Editor-in-Chief: John A. Talbott, MD
ISSN: 0022-3018
Online ISSN: 1539-736X
Frequency: 12 issues / year
Ranking: Psychiatry 51/120
Impact Factor: 1.688
Article Summaries
September 2015

1. DETERMINANTS OF TREATMENT-RESISTANT DEPRESSION: THE SALIENCE OF BENZODIAZEPINES
Gordon B. Parker, MD, PhD, FRANZCP, Rebecca K. Graham, BA (Psych hons), PhD

This study was designed to identify factors contributing to treatment-resistant depression (TRD) in patients diagnosed with a major depressive disorder. Patients were grouped into ‘low’, ‘medium’ and ‘high’ treatment resistant (TR) groups based on their prescribed number of medications. The high TR group was older, had a longer depressive episode duration, higher number of comorbid medical and anxiety disorders, lower education and were less likely to be in full time employment. They also reported less trait irritability and were more likely to view medication as being a contributor. Differences between non-melancholic and melancholic subsets were evident and point to analyzing the two diagnostic groups separately. The most striking finding was benzodiazepine use, which was significantly more common in the high TR group, and within both the melancholic and non-melancholic sub-sets.

2. ASTHMA, DEPRESSION AND SUICIDALITY: RESULTS FROM THE 2007, 2009, AND 2011 YOUTH RISK BEHAVIOR SURVEY
Leah Steinberg, MD, Ivanjo Aldea, MD, Erick Messias, MD, MPH, PhD

We assessed the association between asthma and suicidality in a nationally representative sample of U.S. high school students. Data came from the 2007, 2009 and 2011 Youth Risk Behavioral Surveys. Subjects with asthma are more likely to report 2-week sadness (35.2%) compared to those without asthma (26.7%). Teens with asthma are more likely to report suicide ideation (20.1% vs. 15%), planning (15.7% vs. 12.1%), attempt (10.1% vs. 6.9%) and treatment for attempt (3.5% vs. 2%). While the unadjusted association between lifetime asthma and suicide attempts is statistically significant (crude odds ratio 1.5 (95% C.I. 1.3-1.8)), after controlling for confounders that association is no longer statistically significant (AOR 1.2 (1-1.6)). Thus, this increase in suicidality seems to be due to the increased prevalence of sadness among teens with asthma.

3. MENTAL HEALTH AND EXPOSURE TO THE UNITED STATES:  KEY CORRELATES FROM THE HISPANIC COMMUNITY HEALTH STUDY OF LATINOS
Krista M. Perreira, PhD, Nathan Gotman, MS, Carmen R. Isasi, MD, PhD, William Arguelles, PhD, Sheila F. Castañeda, PhD, Martha L. Daviglus, MD, PhD, Aida L. Giachello, PhD, Patricia Gonzalez, PhD, Frank J. Penedo, PhD, Hugo Salgado, PhD, Sylvia Wassertheil-Smoller, PhD

Using data from the Hispanic Community Health Study of Latinos (HCHS/SOL), we estimated logistic regressions to model the risk of moderate to severe symptoms of psychological distress, depression, and anxiety as a function of years in the U.S. and 6 key psychosocial risk and protective factors. In unadjusted models, increased time in the U.S. was associated with higher risk of poor mental health.  After adjustment for just 3 key factors – perceived discrimination, perceived U.S. social standing, and the size of close social networks, differences in the odds of poor mental health by years in the U.S became insignificant for Hispanics/Latinos overall. 

4. PROSPECTIVE STUDY OF POSTTRAUMATIC STRESS IN ADOLESCENTS 6 AND 24 MONTHS AFTER THE 2010 YUSHU EARTHQUAKE IN CHINA
Yuchang Jin, PhD, and Junyi Li

The goals of the present study are to describe longitudinally the prevalence and the severity of posttraumatic stress disorder (PTSD) in adolescent survivors of the Yushu earthquake in China and to explore the risk factors which lead to psychiatric disorders. The rates of PTSD were found to be 10.9% after 6 months and 5.8% after 24 months. Bereavement, being buried in the ruins and personal injury were found to be significant risk factors for the development of PTSD. We suggest that intervention strategies should be addressed and more attention should be paid to adolescents.

