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- Colins, Olivier F., 1978-, et al.
(författare)
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Informant agreement in the assessment of disruptive behavior disorders in detained minors in Belgium : a diagnosis-level and symptom-level examination
- 2008
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Ingår i: Journal of Clinical Psychiatry. - : Physicians Postgraduate Press, Inc. - 0160-6689 .- 1555-2101. ; 69:1, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Because diagnostic assessment of children emphasizes information from multiple informants, the reliability of findings in detained and incarcerated samples may be hampered. The objective of the current study was to examine parent-child agreement with regard to disruptive behavior disorders (with or without impairment) and disorder-related symptoms in detained male youths.METHOD: Between January 2005 and February 2007, a representative sample of 150 detainees, 12 to 17 years old, from the 3 Youth Detention Centers for boys in Flanders, Belgium, and 1 parent of each were interviewed with the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Interviewees were selected consecutively on the basis of Belgian origin for practical, financial, and time-related reasons. Of the 150 participants, 9 were excluded and the parents of 26 could not be included for various reasons, and thus full data were obtained for 115 parents.RESULTS: Overall poor parent-child agreement at the disorder and symptom level was found, which is consistent with previous studies. Parents reported significantly more unique information on attention-deficit/hyperactivity disorder (ADHD) (p < .001) and oppositional defiant disorder (ODD) (p < .001), while youths reported significantly more unique conduct disorder (CD)-related information (p = .01).CONCLUSION: The large proportion of parents uniquely reporting ADHD and ODD supports previous concerns about the reliability of self-reported ADHD and ODD and suggests an essential contribution by parents to the accurate assessment of these disorders in adolescent detainees. With regard to CD, it may be appropriate to rely on youth self-report.
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| 2. |
- Cuijpers, Pim, et al.
(författare)
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Adding Psychotherapy to Pharmacotherapy in the Treatment of Depressive Disorders in Adults : A Meta-Analysis
- 2009
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Ingår i: JOURNAL OF CLINICAL PSYCHIATRY. - 0160-6689 .- 1555-2101. ; 70:9, s. 1219-1229
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Tidskriftsartikel (refereegranskat)abstract
- Objective: A considerable number of studies has examined whether adding psychotherapy to pharmacotherapy results in stronger effects than pharmacotherapy alone. However, earlier meta-analyses in this field have included only a limited number of available studies and did not conduct extended subgroup analyses to examine possible sources of heterogeneity. Data Sources: We used a database derived from a comprehensive literature search in Pubmed, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published from 1966 to January 2008 that examined the psychological treatment of depression. The abstracts of these studies were identified by combining terms indicative of psychological treatment and depression. Study Selection: We included randomized trials in which the effects of a pharmacologic treatment were compared to the effects of a combined pharmacologic and psychological treatment in adults with a depressive disorder. Data Extraction: For each of the studies, we calculated a standardized mean effect size indicating the difference between pharmacotherapy and the combined treatment at posttest. We also coded major characteristics of the population, the interventions, and the quality and design of the study. Data Synthesis: Twenty-five randomized trials, with a total of 2,036 patients, were included. A mean effect size of d=0.31 (95% CI, 0.20 similar to 0.43) was found for the 25 included studies, indicating a small effect in favor of the combined treatment over pharmacotherapy alone. Studies aimed at patients with dysthymia resulted in significantly lower effect sizes compared to studies aimed at patients with major depression, a finding that suggests that the added value of psychotherapy is less in patients with dysthymia. The dropout rate was significantly lower in the combined treatment group compared to the pharmacotherapy only group (OR = 0.65; 95% CI, 0.50 similar to 0.83). Conclusions: Psychotherapy seems to have an additional value compared to pharmacotherapy alone for depression.
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| 3. |
- Cuijpers, Pim, et al.
