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Klenfeldt IF, Skoog G, Skoog J, Skoog I. The natural history of lifetime psychiatric disorders in patients with obsessive-compulsive disorder followed over half a century. Acta Psychiatr Scand 2024; 149:284-294. [PMID: 38332338 DOI: 10.1111/acps.13665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Few long-term studies have examined the life-time prevalence of comorbid psychiatric conditions in patients with obsessive-compulsive disorder (OCD). We therefore studied the frequency of comorbid psychiatric disorders, and their relation to onset and prognosis, in patients with OCD who were followed for almost half a century. METHODS During 1947-1953, 285 OCD patients were admitted as inpatients to a university hospital in Gothenburg, Sweden. Among those, 251 (88%) accepted a structured comprehensive psychiatric examination in 1954-1956. In 1989-1993, 176 survivors were eligible and 144 (response rate 82%) were re-examined. The same psychiatrist performed both examinations. OCD was diagnosed according to the Schneider criteria, and other mental disorders according to DSM-IV. Mean follow-up since onset was 47 years. RESULTS The lifetime frequency of depressive disorders was 84.7% (major depression 43.8%), generalized anxiety disorder (GAD) 71.5%, panic anxiety disorder 47.9%, agoraphobia 52.1%, specific phobias 64.6%, social phobia 47.9%, paranoid conditions 40.3% (29.1% paranoid ideation), psychotic disorders 15.3%, alcohol abuse 13.2% (men 39%, women 3%) and substance abuse 17.4%. Specific phobia most often started before OCD, while depression had a varied onset in relation to OCD. Social phobia, agoraphobia, GAD, alcohol and substance abuse, psychotic disorders and paranoid conditions most often started after OCD. Presence of GAD, psychotic disorder and substance abuse worsened prognosis of OCD. CONCLUSION Comorbid psychiatric conditions are common in OCD patients, and have onset throughout the course. OCD signals vulnerability for other psychiatric conditions, which are important to detect in clinical practice as they negatively affect the outcome.
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Affiliation(s)
- Isak Fredén Klenfeldt
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Affective Clinic, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Gunnar Skoog
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Skoog
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
- The Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
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Lundin A, Möller J, Forsell Y. The Major Depression Inventory for diagnosing according to DSM-5 and ICD-11: Psychometric properties and validity in a Swedish general population. Int J Methods Psychiatr Res 2023; 32:e1966. [PMID: 37042546 DOI: 10.1002/mpr.1966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES The Major Depression Inventory (MDI) was constructed to assess DSM-IV and ICD-10 depression symptoms, and does not fully cover the symptoms listed in DSM-5 and ICD-11. This study aimed to augment the MDI to the new diagnostic standards by adding a new item, and to assess and compare the measurement performance of the MDI items and diagnostic algorithms for major depression according to DSM-IV, ICD-10, DSM-5 and ICD-11. METHODS Surveys collected 2001-2003 and 2021, including self-assessed MDI were used. A new hopelessness item was constructed and analyzed alongside the hopelessness item in the Symptom Checklist. The performance of items was compared using Rasch and Mokken analyses. Criterion validity was examined using equivalent diagnoses from psychiatric interview (Schedules for Clinical Assessments in Neuropsychiatry [SCAN]) as standard. RESULTS MDI information was provided by 8511 individuals in 2001-2003 (SCAN subsample n = 878), and 8863 in 2021. All items, including hopelessness had good psychometric properties. Sensitivity ranged between 56% and 70%, and specificity between 95% and 96%, indicating similar criterion validity. CONCLUSIONS Hopelessness and the MDI items had good psychometrics. MDI for DSM-5 and ICD-11 had similar validity as for DSM-IV and ICD-10. We recommend that MDI is updated to DSM-5 and ICD-11 by adding a hopelessness item.
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Affiliation(s)
- Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Bovin MJ, Mahoney CT, Klein AB, Keane TM, Marx BP. Comparing the Prevalence of Probable DSM-IV and DSM-5 Posttraumatic Stress Disorder in a Sample of U.S. Military Veterans Using the PTSD Checklist. Assessment 2023; 30:2050-2057. [PMID: 36382778 DOI: 10.1177/10731911221133483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Posttraumatic stress disorder (PTSD) changed substantially when Diagnostic and Statistical Manual of Mental Disorders transitioned from fourth (DSM-IV) to fifth (DSM-5) edition. Hoge et al. found that although diagnostic prevalence remained consistent across nomenclatures, diagnostic concordance was low (55%). Study goals were to examine both the generalizability of these findings and whether either diagnosis systematically excluded patients. U.S. veterans (N = 1,171) who completed the PTSD Checklist for DSM-IV (PCL-S) and DSM-5 (PCL-5) were classified as: probable PTSD on both measures; probable PTSD on PCL-S only; probable PTSD on PCL-5 only; or no PTSD on either measure. Diagnostic prevalence was equivalent. Unlike Hoge et al.'s findings, diagnostic concordance was high (91.3%). Furthermore, observed demographic and severity differences were driven by disparities between veterans in the no PTSD versus the probable PTSD groups, not diagnostic changes. Findings suggest translatability across measures and that diagnostic changes do not systematically exclude patients.
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Affiliation(s)
- Michelle J Bovin
- National Center for PTSD at VA Boston Healthcare System, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, MA, USA
| | - Colin T Mahoney
- University of Colorado at Colorado Springs, USA
- Lyda Hill Institute for Human Resilience, Colorado Springs, CO, USA
| | | | - Terence M Keane
- National Center for PTSD at VA Boston Healthcare System, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, MA, USA
| | - Brian P Marx
- National Center for PTSD at VA Boston Healthcare System, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, MA, USA
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Kember RL, Hartwell EE, Xu H, Rotenberg J, Almasy L, Zhou H, Gelernter J, Kranzler HR. Phenome-wide Association Analysis of Substance Use Disorders in a Deeply Phenotyped Sample. Biol Psychiatry 2023; 93:536-545. [PMID: 36273948 PMCID: PMC9931661 DOI: 10.1016/j.biopsych.2022.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 02/09/2022] [Revised: 06/17/2022] [Accepted: 08/05/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are associated with a variety of co-occurring psychiatric disorders and other SUDs, which partly reflects genetic pleiotropy. Polygenic risk scores (PRSs) and phenome-wide association studies are useful in evaluating pleiotropic effects. However, the comparatively low prevalence of SUDs in population samples and the lack of detailed information available in electronic health records limit these data sets' informativeness for such analyses. METHODS We used the deeply phenotyped Yale-Penn sample (n = 10,610 with genetic data; 46.3% African ancestry, 53.7% European ancestry) to examine pleiotropy for 4 major substance-related traits: alcohol use disorder, opioid use disorder, smoking initiation, and lifetime cannabis use. The sample includes both affected and control subjects interviewed using the Semi-Structured Assessment for Drug Dependence and Alcoholism, a comprehensive psychiatric interview. RESULTS In African ancestry individuals, PRS for alcohol use disorder, and in European individuals, PRS for alcohol use disorder, opioid use disorder, and smoking initiation were associated with their respective primary DSM diagnoses. These PRSs were also associated with additional phenotypes involving the same substance. Phenome-wide association study analyses of PRS in European individuals identified associations across multiple phenotypic domains, including phenotypes not commonly assessed in phenome-wide association study analyses, such as family environment and early childhood experiences. CONCLUSIONS Smaller, deeply phenotyped samples can complement large biobank genetic studies with limited phenotyping by providing greater phenotypic granularity. These efforts allow associations to be identified between specific features of disorders and genetic liability for SUDs, which help to inform our understanding of the pleiotropic pathways underlying them.
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Affiliation(s)
- Rachel L Kember
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
| | - Emily E Hartwell
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Heng Xu
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - James Rotenberg
- Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Laura Almasy
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hang Zhou
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut; Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Henry R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
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Shi HM, Jiang DG. A two-year follow-up study on the first manic episode due to mood-incongruent psychosis. Asian J Psychiatr 2022; 73:103118. [PMID: 35468481 DOI: 10.1016/j.ajp.2022.103118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/07/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Mood-incongruent psychosis during bipolar disorder has been associated with poor outcomes. However, it remains unknown whether this is secondary to persistent affective or psychotic symptoms or both. METHOD Sixty-eight patients with bipolar disorder between the ages of 16 and 45 were recruited during their first psychiatric hospitalization for mania. These patients were evaluated using structured and semi-structured clinical interview then followed longitudinally. Outcomes during the first twenty-four months of follow-up were compared between patients with mood-incongruent psychosis and those without (i.e., patients with mood-congruent psychosis or no psychosis) during the index manic episode. Specifically, ratings of the percent of weeks during follow-up with the duration of mood incongruent psychotic symptom, any psychotic symptom, affective syndromes, and scores of global outcomes were compared. RESULTS Comparing the 24-month follow-up results between the two groups, patients with mood incongruent psychotic symptoms had a lower global functional rating scale, efficacy index, while the duration of mood incongruent psychotic symptom, any psychotic symptom, and complete affective symptom showed statistically significant differences between the two groups. There were also statistically significant differences between the two groups in the duration of mood stabilizers, and antidepressants use, typical antipsychotics, and atypical antipsychotics. Partial correlation analysis reveals the scores of the global assessment of functioning scale (GAF) after 24 months showed a significant negative correlation with the length of time of incongruent psychotic symptoms. Still, the correlation was intermediate (correlation coefficients less than 0.5,r2 = -0.471, P < 0.001). CONCLUSION Mood-incongruent psychosis that occurs during the first manic episode appears to predict an increased likelihood of persistent psychotic symptoms during the subsequent twenty-four months. This persistence of psychosis is associated with a worse overall course of illness than patients without mood-incongruent psychosis. LIMITATIONS These results apply to a relatively short outcome period, and the sample size is relatively small.
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Affiliation(s)
- Hua-Meng Shi
- Shanghai Jiao Tong University School of Medicine Affiliated mental health center, Shanghai Mental Health Center, China.
| | - De-Guo Jiang
- The Seventh People's Hospital of Wenzhou, Zhejiang Province, China
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Wilson JE, Blizzard L, Gall SL, Magnussen CG, Oddy WH, Dwyer T, Venn AJ, Smith KJ. Youth diet quality and hazard of mood disorder in adolescence and adulthood among an Australian cohort. J Affect Disord 2020; 276:511-518. [PMID: 32871682 DOI: 10.1016/j.jad.2020.07.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/26/2019] [Revised: 05/19/2020] [Accepted: 07/05/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Prospective studies on youth diet and mood disorders outcomes are limited. We examined if youth diet quality was associated with mood disorder onset over a 25-year follow-up period. METHODS In 1985, Australian participants (aged 10-15 years) completed a 24-hour food record. A validated 100-point Dietary Guidelines Index (DGI) assessed diet quality. In 2009-11, 1005 participants (aged 33-41 years) completed the lifetime Composite International Diagnostic Interview for age of first DSM-IV defined mood disorder (depression or dysthymia). Cox proportional hazards regression estimated hazard of mood disorder during the 25-year follow-up according to baseline DGI score. Sensitivity analyses censored the study at 5, 10, and 15 years after baseline and used log binomial regression to estimate relative risk (RR). Covariates included baseline negative affect, BMI, academic performance, smoking, breakfast eating, physical activity, and socioeconomic status. RESULTS The mean(SD) youth DGI score was 45.0(11.5). A 10-point higher DGI was not associated with hazard of mood disorder onset over the 25-year follow-up (Hazard Ratio (HR):1.00; 95% Confidence Interval (CI):0.89-1.13). The only indication that higher DGI might be associated with lower risk of mood disorder was within the first 5 years after baseline and this was not statistically significant (RR=0.85; 95% CI:0.60-1.18). LIMITATIONS Loss-to-follow-up. A single 24-hour food record may not represent usual diet. CONCLUSION Youth diet did not predict mood disorders in adulthood. The suggestions of a lower risk of mood disorder during late adolescence highlights that further prospective studies are needed.
