Psychiatry Commons^™

The 12th Annual Pharmacogenetics In Psychiatry Meeting Report, J. Zhang, K. J. Aitchison, A. K. Malhotra

Journal Articles

The 12th Annual Pharmacogenetics in Psychiatry meeting was held in Hollywood, Florida, from 31 May to 1 June 2013, in conjunction with the NCDEU meeting. It included a series of oral presentations as well as a poster session. This report summarizes the presentations at the conference. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Prospective Memory Performance In Non-Psychotic First-Degree Relatives Of Patients With Schizophrenia: A Controlled Study, F. C. Zhou, W. M. Hou, C. Y. Wang, G. S. Ungvari, H. F. K. Chiu, C. U. Correll, D. H. K. Shum, D. Man, D. T. Liu, Y. T. Xiang

Journal Articles

Objective: We aimed at investigating prospective memory and its socio-demographic and neurocognitive correlates in nonpsychotic, first-degree relatives (FDRs) of patients with schizophrenia compared to patients with first episode schizophrenia (FES), and healthy controls (HCs). Methods: Forty-seven FES patients, 50 non-psychotic FDRs (23 offspring and 27 siblings) of patients with chronic schizophrenia (unrelated to the FES group) and 51 HCs were studied. The Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT) was used to measure time-based prospective memory (TBPM) and event-based prospective memory (EBPM) performance. Other cognitive functions (involving respective memory and executive functions) were evaluated with standardized tests. Results: …

Substance Use In Clinical High Risk For Psychosis: A Review Of The Literature, J. Addington, N. Case, M. M. Saleem, A. M. Auther, B. A. Cornblatt, K. S. Cadenhead

Journal Articles

AimIn the literature, there is evidence suggesting an association between substance use and psychosis. However, little is known about substance use in those who may be in the pre-psychotic phase, that is, those who are putatively prodromal are considered to be at clinical high risk (CHR) of developing psychosis. MethodsWe conducted a review of publications measuring patterns and rates of substance use in CHR for psychosis individuals and the effects on the transition to psychosis. ResultsOf 5527 potentially relevant research papers, 10 met inclusion criteria of CHR subjects and specifically mentioned substance use in the sample. The results of these …

The Subjective Experience Of Youths At Clinically High Risk Of Psychosis: A Qualitative Study, S. Ben-David, M. L. Birnbaum, M. E. Eilenberg, J. E. Devylder, K. E. Gill, J. Schienle, N. Azimov, E. P. Lukens, L. Davidson, C. M. Corcoran

Journal Articles

Objective: Understanding the experience of individuals across stages of schizophrenia is important for development of services to promote recovery. As yet, little is known about the experience of individuals who exhibit prodromal symptoms of schizophrenia. Methods: Audiotaped interviews were conducted with 27 participants of diverse racial-ethnic backgrounds who were at clinically high risk of psychosis (15 males and 12 females; mean age 21). Phenomenological qualitative research techniques of coding, consensus, and comparison were used. Results: Emergent themes differed by gender. Themes for males were feeling abnormal or "broken," focus on going " crazy," fantasy and escapism, and alienation and despair, …

Effectiveness Of Lurasidone In Schizophrenia Or Schizoaffective Patients Switched From Other Antipsychotics: A 6-Month, Open-Label, Extension Study, L. Citrome, P. J. Weiden, J. P. Mcevoy, C. U. Correll, J. Cucchiaro, J. Hsu, A. Loebel

Journal Articles

Objective. To evaluate the long-term safety and tolerability of lurasidone in schizophrenia and schizoaffective disorder patients switched to lurasidone. Method. Patients in this multicenter, 6-month open-label, flexible-dose, extension study had completed a core 6-week randomized trial in which clinically stable, but symptomatic, outpatients with schizophrenia or schizoaffective disorder were switched to lurasidone. Patients started the extension study on treatment with the same dose of lurasidone taken at study endpoint of the 6-week core study; following this, lurasidone was flexibly dosed (40-120 mg/day), if clinically indicated, starting on Day 7 of the extension study. The primary safety endpoints were the proportion …

Neural Activation During Response Inhibition In Adult Attention-Deficit/Hyperactivity Disorder: Preliminary Findings On The Effects Of Medication And Symptom Severity, E. Congdon, L. L. Altshuler, J. A. Mumford, K. H. Karlsgodt, F. W. Sabb, J. Ventura, E. D. London, T. D. Cannon, R. M. Bilder, R. A. Poldrack, +1 Additional Author

