmacology and Toxicology, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Emily Howes Vallis
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| | - Barbara Pavlova
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Martin Alda
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - Rudolf Uher
- Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Pathology, Dalhousie University, Halifax, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Howes Vallis E, MacKenzie LE, Zwicker A, Drobinin V, Rempel S, Abidi S, Lovas D, Bagnell A, Propper L, Omisade A, Fisher HL, Pavlova B, Uher R. Visual memory and psychotic symptoms in youth. Cogn Neuropsychiatry 2020; 25:231-241. [PMID: 32200701 DOI: 10.1080/13546805.2020.1741342] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Psychotic symptoms are common during childhood and adolescence and may indicate transdiagnostic risk of future psychiatric disorders. Lower visual memory ability has been suggested as a potential indicator of future risk of mental illness. The relationship between visual memory and clinician-confirmed definite psychotic symptoms in youth has not yet been explored. METHODS We examined visual memory and psychotic symptoms among 205 participants aged 7-27 years in a cohort enriched for parental mood and psychotic disorders. We assessed visual memory using the Rey Complex Figure Test (RCFT) and psychotic symptoms using validated semi-structured interview measures. We tested the relationship between visual memory and psychotic symptoms using mixed-effects logistic regression. RESULTS After accounting for age, sex, and family clustering, we found that psychotic symptoms were significantly associated with lower visual memory (OR = 1.80, 95% CI 1.06-3.06, p = 0.030). This result was unchanged after accounting for general cognitive ability. CONCLUSION Lower visual memory performance is associated with psychotic symptoms among youth, regardless of general cognitive ability. This finding may inform future targeted early interventions.
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Affiliation(s)
- Emily Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,Nova Scotia Health Authority, Halifax, Canada
| | - Lynn E MacKenzie
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Alyson Zwicker
- Nova Scotia Health Authority, Halifax, Canada.,Department of Pathology, Dalhousie University, Halifax, Canada
| | - Vladislav Drobinin
- Nova Scotia Health Authority, Halifax, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | | | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,IWK Health Centre, Halifax, Canada
| | - David Lovas
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,IWK Health Centre, Halifax, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,IWK Health Centre, Halifax, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,IWK Health Centre, Halifax, Canada
| | - Antonina Omisade
- Nova Scotia Health Authority, Halifax, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,Nova Scotia Health Authority, Halifax, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada.,Nova Scotia Health Authority, Halifax, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada.,Department of Pathology, Dalhousie University, Halifax, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, Canada.,IWK Health Centre, Halifax, Canada.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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10
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Zwicker A, Drobinin V, MacKenzie LE, Howes Vallis E, Patterson VC, Cumby J, Propper L, Abidi S, Bagnell A, Pavlova B, Alda M, Uher R. Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Eur Child Adolesc Psychiatry 2020; 29:445-451. [PMID: 31172297 DOI: 10.1007/s00787-019-01355-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/17/2018] [Accepted: 05/16/2019] [Indexed: 12/19/2022]
Abstract
Affective lability, defined as the propensity to experience excessive and unpredictable changes in mood, has been proposed as a potential transdiagnostic predictor of major mood and psychotic disorders. A parental diagnosis of bipolar disorder has been associated with increased affective lability in offspring. However, the association between affective lability and family history of other mood and psychotic disorders has not been examined. We measured affective lability using the self- and parent-reported Children's Affective Lability Scale in a cohort of 320 youth aged 6-17 years, including 137 offspring of a parent with major depressive disorder, 68 offspring of a parent with bipolar disorder, 24 offspring of a parent with schizophrenia, and 91 offspring of control parents. We tested differences in affective lability between groups using mixed-effects linear regression. Offspring of a parent with major depressive disorder (β = 0.46, 95% CI 0.17-0.76, p = 0.002) or bipolar disorder (β = 0.47, 95% CI 0.12-0.81, p = 0.008) had significantly higher affective lability scores than control offspring. Affective lability did not differ significantly between offspring of a parent with schizophrenia and offspring of control parents. Our results suggest that elevated affective lability during childhood is a marker of familial risk for mood disorders.
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Affiliation(s)
- Alyson Zwicker
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Vladislav Drobinin
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Lynn E MacKenzie
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Emily Howes Vallis
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Victoria C Patterson
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jill Cumby
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - Barbara Pavlova
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Martin Alda
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Rudolf Uher
- Nova Scotia Health Authority, Halifax, NS, Canada.
- Department of Pathology, Dalhousie University, Halifax, NS, Canada.
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
- IWK Health Centre, Halifax, NS, Canada.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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11
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Sandstrom A, MacKenzie L, Pizzo A, Fine A, Rempel S, Howard C, Stephens M, Patterson VC, Drobinin V, Van Gestel H, Howes Vallis E, Zwicker A, Propper L, Abidi S, Bagnell A, Lovas D, Cumby J, Alda M, Uher R, Pavlova B. Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychol Med 2020; 50:1050-1056. [PMID: 31120010 DOI: 10.1017/s0033291719001089] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children of parents with mood and psychotic disorders are at elevated risk for a range of behavioral and emotional problems. However, as the usual reporter of psychopathology in children is the parent, reports of early problems in children of parents with mood and psychotic disorders may be biased by the parents' own experience of mental illness and their mental state. METHODS Independent observers rated psychopathology using the Test Observation Form in 378 children and youth between the ages of 4 and 24 (mean = 11.01, s.d. = 4.40) who had a parent with major depressive disorder, bipolar disorder, schizophrenia, or no history of mood and psychotic disorders. RESULTS Observed attentional problems were elevated in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia (effect sizes ranging between 0.31 and 0.56). Oppositional behavior and language/thought problems showed variable degrees of elevation (effect sizes 0.17 to 0.57) across the three high-risk groups, with the greatest difficulties observed in offspring of parents with bipolar disorder. Observed anxiety was increased in offspring of parents with major depressive disorder and bipolar disorder (effect sizes 0.19 and 0.25 respectively) but not in offspring of parents with schizophrenia. CONCLUSIONS Our results suggest that externalizing problems and cognitive and language difficulties may represent a general manifestation of familial risk for mood and psychotic disorders, while anxiety may be a specific marker of liability for mood disorders. Observer assessment may improve early identification of risk and selection of youth who may benefit from targeted prevention.