5. RELATIONSHIPS OF CHILDHOOD ADVERSE EXPERIENCES WITH MENTAL HEALTH AND QUALITY OF LIFE AT TREATMENT START FOR ADULT REFUGEES TRAUMATIZED BY PRE-FLIGHT EXPERIENCES OF WAR AND HUMAN RIGHTS VIOLATIONS
Marianne Opaas, PhD-candidate, Sverre Varvin, DrPhilos, MD

Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRV), and related to mental health and quality of life. Childhood PTEs were more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs was significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence were significantly related to increased mental health symptoms and reduced quality of life.

6. HOW TO RESPOND TO A PARANOID THOUGHT? A COMPARISON OF PATIENTS WITH CLINICALLY RELEVANT DELUSIONS AND HEALTHY CONTROLS IN CHILE
Caroline Wüstena, MSc, and Tania M. Lincoln, PhD

The main purpose was to explore whether participants without a mental disorder will respond in a more functional way to paranoid thoughts and be more flexible in their cognitive processes than patients with clinically relevant delusion. The Responses to Paranoid Thoughts Scale was translated into Spanish and assessed the responses in patients (n=36) and healthy controls (n=39) in Chile. The patients responded in a more depressive, physical and concealing way to paranoid thoughts than the healthy controls and showed significantly less cognitive insight and self-reflectiveness. Higher cognitive insight and self-reflectiveness were associated with more normalizing and communicative responses to paranoid thoughts.

7. LEXICAL CHARACTERISTICS OF EMOTIONAL NARRATIVES IN SCHIZOPHRENIA: RELATIONSHIPS WITH SYMPTOMS, FUNCTIONING, AND SOCIAL COGNITION
Benjamin Buck, MA, and David L. Penn, PhD

The current study examined lexical differences to better characterize the cognitive substrates of speech disturbances in schizophrenia. Brief narratives of individuals with schizophrenia (n = 42) and non-clinical controls (n = 48) were compared according to their lexical characteristics, and these were examined for relationships to social cognition and real-world functioning. Significant differences between the groups were found in words per sentence as well as pronoun use. Lexical characteristics effectively distinguished between individuals with schizophrenia from non-clinical controls. Language disturbances in schizophrenia appear related to social cognition impairments, real-world functioning, and are a robust indicator of clinical status.

8. EVIDENCE OF CONTRASTING PATTERNS FOR SUPPRESSION AND REAPPRAISAL EMOTIONAL REGULATION STRATEGIES IN ALEXITHYMIA
Julien Laloyaux, MS, Carole Fantini, Morgan Lemaire, Olivier Luminet, Frank Larøi

In this paper, two studies explored whether the emotional deficits observed in alexithymia may be related to the use of emotion regulation strategies. Relations with various socio-demographic variables were also explored. In the first study, 255 students completed the Emotion Regulation Questionnaire (ERQ) and the Toronto Alexithymia Scale-20. For the second study, 1107 participants from the general population completed the ERQ and the Bermond-Vorst Alexithymia Questionnaire. Results demonstrated that alexithymia was related to the use of a suppression strategy and to difficulties verbalizing emotions, suggesting that the capacity to communicate and name one’s emotion is a central aspect in alexithymia. Concerning socio-demographic variables, alexithymia and the use of a suppression strategy were found to be related to age and to be higher in males.

9. IMPAIRMENTS IN NEGATIVE FACIAL EMOTION RECOGNITION IN CHINESE SCHIZOPHRENIA PATIENTS DETECTED WITH A NEWLY DESIGNED TASK
Yuqing Song, MD, PhD, Yutao Xiang, MD, PhD, Yueqin Huang, MD, PhD, Xiangqun Wang, MD, Xilin Wang, MD, Fuquan Zhang, MD, PhD, Johnny Sheung Him Kwan, PhD, Oi Chi Chan, BEng, Zhiren Wang, MD, PhD, Gabor S. Ungvari, MD, PhD, Christoph U. Correll, MD, Charles Zaroff, PhD

Facial emotion stimuli with Chinese faces was developed, using static and dynamic avatars, the identification of which were validated in 562 healthy controls. This test was used to identify facial emotion recognition accuracy in 44 patients with schizophrenia and 41 healthy controls. Overall, patients identified facial emotions significantly worse than healthy controls (p=0.018) with a significant main effect for type of emotion (p=0.016). Patients performed significantly worse in fear (p=0.029) and sadness (p=0.037), and marginally worse in anger (p=0.052). No significant differences were evident in contempt or happiness. Regarding error rates of misattribution, patients overidentified contempt (p=0.035) and sadness (p=0.01), but not anger, fear or happiness. Patients of Chinese ethnicity with schizophrenia may have significantly greater difficulties identifying negative, but not positive, emotions.

