Psychiatry Commons^™

Fuzzy Logic: A “Simple” Solution For Complexities In Neurosciences?, Saniya Siraj Godil, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai

Medical College Documents

Background: Fuzzy logic is a multi-valued logic which is similar to human thinking and interpretation. It has the potential of combining human heuristics into computer-assisted decision making, which is applicable to individual patients as it takes into account all the factors and complexities of individuals. Fuzzy logic has been applied in all disciplines of medicine in some form and recently its applicability in neurosciences has also gained momentum.
Methods: This review focuses on the use of this concept in various branches of neurosciences including basic neuroscience, neurology, neurosurgery, psychiatry and psychology.
Results: The applicability of fuzzy logic is not limited …

Universal Or Indicated Screening In Primary Care?, Matthew Wintersteen, Md

Department of Psychiatry and Human Behavior Faculty Papers

To the Editor: In the November 2010 issue, Schmitt and colleagues (1) reported that the duration of visits increased when depression screening was conducted in primary care. This report is timely given recent recommendations for both adult and pediatric screening for depression in primary care. Schmitt and colleagues examined data representative of more than 641 million primary care visits in2005–2007 and found that when depression screening was documented in patients’ records, physicians’ time with patients increased significantly.

Safety And Efficacy Of Abt-089 In Pediatric Attention-Deficit/Hyperactivity Disorder: Results From Two Randomized Placebo-Controlled Clinical Trials., Timothy E. Wilens, Laura M. Gault, Ann Childress, Christopher J. Kratochvil, Lindsey Bensman, Coleen M. Hall, Evelyn Olson, Weining Z. Robieson, Tushar S. Garimella, Walid M. Abi-Saab, George Apostol, Mario D. Saltarelli

Journal Articles: Psychiatry

OBJECTIVE: To assess the safety and efficacy of ABT-089, a novel α(4)β(2) neuronal nicotinic receptor partial agonist, vs. placebo in children with attention-deficit/hyperactivity disorder (ADHD).

METHOD: Two multicenter, randomized, double-blind, placebo-controlled, parallel-group studies of children 6 through 12 years of age were conducted. Study 1 (n = 274) assessed six treatment groups over 8 weeks: 4 once-daily (QD) ABT-089 doses (0.085-0.700 mg/kg), QD atomoxetine, and placebo. Study 2 (n = 119) assessed three treatment groups over 6 weeks: 2 QD ABT-089 doses (0.7 mg/kg, 1.4 mg/kg) and placebo. The primary efficacy variable was the investigator-administered Attention-Deficit/Hyperactivity Disorder Rating Scale-IV: Home …

Suicide Bombing: A Geopolitical Perspective, Haider Naqvi, Syed Faraz Kazim, Shafqat Huma

Department of Psychiatry

Suicide bombing is a very complex phenomenon. It has been a focus of research in recent times. However inherent biases of researchers muddle the picture: researchers from western countries focus the issue around political liberty and notion of democracy, while those from Islamic countries tend to take the afterlife-reward notion as an incentive for suicide bombing. However in order to understand this complex phenomenon it is important to consider the contextual factors. In this review we have attempted to highlight various geopolitical factors which contribute to increased incidence of suicide bombing in South East Asia.

Event-Related Potential Studies Of Post-Traumatic Stress Disorder: A Critical Review And Synthesis, Arash Javanbakht, Israel Liberzon, Alireza Amirsadri, Klevest Gjini, Nash N. Boutros

Wayne State University Associated BioMed Central Scholarship

Abstract

Despite the sparseness of the currently available data, there is accumulating evidence of information processing impairment in post-traumatic stress disorder (PTSD). Studies of event-related potentials (ERPs) are the main tool in real time examination of information processing. In this paper, we sought to critically review the ERP evidence of information processing abnormalities in patients with PTSD. We also examined the evidence supporting the existence of a relationship between ERP abnormalities and symptom profiles or severity in PTSD patients. An extensive Medline search was performed. Keywords included PTSD or post-traumatic stress disorder, electrophysiology or EEG, electrophysiology, P50, P100, N100, P2, …

A Double-Blind, Randomized, Placebo Controlled Trial Of Ramelteon For The Treatment Of Insomnia And Mood Stability In Patients With Euthymic Bipolar Disorder (Poster), Edward R. Norris Md, Fapa, Fapm, Karen Burke Rn, Julia R. Correll Ba, Ken Zemanek Md, Joel Lerman Md, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