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Affiliation(s)
- A Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - L MacKenzie
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology, Dalhousie University, Halifax, NS, Canada
| | - A Pizzo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - A Fine
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Rempel
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - C Howard
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - M Stephens
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - V C Patterson
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology, Dalhousie University, Halifax, NS, Canada
| | - V Drobinin
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - H Van Gestel
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - E Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - A Zwicker
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - L Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - S Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - D Lovas
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - J Cumby
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - B Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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12
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Pizzo A, Drobinin V, Sandstrom A, Zwicker A, Howes Vallis E, Fine A, Rempel S, Stephens M, Howard C, Villars K, MacKenzie LE, Propper L, Abidi S, Lovas D, Bagnell A, Cumby J, Alda M, Uher R, Pavlova B. Active behaviors and screen time in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychiatry Res 2020; 285:112709. [PMID: 31813597 DOI: 10.1016/j.psychres.2019.112709] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/07/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022]
Abstract
Activities may be modifiable factors that moderate the risk and resilience in the development of mental health and illness. Youth who spend more time using screens are more likely to have poor mental health. Conversely, time spent engaged in active behaviors (i.e., physical activity, socializing and reading) is associated with better mental health. The choice of activities may be important in offspring of parents with mental illness, who are at increased risk for developing mental disorders. Among 357 youth of the FORBOW (Families Overcoming Risks and Building Opportunities for Well-being) cohort aged 6-21, we examined whether parental diagnosis of mental illness (i.e., major depressive disorder, schizophrenia and bipolar disorder) and current levels of depression influenced the amount of time their offspring spent using screens and engaging in active behaviors. Parental history of mental illness and higher levels of current depression in mothers were associated with less time spent engaged in active behaviors and more time spent using screens. Creating opportunities and incentives for active behaviors may redress the balance between youth with and without a familial history of mental illness.
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Affiliation(s)
- Alex Pizzo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Vlad Drobinin
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Dalhousie University, Department of Medical Neuroscience, Halifax, Nova Scotia, Canada
| | - Andrea Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Alyson Zwicker
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Dalhousie University, Department of Pathology, Halifax, Nova Scotia, Canada
| | - Emily Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Alexa Fine
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Sheri Rempel
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Meg Stephens
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Cynthia Howard
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Kelsey Villars
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Lynn E MacKenzie
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Dalhousie University, Department of Psychology, Halifax, Nova Scotia, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Sabina Abidi
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada
| | - David Lovas
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jill Cumby
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
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13
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Masmoudi S, Ellouze F, Abidi S, Boussen H, M’rad F. Cancer du sein et sexualité. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
L’influence du cancer du sein et de ses traitements sur la sexualité reste encore très peu explorée en Tunisie. Dans ce travail, on se propose de rapporter les difficultés et le vécu sexuels de deux femmes tunisiennes présentant un cancer du sein. À travers ces deux vignettes, il s’avère que les causes sont multiples et intriquées, on pourrait schématiquement les classer en cinq catégories : difficultés dans la communication avec le médecin traitant, croyances erronées, réaction dépressive, iatrogénie et modification de l’image du corps, troubles de la communication au sein du couple. Maintenir une image de soi positive, se sentir encore féminine et rester sexuellement attirante contribuent au bien-être des femmes confrontées au cancer du sein.
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Zwicker A, MacKenzie LE, Drobinin V, Howes Vallis E, Patterson VC, Stephens M, Cumby J, Propper L, Abidi S, Bagnell A, Schultze-Lutter F, Pavlova B, Alda M, Uher R. Basic symptoms in offspring of parents with mood and psychotic disorders. BJPsych Open 2019; 5:e54. [PMID: 31530297 PMCID: PMC6582212 DOI: 10.1192/bjo.2019.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/12/2023] Open
Abstract
BACKGROUND Basic symptoms, defined as subjectively perceived disturbances in thought, perception and other essential mental processes, have been established as a predictor of psychotic disorders. However, the relationship between basic symptoms and family history of a transdiagnostic range of severe mental illness, including major depressive disorder, bipolar disorder and schizophrenia, has not been examined. AIMS We sought to test whether non-severe mood disorders and severe mood and psychotic disorders in parents is associated with increased basic symptoms in their biological offspring. METHOD We measured basic symptoms using the Schizophrenia Proneness Instrument - Child and Youth Version in 332 youth aged 8-26 years, including 93 offspring of control parents, 92 offspring of a parent with non-severe mood disorders, and 147 offspring of a parent with severe mood and psychotic disorders. We tested the relationships between parent mental illness and offspring basic symptoms in mixed-effects linear regression models. RESULTS Offspring of a parent with severe mood and psychotic disorders (B = 0.69, 95% CI 0.22-1.16, P = 0.004) or illness with psychotic features (B = 0.68, 95% CI 0.09-1.27, P = 0.023) had significantly higher basic symptom scores than control offspring. Offspring of a parent with non-severe mood disorders reported intermediate levels of basic symptoms, that did not significantly differ from control offspring. CONCLUSIONS Basic symptoms during childhood are a marker of familial risk of psychopathology that is related to severity and is not specific to psychotic illness. DECLARATION OF INTEREST None.