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Affiliation(s)
- J E Wilson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia
| | - L Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia
| | - S L Gall
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia
| | - C G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku FIN-20520, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku FIN-20520, Finland
| | - W H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia
| | - T Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia; The George Institute for Global Health, University of Oxford, Oxford OX1 3QX, United Kingdom
| | - A J Venn
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia
| | - K J Smith
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7001, Australia.
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Engebretsen IMS, Nalugya JS, Skylstad V, Ndeezi G, Akol A, Babirye JN, Nankabirwa V, Tumwine JK. "I feel good when I drink"-detecting childhood-onset alcohol abuse and dependence in a Ugandan community trial cohort. Child Adolesc Psychiatry Ment Health 2020; 14:42. [PMID: 33110445 PMCID: PMC7585688 DOI: 10.1186/s13034-020-00349-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 10/15/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Alcohol, substance use, and mental health disorders constitute major public health issues worldwide, including in low income and lower middle-income countries, and early initiation of use is an important predictor for developing substance use disorders in later life. This study reports on the existence of childhood alcohol abuse and dependence in a sub-study of a trial cohort in Eastern Uganda. METHODS The project SeeTheChild-Mental Child Health in Uganda (STC) included a sub-study of the Ugandan site of the study PROMISE SB: Saving Brains in Uganda and Burkina Faso. PROMISE SB was a follow-up study of a trial birth cohort (PROMISE EBF) that estimated the effect that peer counselling for exclusive breast-feeding had on the children's cognitive functioning and mental health once they reached 5-8 years of age. The STC sub-study (N = 148) used the diagnostic tool MINI-KID to assess mental health conditions in children who scored medium and high (≥ 14) on the Strengths and Difficulties Questionnaire (SDQ) in the PROMISE SB cohort N = (119/148; 80.4%). Another 29/148 (19.6%) were recruited from the PROMISE SB cohort as a comparator with low SDQ scores (< 14). Additionally, the open-ended questions in the diagnostic history were analysed. The MINI-KID comprised diagnostic questions on alcohol abuse and dependence, and descriptive data from the sub-study are presented in this paper. RESULTS A total of 11/148 (7.4%) children scored positive for alcohol abuse and dependence in this study, 10 of whom had high SDQ scores (≥ 14). The 10 children with SDQ-scores ≥ 14 had a variety of mental health comorbidities of which suicidality 3/10 (30.0%) and separation anxiety disorder 5/10 (50.0%) were the most common. The one child with an SDQ score below 14 did not have any comorbidities. Access to homemade brew, carer's knowledge of the drinking, and difficult household circumstances were issues expressed in the children's diagnostic histories. CONCLUSIONS The discovery of alcohol abuse and dependence among 5-8 year olds in clinical interviews from a community based trial cohort was unexpected, and we recommend continued research and increased awareness of these conditions in this age group.Trial registration Trial registration for PROMISE SB: Saving Brains in Uganda and Burkina Faso: Clinicaltrials.gov (NCT01882335), 20 June 2013. Regrettably, there was a 1 month delay in the registration compared to the commenced re-inclusion in the follow-up study: https://clinicaltrials.gov/ct2/show/NCT01882335?term=saving+brains&draw=2&rank=1.
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Affiliation(s)
- Ingunn Marie Stadskleiv Engebretsen
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Joyce S. Nalugya
- grid.11194.3c0000 0004 0620 0548Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vilde Skylstad
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- grid.11194.3c0000 0004 0620 0548Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Angela Akol
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Juliet N. Babirye
- grid.11194.3c0000 0004 0620 0548School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- grid.11194.3c0000 0004 0620 0548School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda ,grid.7914.b0000 0004 1936 7443Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - James K. Tumwine
- grid.11194.3c0000 0004 0620 0548Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Park JE, Hong JP, Jeon HJ, Seong SJ, Sohn JH, Ha TH, Lee DW, Park JI, Cho SJ, Chang SM, Kim BS, Suk HW, Cho MJ, Hahm BJ. Age-related differences in the associations among at-risk drinking, alcohol use disorder, and psychological distress across the adult lifespan: a nationwide representative study in South Korea. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1335-1344. [PMID: 32052102 DOI: 10.1007/s00127-020-01845-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 08/15/2019] [Accepted: 02/03/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate age-related differences in the relationships among at-risk alcohol consumption, alcohol use disorder (AUD), and psychological distress with a special focus on older adults. METHODS We used a nationwide cross-sectional study of a representative sample of community-dwelling adults from the Korean Epidemiologic Catchment Area study for psychiatric disorders conducted by door-to-door interviews. The Korean version of the Composite International Diagnostic Interview was applied. Subjects were categorized into four age groups: young-to-middle-aged (20-54 years), near-old (55-64 years), early-old (65-74 years), and late-old (≥ 75 years). The associations among at-risk drinking, alcohol use disorder, and psychological distress were examined according to age groups. RESULTS Among a total of 5102 individuals, half of them drank alcohol in the previous year, of whom 20.5% were at-risk drinkers (≥ 100 g/week). Older people were less often diagnosed with AUD than young-to-middle-aged adults with a similar degree of at-risk drinking. They were less likely to meet the DSM-5 AUD criteria in terms of social and vocational role disruption or creation of a physically hazardous situation. However, at-risk drinking showed a stronger association with subjective psychological distress in older adults, particularly in the near-old group (adjusted odds ratio 1.82, 95% confidence interval 1.09-3.03; p = 0.023). CONCLUSIONS These findings indicate the importance of screening for mental health problems in older adults, especially near-old adults, who drink more than 100 g of alcohol per week even when they do not satisfy the criteria for a diagnosis of AUD.
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Affiliation(s)
- Jee Eun Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Su Jeong Seong
- Department of Psychiatry, Hallym University Medical Center, Seoul, South Korea
| | - Jee Hoon Sohn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Dong-Woo Lee
- Department of Psychiatry, Inje University College of Medicine, Seoul, South Korea
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon Medical School, Incheon, South Korea
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Byung-Soo Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hye Won Suk
- Department of Psychology, Sogang University, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Bong-Jin Hahm
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
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Jones AL, Cochran SD, Rafferty J, Taylor RJ, Mays VM. Lifetime and Twelve-Month Prevalence, Persistence, and Unmet Treatment Needs of Mood, Anxiety, and Substance Use Disorders in African American and U.S. versus Foreign-Born Caribbean Women. Int J Environ Res Public Health 2020; 17:ijerph17197007. [PMID: 32992680 PMCID: PMC7579446 DOI: 10.3390/ijerph17197007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 02/07/2023]
Abstract
There is growing diversity within the Black population in the U.S., but limited understanding of ethnic and nativity differences in the mental health treatment needs of Black women. This study examined differences in the prevalence of psychiatric disorders, their persistence, and unmet treatment needs among Black women in the U.S. Data were from the National Survey of American Life, a nationally representative survey that assessed lifetime and twelve-month mood, anxiety, and substance use disorders according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria, and mental health service use among those meeting disorder criteria. One in three African American women met criteria for a lifetime disorder, compared to one in three Caribbean women born within the U.S. and one in five Caribbean women born outside the U.S. About half of African American women with a lifetime disorder had a persistent psychiatric disorder, compared to two in five Caribbean women born within the U.S. and two in three Caribbean women born outside the U.S. African Americans had more persisting dysthymia and panic disorder and less persisting social phobia compared to foreign-born Caribbean women. Of the three groups, Caribbean women born within the U.S. were most likely to seek mental health treatment during their lifetime. These results demonstrate, despite a lower prevalence of psychiatric disorders in Black women, that there is a great likelihood their disorders will be marked by persistence and underscores the need for culturally specific treatment approaches. As Black immigrants in the United States are increasing in number, adequate mental health services are needed.
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Affiliation(s)
- Audrey L. Jones
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
- Correspondence:
| | - Susan D. Cochran
- Departments of Epidemiology and Statistics, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA;
- UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions (BRITE), Los Angeles, CA 90095, USA;
| | - Jane Rafferty
- Program for Research on Black Americans, Institute of Social Research, Ann Arbor, MI 48106, USA; (J.R.); (R.J.T.)
| | - Robert Joseph Taylor
- Program for Research on Black Americans, Institute of Social Research, Ann Arbor, MI 48106, USA; (J.R.); (R.J.T.)
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
| | - Vickie M. Mays
- UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions (BRITE), Los Angeles, CA 90095, USA;
- Departments of Psychology and Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
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Najman JM, Middeldorp C, Williams GM, Scott JG, McGee T, Bor W, Clavarino AM, Mamun A. Illicit drug use by mothers and their daughters in Australia: A comparison of two generations. Addict Behav 2020; 106:106321. [PMID: 32087472 DOI: 10.1016/j.addbeh.2020.106321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND While recent decades have witnessed an increase in the use of illicit drugs in Australia, the extent to which the types of drugs used has changed over a generation of young women has not been documented. METHODS Data are from a prospective birth cohort study. Mothers were recruited in early pregnancy (1981-83) and then they and their child were followed up, with mothers interviewed 27 years (2008-2011), and daughters 30 years (2010-14), after the birth. At these most recent interviews both mothers and daughters were administered the Composite International Diagnostic Interview (CIDI III). Comparisons are for mothers and daughters separated by a 25 year period. For this study, we compare levels of lifetime use of a range of illicit drugs and drug use disorders reported by mothers and their daughters (N = 998 mother/daughter pairs) with adjustment for family income, marital status, education and occupation. RESULTS There has been a generational increase in the use of illicit substances and prevalence of substance use disorders experienced by Australian women. Mothers' use of illicit drugs was generally restricted to cannabis. By contrast the majority of daughters report lifetime use of an illicit drug with cannabis, club drugs and stimulants the most common. Compared to the mothers, daughters used club drugs 50 times, cocaine 19 times and inhalants 20 times more often. Daughters report experiencing 12 times the rate of cocaine use disorders, 9 times the rate of stimulant disorders and 7 times the rate of cannabis use disorders compared to their mothers. CONCLUSIONS Mothers of the current generation of 30 year old Australian women rarely used illicit drugs and few experienced a drug use disorder. The current generation of young women report commonly using one or more illicit drugs with a substantial minority experiencing a drug use disorder. It is unlikely that the use of illicit drugs by young women in Australia will be reversed in the foreseeable future. Government policies and treatment practices need to be calibrated to the reality of the much greater contact with illicit drugs being exhibited by younger women.
