Medicine and Health Sciences Commons^™

Screening For Adult Adhd In Ontario: A Cross-Sectional Study Examining Sex Differences, Mental Health Correlates And Substance Use, Deanne Daigle

Electronic Thesis and Dissertation Repository

The vast majority of studies on attention-deficit/hyperactivity disorder (ADHD) are based on samples with inherent age, sex, and referral biases. Therefore, the current study used population-based data to 1) estimate the prevalence of adult ADHD (as well as previous diagnosis and medication use using an ADHD screener) and co-occurring psychiatric distress and substance use in Ontario 2) examine the sex differences in ADHD screening status and co-occurring psychiatric distress and substance use and 3) model ADHD screening status as a risk factor for psychiatric distress using the 2011 cycle of the Centre for Addiction and Mental Health Monitor. A positive …

"It Doesn't Do Any Harm, But Patients Feel Better": A Qualitative Exploratory Study On Gastroenterologists' Perspectives On The Role Of Antidepressants In Inflammatory Bowel Disease, Antonina Mikocka-Walus, Deborah Turnbull, Nicole Moulding, Ian Wilson, Jane Andrews, Gerald Holtmann

Ian G Wilson

Background: Interest in psychological factors in patients with inflammatory bowel disease (IBD) has increased in recent years. It has even been proposed that treating psychological co-morbidities with antidepressants may control disease activity and improve quality of life. Despite this, there is no data on gastroenterologists' attitudes to, and experiences with, antidepressant therapy in patients with IBD. Methods: We conducted semi-structured interviews with 18 gastroenterologists associated with metropolitan teaching hospitals. Qualitative content analysis was used to examine their responses. Results: Seventy-eight percent of gastroenterologists had treated IBD patients with antidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reported to …

Antidepressants And Inflammatory Bowel Disease: A Systematic Review, Antonina A. Mikocka-Walus, Deborah Turnbull, Nicole T. Moulding, Ian G. Wilson, Jane M. Andrews, Gerald J. Holtmann

Ian G Wilson

Background: A number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD). Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological comorbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed. Methods: We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined. Results: 12 relevant publications were identified. All of them referred …

Cellular Effects Of Platinum Chemotherapeutics: Alterations By Antidepressants And Heparan Sulfate Proteoglycans, Brigitte Engelmann

Theses and Dissertations

The work discussed here is divided into two projects. The first project involves the interactions between antidepressants and the platinum based chemotherapeutics while the second project begins to investigate possible implications of a recently discovered uptake mechanism for positively charged platinum drugs. Gaining understanding of the interactions between antidepressants and platinum-based chemotherapeutics is important due to the frequency with which they are prescribed together. Although using a combination regimen of antineoplastics is beneficial to the patient, not all drug interactions are. For instance, many of the serotonin reuptake inhibitors have been shown to decrease the efficacy of tamoxifen. Desipramine, a …

Effects Of Benzodiazepines, Antidepressants And Opioids On Driving: A Systematic Review And Meta-Analysis Of Epidemiological And Experimental Evidence, Tharaka L. Dassanayake, Patricia Michie, Gregory Carter, Alison L. Jones

Alison L Jones

Background: Many individuals in the community are prescribed psychoactive drugs with sedative effects. These drugs may affect their daily functions, of which automobile driving is a major component. Objective: To examine the association of three classes of commonly used psychoactive drugs (viz. benzodiazepines and newer non-benzodiazepine hypnotics, antidepressants and opioids) with (i) the risk of traffic accidents (as indexed by epidemiological indicators of risk); and (ii) driving performance (as indexed by experimental measures of driving performance). Methods: A literature search for material published in the English language between January 1966 and January 2010 in PubMed and EMBASE databases was combined …

Four Potential Criteria For Deciding When To Use Antidepressants Or Psychotherapy For Unipolar Depression: A Literature Review, Christopher Sharpley, Vicki Bitsika

Vicki Bitsika

Objective: To evaluate the literature supporting four potential criteria for deciding whether to use psychotherapy or pharmacology when treating depression.

Method: Literature review of the evidence from the last 10 years on presenting patient’s demographics, aetiology, comorbidity, and genetic factors, as predictors of treatment outcome efficacy.

Results: Demographic information has little support as a potential criteria for decision-making; aetiology (melancholic vs. non-melancholic) has significant support; presence of personality disorder comorbidity is unproven as a criterion but may have some value; genetic predisposition has the strongest evidence supporting it as a criteria for treatment decision-making.