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Affiliation(s)
- Alyson Zwicker
- Nova Scotia Health Authority; and Department of Pathology, Dalhousie University, Canada
| | - Lynn E MacKenzie
- Nova Scotia Health Authority; and Department of Psychology and Neuroscience, Dalhousie University, Canada
| | - Vladislav Drobinin
- Nova Scotia Health Authority; and Department of Medical Neuroscience, Dalhousie University, Canada
| | - Emily Howes Vallis
- Nova Scotia Health Authority; and Department of Psychiatry, Dalhousie University, Canada
| | - Victoria C Patterson
- Nova Scotia Health Authority; and Department of Psychology and Neuroscience, Dalhousie University, Canada
| | - Meg Stephens
- Research Assistant, Nova Scotia Health Authority, Canada
| | | | - Lukas Propper
- Psychiatrist, Department of Psychiatry, Dalhousie University; and IWK Health Centre, Canada
| | - Sabina Abidi
- Psychiatrist, Department of Psychiatry, Dalhousie University; and IWK Health Centre, Canada
| | - Alexa Bagnell
- Psychiatrist, Department of Psychiatry, Dalhousie University; and IWK Health Centre, Canada
| | - Frauke Schultze-Lutter
- Assistant Professor, Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Germany
| | - Barbara Pavlova
- Psychologist, Nova Scotia Health Authority; and Department of Psychiatry, Dalhousie University, Canada
| | - Martin Alda
- Psychiatrist, Nova Scotia Health Authority; and Department of Psychiatry, Dalhousie University, Canada
| | - Rudolf Uher
- Psychiatrist, Nova Scotia Health Authority; Department of Pathology; Department of Psychology and Neuroscience; Department of Medical Neuroscience; Department of Psychiatry, Dalhousie University; IWK Health Centre, Canada; and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Cherif M, Valenti B, Abidi S, Luciano G, Mattioli S, Pauselli M, Bouzarraa I, Priolo A, Ben Salem H. Supplementation of Nigella sativa seeds to Barbarine lambs raised on low- or high-concentrate diets: Effects on meat fatty acid composition and oxidative stability. Meat Sci 2018; 139:134-141. [DOI: 10.1016/j.meatsci.2018.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
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16
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Cherif M, Ben Salem H, Abidi S. Effect of the addition of Nigella sativa seeds to low or high concentrate diets on intake, digestion, blood metabolites, growth and carcass traits of Barbarine lamb. Small Rumin Res 2018. [DOI: 10.1016/j.smallrumres.2017.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Clark S, Emberly D, Pajer K, Delong E, McWilliam S, Bagnell A, Abidi S, Casey B, Gardner W. Improving Access to Child and Adolescent Mental Health Care: The Choice and Partnership Approach. J Can Acad Child Adolesc Psychiatry 2018; 27:5-14. [PMID: 29375628 PMCID: PMC5777686] [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] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The Choice and Partnership Approach (CAPA) is designed to improve access and quality of pediatric mental health care. We tested whether CAPA improved access in an academic pediatric hospital. METHOD We used de-identified administrative data to compare access pre- (2011) and post-CAPA (2013). RESULTS Wait time to first appointment in 2011 was 225.3 days (95% CI = [211.0, 239.6], N = 364), compared to 93.0 days (95% CI = [89.2, 96.8], N = 838) in 2013 (p<.001). Mean wait time between the first and second appointments was 59.2 days (95% CI = [46.5, 71.9], N = 86) in 2011, compared to 95.9 days (95% CI = [90.3, 101.5], N = 487) in 2013 (p < .001). However, overall mean wait time from referral to second appointment decreased from 271.2 days (95% CI = [236.5, 305.9], N = 86) in 2011 to 168.9 days (95% CI = [161.6, 176.2], N = 487) in 2013 (p < .001). Provider productivity increased from 32.6 to 57.0 first appointments/FTE/year. Depending on the question, 65 to 95% of parents and children gave positive answers about CAPA. CONCLUSIONS CAPA implementation was associated with more patients served, decreased waiting time to first appointment, and higher productivity.
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Affiliation(s)
| | | | - Kathleen Pajer
- Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Faculty of Medicine, Ottawa, Ontario
| | | | | | | | | | - Barbara Casey
- Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Faculty of Medicine, Ottawa, Ontario
| | - William Gardner
- CHEO Research Institute and Department of Epidemiology, University of Ottawa, Ottawa, Ontario
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18
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Majdoub A, Zakhama W, Chaouch A, Abidi S, Ajili K, Haddad B, Binous M. Cancer du rein et Grossesse: A propos d’une nouvelle observation. African Journal of Urology 2017. [DOI: 10.1016/j.afju.2016.04.009] [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: 11/25/2022] Open
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19
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MacKenzie LE, Patterson VC, Zwicker A, Drobinin V, Fisher HL, Abidi S, Greve AN, Bagnell A, Propper L, Alda M, Pavlova B, Uher R. Hot and cold executive functions in youth with psychotic symptoms. Psychol Med 2017; 47:2844-2853. [PMID: 28587688 DOI: 10.1017/s0033291717001374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 01/04/2023]
Abstract
BACKGROUND Psychotic symptoms are common in children and adolescents and may be early manifestations of liability to severe mental illness (SMI), including schizophrenia. SMI and psychotic symptoms are associated with impairment in executive functions. However, previous studies have not differentiated between 'cold' and 'hot' executive functions. We hypothesized that the propensity for psychotic symptoms is specifically associated with impairment in 'hot' executive functions, such as decision-making in the context of uncertain rewards and losses. METHODS In a cohort of 156 youth (mean age 12.5, range 7-24 years) enriched for familial risk of SMI, we measured cold and hot executive functions with the spatial working memory (SWM) task (total errors) and the Cambridge Gambling Task (decision-making), respectively. We assessed psychotic symptoms using the semi-structured Kiddie Schedule for Affective Disorders and Schizophrenia interview, Structured Interview for Prodromal Syndromes, Funny Feelings, and Schizophrenia Proneness Instrument - Child and Youth version. RESULTS In total 69 (44.23%) youth reported psychotic symptoms on one or more assessments. Cold executive functioning, indexed with SWM errors, was not significantly related to psychotic symptoms [odds ratio (OR) 1.36, 95% confidence interval (CI) 0.85-2.17, p = 0.204). Poor hot executive functioning, indexed as decision-making score, was associated with psychotic symptoms after adjustment for age, sex and familial clustering (OR 2.37, 95% CI 1.25-4.50, p = 0.008). The association between worse hot executive functions and psychotic symptoms remained significant in sensitivity analyses controlling for general cognitive ability and cold executive functions. CONCLUSIONS Impaired hot executive functions may be an indicator of risk and a target for pre-emptive early interventions in youth.
