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- Anckarsäter, Henrik, 1966, et al.
(author)
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The impact of ADHD and autism spectrum disorders on temperament, character, and personality development.
- 2006
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In: The American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:7, s. 1239-1244
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The authors describe personality development and disorders in relation to symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders. METHOD: Consecutive adults referred for neuropsychiatric investigation (N=240) were assessed for current and lifetime ADHD and autism spectrum disorders and completed the Temperament and Character Inventory. In a subgroup of subjects (N=174), presence of axis II personality disorders was also assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). RESULTS: Patients with ADHD reported high novelty seeking and high harm avoidance. Patients with autism spectrum disorders reported low novelty seeking, low reward dependence, and high harm avoidance. Character scores (self-directedness and cooperativeness) were extremely low among subjects with neuropsychiatric disorders, indicating a high overall prevalence of personality disorders, which was confirmed with the SCID-II. Cluster B personality disorders were more common in subjects with ADHD, while cluster A and C disorders were more common in those with autism spectrum disorders. The overlap between DSM-IV personality disorder categories was high, and they seem less clinically useful in this context. CONCLUSIONS: ADHD and autism spectrum disorders are associated with specific temperament configurations and an increased risk of personality disorders and deficits in character maturation.
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| 2. |
- Araya, Ricardo, et al.
(author)
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Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago, Chile.
- 2006
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In: American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:8, s. 1379-87
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The authors compared the incremental cost-effectiveness of a stepped-care, multicomponent program with usual care for the treatment of depressed women in primary care in Santiago, Chile.METHOD: A cost-effectiveness study was conducted of a previous randomized controlled trial involving 240 eligible women with DSM-IV major depression who were selected from a consecutive sample of adult women attending primary care clinics. The patients were randomly allocated to usual care or a multicomponent stepped-care program led by a nonmedical health care worker. Depression-free days and health care costs derived from local sources were assessed after 3 and 6 months. A health service perspective was used in the economic analysis.RESULTS: Complete data were determined for 80% of the randomly assigned patients. After we adjusted for initial severity, women receiving the stepped-care program had a mean of 50 additional depression-free days over 6 months relative to patients allocated to usual care. The stepped-care program was marginally more expensive than usual care (an extra 216 Chilean pesos per depression-free day). There was a 90% probability that the incremental cost of obtaining an extra depression-free day with the intervention would not exceed 300 pesos (1.04 US dollars).CONCLUSIONS: The stepped-care program was significantly more effective and marginally more expensive than usual care for the treatment of depressed women in primary care. Small investments to improve depression appear to yield larger gains in poorer environments. Simple and inexpensive treatment programs tested in developing countries might provide good study models for developed countries.
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| 3. |
- Carlbring, Per, 1972-, et al.
(author)
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Remote treatment of panic disorder : A randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls
- 2006
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In: American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:12, s. 2119-2125
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Journal article (peer-reviewed)abstract
- Objective: This study evaluated a 10-week Internet-based bibliotherapy self-help program with short weekly telephone calls for people suffering from panic disorder with or without agoraphobia. Method: After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by telephone, 60 participants were randomly assigned to either a wait-listed control group or a multimodal treatment package based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each participant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module. Results: Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pretreatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpretations, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-report measures were maintained at the 9-month follow-up. A blind telephone interview after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it. Conclusions: This study provides evidence to support the use of treatment distributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions.
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| 6. |
- Harvey, P.D, et al.