The Impact Of Assessment On Repeat Deliberate Self-Harm, Kellie Jones

Theses: Doctorates and Masters

Deliberate self-harm is a pervasive issue that is the topic of worldwide clinical and research focus. Among the extensive research findings two salient issues emerge that provide the foundation for this study. The first is that a deliberate self-harm attempt is a significant risk factor for future attempts. The second is that a comprehensive assessment of a person presenting with an incident of deliberate self-harm can reduce further deliberate self-harming behaviour. A limitation of existing research is that no study has clearly identified the nature of assessments that impact on the likelihood of future self-harm attempts. The initial aim of …

Psychiatric Comorbidity In Transformed Migraine: Presentation, Treatment, Impact And Outcome, Muhammad A. Abbas M.D, Haseeba Ismaiel, M.D, William B. Young M.D., Mary Hopkins, Stephen D. Silberstein, M.D

Jefferson Journal of Psychiatry

Transformed migraine is one of the subtypes of chronic daily headache (CDH), and is similar to chronic migraine, described in the new International Headache Society (IHS) classification 2004. The term CDH refers to the Headache disorders experienced 15 or more days a month and includes headaches associated with medication overuse. CDH can be divided into primary and secondary varieties. Primary CDH is not related to a structural or systemic illness. It includes diseases such as Transformed migraine (TM). Chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). Secondary CDH has an identifiable underlying cause, including post-traumatic …

Resident Teaching Expectations And Medical Student Feedback, Michael Ignatowski

Jefferson Journal of Psychiatry

Objective Much of resident teaching of medical students occurs in an informal manner, with bedside teaching a common focus. Hence, the ability to monitor such teaching is limited. Feedback about how students perceive the teaching is perhaps one way to more effectively monitor and influence resident teaching.

Ten Year Follow Up Of A Psychiatry Residency Program Merger, Alvi A. Azad, Julianne Flynn, Thomas Matthews, Kenneth Matthews, Joseph Chozinski

Jefferson Journal of Psychiatry

Objective: To report on the successful merger of a civilian and military psychiatry residency. Methods: The reasons for and the history of the merger between the University of Texas Health Science Center at San Antonio and Wilford Hall Air Force Medical Center psychiatry residencies is described. Results: After some false starts, a bottom-up approach was implemented by first merging seminars, then rotations. Conclusions: Combining two psychiatry residencies in order to capitalize on both their strengths can yield a product even greater than the sum of their two programs and the key to a lasting merger is to start with two …

Growing Organizational Capacity To Facilitate The Streamlining Of Patients With Psychiatric Disorders In A Community Academic Health Network; An Eight Year Review, Edward R. Norris Md, Fapa, Fapm, Michael W. Kaufmann Md, David B. Burmeister Do, Muhamad Aly Rifai Md, Laurence P. Karper Md, Ralph A. Primelo Md

Department of Psychiatry

No abstract provided.

Patients’ Knowledge And Attitudes Toward Psychiatric Medication On Admission To An Inpatient Behavioral Health Unit, Krina H. Patel Pharmad, Edward R. Norris Md, Fapa, Fapm, Julia R. Correll Ba, Laurence P. Karper Md, Mary Ellen O'Connell Rn, Msn, Mba, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

An Evaluation Of An Educational Program On Stigma In Mental Illness Presented By A Mental Health Consumer And Advocate, Edward R. Norris Md, Fapa, Fapm, Karen Burke Rn, Bsn, Brooke Katz Rn, Bsn, Bruce Curry Lcsw, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

Prevalence Of Mistreatment Or Belittlement Among Medical Students--A Cross Sectional Survey At A Private Medical School In Karachi, Pakistan., Sana Shoukat, Mariam Anis, Danesh K Kella, Fahad Qazi, Fatima Samad, Faizia Mir, Maryah Mansoor, Mohammad B Parvez, Bushra Osmani, Sukaina A Panju, Haider Naqvi

Department of Psychiatry

Background: Mistreatment or belittlement of medical students either by faculty or fellow students has often been reported. Perception of mistreatment has also been associated with increased degree of psychological morbidity. There is a lack of such studies being conducted amongst the medical students of Pakistan. The aim of this study was to determine the prevalence and forms of perceived mistreatment and presence of mental health morbidity in a private medical school in Pakistan. Also, any association between mental health morbidity and mistreatment was to be identified. Methods: A cross sectional study was carried out on medical students from Aga Khan …

Students’ Research: Tradition Ahead Of Its Time, Haider A Naqvi

Department of Psychiatry

This view point describes the experience of introducing research at an undergraduate level during clinical rotation in psychiatry. Objective of this initiative was to encourage critical thinking, self directed learning and sensitization to mental health issues. This contributed to student learning besides galvanizing their interest in the subject. The opinion piece aims to expose various issues to students’ research in the context of medical education in Pakistan.