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Affiliation(s)
- Jackob M Najman
- School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia.
| | - Christel Middeldorp
- Child Health Research Centre, University of Queensland, Level 6, Centre for Children's Health Research (CCHR), 62 Graham Street, South Brisbane, Qld 4101, Australia; Children's Health Queensland Hospital and Health Service, Child and Youth Mental Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia; Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7 1081 BT, Amsterdam, The Netherlands
| | - Gail M Williams
- School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia
| | - James G Scott
- School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia; Metro North Mental Health Service, Royal Brisbane and Women's Hospital, Cnr Butterfield Street and Bowen Bridge Road, Herston, Qld 4006, Australia; Queensland Centre for Mental Health Research, The Park, Centre for Mental Health, Cnr Ellerton Drive and Wolston Park Road, Wacol, Qld 4076, Australia
| | - Tara McGee
- School of Criminology, Griffith University, 176 Messines Ridge Road, Mt Gravatt, Qld 4122, Australia
| | - William Bor
- Child Health Research Centre, University of Queensland, Level 6, Centre for Children's Health Research (CCHR), 62 Graham Street, South Brisbane, Qld 4101, Australia; Children's Health Queensland Hospital and Health Service, Child and Youth Mental Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia
| | - Alexandra M Clavarino
- School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, University of Queensland, 80 Meiers Road, Indooroopilly, Qld 4068, Australia
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Compton WM, Han B, Jones CM, Blanco C. Cannabis use disorders among adults in the United States during a time of increasing use of cannabis. Drug Alcohol Depend 2019; 204:107468. [PMID: 31586809 PMCID: PMC7028308 DOI: 10.1016/j.drugalcdep.2019.05.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [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: 12/18/2018] [Revised: 05/02/2019] [Accepted: 05/04/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Using U.S. National Surveys on Drug Use and Health (NSDUH) data, researchers found that prevalence of cannabis use among adults increased in recent years, but prevalence of DSM-IV cannabis use disorder (CUD) was stable. Examining trends of all individual CUD criteria and of CUD severity may elucidate reasons for the lack of increases in CUD. METHODS Data were from 749,500 persons aged 18 or older who participated in the 2002-2017 NSDUH. Descriptive analyses and logistic regressions were applied. RESULTS Among adults during 2002-2017, past-year prevalence of DSM-IV CUD remained stable at 1.5% to 1.4%, but cannabis use increased from 10.4% to 15.3%, daily/near daily use increased from 1.9% to 4.2%, and mild DSM-5 CUD increased from 1.4% to 1.9%. Among adult cannabis users, past-year prevalence of DSM-IV CUD decreased from 14.8% to 9.3%, daily/near daily use increased from 18.0% to 27.2%, and DSM-5 moderate (4-5 criteria) and severe (6+ criteria) CUD decreased from 4.3% to 3.1% and from 2.4% to 1.3%, respectively. Examining trends in individual CUD criteria during 2002-2017 among adults overall revealed increases in two criteria (tolerance; spending a lot of time getting/using cannabis or getting over cannabis effects) and decreases/no changes in other criteria; among adult cannabis users, there was no change in one criterion (tolerance) and decreases in other criteria. CONCLUSIONS DSM-5's single dimension CUD measure may be more sensitive to diagnosis prevalence changes than the separate DSM-IV cannabis dependence and abuse categories. Future diagnostic approaches to assessing CUD may benefit from quantitatively oriented criteria.
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Affiliation(s)
- Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA,Corresponding author at: 6001 Executive Blvd., MSC 9589, Bethesda, MD 20892-9589. (WM Compton)
| | - Beth Han
- Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20857, USA
| | | | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA
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Peralta V, Cuesta MJ. An empirical study of five sets of diagnostic criteria for delusional disorder. Schizophr Res 2019; 209:164-70. [PMID: 31080154 DOI: 10.1016/j.schres.2019.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The diagnosis of paranoia/delusional disorder has been significantly modified and redefined from DSM-III to DSM-5, which in turn also meaningfully differ from the ICD-10 criteria. In this study we examined the degree to which these diagnostic systems differ on external variables. METHOD Two-hundred and eighty-six subjects diagnosed of paranoia/delusional disorder according to DSM-III, DSM-III-R, DSM-IV, DSM-5 or ICD-10 criteria were examined for a number of validators including risk factors, premorbid features, illness-related variables and psychosocial functioning. The prevalence rates of the diagnostic criteria and their concordance level were examined, such as the degree to which the criteria sets and their main diagnostic features were differentially related to the validators. RESULTS Diagnostic criteria showed poor to fair concordance. The most inclusive system was the DSM-5 (n = 274) and the most restrictive the DSM-III (n = 187). Compared with subjects fulfilling other diagnostic criteria, those with a DSM-III diagnosis showed more and stronger associations with the validators: presence of cluster A personality disorders, insidious illness onset, poor response to treatment, chronic illness course and poor psychosocial functioning. This association pattern was mainly due to the 6-month duration criterion. Stability of delusions, type of delusions and the ICD-10 3-month duration criterion were poorly related to the validators. CONCLUSIONS Diagnostic criteria for delusional disorder are not interchangeable. DSM-III criteria for paranoia may identify a more severe disorder mainly because the 6-month duration criterion. Type of delusions had a small impact on the validators across diagnostic systems. These findings have implications for future classifications of delusional disorder.
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Hartwell EE, Bujarski S, Green R, Ray LA. Convergence between the Penn Alcohol Craving Scale and diagnostic interview for the assessment of alcohol craving. Addict Behav Rep 2019; 10:100198. [PMID: 31304230 DOI: 10.1016/j.abrep.2019.100198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 06/09/2019] [Accepted: 06/17/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction The Penn Alcohol Craving Scale (PACS) is one of the most widely used instruments to measure craving for alcohol. Recent research has suggested that scores on the PACS can be used as a “stand in” for the diagnostic criterion of alcohol craving with a proposed cutoff of >20 on the PACS indicating a “positive” alcohol craving symptom. The present study examined the convergence between the PACS and face-to-face diagnostic interview for the assessment of alcohol craving. Method A sample of non-treatment seeking heavy drinkers (N = 338) enrolled in experimental studies of AUD completed the PACS as well as a face-to-face diagnostic interview for AUD, which included the craving item from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Results Using the PACS cut-off score of >20, 12.9% (N = 43) of the sample met criteria for alcohol craving compared to 21% (N = 74) of the sample meeting criteria based on the diagnostic interview. Using the PACS cutoff of >20, sensitivity (i.e., true positive rate) was 41% and specificity (i.e., true negative rate) was 95%. Exploratory analyses suggested that a cut-off score of ≥15 achieved the optimal balance of sensitivity (67%) and specificity (81%) in our sample. Conclusions Advancing the assessment of alcohol craving and the conversion from DSM-IV to DSM-5 diagnostic criteria represents an important research direction. The present study recommends that a PACS score cut off of ≥15 should be used as an indicator of clinically significant alcohol craving in community samples of non-treatment seekers. The relationship between self-report and clinician-administered measures of alcohol craving is poorly understood. Previous studies have used the PACS as a stand-in for diagnostic data, using a score of 20 as a cut off. Using a PACS of >20, 12.9% of the sample would meet for craving; however, this cut off yielded poor sensitivity. Exploratory analysis showed a cut off of >15 produced an acceptable balance of sensitivity and specificity in this sample.
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Wadhwa R, Wen W, Frankland A, Leung V, Sinbandhit C, Stuart A, Dawes L, Hadzi-Pavlovic D, Levy F, Lenrootl R, Mitchell PB, Roberts G. White matter hyperintensities in young individuals with bipolar disorder or at high genetic risk. J Affect Disord 2019; 245:228-236. [PMID: 30412775 DOI: 10.1016/j.jad.2018.10.368] [Citation(s) in RCA: 10] [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] [Received: 06/04/2018] [Revised: 09/26/2018] [Accepted: 10/31/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Increased white matter hyperintensities (WMHs) is one of the most consistent imaging findings amongst participants with bipolar disorder (BD). This study investigated WMHs in a young population at high genetic risk for bipolar disorder (HR). METHODS MRI scans were conducted at baseline in HR individuals (n = 131), patients with BD (n = 47) and controls (CON) (n = 108). Most of the HR (n = 77) and CON (n = 74) group completed scans after two years. Scans were examined for the presence of WMHs. RESULTS There were significantly more periventricular WMHs in the BD compared to the CON group at baseline (p = .04). Although the prevalence of periventricular WMHs was intermediate in the HR group, there were no significant differences between the HR and CON or BD participants. Deep WMHs did not differ significantly between the groups. Over time, there was a significant increase in the prevalence of periventricular WMHs in both the HR and CON groups (p = .02). LIMITATIONS The use of a visual rating scale to examine WMHs is subjective. As the gradings were collapsed into 'present' or 'absent', we could not ascertain whether the severity of hyperintensities worsened over time. CONCLUSIONS Periventricular WMHs are more prevalent in young individuals with BD than controls. As these are not more prevalent in HR individuals, it is possible that these are either secondary to the development of bipolar disorder, its treatment, or resulting changes in lifestyle. In a novel finding, there were similar increases in the prevalence of WMHs in controls and HR youth over the 2-year period.
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Affiliation(s)
- Riya Wadhwa
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | - Wei Wen
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Vivian Leung
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Carina Sinbandhit
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Angela Stuart
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Laughlin Dawes
- Medical Imaging Department, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Florence Levy
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Prince of Wales Hospital, Randwick, NSW, Australia
| | - Rhoshel Lenrootl
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia; University of New Mexico, Albuquerque, New Mexico, United States
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia; Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
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Dal Mas C, Carvalho MS, Marins LA, Yonamine CM, Cordeiro Q, McIntyre RS, Mansur RB, Brietzke E, Hayashi MAF. Oligopeptidases activity in bipolar disorder: Ndel1 and angiotensin I converting enzyme. J Affect Disord 2019; 244:67-70. [PMID: 30321766 DOI: 10.1016/j.jad.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 09/24/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Abnormal activity of two enzymes relevant to neurodevelopment, namely nuclear-distribution element-like 1 (Ndel1) and angiotensin I-converting enzyme (ACE), was reported in individuals with schizophrenia; to our knowledge, these oligopeptidases were never measured in bipolar disorder (BD). AIMS Evaluate the enzyme activity of Ndel1 and ACE in euthymic individuals with BD type 1 which was compare to healthy control (HC) group. METHODS Ndel1 and ACE activities were assessed in the serum of individuals with BD type 1 according to DSM-IV criteria (n = 70) and a HC group (n = 34). The possible differences between BD type 1 and HC groups were evaluated using Analysis of Covariance (ANCOVA), and the results were adjusted for age, gender and body mass index. RESULTS We observed a positive correlation between Ndel1 activity and the total YMRS score in BD group (p = 0.030) and a positive correlation between ACE activity and Ham-D score (p = 0.047). ANCOVA analysis showed lower Ndel1 activity in BDs compared to HCs. Interestingly, we did not observe between-groups differences in ACE activity, despite the recognized correlation of ACE activity levels with cognitive functions, also described to be worsened in psychiatric patients. CONCLUSION Oligopeptidases, especially Ndel1, which has been strongly correlated with neurodevelopment and brain formation, are potentially a good new target in the study of the neurobiology of BD. LIMITATIONS The relatively small sample size did not permit to examine the cause-effect relationship of clinical dimensions of BD and the enzymatic activity.
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Affiliation(s)
- Caroline Dal Mas
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua 3 de maio 100, Ed. INFAR, 3rd floor, CEP 04044-020 São Paulo, Brazil
| | - Michelle S Carvalho
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua 3 de maio 100, Ed. INFAR, 3rd floor, CEP 04044-020 São Paulo, Brazil
| | - Lucas A Marins
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua 3 de maio 100, Ed. INFAR, 3rd floor, CEP 04044-020 São Paulo, Brazil
| | - Camila M Yonamine
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua 3 de maio 100, Ed. INFAR, 3rd floor, CEP 04044-020 São Paulo, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 669, 3rd floor, Vila Clementino, CEP 04039-032 São Paulo, Brazil.
| | - Mirian A F Hayashi
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua 3 de maio 100, Ed. INFAR, 3rd floor, CEP 04044-020 São Paulo, Brazil.