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Affiliation(s)
- L E MacKenzie
- Department of Psychology and Neuroscience,Dalhousie University,Halifax, Nova Scotia,Canada
| | - V C Patterson
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - A Zwicker
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - V Drobinin
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - H L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London,UK
| | - S Abidi
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - A N Greve
- Psychosis Research Unit,Aarhus University Hospital,Risskov,Denmark
| | - A Bagnell
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - L Propper
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - M Alda
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - B Pavlova
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - R Uher
- Department of Psychology and Neuroscience,Dalhousie University,Halifax, Nova Scotia,Canada
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Abidi S, Mian I, Garcia-Ortega I, Lecomte T, Raedler T, Jackson K, Jackson K, Pringsheim T, Addington D. Canadian Guidelines for the Pharmacological Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Children and Youth. Can J Psychiatry 2017; 62:635-647. [PMID: 28764561 PMCID: PMC5593251 DOI: 10.1177/0706743717720197] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Schizophrenia spectrum and other psychotic disorders often have their onset in adolescence. The sequelae of these illnesses can negatively alter the trajectory of emotional, cognitive, and social development in children and youth if left untreated. Early and appropriate interventions can improve outcomes. This article aims to identify best practices in the pharmacotherapy management of children and youth with schizophrenia spectrum disorders. METHODS A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders in children and youth (under age 18 years). Recommendations were drawn from the National Institute for Health and Care Excellence guidelines on psychosis and schizophrenia in children and youth (2013 and 2015 updates). Current guidelines were adopted using the ADAPTE process, which includes consensus ratings by a panel of experts. RESULTS Recommendations identified covered a range of issues in the pharmacotherapy management of children and youth with schizophrenia spectrum disorders. Further work in this area is warranted as we continue to further understand their presentation in the developing brain. CONCLUSIONS Canadian guidelines for the pharmacotherapy management of children and youth with schizophrenia spectrum disorders are essential to assist clinicians in treating this vulnerable population. Ongoing work in this area is recommended.
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Affiliation(s)
- Sabina Abidi
- 1 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Irfan Mian
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | | - Tania Lecomte
- 4 Department of Psychology, University of Montreal, Montreal, Quebec
| | - Thomas Raedler
- 5 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
| | - Kevin Jackson
- 6 Schizophrenia Society of Alberta, Lethbridge, Alberta
| | - Kim Jackson
- 6 Schizophrenia Society of Alberta, Lethbridge, Alberta
| | - Tamara Pringsheim
- 7 Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
| | - Donald Addington
- 7 Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
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21
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Lecomte T, Abidi S, Garcia-Ortega I, Mian I, Jackson K, Jackson K, Norman R. Canadian Treatment Guidelines on Psychosocial Treatment of Schizophrenia in Children and Youth. Can J Psychiatry 2017; 62:648-655. [PMID: 28886670 PMCID: PMC5593249 DOI: 10.1177/0706743717720195] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. METHOD The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth. New treatments were also considered when recent meta-analyses suggested their usefulness. RESULTS The children and youth psychosocial guidelines include many cross-sectional recommendations in terms of clinical and interpersonal skills needed to work with this clientele, setting and collaboration issues and needed adaptations for specific subpopulations. In terms of specific treatments, the treatments most strongly recommended are family intervention and cognitive behavior therapy. Also recommended, although with different degrees of support, are supported employment/supported education programs, patient education, cognitive remediation, and social skills training. Novel and upcoming psychosocial treatments are also briefly discussed. CONCLUSION These novel Canadian guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.
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Affiliation(s)
- Tania Lecomte
- 1 Department of Psychology, University of Montreal, Montreal, Quebec.,2 Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec
| | - Sabina Abidi
- 3 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | | | - Irfan Mian
- 5 The Hospital for Sick Children, University of Toronto, Toronto, Ontario.,6 Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Kevin Jackson
- 7 Schizophrenia Society of Canada, Lethbridge, Alberta
| | - Kim Jackson
- 7 Schizophrenia Society of Canada, Lethbridge, Alberta
| | - Ross Norman
- 8 Departments of Psychiatry and Epidemiology & Biostatistics, Western University, London, Ontario.,9 Prevention & Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, Ontario
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Addington D, Abidi S, Garcia-Ortega I, Honer WG, Ismail Z. Canadian Guidelines for the Assessment and Diagnosis of Patients with Schizophrenia Spectrum and Other Psychotic Disorders. Can J Psychiatry 2017; 62:594-603. [PMID: 28730847 PMCID: PMC5593247 DOI: 10.1177/0706743717719899] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of this article is to identify best practices in the diagnosis and assessment of patients with schizophrenia spectrum and other psychotic disorders. The diagnosis and assessment may occur in a range of situations from the emergency room to the outpatient clinic and at different stages of the disorder. The focus may be on acute exacerbations of illness, residual symptoms, levels of function, or changes in the response to treatment. METHODS A systematic search was conducted for guidelines published in the last 5 years for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted on the diagnosis and assessment were primarily drawn from the American Psychiatric Association practice guidelines for the psychiatric evaluation of adults and the National Institute for Health and Care Excellence guideline on psychosis and schizophrenia in adults. A number of de novo recommendations were also developed. RESULTS Eleven recommendations were identified that cover a range of assessment situations from diagnosis to the involvement of families in assessments. CONCLUSIONS An accurate assessment establishes the baseline for treatment planning based on clinical decision making for both pharmacotherapy and psychosocial treatments.