Gender Difference In Age At Onset Of Schizophrenia: A Cross Sectional Study From Pakistan, Imama Naqvi, Muhammad Murtaza, Muhammad Ressam Nazir, Haider Ali Naqvi

Department of Psychiatry

OBJECTIVE: To validate the effect of gender on age at onset of schizophrenia in a developing country

METHODS: Medical records of 252 patients diagnosed with schizophrenia according to DSM-IV criteria at a tertiary care hospital in Karachi, Pakistan between 2002 and 2008 were reviewed using a structured questionnaire. Age at onset was defined as age at onset of psychotic symptoms, age at first contact with a health care provider and age at first hospitalization. Socio-demographic variables were reported using descriptive statistics and all measures of age at onset were compared across gender using t-test.

RESULTS: There were 119 women and …

18F-Fallypride Binding Potential In Patients With Schizophrenia Compared To Healthy Controls, Douglas S. Lehrer, Bradley T. Christian, Cemil Kirbas, Meicheng Chiang, Shawn Sidhu, Holly Short, Binquan Wang, Bingzhi Shi, King Wai Chu, Brian Merrill, Monte S. Buchsbaum

Psychiatry Faculty Publications

Background: Molecular imaging of dopaminergic parameters has contributed to the dopamine hypothesis of schizophrenia, expanding our understanding of pathophysiology, clinical phenomenology and treatment. Our aim in this study was to compare 18F-fallypride binding potential BPND in a group of patients with schizophrenia-spectrum illness vs. controls, with a particular focus on the cortex and thalamus. Methods: We acquired 18F-fallypride positron emission tomography images on 33 patients with schizophrenia spectrum disorder (28 with schizophrenia; 5 with schizoaffective disorder) and 18 normal controls. Twenty-four patients were absolutely neuroleptic naïve and nine were previously medicated, although only four had a lifetime neuroleptic exposure of …

The Development Of Attribute Dominance In The Knowledge Base, Marc A. Lindberg Ph.D.

Psychology Faculty Research

Two cuing, free-recall studies were conducted to test Bach and Underwood's (1970) hypothesis that acoustic encoding is dominant among second graders and semantic encoding is dominant among sixth graders. When retrieval cues were presented with to-be-remembered items at both input and output (Experiment 1), and when cues were presented only at output (Experiment 2), semantic cues were more efficient in elevating recall than were acoustic cues for both second and sixth graders. When these and other results generally found using recognition, sorting, incidental learning, and free-recall experimental designs are compared, it seems plausible that item presentation and memory-testing formats interact …

The Role Of Gender In Single Vs Married Individuals With Bipolar Disorder., Daniel Z Lieberman, Suena H Massey, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Despite the importance of marriage as a source of social support, it has been largely neglected in studies of bipolar disorder; and differential effects on men and women have not been explored.

METHODS: Data on episodes of depression, mania, and mixed states were collected for the previous 2 years from a sample of 282 bipolar individuals using the National Institute of Mental Health Life Chart Methodology.

RESULTS: Effects unique to women included the following: Bipolar women were significantly more likely to be married. Married women had fewer episodes of depression during the past 2 years than never-married women, and …

A Randomized Comparison Of Online And Paper Mood Charts For People With Bipolar Disorder., Daniel Z Lieberman, Tammas F Kelly, Lanny Douglas, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Longitudinal mood instability is the essential feature of bipolar disorder, however most rating scales are cross sectional in nature, and focus on acute symptoms. By contrast, the NIMH Life Chart Methodology (LCM) characterizes in detail the severity, duration, and frequency of mood episodes. Adherence to daily rating, however, tends to be low. In this study an online version of the LCM, designed to enhance adherence, was compared to the standard paper version.

METHODS: Patients from a mood disorders specialty clinic were randomized to the standard LCM or an online, open-source adaptation. The online version used hypertext links embedded in …

Desvenlafaxine In Major Depressive Disorder: An Evidence-Based Review Of Its Place In Therapy., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

INTRODUCTION: Desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI) recently approved for the treatment of major depressive disorder. It is one of only three medications in this class available in the United States.

AIMS: The objective of this article is to review the published evidence for the safety and efficacy of desvenlafaxine, and to compare it to other antidepressants to delineate its role in the treatment of depression.

EVIDENCE REVIEW: At the recommended dose of 50 mg per day the rate of response and remission was similar to other SNRIs, as was the adverse effect …

Terrorism And Health: The Responsibility Of Intellectuals, Haider A. Naqvi, Syed Faraz Kazim, Shafqat Huma

Department of Psychiatry

No abstract provided.

Emerging Issues In Adolescent Healthcare : An Urgent Call For Action, Waris Qidwai Dr, Tabinda Ashfaq Ashfaq

Department of Family Medicine

No abstract provided.

International Migration Of Doctors, And Its Impact On Availability Of Psychiatrists In Low And Middle Income Countries, Rachel Jenkins, Robert Kydd, Paul Mullen, Kenneth Thomson, James Sculley, Susan Kuper, Joanna Carroll, Oye Gureje, Simon Hatcher, Sharon Brownie, Christopher Carroll, Sheila Hollins, Mai Luen Wong

School of Nursing & Midwifery, East Africa

Background: Migration of health professionals from low and middle income countries to rich countries is a large scale and long-standing phenomenon, which is detrimental to the health systems in the donor countries. We sought to explore the extent of psychiatric migration.

Methods: In our study, we use the respective professional databases in each country to establish the numbers of psychiatrists currently registered in the UK, US, New Zealand, and Australia who originate from other countries. We also estimate the impact of this migration on the psychiatrist population ratios in the donor countries.

Findings: We document large numbers of psychiatrists currently …

Attachment-Based Family Therapy For Adolescents With Suicidal Ideation: A Randomized Controlled Trial., Guy S. Diamond, Matthew B. Wintersteen, Gregory K. Brown, Gary M. Diamond, Robert Gallop, Karni Shelef, Suzanne Levy

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: To evaluate whether Attachment-Based Family Therapy (ABFT) is more effective than Enhanced Usual Care (EUC) for reducing suicidal ideation and depressive symptoms in adolescents. METHOD: This was a randomized controlled trial of suicidal adolescents between the ages of 12 and 17, identified in primary care and emergency departments. Of 341 adolescents screened, 66 (70% African American) entered the study for 3 months of treatment. Assessment occurred at baseline, 6 weeks, 12 weeks, and 24 weeks. ABFT consisted of individual and family meetings, and EUC consisted of a facilitated referral to other providers. All participants received weekly monitoring and access …

Improving Schizophrenia Diagnosis Through Biomarkers: An Upcoming Prospect, Syed Mohammad Asad Zaidi, Abdul Latif Bikak, Rameez-Ul Hassan

Medical College Documents

No abstract provided.

Dysfunctional Attitudes Scale Perfectionism: A Predictor And Partial Mediator Of Acute Treatment Outcome Among Clinically Depressed Adolescents., Rachel H. Jacobs, Susan G. Silva, Mark A. Reinecke, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, John S. March

Journal Articles: Psychiatry

The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. …

An Exploratory Analysis Of The Impact Of Family Functioning On Treatment For Depression In Adolescents., Norah C. Feeny, Susan G. Silva, Mark A. Reinecke, Steven Mcnulty, Robert L. Findling, Paul Rohde, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, Sanjeev M. Pathak, Diane E. May, Betsy D. Kennard, Anne D. Simons, Karen C. Wells, Michele Robins, David Rosenberg, John S. March

Journal Articles: Psychiatry

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts. When family functioning moderated outcome, adolescents who endorsed more negative environments were more likely to benefit from fluoxetine. Similarly, when moderating effects were seen on cognitive behavioral …

Pathways To Care: Duration Of Untreated Psychosis From Karachi, Pakistan., Haider A. Naqvi, Sajjad Hussain, Muhammad Zaman, Mohammad Islam

Department of Psychiatry

Background: Substantial amount of time is lost before initiation of treatment in Schizophrenia. The delay in treatment is labelled as Duration of Untreated Psychosis (DUP). Most of these estimates come from western countries, where health systems are relatively better developed. There is dearth of information on pathway to care from developing countries. Methods And Results: Patients with ICD-10 based diagnosis of Schizophrenia were enrolled by convenient method of sampling. The pathway to care was explored through a semi-structured questionnaire. Onset, course and symptoms of psychosis were assessed using Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS). Ethical …

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …