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Department/Unit:Child and Adolescent Psychiatry

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Early trauma, attachment experiences and comorbidities in schizophrenia

Gabínio, Thalita; Ricci, Thaysse; Kahn, Jeffrey P; Malaspina, Dolores; Moreira, Helena; Veras, André B
Objective To evaluate attachment patterns in subjects with schizophrenia and their relationships to early traumatic events, psychotic symptoms and comorbidities. Methods Twenty patients diagnosed with schizophrenia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) underwent retrospective symptom assessment and careful assessment of the number and manner of childhood caregiver changes. The Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD) was used to assess symptoms related to schizophrenia (positive and negative symptoms), depression and mania. Anxiety disorder comorbidities were assessed by the Liebowitz Social Anxiety Scale (LSAS), Yale-Brown Obsessions and Compulsions Scale (Y-BOCS) and Panic and Schizophrenia Interview (PaSI). Experience in Close Relationships - Relationship Structures (ECR-RS) and Early Trauma Inventory Self Report-Short Form (ETISR-SF) were used to assess attachment patterns and traumatic history, respectively. Results Moderate and significant correlations between attachment patterns and early trauma showed that greater severity of anxious attachment was predicted by a higher frequency of total early traumas (Spearman ρ = 0.446, p = 0.04), mainly general traumas (ρ = 0.526, p = 0.017; including parental illness and separation, as well as natural disaster and serious accidents). Among the correlations between early trauma and comorbid symptoms, panic attacks occurring before the onset of schizophrenia showed significant and positive correlations with ETISR-SF total scores and the sexual trauma subscale. Conclusion Children with an unstable early emotional life are more vulnerable to the development of psychopathology, such as panic anxiety symptoms. Traumatic events may also predict later schizophrenia.
PMID: 29641648
ISSN: 2238-0019
CID: 3037342

Collaborative opportunities for psychiatric trainees and young psychiatrists in Europe: the Early Career Psychiatrists Committee of the European Psychiatric Association [Letter]

Saiz García, Héctor; Pereira Sánchez, Víctor; Ismayilova, Jamila; Smirnova, Daria; Kilic, Ozge; Gondek, Tomas; Mogren, Tove; Pinto da Costa, Mariana
PMID: 29463449
ISSN: 1989-4600
CID: 4223332

Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies

Díaz-Román, Amparo; Mitchell, Raziya; Cortese, Samuele
Sleep alterations associated with adulthood ADHD are poorly understood. Here, we conducted the first meta-analysis of sleep studies in adults with ADHD. Based on a pre-registered protocol (PROSPERO-CRD42017065407), we searched Pubmed, Ovid and Web of Knowledge databases through August 3rd, 2017, with no language or publication type restrictions, and contacted study authors for unpublished data/information. From a pool of 8812 references, we retained 13 studies. Random-effects models were performed and study quality was rated using the Newcastle-Ottawa Scale. Compared to adults without ADHD, those with ADHD significantly differed in seven out of nine subjective parameters (Standardized Mean Difference, SMD, ranging from 0.56 to 1.55) and two out of five actigraphic parameters [SMD (95% CI): sleep onset latency: 0.80 (0.46-1.14); sleep efficiency: -0.68 (-1.03, -0.34)]. No significant differences were detected for polysomnographic parameters. We conclude that, whereas subjectively reported sleep problems are significantly associated with ADHD in adults and should be systematically screened during the clinical interview, additional research is needed to understand if they are underpinned by objective sleep alterations.
PMID: 29477617
ISSN: 1873-7528
CID: 2966122

Extinction of auditory threat memory triggers activation of p70 S6 kinase 1 in the basolateral nucleus of the amygdala

Huynh, T N; Santini, E; Mojica, E; Fink, A E; Hall, B S; Fetcho, R N; Grosenick, L; Deisseroth, K; LeDoux, J E; Liston, C; Klann, E
ORIGINAL:0014544
ISSN: 1476-5578
CID: 4354212

Are ADHD medications under or over prescribed worldwide?: Protocol for a systematic review and meta-analysis

Moreira-Maia, Carlos Renato; Massuti, Rafael; Tessari, Luca; Campani, Fausto; Akutagava-Martins, Glaucia Chiyoko; Cortese, Samuele; Augusto Rohde, Luis
INTRODUCTION/BACKGROUND:Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, characterized by age inappropriate and impairing levels of inattention and/or hyperactivity/impulsivity. Pharmacotherapy is an important part of the ADHD multimodal treatment. The extent to which ADHD is pharmacologically over or under treated worldwide is controversial. We aimed to estimate the pooled worldwide rate of ADHD pharmacological treatment in individuals with and without the disorder. METHOD AND ANALYSIS/UNASSIGNED:We will include published or unpublished studies reporting the rates of ADHD pharmacological treatment in participants with and without ADHD of any age group. Population-based, cohort, or follow-up studies, as well as data from insurance health system and third-party reimbursements will be eligible. Searches will be performed in a large number of electronic databases, including Medline, Embase, CINAHL, Cochrane, PsycINFO, Web of Science, and Scopus. The primary outcome will be the prevalence of ADHD pharmacological treatment in individuals with ADHD and without ADHD. Two independent reviewers will perform the screening, and data extraction process. Study quality/bias will be assessed with the Newcastle-Ottawa scale by 2 independent reviewers. To test the robustness of the findings, we will perform a series of sensitivity and meta-regression analysis. Analyses will be performed with R and STATA software. ETHICS AND DISSEMINATION/UNASSIGNED:No IRB approval will be necessary. The results of this systematic review and meta-analysis will be presented at international conferences and published in peer-reviewed journals. REGISTRATION AND STATUS/UNASSIGNED:PROSPERO 2018 CRD42018085233.
PMCID:6023876
PMID: 29901582
ISSN: 1536-5964
CID: 3154812

Let's keep families together!

