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January 2020 - Volume 208 - Issue 1

  • John A. Talbott, MD
  • 0022-3018
  • 1539-736X
  • 12 issues / year
  • Psychiatry 97/146; Clinical Neurology 145/199
  • 1.859


Posttraumatic Stress and Depression Among Syrian Refugees Living in Turkey: Findings From an Urban Sample
Edip Kaya, MSc, Cengiz Kılıç, MD, PhD, Özge Karadağ Çaman, MD, PhD, Sarp Üner, MD, PhD

A total of 420 adult Syrians living in Ankara were assessed using the Harvard Trauma Questionnaire and the Beck Depression Inventory. Probable PTSD and depression rates were 36.5% and 47.7%, respectively. Female sex, physical illness, and greater number of potentially traumatic events predicted both PTSD and depression. PTSD was additionally predicted by past psychiatric illness, and depression was predicted by lower economic status. Interestingly, lower economic status predicted depression among men, but not among women.

Reactions to Solidarity Versus Normalcy Messages for Antistigma Campaigns
Patrick W. Corrigan, PsyD, and Maya A. Al-Khouja, BS†

This study considers two of many messages that are used in antistigma campaigns: normalcy, that mental illness is like most kinds of illness—"You are just like me," and solidarity, that one's mental illness is accepted—"I stand with you." Three hundred seventy-three participants rated the merit of the two messages provided in random order. They also reported previous experience with mental health services. Overall, participants viewed solidarity messages with greater merit than normalcy. Participants with self-reported mental illness viewed the solidarity message even better than participants without mental illness; this pattern varied by specific mental health experience.

Treatment for Individuals With Severe Mental Illness Who Use Illicit Drugs While Maintained on Methadone Mindfulness and Modification Therapy
Peggilee Wupperman, PhD, Nancy Burns, MA, JD, Cameron P. Pugach, MA, Emily Edwards, PhD

Substantial research has noted the serious consequences of 1) co-occurring severe mental illness (SMI) and substance use disorders, and 2) use of illicit drugs while maintained on methadone for opioid dependence. This pilot study investigated the feasibility and acceptability of a 12-week, transdiagnostic group therapy (mindfulness and modification therapy [MMT]), tailored for opioid dependent individuals (N = 6) with SMI and illicit drug use. Retention was 83%. At posttreatment and 2-month follow-up, participants rated the treatment as highly helpful (9 of 10; 8.67 of 10, respectively), reported routinely practicing the guided-mindfulness exercises, and reported high confidence that they would continue to practice. Preliminary evidence suggests that MMT may be a feasible and acceptable therapy that may improve treatment engagement in this underserved population.

Very Long-Term Outcome of Community-Dwelling Patients With Schizophrenia Spectrum Disorders in Rural Greece
Vaios Peritogiannis, MD, MSc, PhD, Aikaterini Grammeniati, MSc, Afroditi Gogou, BSc, Panagiota Gioti, BSc, Venetsanos Mavreas, MD, PhD

The objective of the present study was to measure the very long-term outcome in community-dwelling patients with a diagnosis of psychosis and to search for possible correlations of outcome with clinical factors. The sample included 55 psychotic patients with at least 15 years of disease duration (M = 32.1 years). The Health of the Nations Outcome Scale and the Clinical Global Impression Scale were used. A total of 34.5% of the patients had a good outcome, whereas 27.3% had poor outcome. Outcome was found to be correlated to symptoms, and it was significantly worse in patients living with other severely mentally ill family members.

Predictors of Disagreement Between Diagnoses From Consult Requesters and Consultation-Liaison Psychiatry
Victor Otani, MD, MSc, Thaís Otani, MD, Andrea Freirias, MD, Elie Calfat, MD, MSc, Patricia Aoki, MD, Sean Cross, MD, Susan Sumskis, BN (Hons), PhD, RN, MHN, FACMHN, Richard Kanaan, PhD, CCT, MB BS, MA, BA, Quirino Cordeiro, MD, PhD, Ricardo Uchida, MD, PhD

We evaluated disagreement between reported symptoms and a final diagnosis of depression, anxiety, withdrawal, psychosis, or delirium through regression models assessing individual and combined diagnoses. Highest disagreement rates were reported for services classified as others (88.2%), general surgery (78.5%), and bone marrow transplant (77.7%). Disagreement rates varied widely across different diagnoses, with anxiety having the highest disagreement rate (63.3%), whereas psychosis had the lowest disagreement rate (10.6%). When evaluating kappa coefficients, the highest agreement occurred with diagnoses of withdrawal and psychosis (0.66% and 0.51%, respectively), whereas anxiety and depression presented the lowest values (0.31% and 0.11%, respectively). The best-performing predictive model for most outcomes was random forest, with the most important predictors being specialties other than the ones focused on single systems, older age, lack of social support, and the requester being a resident.

