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Meeting Criteria (meeting + criterion)
Selected AbstractsReasons for terminating psychotherapy: a general population studyJOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2010Robin Westmacott Abstract Clients' (N=693) reasons for ending psychotherapy and their associations with demographics, mental disorder caseness, and type of mental health care service provider were examined. The most frequently reported reason for termination was feeling better, however, a substantial minority of individuals reported terminating because of treatment dissatisfaction or wanting to solve problems independently. Lower income was associated with lower odds of termination because of feeling better and higher odds of termination because of a perception that therapy was not helping. Meeting criteria for an anxiety disorder, a mood disorder, or substance dependence decreased the odds of termination because of feeling better. These findings provide important information on the challenges to the successful completion of psychotherapy. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source] A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHDACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009E. Rydén Objective:, The occurrence of comorbid attention-deficit hyperactivity disorder (ADHD) might have an impact of the course of the bipolar disorder. Method:, Patients with bipolar disorder (n = 159) underwent a comprehensive evaluation with respect to affective symptoms. Independent psychiatrists assessed childhood and current ADHD, and an interview with a parent was undertaken. Results:, The prevalence of adult ADHD was 16%. An additional 12% met the criteria for childhood ADHD without meeting criteria for adult ADHD. Both these groups had significantly earlier onset of their first affective episode, more frequent affective episodes (except manic episodes), and more interpersonal violence than the bipolar patients without a history of ADHD. Conclusion:, The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early-onset phenotype of bipolar disorder. [source] Patient and direct-care staff body mass index in a state mental hospital: implications for managementACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2004W. V. R. Vieweg Objective:, Obesity is a major problem among chronically psychotic patients. Method:, We assessed body mass index (BMI) of chronically psychotic patients on admission to a state mental hospital and in follow-up. We also compared patient BMI to staff BMI. Results:, The initial patient BMI (26.4 ± 5.8 kg/m2) was in the overweight range. The patient BMI (29.1 ± 5.8 kg/m2) increased (P < 0.0001) on follow-up and almost reached the level of obesity. Staff BMI (35.1 ± 8.6 kg/m2) was in the obese range with 64.9% meeting criteria of obesity and 29.9% meeting criteria of morbid obesity. African-American women made up 84.5% of clinical-care staff and constitute the race,sex mix most vulnerable to obesity in the US. Morbid obesity (BMI , 40 kg/m2) was five times more common among these African-American female clinical-care staff than among African-American women in the general US population. Conclusion:, Our findings may have treatment implications for chronically psychotic patients at risk for obesity. [source] Subthreshold depression as a risk indicator for major depressive disorder: a systematic review of prospective studiesACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2004P. Cuijpers Objective:, In order to examine whether the incidence of major depressive disorder (MDD) is increased in subjects with subthreshold depression, or sD (clinically relevant depressive symptoms, without meeting criteria for a full-blown MDD), we conducted a review of prospective studies examining the incidence of MDD in subjects with sD. Method:, A systematic literature search was conducted. For all studies, the relative risk of developing MDD was calculated, based on person-years. Results:, Twenty studies (23 comparisons) were found, based on community samples, general medical patients and high-risk subjects. Most comparisons showed that subjects with sD had a consistently larger chance of developing MDD. The studies differed considerably in the definition of sD, the recency (occurrence of the last sD) and the in-/exclusion of lifetime MDD. Conclusion:, The incidence of MDD in subjects with sD is larger than in subjects without sD. Otherwise, the concept of sD is too broad to be used. In future studies, some consensus should be reached regarding the definition of sD. [source] The characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)DRUG AND ALCOHOL REVIEW, Issue 5 2005JOANNE ROSS Abstract The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. [source] The validity of an Australian modification of the AUDIT questionnaireDRUG AND ALCOHOL REVIEW, Issue 2 2001LOUISA J. DEGENHARDT Abstract The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. [source] The Effect of Moderate to Heavy Alcohol Consumption on Neuropsychological Performance as Measured by the Repeatable Battery for the Assessment of Neuropsychological StatusALCOHOLISM, Issue 3 2010Alisa Green Background:, Excessive alcohol use is associated with damage to the structure and function of the brain and impairment of cognition and behavior. Traditional test batteries used to assess cognitive performance in alcoholics are extensive and costly, limiting their use across various clinical and research settings. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a relatively new instrument that attempts to overcome some of these limitations. As yet the individual effect of moderate to heavy alcohol consumption on RBANS performance has not been examined. The primary aim of this study was to explore and quantify differences in performance between controls and drinkers on the RBANS and to examine the influence of age, gender, and alcohol use patterns on test performance. Methods:, Data from a subset of "Using Our Brains" (UoB) donors (n = 28) still actively drinking and meeting criteria for moderate to heavy alcohol use (30 to 80 g of ethanol per day) (Harper, 1988) and 28 matched controls (age, education, and premorbid Intelligence Quotient) were compared. Results:, Participants in the alcohol group performed below the healthy control group on the visuospatial and immediate memory index, and also on the RBANS total score p < 0.001 and showed a greater decline in RBANS scores from estimated cross-sectional premorbid levels. There was a positive association between alcohol ingestion in the preceding 12 months and the language index p < 0.03 and the semantic fluency subtest (p < 0.03). Age was negatively associated with story memory (p < 0.02), coding (p < 0.001), list recognition (p < 0.01), story recall (p < 0.03), and figure recall (p < 0.02). Conclusion:, Our results suggest that the RBANS is able to detect and characterize differences in verbal fluency, visuospatial skills, components of declarative memory, and psychomotor speed between healthy controls and moderate to heavy active alcohol users. Executive functions, commonly affected by alcoholism and not included in the RBANS, require assessment with additional measures. [source] Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample,JOURNAL OF TRAUMATIC STRESS, Issue 3 2009Ananda B. Amstadter In 2006, typhoon Xangsane disrupted a multiagency health needs study of 4,982 individuals in Vietnam. Following this disaster, 798 of the original participants were reinterviewed to determine prevalence and risk factors associated with posttraumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD). Posttyphoon prevalences were PTSD 2.6%, MDD 5.9%, PD 9.3%, and GAD 2.2%. Of those meeting criteria for a disorder, 70% reported only one disorder, 15% had two, 14% had three, and 1% met criteria for all four disorders. Risk factors for posttyphoon psychopathology differed among disorders, but generally were related to high typhoon exposure, prior trauma exposure, and in contrast to Western populations, higher age, but not gender. [source] A prospective study on downstaging of hepatocellular carcinoma prior to liver transplantation,LIVER TRANSPLANTATION, Issue 12 2005Francis Y. Yao In patients with hepatocellular carcinoma (HCC) exceeding conventional (T2) criteria for orthotopic liver transplantation (OLT), the feasibility and outcome following loco-regional therapy intended for tumor downstaging to meet T2 criteria for OLT are unknown. In this first prospective study on downstaging of HCC prior to OLT, the eligibility criteria for enrollment into a downstaging protocol included 1 lesion >5 cm and ,8 cm, 2 or 3 lesions at least 1 >3 cm but ,5 cm with total tumor diameter of ,8 cm, or 4 or 5 nodules all ,3 cm with total tumor diameter ,8 cm. Patients were eligible for living-donor liver transplantation (LDLT) if tumors were downstaged to within proposed University of California, San Francisco (UCSF) criteria.13 A minimum follow-up period of 3 months after downstaging was required before cadaveric OLT or LDLT, with imaging studies meeting criteria for successful downstaging. Among the 30 patients enrolled, 21 (70%) met criteria for successful downstaging, including 16 (53%) who had subsequently received OLT (2 with LDLT), and 9 patients (30%) were classified as treatment failures. In the explant of 16 patients who underwent OLT, 7 had complete tumor necrosis, 7 met T2 criteria, but 2 exceeded T2 criteria. No HCC recurrence was observed after a median follow-up of 16 months after OLT. The Kaplan-Meier intention-to-treat survival was 89.3 and 81.8% at 1 and 2 yr, respectively. In conclusion, successful tumor downstaging can be achieved in the majority of carefully selected patients, but longer follow-up is needed to further access the risk of HCC recurrence after OLT. (Liver Transpl 2005;11:1505,1514.) [source] Comorbidity in attention deficit,hyperactivity disorderPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Takashi Ishii Abstract Attention deficit,hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age , 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51,84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD. [source] | |||||||||||||