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Affiliation(s)
- Donald Addington
- 1 Department of Psychiatry, Hotchkiss Brain Institute, Foothills Medical Centre, University of Calgary, Calgary, Alberta
| | - Sabina Abidi
- 2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Iliana Garcia-Ortega
- 1 Department of Psychiatry, Hotchkiss Brain Institute, Foothills Medical Centre, University of Calgary, Calgary, Alberta
| | - William G Honer
- 3 Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Zahinoor Ismail
- 1 Department of Psychiatry, Hotchkiss Brain Institute, Foothills Medical Centre, University of Calgary, Calgary, Alberta
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Addington J, Addington D, Abidi S, Raedler T, Remington G. Canadian Treatment Guidelines for Individuals at Clinical High Risk of Psychosis. Can J Psychiatry 2017; 62:656-661. [PMID: 28730848 PMCID: PMC5593244 DOI: 10.1177/0706743717719895] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Young people who are at clinical high risk (CHR) of developing psychosis are often help seeking and have significant distress and dysfunction. There are limited guidelines for the assessment and treatment for this population. The aim of this guideline was to develop treatment recommendations for this at-risk group. METHOD A systematic search was conducted for published guidelines for CHR. All current guidelines for schizophrenia were reviewed for treatment guidelines on individuals at CHR. The recommendations adopted were primarily drawn from the European Psychiatric Association (EPA) guidance on the early intervention in clinical high-risk states of psychoses and the 2014 National Institute for Health and Care Excellence (NICE) guidelines on the treatment and management of those at CHR for psychosis. RESULTS After the guideline development process described, 9 recommendations were developed based on the quality of evidence, appropriateness for the Canadian health care system, and clinical expert consensus. CONCLUSIONS Assessment by an expert in the field was the first recommendation. It was recommended that treatment follow a staged approach with psychological treatments being the first-line treatment and pharmacotherapy reserved for adults, those who did not respond to psychological interventions, and those who had more severe symptoms.
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Affiliation(s)
- Jean Addington
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
| | - Donald Addington
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
| | - Sabina Abidi
- 2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Thomas Raedler
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta
| | - Gary Remington
- 3 Department of Psychiatry and Psychological Clinical Science, University of Toronto, Toronto, Ontario.,4 Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario
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Abstract
By 2020 mental illness will be one of the 5 most common illnesses causing morbidity, mortality and disability among youth. At least 20% of Canadian youth have a psychiatric disorder the impact of which can dramatically alter their life trajectory. Focus on the factors contributing to this problem is crucial. Lack of coordination between child and adolescent mental health systems (CAMHS) and adult mental health systems (AMHS) and consequent disruption of care during this vulnerable time of transition is one such factor. Reasons for and the impact of this divide are multilayered, many of which are embedded in outdated, poorly informed approaches to care for this population in transition. This paper considers the etiology behind these reasons as potential foci for change. The paper also briefly outlines recent initiatives ongoing in Canada and internationally that reflect appreciation of these factors in the attempt to minimize the gap in service provision for youth in transition. The need to continue with research and program development endeavours for youth with mental illness whereby access to services and readiness for transition is no longer determined by age is strongly supported.
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Affiliation(s)
- Sabina Abidi
- 1 Dalhousie University Department of Psychiatry, Halifax, Nova Scotia
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Propper L, Cumby J, Patterson VC, Drobinin V, Glover JM, MacKenzie LE, Morash-Conway J, Abidi S, Bagnell A, Lovas D, Hajek T, Gardner W, Pajer K, Alda M, Uher R. Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder. Br J Psychiatry 2017; 210:408-412. [PMID: 28385707 DOI: 10.1192/bjp.bp.117.198754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 08/30/2016] [Revised: 01/19/2017] [Accepted: 01/22/2017] [Indexed: 01/19/2023]
Abstract
BackgroundIt has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.AimsWe examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.MethodWe established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6-18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring.ResultsDiagnostic criteria for DMDD were met in none of the offspring of parents with bipolar disorder, 6 of the offspring of parents with major depressive disorder and none of the control offspring. DMDD diagnosis was significantly associated with family history of major depressive disorder.ConclusionsOur results suggest that DMDD is not specifically associated with a family history of bipolar disorder and may be associated with parental depression.