Association of Suicide Attempt With Seroprevalence of Toxoplasma gondii in Adolescents
Seda Aybuke Sari, MD, and Ahu Kara, MD

Fifty patients aged between 12 and 18 years who attempted suicide and 50 healthy adolescents were included in this study. All adolescents were evaluated by a child psychiatrist using a semistructured interview and Rosenberg Self-Esteem Scale (RSES), Children's Depression Inventory (CDI), and Inventory of Parent and Peer Attachment. T. gondii IgM and IgG antibodies of patients and control subjects were analyzed from blood samples by enzyme-linked immunosorbent assay. Psychiatric disorders particularly mood disorders were more common in adolescents in the patient group. Adolescents attempting suicide were found to have worse relationships with their parents; their CDI scores were higher, and their RSES scores were lower than their healthy peers. There were no significant differences between the patient and the control groups in terms of Toxoplasma IgG antibody positivity. Although the seropositivity of Toxoplasma IgG antibody was higher in the patient group than that in the control group, the difference between the two groups was not statistically significant.

A Pilot Study of an Intervention to Prevent Suicide After Psychiatric Hospitalization
Natalie B. Riblet, MD, MPH, Brian Shiner, MD, MPH, Paula Schnurr, PhD, Martha L. Bruce, PhD, MPH, Danuta Wasserman, MD, PhD, Sarah Cornelius, BS, Robert Scott, MD, PhD, Bradley V. Watts, MD, MPH†

We piloted an adapted version of the World Health Organization Brief Intervention and Contact Program (WHO BIC) on an inpatient mental health unit in the United States. We assessed the feasibility and acceptability. We also evaluated changes in suicidal ideation, hopelessness, and connectedness using  repeated measures analysis of variance. Of 13 eligible patients, 9 patients enrolled. Patients experienced significant improvements in suicidal ideation, hopelessness, and connectedness at 1 and 3 months (Beck Scale for Suicidal Ideation, F(2,16) = 14.96, p < 0.01; Beck Hopelessness Scale, F(2,16) = 5.88, p < 0.05; perceived burdensomeness subscale, F(2,16) = 10.97, p < 0.013; and thwarted belongingness subscale, F(2,16) = 4.77, p < 0.03).

Do Changes in Employment Status Induce or "Harvest" Suicides?
Gordon Parker, MD, PhD, DSc

Gemmill and colleagues pursued whether suicides after economic contractions might reflect an "induction" process, whereby economic change induces suicide in those otherwise unlikely to engage in self-destructive behavior, or a "displacement" process whereby economic contractions effectively bring forward suicides that would have occurred eventually, and found support for both hypotheses. We therefore undertook a replication study examining the hypotheses in the Australian state of New South Wales, analyzing suicide data for the same period as examined in Sweden (i.e., 2000–2011) and also over an extended period of 1978 to 2015. Our analyses failed to replicate findings from the Swedish study in that we found greater support for the induction hypothesis. Our findings support the longstanding Durkheim hypothesis that suicide rates increase during times of low social integration and as a consequence of the economic changes acting as a precipitant stressor.

Evaluation of the Clinical Features, Management, and Prognoses of Patients With Charles Bonnet Syndrome
Huseyin Buyukgol, MD, Faik Ilik, MD, and Devrimsel Harika Ertem, MD

Charles Bonnet syndrome (CBS) is characterized by visual hallucinations with preservation of cognitive abilities. The hallucinations consist mostly of vivid (realistic) objects and tend to reoccur. Here, we evaluate the etiologies, symptoms, treatments, and prognoses of 13 CBS cases. All patients had visual hallucinations but were normal on cognitive and psychiatric assessments. Patient demographic and clinical characteristics, treatment options, and 3-month follow-up data were retrospectively reviewed. The possible causes of CBS and what the patients perceived during their hallucinations were recorded. Antipsychotic agents, such as risperidone and quetiapine, and anticonvulsants, such as levetiracetam, may be effective in some cases.

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