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Gruenewald PJ, Mair C. Heterogeneous Dose-Response Analyses of Alcohol Abuse and Dependence. Alcohol Clin Exp Res 2019; 43:299-308. [PMID: 30556903 DOI: 10.1111/acer.13940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/07/2018] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Survey-based estimates of the prevalence of alcohol abuse, dependence, and disorders in the United States rely upon self-reports of drinking patterns (e.g., binge drinking), social problems (e.g., trouble at work), physiological responses to use (e.g., tolerance), and desistance from use (e.g., withdrawal). Diagnostic criteria derived from these reports enable prevalence estimates of abuse and dependence, but moderating structural relationships among symptom groups may lead some light and moderate drinkers to appear to exhibit an alcohol use disorder (AUD). METHODS A dynamic model of drinking and problems predicts that symptoms of dependence will moderate relationships between drinking measures and symptoms of abuse. Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions data on DSM-IV diagnoses of abuse and dependence were used to test predictions from this model and assess whether moderating effects were observed among lighter and heavier drinkers (those who drink 1 to 3 vs. 4 or more drinks on average). A dose-response model that accounts for other known sources of risk heterogeneity related to drinking and problems enabled us to test these predictions. RESULTS As expected from previous work, symptoms of abuse and dependence and dependence criteria were nonlinearly related to drinking patterns; more symptom reports appeared and criteria were met among less frequent drinkers who drank more on each occasion and this pattern of dose-response was substantially moderated among heavier drinkers. Controlling for these effects, relationships between drinking and symptoms of abuse were moderated among respondents who met more dependence criteria. These effects were observed among both lighter and heavier drinkers. CONCLUSIONS Moderating relationships observed between measures of drinking, abuse, and dependence criteria among lighter and heavier drinkers suggest that the same etiologic forces are at play among all drinking groups. Greater symptoms of dependence among lighter drinkers may lead to greater reports of symptoms of abuse and an AUD diagnosis.
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Affiliation(s)
- Paul J Gruenewald
- Prevention Research Center , Pacific Institute for Research and Evaluation, Berkeley, California
| | - Christina Mair
- Department of Behavioral and Community Health Sciences , Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Dong H, Yang C, Shen Y, Liu L, Liu M, Hao W. Effects of ketamine use on psychotic disorders and symptoms in male, methamphetamine-dependent subjects. Am J Drug Alcohol Abuse 2019; 45:276-284. [PMID: 30640573 DOI: 10.1080/00952990.2018.1559849] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Repeated and extensive methamphetamine or ketamine use may cause psychotic symptoms. Whether the chronic and combined use of these substances has a greater psychotic effect is still unknown. OBJECTIVES To examine the effect of different levels of ketamine use on psychotic disorders and symptoms in male methamphetamine-dependent subjects. METHODS A cross-sectional, structured, and clinical interview method was used to examine the differences in DSM-IV-TR Axis I psychotic disorders and symptoms among methamphetamine-dependent subjects in three categories: 205 with no ketamine use, 38 with occasional ketamine use, and 72 with ketamine abuse or dependence from compulsory rehabilitation centers. RESULTS Both methamphetamine-dependent subjects with occasional ketamine use and those with ketamine abuse or dependence had a higher prevalence of psychotic disorders than those who had not used ketamine (p = 0.021; p < 0.001). Subjects who used ketamine occasionally had a higher prevalence of referential and persecutory delusions (p < 0.001; p = 0.013) and auditory hallucinations (p = 0.030), and those with ketamine abuse or dependence had a higher prevalence of referential and persecutory delusions (p = 0.005; p = 0.021), compared with those who had not used ketamine. There was no significant difference in any psychotic disorders or symptoms between subjects with occasional ketamine use and those with ketamine abuse or dependence. CONCLUSIONS The combination of methamphetamine and ketamine was associated with greater psychotic effects than methamphetamine alone. Both occasional ketamine use and ketamine abuse or dependence were associated with increased psychotic symptoms and disorders in methamphetamine-dependent males.
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Affiliation(s)
- Huixi Dong
- a Mental Health Center of Xiangya Hospital , Central South University , Changsha , Hunan , China.,b Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital , Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Cheng Yang
- b Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital , Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Yidong Shen
- b Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital , Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Liang Liu
- c Wuxi Mental Health Center , Nanjing Medical University , Wuxi , Jiangsu , China
| | - Mengqi Liu
- b Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital , Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Wei Hao
- b Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital , Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
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Reilly N, Talcevska K, Black E, Matthey S, Austin MP. A comparison of the interviewer-administered phone and self-complete online versions of the computerized eMINI 6.0 in a sample of pregnant women. J Affect Disord 2019; 242:265-9. [PMID: 30236801 DOI: 10.1016/j.jad.2018.08.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/26/2018] [Accepted: 08/12/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study compares the prevalence rates of depressive and anxiety disorders identified during pregnancy using an interviewer-administered phone version and a self-complete online version of the computerized eMINI 6.0. METHODS 888 pregnant women completed the computerized eMINI 6.0 (interviewer-administered phone, n = 253; self-complete online, n = 635). RESULTS There were no significant differences in the proportions of women meeting eMINI 6.0 criteria for current major depression, any current anxiety disorder, or lifetime panic or depressive disorder, by mode of administration. However, a greater proportion of women in the interviewer-administered phone group than in the self-complete online group met criteria for current minor depression (2.0% vs 0.2%, p = .008). LIMITATIONS Study limitations include its non-randomized design, overall low prevalence of depressive and anxiety disorders in the sample and inclusion of only a select number of eMINI 6.0 modules. CONCLUSIONS This study demonstrated few differences in the rates of DSM-IV depressive and anxiety disorders identified between the interviewer-administered and self-administered versions of the eMINI 6.0. Findings provide preliminary support the practical value of self-completed computerized interviews in large scale studies examining common mental disorders in pregnant women.
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Vergés A, Ellingson JM, Schroder SA, Slutske WS, Sher KJ. Intensity of Daily Drinking and Its Relation to Alcohol Use Disorders. Alcohol Clin Exp Res 2018; 42:1674-1683. [PMID: 29894003 PMCID: PMC6120766 DOI: 10.1111/acer.13812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/08/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. This study examined the heterogeneity of daily drinkers in detail. METHODS Data from the 2 waves of the National Epidemiologic Survey on Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. RESULTS Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups, the DSM-5 criteria diagnosed a larger percentage of participants. CONCLUSIONS Daily drinkers represent a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system.
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Affiliation(s)
- Alvaro Vergés
- Pontificia Universidad Católica de Chile, Escuela de Psicología
| | | | | | - Wendy S. Slutske
- University of Missouri-Columbia, Department of Psychological Sciences
| | - Kenneth J. Sher
- University of Missouri-Columbia, Department of Psychological Sciences
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20
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Abstract
This paper examines the relationship between gambling behavior and subjective wellbeing. It is often asserted that populations consist of different types of gamblers: those for whom gambling is a harmless leisure activity and those (pathological/problem gamblers) for whom the activity has harmful effects. One might, therefore, assume that subjective wellbeing will be negativity associated with an individual's level of gambling addiction. Alternatively, gamblers may choose to gamble because they derive utility from participating in this activity and so the relationship between happiness and gambling might be positively correlated. In this paper we test this association, empirically, using data from the 2010 British Gambling Prevalence Survey. The statistically significant findings from this analysis support the hypothesis that individual wellbeing falls as gambling disorder increases.
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Affiliation(s)
- Lisa Farrell
- School of Economics, Finance and Marketing, RMIT University, Melbourne, VIC, 3000, Australia.
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21
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Sawyer MG, Reece CE, Sawyer ACP, Johnson SE, Lawrence D. Has the Prevalence of Child and Adolescent Mental Disorders in Australia Changed Between 1998 and 2013 to 2014? J Am Acad Child Adolesc Psychiatry 2018; 57:343-350.e5. [PMID: 29706164 DOI: 10.1016/j.jaac.2018.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 10/18/2017] [Revised: 01/16/2018] [Accepted: 03/12/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined whether the 12-month prevalence of major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) among 6- to 17-year-olds in Australia changed between 1998 and 2013 to 2014. It also investigated whether changes in the prevalence of disorders over this time varied for children living in families containing 2 parents versus single parents, and families with high versus low income. METHOD The study used data from national surveys conducted in Australia in 1998 (N = 3,597) and 2013 to 2014 (N = 5,359). In both surveys, the participating individuals were randomly selected from all 6- to 17-year-olds in Australia, and mental disorders were assessed using the Diagnostic Interview Schedule for Children Version IV (DISC-IV), completed by parents. RESULTS There was little change in the overall prevalence of mental disorders between 1998 (12.5%, 95% CI = 11.4-13.7) and 2013 to 2014 (11.1%, 95% CI = 10.1-12.2). Although there were some differences in the changes for children with different disorders, most were small in magnitude. Specifically, MDD prevalence increased from 2.1% (95% CI = 1.7-2.7) to 3.2% (95% CI = 2.7-3.8), ADHD prevalence declined from 9.9% (95% CI = 8.9-10.9) to 7.8% (95% CI = 6.9-8.7), and CD prevalence declined from 2.7% (95% CI = 2.2-3.3) to 2.1% (95% CI = 1.7-2.7). There was a persisting pattern of higher prevalence among children living in single-parent and low-income households. CONCLUSION Lack of change at a population level in the prevalence of child mental disorders suggests that new innovations in research, policy, and practice are needed to successfully address the major public health problem posed by child and adolescent mental disorders in the community.
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Affiliation(s)
- Michael G Sawyer
- School of Medicine, University of Adelaide, and the Women's and Children's Health Network, North Adelaide, Australia.
| | - Christy E Reece
- School of Medicine, University of Adelaide, and the Women's and Children's Health Network, North Adelaide, Australia
| | - Alyssa C P Sawyer
- School of Medicine, University of Adelaide, and the Women's and Children's Health Network, North Adelaide, Australia
| | - Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, West Perth
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, Perth
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22
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Abstract
OBJECTIVE The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. METHOD Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. RESULTS DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DISCUSSION DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical samples.
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Affiliation(s)
- Karina Limburg
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technichal University of Munich, Munich, Germany.,Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Chloe Y Shu
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Hunna J Watson
- School of Psychology, Curtin University, Perth, Australia.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Kimberley J Hoiles
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Sarah J Egan
- School of Psychology, Curtin University, Perth, Australia
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23
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Abstract
This paper aims to understand the DSM-5 through situating it within the context of the historical development of the DSM series. When one looks at the sets of diagnostic criteria, the DSM-5 is strikingly similar to the DSM-IV. I argue that at this level the DSM has become 'locked-in' and difficult to change. At the same time, at the structural, or conceptual, level there have been radical changes, for example in the definition of 'mental disorder', in the role of theory and of values, and in the abandonment of the multiaxial approach to diagnosis. The way that the DSM-5 was constructed means that the overall conceptual framework of the classification only barely constrains the sets of diagnostic criteria it contains.
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24
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Abstract
Objective To assess prevalence of unrecognized autism spectrum disorders (ASDs) in children with epilepsy using Diagnostic and Statistical Manual IV (DSM-IV) criteria and to evaluate factors affecting it in this population. It was a cross-sectional study conducted at a teaching hospital. It included randomly selected 106 children in the age 4-12 years with epilepsy, and without any structural anomaly identifiable on computed tomography/magnetic resonance imaging. Children already diagnosed with ASD were excluded. Materials and Methods Detailed clinical evaluation was carried out. Intelligence quotient (IQ) was assessed using Development Profile-II for all and Binet and Kulshrestha test, wherever possible. Participants were screened using Social Communication Questionnaire (SCQ). Those with SCQ score of ≥15 were evaluated for ASD using DSM-IV criteria. Childhood Autism Rating Scale was administered to assess the severity of autism. Data were analyzed with univariate and logistic regression analyses. Results A total of nine children were screened positive, of them, eight were diagnosed with ASD using DSM-IV criteria. The prevalence of unrecognized ASD was 7.5/100. On univariate analysis, intellectual disability (P < 0.01) and young age of onset of epilepsy (P = 0.03) were significantly associated with ASD. On multivariable analysis, only intellectual disability was significantly associated with ASD (P < 0.01). There was no significant association with gender, seizure type, frequency of seizures, intractability of epilepsy, or the number of antiepileptic drugs used. Conclusion ASDs are more prevalent in children with epilepsy than in general population. In cases with associated intellectual disability, co-occurrence of ASD is further increased. All children with epilepsy, particularly those with IQ ≤ 50, irrespective of age of onset of epilepsy, seizure type, frequency of seizures, or intractability of epilepsy, should be screened for ASD.