Journal Articles

Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N=35) and healthy comparison subjects (N=62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated …

Effects Of Aripiprazole Once-Monthly On Domains Of Personal And Social Performance: Results From 2 Multicenter, Randomized, Double-Blind Studies, W. W. Fleischhacker, R. A. Baker, A. Eramo, R. Sanchez, L. F. Tsai, T. Peters-Strickland, P. P. Perry, R. D. Mcquade, B. R. Johnson, W. H. Carson, J. M. Kane

Journal Articles

Objective: To assess the effects of maintenance therapy with aripiprazole once-monthly 400 mg on personal and social functioning. Methods: Data were analyzed from 2 randomized, double-blind trials of patients with schizophrenia requiring chronic antipsychotic treatment. One study was a 52-week trial of aripiprazole once-monthly 400 mg versus placebo; the other was a 38-week trial of aripiprazole once-monthly 400 mg, oral aripiprazole (10-30 mg daily), and aripiprazole once-monthly 50 mg (subtherapeutic dose to test assay sensitivity). Functioning was assessed using the Personal and Social Performance (PSP) scale, comprising 4 domain subscales. Results: In the 52-week study, 403 patients stabilized on aripiprazole …

Predicting Risky Choices From Brain Activity Patterns, S. M. Helfinstein, T. Schonberg, E. Congdon, K. H. Karlsgodt, J. A. Mumford, F. W. Sabb, T. D. Cannon, E. D. London, R. M. Bilder, R. A. Poldrack

Journal Articles

Previous research has implicated a large network of brain regions in the processing of risk during decision making. However, it has not yet been determined if activity in these regions is predictive of choices on future risky decisions. Here, we examined functional MRI data from a large sample of healthy subjects performing a naturalistic risk-taking task and used a classification analysis approach to predict whether individuals would choose risky or safe options on upcoming trials. We were able to predict choice category successfully in 71.8% of cases. Searchlight analysis revealed a network of brain regions where activity patterns were reliably …

Latent Factor Modeling Of Four Schizotypy Dimensions With Theory Of Mind And Empathy, J. S. Bedwell, M. T. Compton, F. G. Jentsch, A. E. Deptula, S. M. Goulding, E. B. Tone

Journal Articles

Preliminary evidence suggests that theory of mind and empathy relate differentially to factors of schizotypy. The current study assessed 686 undergraduate students and used structural equation modeling to examine links between a four-factor model of schizotypy with performance on measures of theory of mind (Reading the Mind in the Eyes Test [MIE]) and empathy (Interpersonal Reactivity Index [IRI]). Schizotypy was assessed using three self-report measures which were simultaneously entered into the model. Results revealed that the Negative factor of schizotypy showed a negative relationship with the Empathy factor, which was primarily driven by the Empathic Concern subscale of the IRI …

The Sorl1 Gene And Convergent Neural Risk For Alzheimer's Disease Across The Human Lifespan, D. Felsky, P. Szeszko, L. Yu, W. G. Honer, P. L. De Jager, J. A. Schneider, A. K. Malhotra, T. Lencz, T. Ikuta, A. N. Voineskos, +7 Additional Authors

Journal Articles

Prior to intervention trials in individuals genetically at-risk for late-onset Alzheimer's disease, critical first steps are identifying where (neuroanatomic effects), when (timepoint in the lifespan) and how (gene expression and neuropathology) Alzheimer's risk genes impact the brain. We hypothesized that variants in the sortilin-like receptor (SORL1) gene would affect multiple Alzheimer's phenotypes before the clinical onset of symptoms. Four independent samples were analyzed to determine effects of SORL1 genetic risk variants across the lifespan at multiple phenotypic levels: (1) microstructural integrity of white matter using diffusion tensor imaging in two healthy control samples (n = 118, age 18-86; n = …

Altered Relationships Between Age And Functional Brain Activation In Adolescents At Clinical High Risk For Psychosis, K. H. Karlsgodt, T. G. M. Van Erp, C. E. Bearden, T. D. Cannon