(författare)
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Are Psychological and Pharmacologic Interventions Equally Effective in the Treatment of Adult Depressive Disorders? : A Meta-Analysis of Comparative Studies
- 2008
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Ingår i: Journal of Clinical Psychiatry. - 0160-6689 .- 1555-2101. ; 69:11, s. 1675-1685
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Tidskriftsartikel (refereegranskat)abstract
- Objective: A large number of studies suggest that both psychological and pharmacologic therapies are effective in the treatment of mild-to-moderate depressive disorders. Whether both types of intervention are equally effective has not been established definitively. Data Sources: A database was developed through a comprehensive literature search (from 1966 to May 2007) in which 6947 abstracts in PubMed (1244 abstracts), PsycINFO (1736), EMBASE (1911), and the Cochrane Central Register of Controlled Trials (2056) were examined. Abstracts were identified by combining terms indicative of psychological treatment and depression (both MeSH terms and text words). For this database, the primary studies from 22 meta-analyses of psychological treatment for depression were also collected. Study Selection: For the current study, the abstracts of 832 studies were examined. Data Extraction: Thirty randomized trials were included in a meta-analysis that compared the effects of a psychological treatment for 3178 adults with a diagnosed depressive disorder (major depressive disorder, dysthymia, minor depressive disorder) with the effects of a pharmacologic treatment. Data Synthesis: In studies of patients with dysthymia, pharmacotherapy was significantly more effective than psychotherapy (d = -0.28, 95% CI = -0.47 to -0.10). In patients with major depressive disorder, treatments with selective serotonin reuptake inhibitors (SSRIs) were significantly more effective than psychological treatments, while treatment with other antidepressants did not differ significantly. Subgroup and metaregression analyses did not show that pretest severity of depressive symptoms was associated with differential effects of psychological and pharmacologic treatments of major depressive disorder. Dropout rates were smaller in psychological interventions compared with pharmacologic treatments (odds ratio = 0.66, 95% CI = 0.47 to 0.92). Conclusions: Pharmacologic treatments may be more effective than psychological interventions in the treatment of dysthymia. Pharmacologic treatment with SSRIs may also be more effective in the treatment of major depressive disorder, although these differences are small and probably have little meaning from a clinical point of view. We can conclude that both psychological and pharmacologic therapies are effective in the treatment of depressive disorders and that each has its own merits.
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| 6. |
- Fazel, Seena, et al.
(författare)
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Risk Factors for Violent Crime in Schizophrenia : A National Cohort Study of 13,806 Patients
- 2009
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Ingår i: Journal of Clinical Psychiatry. - 0160-6689 .- 1555-2101. ; 70:3, s. 362-369
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine risk factors for and prevalence of violent crime in patients with schizophrenia, and in particular, to explore the contribution of familial risk factors. Method: We designed a cohort study that followed up patients with 2 or more hospitalizations for schizophrenia (ICD-8, ICD-9, and ICD-10 criteria) and investigated the risk for a violent conviction using Cox proportional hazards models. All 13,806 patients with 2 hospital discharge diagnoses of schizophrenia from January 1, 1973. through December 31, 2004, in Sweden were followed until violent conviction, emigration, death, or end of follow-up (December 31, 2004), and associations with sociodemographic, individual (substance abuse comorbidity, and previous violence), and familial (parental violent crime and parental alcohol abuse) factors were examined. Results: Over an average follow-up period of 12 years, 17.1% (N = 15 19) of the men and 5.6% (N = 273) of the women with 2 or more hospitalizations for schizophrenia had a violent conviction after discharge from hospital. Familial risk factors had moderate effects, increasing the risk for violent convictions by 50% to 150%. After adjustment for sociodemographic and individual risk factors, the associations between parental violent crime and risk of violent convictions remained in men (adjusted hazard ratio [HR] = 1.65, 95% Cl = 1.33 to 2.04) and in women (adjusted HR = 1.83. 95% CI = 1.11 to 3.01), whereas parental alcohol abuse was no longer significantly associated with violent crime. Conclusion: Parental violent crime had moderate associations with violent crime in male and female offspring with at least 2 hospitalizations for schizophrenia, which were mostly stronger than the better documented sociodemographic risk factors. This suggests that familial (genetic or early environmental) risk factors have an important role in the etiology of violent offending among individuals with schizophrenia and should be considered in violence risk assessment.
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