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Affiliation(s)
- Monica Juneja
- Department of Paediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Suchit Gupta
- Department of Paediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Abhinav Thakral
- Department of Paediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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25
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Carmassi C, Corsi M, Bertelloni CA, Carpita B, Gesi C, Pedrinelli V, Massimetti G, Peroni DG, Bonuccelli A, Orsini A, Dell'Osso L. Mothers and fathers of children with epilepsy: gender differences in post-traumatic stress symptoms and correlations with mood spectrum symptoms. Neuropsychiatr Dis Treat 2018; 14:1371-1379. [PMID: 29872304 PMCID: PMC5973431 DOI: 10.2147/ndt.s158249] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 12/26/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and post-traumatic stress spectrum have been recently applied to understand the impact of life-threatening disease or injury in one's child; nevertheless, scant data are available on a particular chronic illness such as epilepsy whose phenotypic expression is seizures, which are acute, sudden, and unpredictable manifestations. Subjects with bipolar disorders or with mood spectrum symptoms demonstrated to be more vulnerable to develop PTSD in the aftermath of a trauma. OBJECTIVES The main aim of this study was to evaluate post-traumatic symptoms among 134 parents of children with a diagnosis of epilepsy, followed at the outpatient neurologic unit of Department of Pediatrics in Santa Chiara Hospital in Pisa, as well as gender differences. The second aim of this study was to estimate the impact of lifetime mood spectrum on post-traumatic stress symptoms in the same study sample after fulfillment of the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version. RESULTS Results showed 10.4% and 37.3% of PTSD full and partial, respectively. Demographic characteristics and clinical features of the study sample did not show any impact on stress symptomatology. Mothers presented higher rates at all Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 PTSD symptoms' clusters except avoidance. Nevertheless, noteworthy correlations between post-traumatic symptomatology and mood spectrum symptoms detected with the self-report tools, emerged only in the subgroup of the fathers. CONCLUSION These findings corroborate the need to provide assistance to caregivers of pediatric patients and confirm the hypothesis that lifetime mood spectrum may have an impact on reaction to traumas.
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Affiliation(s)
| | | | | | | | | | | | | | - Diego Giampietro Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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26
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Rosenström T, Torvik FA, Ystrom E, Czajkowski NO, Gillespie NA, Aggen SH, Krueger RF, Kendler KS, Reichborn-Kjennerud T. Prediction of alcohol use disorder using personality disorder traits: a twin study. Addiction 2018; 113:15-24. [PMID: 28734091 PMCID: PMC5725242 DOI: 10.1111/add.13951] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 12/14/2016] [Revised: 03/27/2017] [Accepted: 07/14/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS The DSM-IV personality disorders (PDs) are comorbid with alcohol use disorder (AUD) and with each other. It remains unclear which PD criteria are most likely to drive onset and recurrence of AUD and which are merely confounded with those criteria. We determine which individual PD criteria predict AUD and the degree of underlying genetic and/or environmental aetiology. DESIGN A prospective observational twin study. SETTING Norway 1999-2011. PARTICIPANTS A total of 2528 and 2275 Norwegian adult twins in waves 1 and 2 variable-selection analyses, and 2785 in biometric analyses. MEASUREMENTS DSM-IV PDs and their 80 criteria were assessed using a structured personal interview, and AUD using the World Health Organization's Composite International Diagnostic Interview. FINDINGS In a variable-selection analysis, two PD criteria were associated with AUD even after taking all the other criteria into account: criterion 8 of antisocial PD (childhood conduct disorder) and criterion 4 of borderline PD (self-damaging impulsive behaviours). Adjusting for each other, their respective odds ratios were 3.4 [confidence interval (CI) = 2.1-5.4] and 5.0 (CI = 3.3-7.7). Endorsement strength of the criteria was associated with AUD in a dose-response manner and they explained 5.5% of variation in AUD risk-more than the full diagnoses of antisocial and borderline PDs together (0.5%). The association between borderline criterion 4 and AUD 10 years later derived mainly from their overlapping genetic factors, whereas the association between antisocial criterion 8 and AUD 10 years later was due to both genetic and non-genetic factors. CONCLUSIONS Conduct disorder and self-harming impulsivity are the foremost risk traits for alcohol use disorder among the 80 personality disorder criteria of DSM-IV, predicting alcohol use disorder more effectively than personality disorder diagnoses. The twin-study analysis suggested that conduct disorder represents a joint genetic and developmental risk for alcohol use disorder and that impulsivity is a genetic risk.
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Affiliation(s)
- Tom Rosenström
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Correspondence:
| | - Fartein Ask Torvik
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway,PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Norway
| | - Nikolai Olavi Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Norway
| | - Nathan A. Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Steven H. Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Deparment of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Norway
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27
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Zander E, Wyder L, Holtforth MG, Schnyder U, Hepp U, Stulz N. Validity of routine clinical diagnoses in acute psychiatric inpatients. Psychiatry Res 2018; 259:482-487. [PMID: 29154169 DOI: 10.1016/j.psychres.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 03/21/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
AIM To examine the validity of diagnoses obtained by clinicians during routine clinical examination on acute psychiatric inpatient wards. METHODS N=100 inpatients with a broad spectrum of major mental disorders were randomly selected in a mental hospital's department of general psychiatry. Patients were diagnosed by independent assessors within Md = 5 (Range: 1-18) days of admission using the SCID I in order to examine the validity of the diagnoses given by the clinical staff based on routine assessments. RESULTS The commonly used clinical examination technique had good overall agreement with the SCID I assessments regarding primary diagnoses at the level of ICD-10 main categories (F2, F30-31, F32-F33, F4; κ = 0.65). However, agreement between routine clinical diagnoses and the SCID I diagnoses tended to be low for some specific mental disorders (e.g., depressive disorders) and for secondary diagnoses. CONCLUSIONS The validity of routine clinical diagnoses established in acute inpatient settings is limited and should be improved.
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Affiliation(s)
- Eduard Zander
- Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland
| | - Lea Wyder
- Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland; University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland
| | - Martin Grosse Holtforth
- University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland; Inselspital, Psychosomatic Competence Center, Haus C.L. Lory, CH-3010 Berne, Switzerland
| | - Ulrich Schnyder
- University Hospital Zurich, Department of Psychiatry and Psychotherapy, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur - Zurcher Unterland, Wieshofstrasse 102, P.O. Box 144, CH-8408 Winterthur, Switzerland
| | - Niklaus Stulz
- Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland; University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland
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28
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Ernst V, Bürger A, Hammerle F. Prevalence and severity of eating disorders: A comparison of DSM-IV and DSM-5 among German adolescents. Int J Eat Disord 2017; 50:1255-1263. [PMID: 28963857 DOI: 10.1002/eat.22780] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Changes in the DSM-5 eating disorders criteria sought to increase the clarity of the diagnostic categories and to decrease the preponderance of nonspecified eating disorders. The first objective of this study was to analyze how these revisions affect threshold and EDNOS/OSFED eating disorder diagnoses in terms of prevalence, sex ratios, and diagnostic distribution in a student sample. Second, we aimed to compare the impairment levels of participants with a threshold, an EDNOS/OSFED and no diagnosis using both DSM-IV and DSM-5. METHOD A sample of 1654 7th and 8th grade students completed self-report questionnaires to determine diagnoses and impairment levels in the context of an eating disorder prevention program in nine German secondary schools. Height and weight were measured. RESULTS The prevalence of threshold disorders increased from .48% (DSM-IV) to 1.15% (DSM-5). EDNOS disorders increased from 2.90 to 6.23% when using OSFED-categories. A higher proportion of girls was found throughout all the diagnostic categories, and the sex ratios remained stable. The effect sizes of DSM-5 group differences regarding impairment levels were equal to or larger than those of the DSM-IV comparisons, ranging from small to medium. DISCUSSION We provide an in-depth overview of changes resulting from the revisions of DSM eating disorder criteria in a German adolescent sample. Despite the overall increase in prevalence estimates, the results suggest that the DSM-5 criteria differentiate participants with threshold disorders and OSFED from those no diagnosis as well as or even more distinctly than the DSM-IV criteria.
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Affiliation(s)
- Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arne Bürger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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29
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Hummel SB, Hahn DEE, van Lankveld JJDM, Oldenburg HSA, Broomans E, Aaronson NK. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J Sex Med 2017; 14:1248-59. [PMID: 28923310 DOI: 10.1016/j.jsxm.2017.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Many women develop sexual problems after breast cancer (BC) treatment. Little is known about BC survivors with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sexual dysfunction and their partners, and the factors associated with their sexual functioning. AIM To evaluate (i) patient-related and clinical factors associated with (a) specific DSM-IV sexual dysfunctions and (b) level of sexual functioning and sexual distress as reported by BC survivors and (ii) the association between the sexual functioning of BC survivors and that of their partners. METHODS We analyzed baseline data from a study of the efficacy of online cognitive-behavioral therapy for sexual dysfunction in BC survivors. OUTCOMES Women completed self-report questionnaires assessing sexual functioning, sexual distress, relationship intimacy, marital functioning, menopausal symptoms, body image, and psychological distress. Their partners completed questionnaires assessing sexual functioning. RESULTS The study included 169 BC survivors and 67 partners. The most prevalent female sexual dysfunctions were hypoactive sexual desire disorder (HSDD; 83%), sexual arousal disorder (40%), and dyspareunia (33%). Endocrine therapy was associated with HSDD (P = .003), and immunotherapy was associated with dyspareunia (P = .009). Older age was associated with lower sexual distress (P < .001). Depressive symptoms were highest in women with sexual arousal disorder (P = .004). An indication for erectile disorder was present in two thirds of partners. Lower overall partner sexual satisfaction was associated with lower overall BC survivor sexual functioning (P = .001), lower female arousal (P = .002), and lower female sexual satisfaction (P = .001). Poorer male erectile function was related to higher female sexual pain (P = .006). Partners of women who underwent breast reconstruction reported marginally significantly better orgasmic functioning (P = .012) and overall sexual functioning (P = .015) than partners of women who had undergone breast-conserving treatment. CLINICAL IMPLICATIONS BC survivors and their partners experience sexual problems after BC treatment. This suggests that not only the BC survivor but also her partner could benefit from sexual counseling. STRENGTHS AND LIMITATIONS This is the first study focusing on BC survivors with a DSM-IV sexual dysfunction and their partners. The results cannot necessarily be generalized to women experiencing milder sexual problems or who have no interest in receiving sexual counseling. CONCLUSION Endocrine therapy and immunotherapy are relevant risk factors for HSDD and dyspareunia in BC survivors. The sexual functioning of women and their partners is affected, underscoring the importance of involving both partners in sexual counseling after BC treatment. Hummel SB, Hahn DEE, van Lankveld JJDM, et al. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J Sex Med 2017;14:1248-1259.