Journal Articles

Schizophrenia is considered a neurodevelopmental disorder, but whether the adolescent period, proximal to onset, is associated with aberrant development in individuals at clinical high risk (CHR) for psychosis is incompletely understood. While abnormal gray and white matter development has been observed, alterations in functional neuroimaging (fMRI parameters during adolescence as related to conversion to psychosis have not yet been investigated. Twenty CHR individuals and 19 typically developing controls (TDC), (ages 14-21), were recruited from the Center for Assessment and Prevention of Proclromal States (CAPPS) at UCLA Participants performed a Sternberg-style verbal working memory (WMem) task during fMRI and data were …

Does A Glp-1 Receptor Agonist Change Glucose Tolerance In Patients Treated With Antipsychotic Medications? Design Of A Randomised, Double-Blinded, Placebo-Controlled Clinical Trial, J. R. Larsen, L. Vedtofte, J. J. Holst, P. Oturai, A. Kjaer, Christoph Correll, T. Vilsboll, A. Fink-Jensen

Journal Articles

Background Metabolic disturbances, obesity and life-shortening cardiovascular morbidity are major clinical problems among patients with antipsychotic treatment. Especially two of the most efficacious antipsychotics, clozapine and olanzapine, cause weight gain and metabolic disturbances. Additionally, patients with schizophrenia-spectrum disorders not infrequently consume alcohol. Glucagon-like peptide-1 (GLP-1) has shown to improve glycaemic control and reduce alcohol intake among patients with type 2 diabetes. Objectives To investigate whether the beneficial effects of GLP-1 analogues on glycaemic control and alcohol intake, in patients with type 2 diabetes, can be extended to a population of pre-diabetic psychiatric patients receiving antipsychotic treatment. Methods and analysis Trial …

Disrupted Working Memory Circuitry And Psychotic Symptoms In 22q11.2 Deletion Syndrome, C. A. Montojo, A. Ibrahim, K. H. Karlsgodt, C. Chow, A. E. Hilton, R. K. Jonas, T. K. Vesagas, C. E. Bearden

Journal Articles

22q11.2 deletion syndrome (22q11DS) is a recurrent genetic mutation that is highly penetrant for psychosis. Behavioral research suggests that 22q11DS patients exhibit a characteristic neurocognitive phenotype that includes differential impairment in spatial working memory (WM). Notably, spatial WM has also been proposed as an endophenotype for idiopathic psychotic disorder, yet little is known about the neurobiological substrates of WM in 22q11DS. In order to investigate the neural systems engaged during spatial WM in 22q11DS patients, we collected functional magnetic resonance imaging (fMRI) data while 41 participants (16 22q11DS patients, 25 demographically matched controls) performed a spatial capacity WM task that …

Quetiapine Versus Aripiprazole In Children And Adolescents With Psychosis - Protocol For The Randomised, Blinded Clinical Tolerability And Efficacy Of Antipsychotics (Tea) Trial, A. K. Pagsberg, P. Jeppesen, D. G. Klauber, K. G. Jensen, D. Ruda, M. Stentebjerg-Olesen, P. Jantzen, S. Rasmussen, Christoph Correll, B. Fagerlund, +19 Additional Authors

Journal Articles

Background: The evidence for choices between antipsychotics for children and adolescents with schizophrenia and other psychotic disorders is limited. The main objective of the Tolerability and Efficacy of Antipsychotics (TEA) trial is to compare the benefits and harms of quetiapine versus aripiprazole in children and adolescents with psychosis in order to inform rational, effective and safe treatment selections. Methods/Design: The TEA trial is a Danish investigator-initiated, independently funded, multi-centre, randomised, blinded clinical trial. Based on sample size estimation, 112 patients aged 12-17 years with psychosis, antipsychotic-naive or treated for a limited period are, 1:1 randomised to a 12-week, double-blind intervention …

Sentia: A Systematic Online Monitoring Registry For Children And Adolescents Treated With Antipsychotics, I. Palanca-Maresca, B. Ruiz-Antoran, G. Centeno-Soto, S. Jimenez-Fernandez, L. Garcia-Murillo, A. Siles, S. Villagra, H. Blasco-Fontecilla, L. Iruela-Cuadrado, Christoph Correll, +2 Additional Authors