Marsh, Akeem
ORIGINAL:0012933
ISSN: n/a
CID: 3302002

Violence Exposure and Psychopathology in Latino Youth: The Moderating Role of Active and Avoidant Coping

Gudino, Omar G; Stiles, Allison A; Diaz, Kathleen I
Despite high rates of exposure to community violence among Latino youth in urban communities, there is considerable variability in individual outcomes. This study examined (a) associations between coping and indices of Latino culture, (b) main effects of active/avoidant coping on psychopathology, and (c) whether coping moderates the impact of violence exposure on mental health in Latino youth. Participants included 168 Latino youth (56% female; ages 11-14) that took part in a short-term longitudinal study. Results indicate that youth acculturation was positively associated with active coping, but enculturation level and immigrant status were not associated with coping. Structural equation models suggested that active coping was negatively associated with internalizing problems (p = .046) while avoidant coping was positively associated with internalizing problems (p = .013) and posttraumatic stress symptoms (p = .024). Moderation analyses revealed that violence exposure was more strongly associated with internalizing problems as reliance on avoidance coping increased. However, at high levels of violence exposure, a greater reliance on active coping was related to increased posttraumatic stress problems. Findings suggest that consideration of the specific stressor, level of stress exposure, and mental health problem-type may be crucial in determining the effectiveness of a coping strategy. Implications for future research and intervention are discussed.
PMID: 29134545
ISSN: 1573-3327
CID: 3011982

Increasing Interest of Mass Communication Media and the General Public in the Distribution of Tweets About Mental Disorders: Observational Study

Alvarez-Mon, Miguel Angel; Asunsolo Del Barco, Angel; Lahera, Guillermo; Quintero, Javier; Ferre, Francisco; Pereira-Sanchez, Victor; Ortuño, Felipe; Alvarez-Mon, Melchor
BACKGROUND:The contents of traditional communication media and new internet social media reflect the interests of society. However, certain barriers and a lack of attention towards mental disorders have been previously observed. OBJECTIVE:The objective of this study is to measure the relevance of influential American mainstream media outlets for the distribution of psychiatric information and the interest generated in these topics among their Twitter followers. METHODS:We investigated tweets generated about mental health conditions and diseases among 15 mainstream general communication media outlets in the United States of America between January 2007 and December 2016. Our study strategy focused on identifying several psychiatric terms of primary interest. The number of retweets generated from the selected tweets was also investigated. As a control, we examined tweets generated about the main causes of death in the United States of America, the main chronic neurological degenerative diseases, and HIV. RESULTS:In total, 13,119 tweets about mental health disorders sent by the American mainstream media outlets were analyzed. The results showed a heterogeneous distribution but preferential accumulation for a select number of conditions. Suicide and gender dysphoria accounted for half of the number of tweets sent. Variability in the number of tweets related to each control disease was also found (5998). The number of tweets sent regarding each different psychiatric or organic disease analyzed was significantly correlated with the number of retweets generated by followers (1,030,974 and 424,813 responses to mental health disorders and organic diseases, respectively). However, the probability of a tweet being retweeted differed significantly among the conditions and diseases analyzed. Furthermore, the retweeted to tweet ratio was significantly higher for psychiatric diseases than for the control diseases (odds ratio 1.11, CI 1.07-1.14; P<.001). CONCLUSIONS:American mainstream media outlets and the general public demonstrate a preferential interest for psychiatric diseases on Twitter. The heterogeneous weights given by the media outlets analyzed to the different mental health disorders and conditions are reflected in the responses of Twitter followers.
PMCID:5996178
PMID: 29807880
ISSN: 1438-8871
CID: 4223342

Family practice in integrative behavioral health

McKay, Mary M.; Lindsey, Michael A.; Gopalan, Geetha
SCOPUS:85048491486
ISSN: 1052-2158
CID: 3929132

Test-retest reliability of the adult ADHD Self-Report Scale (ASRS) v1.1 Screener in non-ADHD controls from a primary care physician practice

Silverstein, Michael J; Alperin, Samuel; Faraone, Stephen V; Kessler, Ronald C; Adler, Lenard A
Objectives: To examine the test-retest reliability of the DSM-IV Adult ADHD Self-Report Scale (ASRS) v1.1 Screener in adults without ADHD. Prior studies have not examined test-retest reliability of the Screener in non-ADHD controls. Methods: Subjects completed the Screener in a primary care physician (PCP) waiting room (T1); those who screened negative for ADHD (n = 104) (<4/6 significant Screener items) symptoms were further assessed on the phone (T2). T2 included phone administration of the full ASRS v1.1 Symptom Checklist (which contains the six items from the Screener). Spearman's correlations and intra-class correlation coefficients (ICCs) between T1 and T2 were calculated for the total Screener score and for each Screener item. McNemar-Bowker tests were conducted for the Screener total score and each item to check for significant changes from T1 to T2. Results: Screener T1 and T2 total scores were significantly correlated (Spearman's rho = 0.78, P < 0.0001), as were individual items. Correlations remained significant when controlling for a variety of demographic factors and psychiatric conditions. Confirming the significant Spearman correlations, ICCs for Screener total score and each item were also significant (ICC = 0.75, P < 0.0001). The McNemar-Bowker tests showed no significant differences for Screener total score and for the IA items; however, the H-I items were somewhat higher at T1 versus T2. Conclusions: The DSM-IV ASRS v1.1 Screener has high test-retest reliability in patients without ADHD.
PMID: 29177453
ISSN: 1460-2229
CID: 2798182