(author)
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Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden
- 2009
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In: American Journal of Psychiatry. - : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; :166, s. 821-827
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Recent advances in the assessment of disability in schizophrenia have separated the measurement of functional capacity from real-world functional outcomes. The authors examined the similarity of performance-based assessments of everyday functioning, real-world disability, and achievement of milestones in people with schizophrenia in the United States and Sweden. METHOD: The UCSD Performance-Based Skills Assessment-Brief Version (UPSA-B) and a neuropsychological assessment were administered to schizophrenia patients living in rural areas in Sweden (N=146) and in the New York City area (N=244), and patients' functioning was rated by their case managers. Information from records and case managers was used to determine the frequency of living independently, working, and having ever experienced a stable romantic relationship. RESULTS: Performance on the UPSA-B was essentially identical in the two samples (New York, mean score=13.84; Sweden, mean score=13.30), as were scores on the case manager ratings of everyday activities (New York, mean=49.0; Sweden, mean=48.8). The correlations between UPSA-B score, neuropsychological test performance, and case manager ratings did not differ across the two samples. The proportion of patients who had never had a close relationship and the rate of vocational disability were also nearly identical. However, while 80% of the Swedish patients were living independently, only 46% of the New York patients were. CONCLUSIONS: While scores on performance-based measures of everyday living skills were similar in people with schizophrenia across cultures, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to divergent real-world outcomes among individuals who show evidence of the same levels of ability and potential.
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| 8. |
- Kakko, Johan, et al.
(author)
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A stepped care strategy using buprenorphine and methadone versus conventional methadone maintenance in heroin dependence : A randomized controlled trial
- 2007
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In: American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 164:5, s. 797-803
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Both methadone and buprenorphine are effective therapy for heroin dependence. Efficacy is best documented for methadone maintenance therapy, but safety concerns limit its use. Buprenorphine offers lower overdose risk and improved access, but efficacy may be lower. The authors compared adaptive, buprenorphine-based stepped care to optimal methadone maintenance treatment. METHOD: This randomized controlled trial was undertaken 2004-2006. It consisted of a 24-day uniform double-blind induction phase followed by single-blind flexible dosing based on structured clinical criteria, for a total of 6 months. Ninety-six self-referred subjects with heroin dependence were randomly assigned to methadone or to stepped treatment initiated with buprenorphine/naloxone and escalated to methadone if needed. All subjects received intensive behavioral treatment. Primary outcome was retention in treatment. Secondary outcomes were completer analyses of problem severity (Addiction Severity Index) and proportion of urine samples free of illicit drugs. RESULTS: Overall, 6-month retention was 78%. Stepped treatment and methadone maintenance therapy outcomes were virtually identical. Among completers of stepped therapy, 46% remained on buprenorphine/naloxone. Proportion of urine samples free of illicit opiates increased over time and ultimately reached approximately 80% in both arms. Problem severity decreased significantly and uniformly in both arms. CONCLUSIONS: A stepped treatment of heroin dependence as described here appears equally efficacious compared to optimally delivered methadone maintenance therapy. Together with prior data on the advantageous safety of buprenorphine, this suggests that broad implementation of strategies using buprenorphine as first-line treatment should be considered.
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| 12. |
- Klingberg, T, et al.
(author)
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Working memory remediation and the D1 receptor
- 2009
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In: The American journal of psychiatry. - : American Psychiatric Association Publishing. - 1535-7228 .- 0002-953X. ; 166:5, s. 515-516
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Journal article (peer-reviewed)
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| 13. |
- Lindblad, Frank, et al.
(author)
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Improved survival in adolescent patients with anorexia nervosa : a comparison of two Swedish national cohorts of female inpatients
- 2006
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In: American Journal of Psychiatry. - 0002-953X .- 1535-7228. ; 163:8, s. 1433-1435
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Journal article (peer-reviewed)abstract
- Objective: The authors examined two cohorts of female inpatients with anorexia nervosa a decade apart to determine whether there had been any changes in terms of survival. Method: The Swedish National Registers, which contain information about hospital discharges and deaths for the entire population, were used to investigate differences in mortality. Subjects born between 1958 and 1967 and hospitalized due to anorexia nervosa between 1977 and 1981 (N=564) were compared with subjects born between 1968 and 1977 and hospitalized due to anorexia nervosa between 1987 and 1991 (N=554). The cohorts were followed from first hospital admission until 1992 and 2002, respectively. Results: Twenty-five deaths (4.4%) were recorded within the cohort hospitalized between 1977 and 1981, and seven deaths (1.3%) occurred in the cohort hospitalized between 1987 and 1991. The hazard ratio of death for the 1977—1981 cohort relative to the 1987—1991 cohort was 3.7. Conclusions: Mortality among female patients with anorexia nervosa in hospital care in Sweden has decreased dramatically, which is probably related to the introduction of specialized care units.