Journal Articles

INTRODUCTION: Despite drastic increases in antipsychotic prescribing in youth, data are still limited regarding their safety in this vulnerable population, necessitating additional tools for capturing long-term, real world data. METHODS: We present SENTIA (SafEty of NeurolepTics in Infancy and Adolescence; https://SENTIA.es), an online registry created in 2010 to track antipsychotic adverse effects in Spanish youthsociodemographic, diagnostic and treatment characteristics, past personal medical/psychiatric history, healthy lifestyle habits and treatment adherence. Additionally, efficacy and adverse effect data are recorded including the Children's Global Assessment Scale; Clinical Global Impressions scale for Severity and Improvement, the Safety Monitoring Uniform Report Form, Simpson-Angus Scale, Abnormal …

Genetic Association Signal Near Ntn4 In Tourette Syndrome, P. Paschou, D. M. Yu, G. Gerber, P. Evans, F. Tsetsos, L. K. Davis, Cathy Budman, C. A. Mathews, J. M. Scharf, +29 Additional Authors

Journal Articles

Tourette syndrome (TS) is a neurodevelopmental disorder with a complex genetic etiology. Through an international collaboration, we genotyped 42 single nucleotide polymorphisms (p < 10(-3)) from the recent TS genomewide association study (GWAS) in 609 independent cases and 610 ancestry-matched controls. Only rs2060546 on chromosome 12q22 (p = 3.3 x 10 (-4)) remained significant after Bonferroni correction. Meta-analysis with the original GWAS yielded the strongest association to date (p = 5.8 x 10 (7)). Although its functional significance is unclear, rs2060546 lies closest to NTN4, an axon guidance molecule expressed in developing striatum. Risk score analysis significantly predicted case-control status (p - 0.042), suggesting that many of these variants are true TS risk alleles.

Early Specific Cognitive-Behavioural Psychotherapy In Subjects At High Risk For Bipolar Disorders: Study Protocol For A Randomised Controlled Trial, A. Pfennig, K. Leopold, A. Bechdolf, C. U. Correll, M. Holtmann, M. Lambert, C. Marx, T. D. Meyer, G. Juckel, M. Bauer, +5 Additional Authors

Journal Articles

Background: Bipolar disorders (BD) are among the most severe mental disorders with first clinical signs and symptoms frequently appearing in adolescence and early adulthood. The long latency in clinical diagnosis (and subsequent adequate treatment) adversely affects the course of disease, effectiveness of interventions and health-related quality of life, and increases the economic burden of BD. Despite uncertainties about risk constellations and symptomatology in the early stages of potentially developing BD, many adolescents and young adults seek help, and most of them suffer substantially from symptoms already leading to impairments in psychosocial functioning in school, training, at work and in their …

Head Impact Exposure In Male And Female Collegiate Ice Hockey Players, Bethany J. Wilcox, Jonathan G. Beckwith, Richard M. Greenwald, Jeffrey J. Chu, Thomas W. Mcallister, Laura A. Flashman, Arthur C. Maerlender, Ann-Christine Duhaime, Joseph J. Crisco

Department of Psychology: Faculty Publications

The purpose of this study was to quantify head impact exposure (frequency, location and magnitude of head impacts) for individual male and female collegiate ice hockey players and to investigate differences in exposure by sex, player position, session type, and team. Ninety-nine (41 male, 58 female) players were enrolled and 37,411 impacts were recorded over three seasons. Frequency of impacts varied significantly by sex (males: 287 per season, females: 170, p < 0.001) and helmet impact location (p < 0.001) but not by player position (p = 0.088). Head impact frequency also varied by session type; both male and female players sustained more impacts in games than in practices (p < 0.001), however the magnitude of impacts did not differ between session types. There was no difference in 95th percentile peak linear acceleration between sexes (males: 41.6 g, females: 40.8 g), but 95th percentile peak rotational acceleration and HITsp (a composite severity measure) were greater for males than females (4424, 3409 rad/s2, and 25.6, 22.3, respectively). Impacts to the back of the helmet resulted in the greatest 95th percentile peak linear accelerations for males (45.2 g) and females (50.4 g), while impacts to the side and back of the head were associated with the greatest 95th percentile peak rotational accelerations (males: 4719, 4256 rad/sec², females: 3567, 3784 rad/sec², respectively). It has been proposed that reducing an individual’s head impact exposure is a practical approach for reducing the risk of …

The Importance Of Early Identification And Treatment Of Childhood Onset Bipolar Disorder: Creating Specialty Care, Robert M. Post

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Profiles Of Binge Eating: The Interaction Of Depressive Symptoms, Eating Styles, And Body Mass Index, Tyler B. Mason, Robin J. Lewis