10. BIPOLAR SPECTRUM DISORDERS IN PATIENTS WITH CEREBELLAR LESIONS. A COMPARISON WITH PARKINSON’S DISEASE
Roberto Delle Chiaie, MD, Amedeo Minichino, MD, Massimo Salviati, MD, Samantha Fiorentini, MD, Angelo Tonini, MD, Francesco Saverio Bersani, MD, Francesco De Michele, MD, Maria Caredda, MD, Massimo Biondi, MD

This study investigates the relationship between three dimensions of religiosity and professional mental health service utilization among a large (n=3,570), nationally representative sample of African American adults. African American adults who reported high levels of organizational and subjective religiosity were less likely than those with lower levels of religiosity to utilize professional mental health services. This inverse relationship was generally consistent across individuals with and without a diagnosable DSM-IV anxiety, mood, or substance use disorder. No association was found between non-organizational religiosity and professional mental health service use. Strategic efforts should be made to engage African American clergy and religious communities in the conceptualization and delivery of mental health services.

BRIEF REPORTS

11. GROUP PSYCHOEDUCATION FOR RELATIVES OF PERSONS WITH BIPOLAR DISORDER: PERCEIVED BENEFITS FOR PARTICIPANTS AND PATIENTS
Marianne Gex-Fabry, PhD, Sandrine Cuénoud, MD, Marie-Joëlle Stauffer-Corminboeuf, RN, Nancy Aillon, RN, Nader Perroud, MD, Jean-Michel Aubry, MD

The present study explored the perception of patients and family members with respect to group psychoeducation for relatives. Patients (n=20) and relatives (n=26) were assessed with questionnaires about perceived benefits and quality of life (median four years after participation). A large majority (>80%) of relatives acknowledged benefits with respect to easier detection of the early warning signs of relapse, improved quality of life, feeling more involved and engaging in higher quality caregiving activities. Patients were less positive in general, but agreed that the program had helped them deal with crises, increased their feeling of being understood by relatives, and promoted positive changes in the family (>60%). Perceived positive changes in the family were associated with higher quality of life for relatives and patients. The present study highlights the importance of communication enhancement in group psychoeducation for relatives.

12. PSYCHOTHERAPY FOR PERSONALITY DISORDERS IN A NATURAL SETTING: A PILOT STUDY OVER TWO YEARS OF TREATMENT
Stéphane Kolly, MD, Ueli Kramer, PD PhD, Pauline Maillard, MPs, Patrick Charbon, MD, Jessica Droz, MD, Emmanuelle Frésard, MPs, Sylvie Berney, MD, Jean-Nicolas Despland, Prof. MD

The present pilot study used rigorous assessment procedures and incorporated feed-back loops of outcome information to the therapists in demonstrating the effects of psychotherapy for PD in a natural setting. The number of DSM-IV criteria for any PD was the primary outcome, assessed at intake, 6, 12, 18 and 24 months of psychotherapy for N=13 patients with PD. Data were analyzed using Hierarchical Linear Modeling. Results demonstrated a large pre-post effect (d = 2.22) for the observer-rated measure (primary outcome), and small to medium effects for the secondary outcomes; these results were corroborated by a steady decrease of symptoms over all 5 time-points. These results demonstrate the effects of long-term psychotherapy for PDs in increasingly diverse contexts and suggest that practice-oriented research can be carried out in a collaborative manner.

BOOK REVIEWS

13. Understanding Mental Disorders: Your Guide to DSM-5. Donald W. Black, Jeffrey Borenstein, Ellen Frank, Robert E. Hales, David J. Kupfer, Susan K. Schultz, Editorial Advisory Board (2015) Washington, DC: American Psychiatric Association.
Reviewed by Pedro Ruiz, MD. 

14. Public Safety Suicide: The Human Dimension. Mary Van Haute and John M. Violanti, Eds (2015) Springfield, Illinois: Charles C. Thomas Publisher LTD. 119 pp.
Reviewed by Frank W. Brown, MD.

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Dr. Talbott and Lippincott Williams & Wilkins
wish to thank the
University of Maryland School of Medicine
Department of Psychiatry
for their support of
The Journal of Nervous and Mental Disease 

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