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Affiliation(s)
- Lukas Propper
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jill Cumby
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Victoria C Patterson
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Vladislav Drobinin
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jacqueline M Glover
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Lynn E MacKenzie
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jessica Morash-Conway
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Sabina Abidi
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Alexa Bagnell
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - David Lovas
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Tomas Hajek
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - William Gardner
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Kathleen Pajer
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Lukas Propper, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Jill Cumby, RN, Victoria C. Patterson, BA (Hons), Vladislav Drobinin, BSc, Jacqueline M. Glover, BSc, Lynn E. MacKenzie, MA, Jessica Morash-Conway, MA, Nova Scotia Health Authority, Halifax, Nova Scotia, Sabina Abidi, MD, Alexa Bagnell, MD, David Lovas, MD, Department of Psychiatry, Dalhousie University, Halifax and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia; Tomas Hajek, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; William Gardner, PhD, Children's Hospital of Eastern Ontario, Ottawa and Department of Epidemiology, University of Ottawa, Ottawa, Ontario; Kathleen Pajer, MD, Children's Hospital of Eastern Ontario, Ottawa and Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Martin Alda, MD, Department of Psychiatry, Dalhousie University, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia; Rudolf Uher, PhD, Department of Psychiatry, Dalhousie University, Halifax, Department of Psychiatry, IWK Health Centre, Halifax and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Zayed R, Davidson B, Nadeau L, Callanan TS, Fleisher W, Hope-Ross L, Espinet S, Spenser HR, Lipton H, Srivastava A, Lazier L, Doey T, Khalid-Khan S, McKerlie A, Stretch N, Flynn R, Abidi S, St. John K, Auclair G, Liashko V, Fotti S, Quinn D, Steele M. Canadian Rural/Remote Primary Care Physicians Perspectives on Child/Adolescent Mental Health Care Service Delivery. J Can Acad Child Adolesc Psychiatry 2016; 25:24-34. [PMID: 27047554 PMCID: PMC4791103] [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] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Primary Care Physicians (PCP) play a key role in the recognition and management of child/adolescent mental health struggles. In rural and under-serviced areas of Canada, there is a gap between child/adolescent mental health needs and service provision. METHODS From a Canadian national needs assessment survey, PCPs' narrative comments were examined using quantitative and qualitative approaches. Using the phenomenological method, individual comments were drawn upon to illustrate the themes that emerged. These themes were further analyzed using chi-square to identify significant differences in the frequency in which they were reported. RESULTS Out of 909 PCPs completing the survey, 39.38% (n = 358) wrote comments. Major themes that emerged were: 1) psychiatrist access, including issues such as long waiting lists, no child/adolescent psychiatrists available, no direct access to child/adolescent psychiatrists; 2) poor communication/continuity, need for more systemized/transparent referral processes, and need to rely on adult psychiatrists; and, 3) referral of patients to other mental health professionals such as paediatricians, psychologists, and social workers. CONCLUSIONS Concerns that emerged across sites primarily revolved around lack of access to care and systems issues that interfere with effective service delivery. These concerns suggest potential opportunities for future improvement of service delivery. IMPLICATIONS Although the survey only had one comment box located at the end, PCPs wrote their comments throughout the survey. Further research focusing on PCPs' expressed written concerns may give further insight into child/adolescent mental health care service delivery systems. A comparative study targeting urban versus rural regions in Canada may provide further valuable insights.
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Affiliation(s)
- Richard Zayed
- The University of Western Ontario, Department of Psychiatry, London, Ontario
| | - Brenda Davidson
- The University of Western Ontario, Department of Psychiatry, London, Ontario
| | | | | | | | - Lindsay Hope-Ross
- Alberta Health Services, Healthy Minds/Healthy Children Outreach Services, Calgary, Alberta
| | - Stacey Espinet
- The University of Western Ontario, Department of Psychiatry, London, Ontario
| | | | | | - Amresh Srivastava
- The University of Western Ontario, Department of Psychiatry, London, Ontario
| | | | | | | | - Ann McKerlie
- Hamilton-Wentworth District School Board, Hamilton, Ontario
| | | | | | | | | | | | | | | | - Declan Quinn
- University of Saskatchewan, Division of Child and Adolescent Psychiatry, Saskatoon, Saskatchewan
| | - Margaret Steele
- The University of Western Ontario – London Health Sciences Centre, London, Ontario
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MacKenzie LE, Abidi S, Fisher HL, Propper L, Bagnell A, Morash-Conway J, Glover JM, Cumby J, Hajek T, Schultze-Lutter F, Pajer K, Alda M, Uher R. Stimulant Medication and Psychotic Symptoms in Offspring of Parents With Mental Illness. Pediatrics 2016; 137:peds.2015-2486. [PMID: 26719291 DOI: 10.1542/peds.2015-2486] [Citation(s) in RCA: 18] [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] [Accepted: 10/20/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to drug-induced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. METHODS We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. RESULTS Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P = .001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. CONCLUSIONS Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.
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Affiliation(s)
- Lynn E MacKenzie
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry, Psychology and Neuroscience
| | - Sabina Abidi
- IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | - Helen L Fisher
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and
| | - Lukas Propper
- IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | - Alexa Bagnell
- IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | | | | | - Jill Cumby
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Tomas Hajek
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kathleen Pajer
- IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | - Martin Alda
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Departments of Psychiatry
| | - Rudolf Uher
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry, Psychology and Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and Medical Neuroscience, and Public Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada;
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Uher R, Cumby J, MacKenzie LE, Morash-Conway J, Glover JM, Aylott A, Propper L, Abidi S, Bagnell A, Pavlova B, Hajek T, Lovas D, Pajer K, Gardner W, Levy A, Alda M. A familial risk enriched cohort as a platform for testing early interventions to prevent severe mental illness. BMC Psychiatry 2014; 14:344. [PMID: 25439055 PMCID: PMC4267051 DOI: 10.1186/s12888-014-0344-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Severe mental illness (SMI), including schizophrenia, bipolar disorder and severe depression, is responsible for a substantial proportion of disability in the population. This article describes the aims and design of a research study that takes a novel approach to targeted prevention of SMI. It is based on the rationale that early developmental antecedents to SMI are likely to be more malleable than fully developed mood or psychotic disorders and that low-risk interventions targeting antecedents may reduce the risk of SMI. METHODS/DESIGN Families Overcoming Risks and Building Opportunities for Well-being (FORBOW) is an accelerated cohort study that includes a large proportion of offspring of parents with SMI and embeds intervention trials in a cohort multiple randomized controlled trial (cmRCT) design. Antecedents are conditions of the individual that are distressing but not severely impairing, predict SMI with moderate-to-large effect sizes and precede the onset of SMI by at least several years. FORBOW focuses on the following antecedents: affective lability, anxiety, psychotic-like experiences, basic symptoms, sleep problems, somatic symptoms, cannabis use and cognitive delay. Enrolment of offspring over a broad age range (0 to 21 years) will allow researchers to draw conclusions on a longer developmental period from a study of shorter duration. Annual assessments cover a full range of psychopathology, cognitive abilities, eligibility criteria for interventions and outcomes. Pre-emptive early interventions (PEI) will include skill training for parents of younger children and courses in emotional well-being skills based on cognitive behavioural therapy for older children and youth. A sample enriched for familial risk of SMI will enhance statistical power for testing the efficacy of PEI. DISCUSSION FORBOW offers a platform for efficient and unbiased testing of interventions selected according to best available evidence. Since few differences exist between familial and 'sporadic' SMI, the same interventions are likely to be effective in the general population. Comparison of short-term efficacy of PEI on antecedents and the long term efficacy for preventing the onset of SMI will provide an experimental test of the etiological role of antecedents in the development of SMI.