Psychology Faculty Publications

Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders. Copyright …

Three‐Dimensional Brain Mri For Dbs Patients Within Ultra‐Low Radiofrequency Power Limits, Subhendra N. Sarkar, Efstathios Papavassiliou, David Hackney, David Alsop, Ananth Madhuranthakam, Ludy Shih, Reed Busse, Susan Laruche, Rafeeque Bhadelia

Publications and Research

Background: For patients with deep brain stimulators (DBS), local absorbed radiofrequency (RF) power is unknown and is much higher than what the system estimates. We developed a comprehensive, highquality brain magnetic resonance imaging (MRI) protocol for DBS patients utilizing three-dimensional (3D) magnetic resonance sequences at very low RF power. Methods: Six patients with DBS were imaged (10 sessions) using a transmit/receive head coil at 1.5 Tesla with modified 3D sequences within ultra-low specific absorption rate (SAR) limits (0.1 W/kg) using T2, fast fluid-attenuated inversion recovery (FLAIR) and T1- weighted image contrast. Tissue signal and tissue contrast from the low-SAR images …

Sociocultural Influences On Diabetes Self-Management Behaviors In Older African Americans, Barry W. Rovner, Robin J. Casten, Lynn Fields Harris

Department of Psychiatry and Human Behavior Faculty Papers

Objective. The purpose of this observational study was to describe the associations between cultural beliefs that are prevalent in older African Americans and adherence to diabetes self-management (DSM) behaviors.

Methods. In a community population of 110 older African Americans with type 2 diabetes, the investigators administered surveys that assess present time orientation (PTO), future time orientation (FTO), and religiosity, as well as exercising habits, reading food labels, and checking blood glucose.

Results. Participants who reported regularly exercising had significantly lower PTO scores and higher FTO and religiosity scores than participants who did not regularly exercise. Similarly, participants who reported reading …

Prenatal Development: Annotated Bibliography, Victoria J. Molfese, Amanda Prokasky, Kathleen Moritz Rudasill, Ibrahim H. Acar, Xiaoqing Tu, Kate Sirota, Brian Keiser

Department of Child, Youth, and Family Studies: Faculty Publications

For decades, researchers have investigated how events in the prenatal period impact women and their infants. These studies, particularly by researchers in the medical, neuroscience, and behavioral science fields, led to discoveries of important information regarding the prenatal events that were strongly associated with mortality (or death) and morbidity (or incidences of injury, pathology and abnormalities/anomalies, and neurobehavioral sequelae) in the neonatal and infancy periods. Among the many common findings from early research studies, two are particularly noteworthy. First, maternal and fetal risk conditions arising in the prenatal period do not do so in isolation. Sameroff and Chandler characterized this …

Second Messenger/Signal Transduction Pathways In Major Mood Disorders: Moving From Membrane To Mechanism Of Action, Part Ii: Bipolar Disorder, Mark Niciu, Dawn F. Ionescu, Daniel C. Matthews, Erica M. Richards, Carlos A. Zarate

Psychiatry and Behavioral Sciences Faculty Publications

The etiopathogenesis and treatment of major mood disorders have historically focused on modulation of monoaminergic (serotonin, norepinephrine, dopamine) and amino acid [γ-aminobutyric acid (GABA), glutamate] receptors at the plasma membrane. Although the activation and inhibition of these receptors acutely alter local neurotransmitter levels, their neuropsychiatric effects are not immediately observed. This time lag implicates intracellular neuroplasticity as primary in the mechanism of action of antidepressants and mood stabilizers. The modulation of intracellular second messenger/signal transduction cascades affects neurotrophic pathways that are both necessary and sufficient for monoaminergic and amino acid–based treatments. In this review, we will discuss the evidence in …

An Organization-Wide Service Improvement Approach, Jennifer Jasmine Arfaa, Phd, Mhsa, Cynthia Line, Phd, Nora Kramer, Msn, Rn, Karen Montoro, Rn, Richard D. Blob,, Maria Francesco, Jaime Stazi, Rn, Elisabeth Kunkel, Md, Susan Krekun, Md, Lizanne Mason, Rn, Kathy Evans, Rn, Lorraine Weikel, Rn, Ann D. Clark, Ms, Otr/L, Ray Wisniewski, Teresa Heavens

Department of Nursing papers and presentations

APPROACH TO PROBLEM SOLVING

High priority index questions from HCAHPS and Press Ganey surveys, including overall ratings, communication with RNs and MDs, hospital environment and response to concerns and complaints, were targeted for improvement. These high priority indices served as the basis for redesigning Patient Services using a multi-faceted approach to improve patients’ experiences.