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| 17. |
- Pope, HG, et al.
(author)
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Binge eating disorder: a stable syndrome
- 2006
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In: The American journal of psychiatry. - : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; 163:12, s. 2181-2183
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Journal article (peer-reviewed)
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| 18. |
- Ruchkin, Vladislav, et al.
(author)
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Is posttraumatic stress in youth a culture-bound phenomenon? A comparison of symptom trends in selected U.S. and Russian communities.
- 2005
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In: American Journal of Psychiatry. - : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; 162:3, s. 538-44
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The cross-cultural applicability of the concept of posttraumatic stress was investigated by assessing symptom frequency and levels of comorbid psychopathology in adolescents from the United States and Russia.METHOD: A self-report survey was conducted in representative samples of 2,157 adolescents 14 to 17 years old from urban communities of the United States (N=1,212) and Russia (N=945).RESULTS: In both countries, the levels of all three major clusters of posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well as of internalizing psychopathology, increased along with the level of posttraumatic stress. Expectations about the future had a tendency to decrease with increasing posttraumatic stress. No differences between countries in significant interaction effects for symptom levels were found.CONCLUSIONS: The current findings suggest that posttraumatic symptoms and their associations with other adolescent mental health problems are not culture bound and that the psychological consequences of trauma follow similar dynamics cross-culturally.
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| 20. |
- Sodersten, P, et al.
(author)
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Prevalence and recovery from anorexia nervosa
- 2008
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In: The American journal of psychiatry. - : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; 165:2, s. 264-265
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Journal article (other academic/artistic)
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| 25. |
- Cantor-Graae, Elizabeth, et al.
(author)
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Schizophrenia and migration: a meta-analysis and review.
- 2005
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In: American Journal of Psychiatry. - 1535-7228. ; 162:1, s. 12-24
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Research review (peer-reviewed)abstract
- OBJECTIVE: The authors synthesize findings of previous studies implicating migration as a risk factor for the development of schizophrenia and provide a quantitative index of the associated effect size. METHOD: MEDLINE was searched for population-based incidence studies concerning migrants in English-language publications appearing between the years 1977 and 2003. Article bibliographies and an Australian database were cross-referenced. Studies were included if incidence reports provided numerators and denominators and if age correction was performed or could be performed by the authors. Relative risks for migrant groups were extracted or calculated for each study. Significant heterogeneity across studies indicated the need for a mixed-effects meta-analytic model. RESULTS: The mean weighted relative risk for developing schizophrenia among first-generation migrants (40 effect sizes) was 2.7 (95% confidence interval [CI]=2.3–3.2). A separate analysis performed for second-generation migrants (seven effect sizes) yielded a relative risk of 4.5 (95% CI=1.5–13.1). An analysis performed for studies concerning both first- and second-generation migrants and studies that did not distinguish between generations (50 effect sizes) yielded a relative risk of 2.9 (95% CI=2.5–3.4). Subgroup comparisons yielded significantly greater effect sizes for migrants from developing versus developed countries (relative risk=3.3, 95% CI=2.8–3.9) and for migrants from areas where the majority of the population is black (relative risk=4.8, 95% CI=3.7–6.2) versus white and neither black nor white. CONCLUSIONS: A personal or family history of migration is an important risk factor for schizophrenia. The differential risk pattern across subgroups suggests a role for psychosocial adversity in the etiology of schizophrenia.
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