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Affiliation(s)
- Rudolf Uher
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
- Department of Public Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Jill Cumby
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
| | - Lynn E MacKenzie
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
| | | | | | - Alice Aylott
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Lukas Propper
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Sabina Abidi
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Alexa Bagnell
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Barbara Pavlova
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Tomas Hajek
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - David Lovas
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Kathleen Pajer
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - William Gardner
- IWK Health Centre, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Adrian Levy
- Department of Public Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Martin Alda
- Capital District Health Authority, Halifax, Nova Scotia, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
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Razik F, Bensadoun FZ, Abidi S, Bouzghou N. Infection à VIH/sida en Algérie. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.680] [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: 11/25/2022] Open
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Razik F, Bensadoun FZ, Abidi S. Emergence de l’infection à VIH/sida chez l’enfant dans l’Ouest algérien. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.058] [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: 11/16/2022] Open
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Abstract
On the basis of strong research evidence (1)(3) very early onset (VEOS) and early onset schizophrenia (EOS) carry significant morbidity and mortality risks for children and adolescents. On the basis of strong research evidence, the pathogenesis of EOS is linked to a dysregulation of dopamine and morphologic brain changes. (6)(7) On the basis of some research evidence and consensus, development of schizophrenia is the result of the interplay between genetic and environmental risk factors. (4) On the basis of strong research evidence, antipsychotic medications are the cornerstones of treatment for EOS. (11)(12)(13) On the basis of some research evidence and consensus, (13) treatment for schizophrenia should be timely, multimodal and multidisciplinary, including both pharmacologic and nonpharmacologic modalities tooptimize recovery.
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Affiliation(s)
- Sabina Abidi
- Assistant Professor Dalhousie University Faculty of Medicine, Child/Adolescent Psychiatrist, IWK Youth Psychosis Program, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
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Steele M, Zayed R, Davidson B, Stretch N, Nadeau L, Fleisher W, Doey T, Spenser HR, Abidi S, Auclair G, Callanan TS, Duncan D, Ferguson G, Flynn R, Hope-Ross L, Khalid-Khan S, Lazier L, Liashko V, Lipton H, Postl L, St. John K. Referral Patterns and Training Needs in Psychiatry among Primary Care Physicians in Canadian Rural/Remote Areas. J Can Acad Child Adolesc Psychiatry 2012; 21:111-123. [PMID: 22548108 PMCID: PMC3338177] [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] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 02/27/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVES This study examined the referral patterns of rural/remote primary care physicians (PCPs) as well as their needs and interests for further training in child/adolescent mental health. METHODS Surveys were mailed to Canadian rural/remote PCPs requesting participants' demographic information, training and qualifications, referral patterns, and identification of needs and interests for continuing medical education (CME). RESULTS PCPs were most likely to refer to mental health programs, and excessive wait times are the most common deterrent. Major reasons for referral were to obtain recommendations regarding medications and assessing non-responsive patients. While PCPs expressed higher levels of confidence in making appropriate referrals, they were much less confident in their knowledge and skills in managing mental health problems. Professional development in child/adolescent psychiatry is a moderate or highly perceived CME need. Overall, attention deficit/hyperactivity disorder (ADHD) was the most commonly chosen topic of interest and CME in the community was preferred, but some regional differences emerged. CONCLUSIONS PCPs viewed limited community resources and self-identified gaps in skills as barriers to service provision. Professional development in child and adolescent mental health for PCPs by preferred modes appears desired.
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Affiliation(s)
- Margaret Steele
- The University of Western Ontario, Schulich School of Medicine & Dentistry, London, Ontario
- Children’s Hospital, London Health Sciences Centre, London, Ontario
| | - Richard Zayed
- The University of Western Ontario, Schulich School of Medicine & Dentistry, London, Ontario
| | - Brenda Davidson
- The University of Western Ontario, Schulich School of Medicine & Dentistry, London, Ontario
- Children’s Hospital, London Health Sciences Centre, London, Ontario
| | | | | | | | - Tamison Doey
- The University of Western Ontario, Schulich School of Medicine & Dentistry, Windsor Program, Windsor, Ontario
| | - Helen R. Spenser
- University of Ottawa, Ottawa, Ontario
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario
| | | | | | | | - Don Duncan
- University of British Columbia, Vancouver, British Columbia
| | | | | | | | | | | | | | | | - Lara Postl
- University of Manitoba, Winnipeg, Manitoba
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Nasri S, Ben Salem H, Vasta V, Abidi S, Makkar H, Priolo A. Effect of increasing levels of Quillaja saponaria on digestion, growth and meat quality of Barbarine lamb. Anim Feed Sci Technol 2011. [DOI: 10.1016/j.anifeedsci.2010.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Brake JA, Abidi S. A case of adolescent catatonia. J Can Acad Child Adolesc Psychiatry 2010; 19:138-140. [PMID: 20467550 PMCID: PMC2868561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Jonathan A Brake
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia.