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Couvy-Duchesne B, Davenport TA, Martin NG, Wright MJ, Hickie IB. Validation and psychometric properties of the Somatic and Psychological HEalth REport (SPHERE) in a young Australian-based population sample using non-parametric item response theory. BMC Psychiatry 2017; 17:279. [PMID: 28764680 PMCID: PMC5540428 DOI: 10.1186/s12888-017-1420-1] [Citation(s) in RCA: 11] [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] [Received: 07/01/2016] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Somatic and Psychological HEalth REport (SPHERE) is a 34-item self-report questionnaire that assesses symptoms of mental distress and persistent fatigue. As it was developed as a screening instrument for use mainly in primary care-based clinical settings, its validity and psychometric properties have not been studied extensively in population-based samples. METHODS We used non-parametric Item Response Theory to assess scale validity and item properties of the SPHERE-34 scales, collected through four waves of the Brisbane Longitudinal Twin Study (N = 1707, mean age = 12, 51% females; N = 1273, mean age = 14, 50% females; N = 1513, mean age = 16, 54% females, N = 1263, mean age = 18, 56% females). We estimated the heritability of the new scores, their genetic correlation, and their predictive ability in a sub-sample (N = 1993) who completed the Composite International Diagnostic Interview. RESULTS After excluding items most responsible for noise, sex or wave bias, the SPHERE-34 questionnaire was reduced to 21 items (SPHERE-21), comprising a 14-item scale for anxiety-depression and a 10-item scale for chronic fatigue (3 items overlapping). These new scores showed high internal consistency (alpha > 0.78), moderate three months reliability (ICC = 0.47-0.58) and item scalability (Hi > 0.23), and were positively correlated (phenotypic correlations r = 0.57-0.70; rG = 0.77-1.00). Heritability estimates ranged from 0.27 to 0.51. In addition, both scores were associated with later DSM-IV diagnoses of MDD, social anxiety and alcohol dependence (OR in 1.23-1.47). Finally, a post-hoc comparison showed that several psychometric properties of the SPHERE-21 were similar to those of the Beck Depression Inventory. CONCLUSIONS The scales of SPHERE-21 measure valid and comparable constructs across sex and age groups (from 9 to 28 years). SPHERE-21 scores are heritable, genetically correlated and show good predictive ability of mental health in an Australian-based population sample of young people.
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Affiliation(s)
- Baptiste Couvy-Duchesne
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia. .,Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia. .,Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Tracey A. Davenport
- 0000 0004 1936 834Xgrid.1013.3Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Nicholas G. Martin
- 0000 0001 2294 1395grid.1049.cGenetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Margaret J. Wright
- 0000 0000 9320 7537grid.1003.2Queensland Brain Institute, the University of Queensland, Brisbane, Australia
| | - Ian B. Hickie
- 0000 0004 1936 834Xgrid.1013.3Brain and Mind Centre, The University of Sydney, Sydney, Australia
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31
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Tohen M, Gold AK, Sylvia LG, Montana RE, McElroy SL, Thase ME, Rabideau DJ, Nierenberg AA, Reilly-Harrington NA, Friedman ES, Shelton RC, Bowden CL, Singh V, Deckersbach T, Ketter TA, Calabrese JR, Bobo WV, McInnis MG. Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study. J Affect Disord 2017; 217:183-189. [PMID: 28411507 DOI: 10.1016/j.jad.2017.03.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/11/2016] [Revised: 02/09/2017] [Accepted: 03/28/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. METHODS We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. RESULTS At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). LIMITATIONS Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. CONCLUSIONS The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV.
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Affiliation(s)
- Mauricio Tohen
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA.
| | - Alexandra K Gold
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Rebecca E Montana
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Susan L McElroy
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael E Thase
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Dustin J Rabideau
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Noreen A Reilly-Harrington
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Richard C Shelton
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charles L Bowden
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Vivek Singh
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Terence A Ketter
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Joseph R Calabrese
- Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Gordon-Smith K, Jones LA, Forty L, Craddock N, Jones I. Changes to the Diagnostic Criteria for Bipolar Disorder in DSM-5 Make Little Difference to Lifetime Diagnosis: Findings From the U.K. Bipolar Disorder Research Network (BDRN) Study. Am J Psychiatry 2017; 174:803. [PMID: 28760020 DOI: 10.1176/appi.ajp.2017.17010109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Katherine Gordon-Smith
- From the Department of Psychological Medicine, University of Worcester, Worcester, U.K.; and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, U.K
| | - Lisa A Jones
- From the Department of Psychological Medicine, University of Worcester, Worcester, U.K.; and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, U.K
| | - Liz Forty
- From the Department of Psychological Medicine, University of Worcester, Worcester, U.K.; and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, U.K
| | - Nick Craddock
- From the Department of Psychological Medicine, University of Worcester, Worcester, U.K.; and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, U.K
| | - Ian Jones
- From the Department of Psychological Medicine, University of Worcester, Worcester, U.K.; and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, U.K
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Takahashi T, Lapham G, Chavez LJ, Lee AK, Williams EC, Richards JE, Greenberg D, Rubinsky A, Berger D, Hawkins EJ, Merrill JO, Bradley KA. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial. Addict Sci Clin Pract 2017; 12:17. [PMID: 28716049 PMCID: PMC5514480 DOI: 10.1186/s13722-017-0082-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 05/25/2017] [Indexed: 12/04/2022] Open
Abstract
Background Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. Methods VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Results Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. Conclusions In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17 Electronic supplementary material The online version of this article (doi:10.1186/s13722-017-0082-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Traci Takahashi
- Department of Veterans Affairs Puget Sound Health Care System, General Medicine Services, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA. .,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
| | - Gwen Lapham
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA
| | - Laura J Chavez
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA.,Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy K Lee
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA
| | - Emily C Williams
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA
| | - Julie E Richards
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA
| | - Diane Greenberg
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Department of Veterans Affairs Puget Sound Health Care System, Mental Health Service, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA
| | - Anna Rubinsky
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,The Kidney Health Research Collaborative, San Francisco and San Francisco VA Medical Center, University of California, 4150 Clement Street (111A1), San Francisco, CA, 94121, USA
| | - Douglas Berger
- Department of Veterans Affairs Puget Sound Health Care System, General Medicine Services, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA.,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Eric J Hawkins
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Joseph O Merrill
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Katharine A Bradley
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA.,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
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Tay AK, Mohsin M, Rees S, Steel Z, Tam N, Soares Z, Baker J, Silove D. The factor structures and correlates of PTSD in post-conflict Timor-Leste: an analysis of the Harvard Trauma Questionnaire. BMC Psychiatry 2017; 17:191. [PMID: 28532449 PMCID: PMC5441051 DOI: 10.1186/s12888-017-1340-0] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is the most widely assessed form of mental distress in cross-cultural studies conducted amongst populations exposed to mass conflict and displacement. Nevertheless, there have been longstanding concerns about the universality of PTSD as a diagnostic category when applied across cultures. One approach to examining this question is to assess whether the same factor structure can be identified in culturally diverse populations as has been described in populations of western societies. We examine this issue based on an analysis of the Harvard Trauma Questionnaire (HTQ) completed by a large community sample in conflict-affected Timor-Leste. METHOD Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), ongoing adversities, symptoms of PTSD and psychological distress, and functional impairment amongst a large population sample (n = 2964, response rate: 82.4%) in post-conflict Timor-Leste. RESULTS Confirmatory factor analyses of the ICD-10, ICD-11, DSM-IV, four-factor Emotional Numbing and five-factor Dysphoric-Arousal PTSD structures, found considerable support for all these models. Based on these classifications, concurrent validity was indicated by logistic regression analyses which showed that being a woman, trauma exposure, ongoing adversity, severe distress, and functional impairment were all associated with PTSD. CONCLUSIONS Although symptom prevalence estimates varied widely based on different classifications, our study found a general agreement in PTSD assignments across contemporary diagnostic systems in a large conflict-affected population in Timor-Leste. Further studies are needed, however, to establish the construct and concurrent validity of PTSD in other cultures.
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Affiliation(s)
- Alvin Kuowei Tay
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW, 2170, Australia.
| | - Mohammed Mohsin
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Susan Rees
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Zachary Steel
- 0000 0001 0640 7766grid.418393.4The Black Dog Institute, Sydney, Australia ,St John of God, Richmond Hospital, Richmond, NSW Australia
| | - Natalino Tam
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Zelia Soares
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Jessica Baker
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Derrick Silove
- 0000 0004 4902 0432grid.1005.4Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
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Nesvåg R, Jönsson EG, Bakken IJ, Knudsen GP, Bjella TD, Reichborn-Kjennerud T, Melle I, Andreassen OA. The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview. BMC Psychiatry 2017; 17:93. [PMID: 28292279 PMCID: PMC5351165 DOI: 10.1186/s12888-017-1256-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Utilization of diagnostic information from national patient registries rests on the quality of the registered diagnoses. We aimed to investigate the agreement and consistency of diagnoses of psychotic and bipolar disorders in the Norwegian Patient Registry (NPR) compared to structured interview-based diagnoses given as part of a clinical research project. METHODS Diagnostic data from NPR were obtained for the period 01.01.2008-31.12.2013 for all patients who had been included in the Thematically Organized Psychosis (TOP) study between 18.10.2002 and 01.09.2014 with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of schizophrenia (n = 537), delusional disorder (n = 48), schizoaffective disorder (n = 118) or bipolar disorder (n = 408). Diagnostic agreement between the primary DSM-IV diagnosis in TOP and the International Classification of Diseases, 10th revision (ICD-10) diagnoses in NPR was evaluated using Cohen's unweighted nominal kappa (κ). Diagnostic consistency was calculated as the proportion of all registered severe mental disorder diagnoses in NPR that were equivalent to the primary diagnosis given in the TOP study. RESULTS The proportion of patients registered with the equivalent ICD-10 diagnosis as the primary DSM-IV diagnosis given in TOP was 84.2% for the schizophrenia group, 68.8% for the delusional disorder group, 76.3% for the schizoaffective disorder group, and 78.4% for the bipolar disorder group. Diagnostic agreement was good for schizophrenia (κ = 0.74) and bipolar disorder (κ = 0.72), fair for schizoaffective disorder (κ = 0.63), and poor for delusional disorder (κ = 0.39). Among patients with DSM-IV schizophrenia, 4.7% were diagnosed with ICD-10 bipolar disorder, and among patients with DSM-IV bipolar disorder, 2.5% were diagnosed with ICD-10 schizophrenia. Diagnostic consistency was 84.9% for schizophrenia, 59.1% for delusional disorder, 65.9% for schizoaffective disorder, and 91.0% for bipolar disorder. CONCLUSIONS When compared to research-based diagnoses, clinical diagnoses of schizophrenia and bipolar disorder in the NPR are accurate and consistent, with minimal diagnostic overlap between the two disorders.
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Affiliation(s)
- Ragnar Nesvåg
- Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403, Oslo, Norway.
| | - Erik G. Jönsson
- 0000 0004 0389 8485grid.55325.34Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway ,0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, Centre of Psychiatric Research, Karolinska Institutet, Administration, Tomtebodavägen 18A, 5th floor, 171 77 Stockholm, Sweden
| | - Inger Johanne Bakken
- 0000 0001 1541 4204grid.418193.6Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403 Oslo, Norway
| | - Gun Peggy Knudsen
- 0000 0001 1541 4204grid.418193.6Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403 Oslo, Norway
| | - Thomas D. Bjella
- 0000 0004 0389 8485grid.55325.34Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway
| | - Ted Reichborn-Kjennerud
- 0000 0001 1541 4204grid.418193.6Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403 Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0319 Oslo, Norway
| | - Ingrid Melle
- 0000 0004 0389 8485grid.55325.34Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0319 Oslo, Norway
| | - Ole A. Andreassen
- 0000 0004 0389 8485grid.55325.34Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0319 Oslo, Norway
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Stinchfield R, McCready J, Turner NE, Jimenez-Murcia S, Petry NM, Grant J, Welte J, Chapman H, Winters KC. Reliability, Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV. J Gambl Stud 2016; 32:905-22. [PMID: 26408026 DOI: 10.1007/s10899-015-9573-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5-DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.
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Affiliation(s)
- Joseph R Calabrese
- From the Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland; and the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Keming Gao
- From the Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland; and the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Gary Sachs
- From the Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland; and the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
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Abstract
From DSM-III onward, successive DSM editions have strived to ground the diagnostic definitions in empirical evidence. DSM-IV established a three-stage process of empirical review, consisting of comprehensive and systematic literature reviews, secondary analyses of datasets, and field trials to provide reliability and validity data for the most substantial or controversial proposals. DSM-IV Work Group members were required to review the empirical literature to document explicitly the evidence supporting the text and criteria published in DSM-IV. As noted by Kendler and Solomon (2016), in contrast to the emphasis on systematic reviews in medicine which is a manifestation of the evidence-based medicine movement, such systematic evidence-based reviews have not been consistently integrated into the development of DSM-5, raising questions about empirical rigor underlying the DSM-5 revision. It is likely that this regression in terms of anchoring the revision process in a comprehensive review of empirical data stemmed from the emphasis during the DSM-5 revision process on trying to move DSM-5 from its categorical descriptive approach towards a more etiological dimensional approach. Although such a shift ultimately did not occur, the effort spent on trying to achieve a paradigm shift likely came at the expense of the hard work of conducting systematic empirical reviews. For the DSM to continue to remain credible in the current era of evidence-based medicine, it is essential that the developers of future editions of the DSM avoid taking their eye off the empirical ball and insure that the manual remains grounded in solid empirical evidence.