At Thomas Jefferson University Hospital (TJUH), high performance on the Patient Experiences of Care Survey has been driven by a successful multi-tiered approach to patient services:

·Hospital leadership guided and implemented new approaches to ensure excellence in patient services is an ever-present and obtainable goal

·Physician …

Vitamin B12 Supplementation In Trea Ting Major Depressive Disorder: A Randomized Controlled Trial, Ehsan Ullah Syed, Mohammad Wasay, Safia Awan

Department of Medicine

Recent literature has identified links between vitamin B12 deficiency and depression. We compared the clinical response of SSRI-monotherapy with that of B12-augmentation in a sample of depressed patients with low normal B12 levels who responded inadequately to the first trial with the SSRIs. Methods: Patients with depression and low normal B12 levels were randomized to a control arm (antidepressant only) or treatment arm (antidepressants and injectable vitamin B12 supplementation). Results: A total of 199 depressed patients were screened. Out of 73 patients with low normal B12 levels 34 (47%) were randomized to the treatment group while 39 (53%) …

Interests In High-Functioning Autism Are More Intense, Interfering, And Idiosyncratic Than Those In Neurotypical Development, Laura G. Anthony, Lauren Kenworthy, Benjamin E. Yerys, Kathryn F. Jankowski, Joette James, Madeline B. Harms, Alex Martin, Gregory L. Wallace

Psychiatry and Behavioral Sciences Faculty Publications

Although circumscribed interests are pathognomonic with autism, much about these interests remains unknown. Using the Interests Scale (IS), this study compares interests between 76 neurotypical (NT) individuals and 109 individuals with high-functioning autism spectrum disorder (HF-ASD) matched groupwise on age, IQ, and gender ratio. Participants and their parents/caregivers completed diagnostic measures (the Autism Diagnostic Interview—Revised and the Autism Diagnostic Observation Schedule; HF-ASD only), cognitive tests (Wechsler IQ Scales), and questionnaires (the Repetitive Behavior Scale—Revised, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale), in addition to the IS. Consistent with previous research, HF-ASD and NT individuals did …

Interventions For Common Perinatal Mental Disorders In Women In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Atif Rahman, Jane Fisher, Peter Bower, Stanley Luchters, Thach Tran, M. Taghi Yasamy, Shekhar Saxena, Waquas Waheed

Population Health, East Africa

Objective: To assess the effectiveness of interventions to improve the mental health of women in the perinatal period and to evaluate any effect on the health, growth and development of their offspring, in low- and middle-income (LAMI) countries.

Methods: Seven electronic bibliographic databases were systematically searched for papers published up to May 2012 describing controlled trials of interventions designed to improve mental health outcomes in women who were pregnant or had recently given birth. The main outcomes of interest were rates of common perinatal mental disorders (CPMDs), primarily postpartum depression or anxiety; measures of the quality of the mother-infant relationship; …

Improving Function In Age-Related Macular Degeneration: A Randomized Clinical Trial., Barry W. Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E. Leiby, Allen C. Ho, William S. Tasman

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To compare the efficacy of problem-solving therapy (PST) with supportive therapy (ST) to improve targeted vision function (TVF) in age-related macular degeneration (AMD).

DESIGN: Single-masked, attention-controlled, randomized clinical trial with outcome assessments at 3 months (main trial endpoint) and 6 months (maintenance effects).

PARTICIPANTS: Patients with AMD (n = 241) attending retina practices.

INTERVENTIONS: Whereas PST uses a structured problem-solving approach to reduce vision-related task difficulty, ST is a standardized attention-control treatment.

MAIN OUTCOME MEASURES: We assessed TVF, the 25-item National Eye Institute Vision Function Questionnaire plus Supplement (NEI VFQ), the Activities Inventory (AI), and vision-related quality of life …

Trauma And Posttraumatic Stress Disorder In South Africa: Analysis From The South African Stress And Health Study, Lukoye Atwoli, Dan J. Stein, David R. Williams, Katie A. Mclaughlin, Maria Petukhova, Ronald C. Kessler, Karestan C. Koenen

Internal Medicine, East Africa

Background: South Africa’s unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.

Methods: The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO’s Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental …