Mental and Social Health Commons^™

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 …

Evaluation Of The Stability And Validity Of Participant Samples Recruited Over The Internet., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Research conducted via the Internet has the potential to reach important clinical populations of participants who would not participate in traditional studies. Concerns exist, however, about the validity of samples recruited in this manner, especially when participants are anonymous and never have contact with study staff. This study evaluated two anonymous samples that were recruited over the Internet to test an online program designed to help problem drinkers. The two studies were conducted 3 years apart, and different recruitment strategies were utilized. Despite these differences, the two samples were highly similar in demographic and clinical features. Correlations that have been …

Knowledge And Practices Regarding Cigarette Smoking Among Adult Women In A Rural District Of Sindh, Pakistan, Sajid Ali, Naseem Ara, Arif Ali, Beena Ali, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE: To determine the prevalence of cigarette smoking and to obtain information on socio-demographic factors and attitude regarding cigarette smoking among adult women in a rural district of Sindh Province, Pakistan.

METHODS: A cross sectional community based survey was done in a rural district of Sindh province of Pakistan using a two stage cluster sampling design. A pre tested questionnaire was used to interview 502 adult women (aged 18- 60 years) from the study site. The study was approved by the ethical research committee and informed consent was taken from participants.

RESULTS: A total of 502 women were interviewed for …

Pathways To Change: The Effect Of A Web Application On Treatment Interest., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

Most individuals with drinking problems do not receive treatment, generally because they do not perceive the need for it. It is difficult to access this population of problem drinkers in order to encourage treatment-seeking. A Web-based program was written, designed to increase motivation for change. The program guided non-treatment-seekers through a multi-stage assessment and provided them with feedback. The level of interest in treatment was measured pre-and post-intervention. Compared to baseline, after the intervention, significantly more individuals rated themselves "very interested" in participating in some form of traditional treatment (19% vs. 28%), and their focus on a specific modality increased.

A Technological Approach To Reaching A Hidden Population Of Problem Drinkers., Daniel Z Lieberman, Suena W Huang

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: The most common obstacle to the treatment of individuals with drinking problems is that most do not seek treatment. This study compared a group of treatment-seeking patients with users of an alcohol-evaluation Web site to determine whether an Internet application could reach a population of problem drinkers who are distinct from those served by currently available forms of care.

METHODS: An open-source application was developed that was modeled on the Drinker's Check-Up, which has been shown to increase motivation for behavior change while presenting itself as a nonthreatening evaluation. To recruit non-treatment seekers, the program was offered as a …

Socio-Demographic Correlates Of Exhaled Breath Carbon Monoxide In Karachi's Adult Population, Majid Shafiq, Sumera Khan, M. Rizwanulhaq Khawaja, Suleman Haque, Javaid Khan

Section of Pulmonary & Critical Care

OBJECTIVE: To examine the relationship between CO levels and putative factors including smoking status among residents of Karachi, an urban center with very high levels of air pollution.

METHODS: Two hundred and eighteen volunteering subjects were asked to maximally exhale into a Smokerlyzer breath CO analyzer. Each of the volunteers was also asked to reply to a questionnaire-based interview seeking demographic information as well as details of exposure to tobacco, traffic fumes and other air pollutants.

RESULTS: Out of the 218 participating subjects, 75% were males and 27% were current or ex-smokers. The mean CO level was 2.92 parts per …

Effects Of A Personified Guide On Adherence To An Online Program For Alcohol Abusers., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

The quality of the therapeutic alliance has robust effects on the outcome of psychotherapy and psychopharmacologic interventions. Automated behavioral health programs that are being developed to increase access to mental health treatment are administered in the absence of direct human participation, thereby precluding the development of a traditional therapeutic relationship. The aim of this study was to develop a personified guide designed to stimulate reactions similar to those experienced in a therapeutic relationship, and evaluate the effect of the guide on adherence to and satisfaction with an online alcohol use evaluation program. After completing a battery of four standard questionnaires …

A Model Program For Youth Suicide Prevention, Hatim A. Omar

Pediatrics Faculty Publications

Youth suicide continues to be one of the leading causes of death in the United States. Nation wide it is the third leading cause of death in the 10-24 year old age group. The rate of suicide varies somewhat from state to state. In the state of Kentucky, youth suicide is the second leading cause of death. This article describes a grass root, community-based program for youth suicide prevention and its impact on the community. The Stop Youth Suicide Campaign was launched in October 2000 and included more than 30 local agencies. This program worked. through public education, education of …

Clinical Characteristics Of Individuals Using An Online Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions. Automated or semi-automated treatments have shown promise in other disorders. Identifying the characteristics of patients who will be able to benefit from this unconventional approach will increase the likelihood of success. The current study examined 1,297 individuals using an online alcohol evaluation program. Subjects had high scores on the Alcohol Use Disorders Identification Test (AUDIT) and a substantial amount of ambivalence about the possible harm that their drinking caused, but they also had very low levels of …

Determinants Of Satisfaction With An Automated Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

High rates of untreated mental illness cause serious health problems in the United States and worldwide. The use of computer-administered therapy has the potential to increase access to mental health care for certain patient populations. An online version of an alcohol check-up was developed that guided subjects through a series of standardized questionnaires, and provided them with feedback designed to enhance their appreciation of the negative aspects of their alcohol use. Ratings of the helpfulness of the questionnaires were evaluated in order to determine the characteristics of individuals who would potentially benefit from an automated substance abuse intervention, and to …

Retrospective Analysis Of Youth Evaluated For Suicide Attempt Or Suicidal Ideation In An Emergency Room Setting, Julie Hagedorn, Hatim A. Omar

Pediatrics Faculty Publications

Suicide is the third leading cause of death in adolescents and a major contributor to morbidity in this age group. The objective of this study was to look at the demographics, major stressors and factors leading to attempting suicide as well as the methods of attempted suicide in adolescents admitted to two hospitals in a medium size city. Medical records were reviewed of adolescents admitted to two area hospitals for attempted suicide between 7/1/97-12/31/99. Coroner's data on completed suicide were also reviewed. In the study period a total of 287 persons aged 21 years or under were admitted for attempted …

Internet Facilitation Of Opioid Dependence., D Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Measuring Hospital Use Without Claims: A Comparison Of Patient And Provider Reports., R E. Clark, S K. Ricketts, G J. Mchugo

Dartmouth Scholarship

We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data were collected from people enrolled in a randomized trial of treatment for severe mental illness and substance use disorders, from community mental health centers (CMHCs), and from hospitals. Reports for each of the 74 study participants covered two-year time periods beginning and ending at various times between 1989 and 1993. We compared reports from the various sources and constructed a hybrid with data from all three sources. Using parametric and non-parametric statistics, we compared …