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Affiliation(s)
- M B First
- Department of Psychiatry,Columbia University,1051 Riverside Drive - Unit 60,New York,NY 10032,USA
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Gualandi M, Simoni M, Manzato E, Scanelli G. Reassessment of patients with Eating Disorders after moving from DSM-IV towards DSM-5: a retrospective study in a clinical sample. Eat Weight Disord 2016; 21:617-24. [PMID: 27573908 DOI: 10.1007/s40519-016-0314-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To compare the relative prevalence of eating disorders moving from DSM-IV to DSM-5, and to reassess the overall medical impairment in the revised diagnostic classes. METHODS We applied DSM-5 to 206 patients (age 15-56 years) previously studied and classified according to DSM-IV. Medical impairment was classified as low, medium, or high, based on a cumulative score of clinical severity (SCS), computed as the sum of specific weights assigned to different pathological conditions and their ascertained prognostic impact. RESULTS Application of DSM-5 produced a decrease in Eating Disorders Not Otherwise Specified (EDNOS) by 17 %, an increase in anorexia (AN) by 14 % and bulimia (BN) by 2.4 %; 44.6 % of EDNOS migrated to AN, 8 % to BN, and 30.8 % was reclassified as Other Specified Feeding and Eating Disorders (OSFED). Mean SCS was higher in AN than in other diagnoses independent of classification. Differently from EDNOS, no high score was found in OSFED. BMI (OR 0.74, 95 % CI 0.56-0.98) and duration of amenorrhea >1 year (OR 6.63, 95 % CI 1.29-34.16) resulted significantly associated with the risk for medium-high SCS level in AN classified with DSM-5. CONCLUSION The results confirmed that DSM-5 reduces the number of EDNOS. DSM-5 seems to better represent the clinical picture in OSFED than in EDNOS. The clinical relevance of BMI and duration of amenorrhea should be considered even more now that they are no longer used as diagnostic hallmarks of AN.
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Scott KM, Lim CCW, Hwang I, Adamowski T, Al-Hamzawi A, Bromet E, Bunting B, Ferrand MP, Florescu S, Gureje O, Hinkov H, Hu C, Karam E, Lee S, Posada-Villa J, Stein D, Tachimori H, Viana MC, Xavier M, Kessler RC. The cross-national epidemiology of DSM-IV intermittent explosive disorder. Psychol Med 2016; 46:3161-3172. [PMID: 27572872 PMCID: PMC5206971 DOI: 10.1017/s0033291716001859] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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 This is the first cross-national study of intermittent explosive disorder (IED). METHOD A total of 17 face-to-face cross-sectional household surveys of adults were conducted in 16 countries (n = 88 063) as part of the World Mental Health Surveys initiative. The World Health Organization Composite International Diagnostic Interview (CIDI 3.0) assessed DSM-IV IED, using a conservative definition. RESULTS Lifetime prevalence of IED ranged across countries from 0.1 to 2.7% with a weighted average of 0.8%; 0.4 and 0.3% met criteria for 12-month and 30-day prevalence, respectively. Sociodemographic correlates of lifetime risk of IED were being male, young, unemployed, divorced or separated, and having less education. The median age of onset of IED was 17 years with an interquartile range across countries of 13-23 years. The vast majority (81.7%) of those with lifetime IED met criteria for at least one other lifetime disorder; co-morbidity was highest with alcohol abuse and depression. Of those with 12-month IED, 39% reported severe impairment in at least one domain, most commonly social or relationship functioning. Prior traumatic experiences involving physical (non-combat) or sexual violence were associated with increased risk of IED onset. CONCLUSIONS Conservatively defined, IED is a low prevalence disorder but this belies the true societal costs of IED in terms of the effects of explosive anger attacks on families and relationships. IED is more common among males, the young, the socially disadvantaged and among those with prior exposure to violence, especially in childhood.
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Affiliation(s)
- K. M. Scott
- Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - C. C. W. Lim
- Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - I. Hwang
- Department of Health Care Policy, Harvard University Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
| | - T. Adamowski
- Medical University of Wroclaw, L. Pasteur Str. 10, 50-367 Wroclaw, Poland
| | - A. Al-Hamzawi
- Department of Psychiatry, College of Medicine, Qadisia University, Diwaniya 00964, Iraq
| | - E. Bromet
- Department of Psychiatry, State University of New York at Stony Brook, Putnam Hall – South Campus, Stony Brook, NY 11794-8790, USA
| | - B. Bunting
- University of Ulster, College Avenue, Londonderry BT48 7JL, UK
| | - M. P. Ferrand
- Universidad Peruana Cayetano Heredia, Facultad de Salud Pública y Administración, Honorio Delgado, Lima, Peru
| | - S. Florescu
- Health Services and Research Evaluation Center, National School of Public Health Management and Professional Development, 31 Vaselor Street, Bucharest, 021253, Romania
| | - O. Gureje
- Department of Psychiatry, University College Hospital, PMB 5116, Ibadan, Nigeria
| | - H. Hinkov
- National Center for Public Health Protection, 15 Acad. Ivan Ev. Geshov blvd, 1431 Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, 13-15/F, Block B, No. 2019 Buxin Road, Luohu District, No. 1080 Cuizu Road, Luohu District, 518020, Guangdong Province, People's Republic of China
| | - E. Karam
- St. George Hospital University Medical Center, Balamand University, Faculty of Medicine, Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Medical Institute for Neuropsychological Disorders (MIND), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Institute for Development, Research Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Ashrafieh 166378, Lebanon
| | - S. Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Flat 7A, Block E, Staff Quarters, Prince of Wales Hospital, Shatin, Hong Kong SAR
| | - J. Posada-Villa
- Universidad Colegio Mayor de Cundinamarca, Cra 7 No. 119-14 Cons. 511, Bogotá D.C., Colombia
| | - D. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Private Bag X3, Rondebosch 7701, Cape Town, South Africa
| | - H. Tachimori
- National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo (UFES), Rua Dr Eurico de Aguiar 888/705, Vitoria, ES 29055-280, Brazil
| | - M. Xavier
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - R. C. Kessler
- Department of Health Care Policy, Harvard University Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
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Lindvall Dahlgren C, Wisting L. Transitioning from DSM-IV to DSM-5: A systematic review of eating disorder prevalence assessment. Int J Eat Disord 2016; 49:975-997. [PMID: 27528542 DOI: 10.1002/eat.22596] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 07/06/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature on assessment of eating disorder prevalence during the DSM-IV era (1994-2015). METHOD A PubMed search was conducted targeting articles on prevalence, incidence and epidemiology of eating disorders. The review was performed in accordance with PRISMA guidelines, and was limited to DSM-IV based eating disorder diagnoses published between 1994 and 2015. RESULTS A total of 74 studies fulfilled inclusion criteria and were included in the study. Results yielded evidence of over 40 different assessment instruments used to assess eating disorder prevalence, with the EAT-40 being the most commonly used screening instrument, and the SCID being the most frequently used interview. The vast majority of studies employed two-stage designs, closely followed by clinical interviews. Observations of higher prevalence rates were found in studies employing self-reports compared to two-stage designs and interviews. DISCUSSION Eating disorder prevalence rates have varied significantly during the DSM-IV era, and are dependent on assessment methods used and samples investigated. Following the transition to the DSM-5, eating disorder prevalence will change, warranting novel approaches to assessment and treatment planning. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Camilla Lindvall Dahlgren
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Oslo, 0424, Norway
| | - Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Oslo, 0424, Norway
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Del Giacco SR, Cappai A, Gambula L, Cabras S, Perra S, Manconi PE, Carpiniello B, Pinna F. The asthma-anxiety connection. Respir Med 2016; 120:44-53. [PMID: 27817815 DOI: 10.1016/j.rmed.2016.09.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The literature reports a significant association between various mental disorders and asthma, in particular depression and/or anxiety, with some more robust data regarding anxiety disorders. However, the nature of this association remains largely unclear. OBJECTIVES (1) To test the hypothesis of a specific association of anxiety and depressive disorder (according to the DSM-IV) with asthma and (2) to test the bidirectional hypothesis of causality between asthma and psychiatric disorders. METHODS Ninety-six adults were compared with 96 control subjects matched according to main socio-demographic variables (i.e., gender, age, marital status, cohabiting/non-cohabiting, and BMI). Subjects with asthma were divided according to GINA and ACT classifications. All subjects underwent Structured Clinical Interviews for DSM-IV Axis I (SCID-I) diagnosis. RESULTS Significant association between asthma and lifetime anxiety disorders emerged (OR 3.03; p = 0.003); no significant association with other psychiatric diagnosis emerged. Moreover, lifetime and current anxiety were associated with asthma severity levels (p < 0.01 and p = 0.001 based on age). Asthma preceded anxiety in 48% of cases; in 52% of cases, anxiety preceded asthma, without significant group differences. The risk of asthma, particularly of severe, uncontrolled forms (p < 0.01), resulted higher in lifetime anxiety disorder patients (p = 0.003 and p = 0.001 based on age at onset). Current anxiety increased the risk of asthma, and that of an uncontrolled form (p < 0.05). Asthma increased the risk of lifetime anxiety disorders (p = 0.002 and p = 0.018 using ages). Intermittent asthma increased the risk of lifetime and current anxiety disorders (p < 0.01). CONCLUSIONS Anxiety disorders, in particular Lifetime Anxiety Disorders, represent the only psychiatric disorder significantly associated with asthma, with a possible bidirectional, anxiety-asthma relationship, each of which can be caused or result from the other.
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Affiliation(s)
- Stefano R Del Giacco
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy.
| | - Alessandra Cappai
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Luisanna Gambula
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Stefano Cabras
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy; Department of Statistics, Carlos III University of Madrid, Madrid, Spain
| | - Silvia Perra
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy
| | - Paolo Emilio Manconi
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
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Kuroki T, Ishitobi M, Kamio Y, Sugihara G, Murai T, Motomura K, Ogasawara K, Kimura H, Aleksic B, Ozaki N, Nakao T, Yamada K, Yoshiuchi K, Kiriike N, Ishikawa T, Kubo C, Matsunaga C, Miyata H, Asada T, Kanba S. Current viewpoints on DSM-5 in Japan. Psychiatry Clin Neurosci 2016; 70:371-93. [PMID: 27414748 DOI: 10.1111/pcn.12421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 07/08/2016] [Indexed: 01/10/2023]
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, and its official Japanese version was published in 2014. The Japanese Government uses classifications from the 10th revision of the I nternational C lassification of D iseases (ICD-10) to categorize disorders and determine treatment fees. However, since the publication of the DSM-III, the use of the DSM system has become prevalent in research and educational settings in Japan. In addition to traditional psychiatry, both the ICD and the DSM are taught by many Japanese medical schools, and virtually all clinical research and trials refer to the DSM to define targeted disorders. Amid the current backdrop in which the reputation of the DSM-5 is being established, the editorial board of P sychiatry and C linical N eurosciences has asked Japanese experts across 12 specialties to examine the structure of the DSM-5, including the following categories: Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders, Major Depression, Bipolar Disorders, Obsessive-Compulsive Disorders, Somatic Symptom Disorder, Eating Disorders, Substance-Related and Addictive Disorders, Gender Dysphoria, and Neurocognitive Disorders. Although opinions were only obtained from these selected experts, we believe that we have succeeded, to a certain extent, in presenting views that are representative of each specialty.
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Affiliation(s)
- Toshihide Kuroki
- Department of Clinical Psychology Practice, Graduate School of Human Environment Studies, Kyushu University, Fukuoka, Japan
| | - Makoto Ishitobi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keisuke Motomura
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuyoshi Ogasawara
- Department of Human Care, Nagoya University of Arts and Sciences, Nagoya, Japan
| | - Hiroyuki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuo Yamada
- Department of Psychiatry, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuo Kiriike
- Department of Neuropsychiatry, Osaka City University, Osaka, Japan
| | - Toshio Ishikawa
- Department of Psychosomatic Medicine, Kohnodai Hospital, Tokyo, Japan
| | - Chiharu Kubo
- Department of Psychosomatic Medicine, Kyushu University, Fukuoka, Japan
| | - Chiaki Matsunaga
- Chiaki Clinic, Jikei University School of Medicine, Tokyo, Japan
| | - Hisatsugu Miyata
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Asada
- Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Duresso SW, Matthews AJ, Ferguson SG, Bruno R. Is khat use disorder a valid diagnostic entity? Addiction 2016; 111:1666-76. [PMID: 27061394 DOI: 10.1111/add.13421] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/08/2015] [Accepted: 03/31/2016] [Indexed: 11/26/2022]
Abstract
AIMS This study aimed to validate the presence of a khat use disorder syndrome using DSM-5 criteria and to examine its relationship with increased experience of harms. DESIGN Cross-sectional, purposive sample of current khat-chewers, recruited from khat markets and cafes. SETTING Participants were recruited from the general community and from Adama Science and Technology University in Ethiopia. PARTICIPANTS A total of 400 current khat consumers aged 16 and above were recruited between September 2014 and January 2015 MEASURES: Survey comprising current clinical symptoms (using a modified Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV), and validated measures of health, psychological distress, quality of life and academic functioning. FINDINGS A third [35.5% 95% confidence interval (CI) = 31.0-40.3] of respondents reported daily khat use and a quarter (25.4% 95% CI = 21.4-30.0) using three times or more per week. Using DSM-5 criteria, 10.5% (95% CI = 7.9-13.9) were categorized as experiencing mild, 8.8% (95% CI = 6.4-12.0) moderate and 54.5% (95% CI = 49.6-59.3) severe khat use disorder. Confirmatory factor analysis demonstrated a good fit of symptoms to a single underlying construct, consistent with other substance use disorders. Individuals categorized as experiencing khat use disorder demonstrated significantly greater frequency [odds ratio (OR) = 45.29; 95% CI = 10.97-19.01) and quantity of khat use (OR = 2.35; 95% CI = 1.29-4.29). They also demonstrated increased financial problems associated with use, greater problems with academic functioning and higher rates of self-reported mental health problems, higher psychological distress and poorer quality of life. Treatment access was poor, with only one-third (32.9%) of individuals with khat use disorder reporting life-time access, near-exclusively related to help-seeking from friends and relatives. CONCLUSION The construct of a substance use disorder syndrome for khat using DSM-5 criteria appears valid and performs in a manner consistent with other substances of dependence. Individuals with khat use disorder experience substantial problems in association with khat use. Despite this, there are low levels of help-seeking for these problems.
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Affiliation(s)
| | | | | | - Raimondo Bruno
- School of Medicine, University of Tasmania, Hobart, Australia
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Abstract
OBJECTIVE To compare the results of categorically based versus dimensionally based scoring algorithms for a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV)-referenced teacher rating scale for assessing ADHD and commonly co-occurring conditions and to determine their relative agreement with ratings of symptom-induced impairment. METHOD Teachers completed Child and Adolescent Symptom Inventory-4R (CASI-4R) ratings for 1,092 youth (ages 6-18 years) referred to a child and adolescent psychiatry outpatient service. Caseness was determined according to DSM-IV symptom count (categorical model) and T-score (dimensional model) criteria. RESULTS Agreement between symptom count and T-score cutoffs was generally good (kappa ≥ 0.61) for ADHD-Inattentive, ADHD-Hyperactive-Impulsive, ADHD-Combined (except adolescent females), Oppositional Defiant Disorder, and Conduct Disorder, but this was not the case for anxiety and depressive disorders where only 15% of kappas were good. Agreement of impairment cutoff with T-score and symptom count cutoffs ranged from poor to good. CONCLUSION In general, although in many cases CASI-4R categorical and dimensional scoring algorithms generated similar results, there was considerable variability across disorders, age groups, scoring method, and in some cases, gender. Moreover, symptom counts and T-scores are not a proxy for assessing impairment suggesting that each scoring strategy likely provides unique information for clinical decision-making.
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Slade T, Chiu WT, Glantz M, Kessler RC, Lago L, Sampson N, Al-Hamzawi A, Florescu S, Moskalewicz J, Murphy S, Navarro-Mateu F, Torres de Galvis Y, Viana MC, Xavier M, Degenhardt L. A Cross-National Examination of Differences in Classification of Lifetime Alcohol Use Disorder Between DSM-IV and DSM-5: Findings from the World Mental Health Survey. Alcohol Clin Exp Res 2016; 40:1728-36. [PMID: 27426631 DOI: 10.1111/acer.13134] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 03/22/2016] [Accepted: 05/23/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The current study sought to examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the 2 classification systems. METHODS DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data in 9 low-, middle-, and high-income countries. Participants were 31,367 respondents to surveys in the World Health Organization's World Mental Health Survey Initiative. The Composite International Diagnostic Interview, version 3.0, was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety; mood and drug use disorders; lifetime suicidal ideation, plan, and attempt; general functional impairment; and psychological distress. RESULTS Compared with DSM-IV AUD (12.3%, SE = 0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE = 0.2%). Almost one-third (n = 802) of all DSM-IV abuse cases switched to subthreshold according to DSM-5 and one-quarter (n = 467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 noncases were similar to those who were subthreshold across both classifications. The exception to this was with regard to the prevalence of any lifetime drug use disorder. CONCLUSIONS In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless, there was considerable diagnostic switching, with a large number of people inconsistently identified across the 2 DSM classifications.
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Affiliation(s)
- Tim Slade
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia
| | - Wai-Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Meyer Glantz
- Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, Maryland
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Luise Lago
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Jacek Moskalewicz
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Sam Murphy
- School of Psychology, University of Ulster, Belfast, Ireland
| | - Fernando Navarro-Mateu
- IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar, Murcia, Spain
| | | | - Maria Carmen Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - Miguel Xavier
- Nova Medical School/Faculdade Ciencias Medicas-Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia
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Abstract
Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the "atheoretical" approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry's over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry. As a result, the field has suffered a loss of knowledge that may be difficult to recover.
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Affiliation(s)
- Mark J Sedler
- Psychiatry and Public Health, Global Medical Education, Health Sciences Center, Stony Brook University School of Medicine, L-4, Rm. 158, Stony Brook, NY, 11794-8432, USA.
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Haravuori H, Kiviruusu O, Suomalainen L, Marttunen M. An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings: factor analysis and comparisons to ICD-10 and DSM-IV. BMC Psychiatry 2016; 16:140. [PMID: 27176723 PMCID: PMC4864920 DOI: 10.1186/s12888-016-0849-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 05/04/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. METHODS Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. RESULTS Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4%) PTSD cases, the two-factor ICD-11 identified 56 (24.6%) cases and the DSM-IV identified 43 (18.9%) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3%) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. CONCLUSIONS The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases identified by ICD-11, when compared to ICD-10 and DSM-IV.
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Affiliation(s)
- Henna Haravuori
- Department of Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland. .,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, HUS, P.O. Box 590, FI-00029, Helsinki, Finland.
| | - Olli Kiviruusu
- Department of Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Laura Suomalainen
- Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, HUS, P.O. Box 590, FI-00029 Helsinki, Finland
| | - Mauri Marttunen
- Department of Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland ,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, HUS, P.O. Box 590, FI-00029 Helsinki, Finland
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Pérez Romero A, González Garrido S. The importance of behavioural and pyschological symptoms in Alzheimer's disease. Neurologia 2016; 33:S0213-4853(16)30011-1. [PMID: 27130309 DOI: 10.1016/j.nrl.2016.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 08/06/2015] [Revised: 12/25/2015] [Accepted: 02/27/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Behavioral and psychological symptoms of dementia (BPSD), present in the vast majority of patients with Alzheimer's disease (AD), cause extensive impairment in all areas, including functionality. Early diagnosis and management are critical, especially since these symptoms are not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a diagnostic criterion of AD, but only as specific features of some patients. The main purpose of this review is to highlight the importance of these behavioural and psychological symptoms of dementia, particularly in AD. In addition, we discuss why these symptoms have not been included in the latest DSM-V. DEVELOPMENT We conducted a literature search through various databases to gather data about BPSD in AD, and found a total of 12 articles. CONCLUSIONS BPSD are present in almost all patients and result in cognitive and functional impairment. The prevalence of these symptoms varies depending on the study and the symptom in question. In our view, BPSD should be included among the DSM diagnostic criteria for AD.
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Affiliation(s)
- A Pérez Romero
- Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
| | - S González Garrido
- Departamento de Psiquiatría, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, España
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Subramaniam M, Chong SA, Vaingankar JA, Abdin E, Chua BY, Chua HC, Eng GK, Heng D, Hia SB, Huang W, Jeyagurunathana A, Kua J, Lee SP, Mahendran R, Magadi H, Malladi S, McCrone P, Pang S, Picco L, Sagayadevan V, Sambasivam R, Seng KH, Seow E, Shafie S, Shahwan S, Tan LL, Yap M, Zhang Y, Ng LL, Prince M. Prevalence of Dementia in People Aged 60 Years and Above: Results from the WiSE Study. J Alzheimers Dis 2016; 45:1127-38. [PMID: 25672767 DOI: 10.3233/jad-142769] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [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: 11/15/2022]
Abstract
BACKGROUND The challenge of an aging population with its expected attendant problem of an increase in the number of people with dementia is a growing concern across the world. OBJECTIVE The aims of this study were to establish the prevalence and risk factors of dementia in Singapore among the elderly resident population (aged 60 years and above). METHODS The WiSE study was a comprehensive single phase, cross-sectional, epidemiological survey that adapted the 10/66 protocol to establish the 10/66 and the Diagnostic and Statistical Manual of mental disorders -fourth edition (DSM-IV) diagnosis of dementia. 10/66 and DSM-IV dementia diagnosis as established by the survey questionnaires was validated by comparing against a gold standard of clinical assessment. RESULTS A total of 2,565 respondents completed the study giving a response rate of 65.6%. The validity of 10/66 dementia was higher (sensitivity = 95.6%, specificity = 81.8%) than that of DSM-IV dementia (sensitivity = 75.6%, specificity = 88.6%) when compared against the clinical gold standard. The study found that the prevalence of 10/66 dementia was 10% in the older adult population while the prevalence of DSM-IV dementia was 4.6%. Older age (75 years and above); no formal education, or completed primary education (versus higher education); homemaker and retired status (versus employed); and a history of stroke were associated with a higher risk of 10/66 dementia. CONCLUSION The establishment of accurate data on the number of people with dementia is essential in the planning of services and initiatives.
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Affiliation(s)
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Goi Khia Eng
- Research Division, Institute of Mental Health, Singapore, Singapore Nanyang Technological University, Singapore, Singapore
| | | | - Soo Boon Hia
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Wanping Huang
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | | | - Joshua Kua
- Raffles Medical Group, Singapore, Singapore
| | - Siau Pheng Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Srinivasa Malladi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | | | - Shirlene Pang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Kok Han Seng
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Mabel Yap
- Ministry of Health, Singapore, Singapore
| | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Changi General Hospital, Singapore, Singapore
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