Conclusion: Although some presenting cases will …

Taking The Perspective That A Depressive State Reflects Inflammation: Implications For The Use Of Antidepressants, Jill Littrell

SW Publications

This paper reviews both the evidence that supports the characterization of depression as an inflammatory disorder and the different biochemical mechanisms that have been postulated for the connection between inflammation and depression. This association offers credible explanation for the short term efficacy of antidepressants, which have short term anti-inflammatory effects. Evidence for those anti-inflammatory effects is discussed. Evidence of the contrary long-term effects of antidepressants, which increase rather than decrease inflammation, is also reviewed. It is argued that this increase in inflammation would predict an increase in chronicity among depressed patients that have been treated with antidepressants drugs, which has …

Antidepressant Pharmacotherapy: Prescription Practices In Psychiatric Resident Care, Rachel Dew, W. Vaughn Mccall

Jefferson Journal of Psychiatry

Background: Research on treatment of depression has raised concerns regarding adequacy of medication trials and rationality of drug choice. Little data exists regarding pharmacotherapy by psychiatric residents. As practice habits begun in training will likely persist after graduation, examination of residents' antidepressant use may ultimately improve treatment by psychiatrists.

Methods: Charts of new patients presenting to the Wake Forest University Psychiatry Resident Clinic were reviewed. Survey was made of medications prescribed to 112 patients diagnosed with major depression, dysthymia, depressive disorder NOS, adjustment disorder with depressed mood, or bipolar disorder with a documented depression during the studied period. Drug choice …

The American Psychiatric Association’S Guideline For Major Depressive Disorder: A Commentary, Lisa Cosgrove, Allen F. Shaughnessy, Emily E. Wheeler, Kirsten E. Austad, Irving Kirsch, Harold J. Bursztajn

Counseling and School Psychology Faculty Publication Series

The American Psychiatric Association (APA) published a new guideline for Major Depressive Disorder (MDD) which will undoubtedly be used by many practitioners to guide clinical decision-making. In fact, it is non-psychiatrist clinicians who prescribe the majority of antidepressants (AD). We review the APA’s most recent guideline on MDD and report on our observations.

Dynamic Informed Consent Processes Vital For Treatment With Antidepressants, Abilash A. Gopal, Lisa Cosgrove, Itay Shuv-Ami, Emily E. Wheeler, Melissa J. Yerganian, Harold J. Bursztajn

Counseling and School Psychology Faculty Publication Series

Advances in technology and transparency have greatly accelerated the ability of clinicians to remain current with regards to being informed and informing patients about the risk/benefit ratio when considering antidepressant medication. In spite of this, the current climate of pharmaceutical industry influence on medical practice does much to hinder informed consent processes. Recent findings of previously unknown and potentially dangerous adverse effects of the second- and third-generation classes of antidepressants underscore the importance of enhancing the practice of informed consent. After considering the concept of informed consent as it has evolved over time, the authors summarize some of the newer …

The Controversy Over Antidepressant Drugs In An Era Of Evidence-Based Practice, Jill Littrell, Jeffrey Lacasse

SW Publications

Questions regarding the efficacy of antidepressant drugs have been a recent focus of attention in the national news both in print and in the television media. Many clients will have questions regarding what they can believe and how they can address mood problems. Social workers constitute a greater percentage of the mental health work force than any other profession. Thus, social workers will probably be asked by clients about these issues. This article presents information on the efficacy of antidepressants for both the short and long term. It covers adverse effects and withdrawal symptoms. Clients' self-determination should be honored. However, …

Are Anti Depressants Effective In The Treatment Of Depressed Patients Who Do Not Seek Psychotherapy?, Joseph D. Mcgluinness

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE The objective of this selective EBM review is to determine whether or not anti depressants are effective in the treatment of depressed patients who do not seek psychotherapy.

STUDY DESIGN: Review of all English language primary randomized controlled trials published from 2000-2009.

DATA SOURCES: Three randomized controlled trials were found using OVID, Medline, EbscoHost, Pubmed, and Cochrane databases.

OUTCOMES MEASURED: The three trials measured the change in the severity of depression symptoms using different outcomes: The Montgomery Asburg Depression Scale, Hamilton Depression Rating Scale, and Hopkins Symptom Checklist Depression Scale.

RESULTS: Hermens et al. found that the use of …

Do Antidepressants Improve The Quality Of Life And Decrease The Severity Of Symptoms In Patients With Irritable Bowel Syndrome?, Courtney E. Houde

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the use of antidepressants improves the quality of life and decreases the severity of symptoms in patients with IBS.

Study Design: Review of three English language, double-blind, randomized controlled trials published in 2009.

Data sources: Randomized controlled trials comparing the use of three different antidepressants to a controlled placebo were found on PubMed, OVID and the Cochrane database.

Outcome(s) Measured: Primary end point was overall bowel symptom score at the end of twelve weeks. Secondary end points include individual BSS for each irritable bowel syndrome subset, …