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Abidi S, Ben Salem H, Vasta V, Priolo A. Supplementation with barley or spineless cactus (Opuntia ficus indica f. inermis) cladodes on digestion, growth and intramuscular fatty acid composition in sheep and goats receiving oaten hay. Small Rumin Res 2009. [DOI: 10.1016/j.smallrumres.2009.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Akkari H, Ben Salem H, Gharbi M, Abidi S, Darghouth M. Feeding Acacia cyanophylla Lindl. foliage to Barbarine lambs with or without PEG: Effect on the excretion of gastro-intestinal nematode eggs. Anim Feed Sci Technol 2008. [DOI: 10.1016/j.anifeedsci.2007.09.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ben Salem H, Makkar H, Nefzaoui A, Hassayoun L, Abidi S. Benefit from the association of small amounts of tannin-rich shrub foliage (Acacia cyanophylla Lindl.) with soya bean meal given as supplements to Barbarine sheep fed on oaten hay. Anim Feed Sci Technol 2005. [DOI: 10.1016/j.anifeedsci.2005.04.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
The pharmacotherapy of schizophrenia remains an ongoing challenge for researchers and clinicians alike. Current medications remain suboptimal to effectively treat this illness despite the recent surge of what are considered to be better antipsychotics: the atypicals. The atypicals cause fewer extrapyramidal symptoms and tardive dyskinesia, but there is growing concern regarding the significant long-term metabolic and cardiac adverse effects of these novel antipsychotics. There are differences among the atypicals in their propensity to produce these adverse effects, and clinicians should weigh the risk-benefit ratio for each drug with each individual patient. Diabetes, heart disease, obesity, and unhealthy lifestyle choices are on the rise in the general population, and individuals with chronic schizophrenia are even more at risk. The dilemma clinicians face in trying to avoid the neurological morbidity of the typicals (extrapyramidal side effects and tardive dyskinesia) is the risk of consequently exposing patients to both the morbidity and potential mortality of the atypicals (cardiovascular, endocrine, and metabolic adverse effects). The importance of baseline investigations and monitoring at regular intervals as well as identification of patients at risk for obesity, diabetes, and cardiovascular morbidity has become crucial. Informed decision making is essential for successful antipsychotic pharmacotherapy. For a condition, which often necessitates long-term pharmacotherapy, the importance of prevention and (or) minimization of morbidity and mortality related to adverse effects of such pharmacotherapy cannot be understated.
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Abstract
Hospitalization rates are declining more rapidly for peritoneal dialysis (PD) than for hemodialysis patients. This has been postulated to be caused in part by lower peritonitis rates. However, the causes of admission have not been reexamined in the setting of declining rates. We prospectively examined our hospitalization rates, causes of admission, and impact of peritonitis on hospitalization in adult PD patients at a single center over a 4-year period. There were 274 admissions in 168 patient-years for a rate of 1.6 admissions and 13.0 hospital days per patient-year. Rates were greater for men (1.8 v 1.5; P = 0.013), patients with diabetes (2.2 v 1.4, P < 0.001), and those with a higher peritoneal equilibration test result. Creatinine clearance and sex were independent predictors in a multivariate analysis. The most common causes for admission were cardiac disease (14.6%) and peritonitis (13.5%). Peritonitis accounted for 0.21 admissions and 2.0 hospital days per patient-year. Thirty percent of the incident patients were admitted during the first 90 days of dialysis. Admissions for dehydration and glucose abnormalities were more common in the first 90 days. Overall admission rates, as well as admission rates for peritonitis, did not change over time, although hospital days per year decreased. Those admitted for peritonitis had higher peritonitis rates, more time on PD, and were more likely to be black. Eighty-one percent of the admissions for peritonitis were caused by Staphylococcus aureus, Streptococcus spp, or gram-negative/fungal peritonitis. Patients with peritonitis caused by Staphylococcus epidermidis were less likely to be admitted than patients with peritonitis caused by other organisms. To conclude, peritonitis remains a common cause of hospitalization, despite low peritonitis rates. To decrease admissions for peritonitis, attention should be focused on preventing peritonitis caused by organisms other than S epidermidis.
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Affiliation(s)
- L Fried
- Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Zafar N, Hafiz S, Khan S, Abbas K, Ahmed S, Khalique M, Aziz T, Shaikh R, Abidi S, Yawar A, Ahmed N, Naqvi A, Rizvi A. Histocompatibility in live related donor renal transplantation. Transplant Proc 1997; 29:2973-4. [PMID: 9365634 DOI: 10.1016/s0041-1345(97)00750-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- N Zafar
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Askari H, Abidi S, Abbas K, Sultan S, Akhtar F, Zafar N, Hafiz S, Naqvi A, Rizvi A. Early experience of renal transplantation in hepatitis C patients. Transplant Proc 1995; 27:2600-1. [PMID: 7482848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- H Askari
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Abstract
Two tumorigenic agents, N-nitrosodiethanolamine and 1,1-dimethylhydrazine, have been isolated from tobacco for the first time. The former, a reportedly weak hepatic carcinogen in rats, varied in amounts from a low of 0.1 ppb in flue-cured tobacco not treated with the herbicide MH-30, to a high of 173 ppb in Burley tobacco to which the herbicide had been applied prior to harvesting. MH-30 (maleic hydrazide) used by farmers to remove 'suckers' from tobacco plants, is commonly formulated as the diethanolamine salt. 1,1-Dimethylhydrazine, reported to induce tumors in mice, ranged in amounts from 60 to 147 ppb, except in the case of Burley tobacco where none was detected (detection limit: 0.1 ng). The source of the nitrosamine in the tobacco appears to be the MH-30, whereas that of dimethylhydrazine has not been determined.
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