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Psychiatric Research (psychiatric + research)
Terms modified by Psychiatric Research Selected AbstractsPsychiatric research in low- and middle-income countries: the need for concrete actionACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2005Acta Psychiatric Scandinavica No abstract is available for this article. [source] The Tidal Model: Psychiatric colonization, recovery and the paradigm shift in mental health careINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2003Phil Barker ABSTRACT: Psychiatric research and practice involves the colonization of the personal experience of problems of human living. From a Western perspective, this process shares many similarities with the subjugation of women, people of colour and people embracing non-Christian faiths and cultures. The Tidal Model® is a mental health recovery and reclamation model, developed to provide the framework for discrete alternatives to the colonizing approach of mainstream psychiatric practice. The Model asserts the intrinsic value of personal experience and the centrality of narrative in the development of contextually bound, personally appropriate, mental health care. This paper summarizes the features of the Model, which attempt to address the foci of the more significant critiques of psychiatric practice (and psychiatric nursing), against a background sketch of psychiatric colonization. [source] Rates and Impact of Trauma and Current Stressors Among Darfuri Refugees in Eastern ChadAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010Andrew Rasmussen Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. This article reports rates of past trauma and current stressors among Darfur refugees and gauges the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in 2 refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress, and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (rs = .19,.31) than were war-related traumatic events (rs = .09,.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events. [source] From age correction to genome-wide associationACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009S. Cohen-Woods Objective:, Eric Strömgren was one of the pioneers of psychiatric genetics and family studies. There has now been an explosion of interest in this field and research progress, including linkage and association studies, whole genome genotyping, copy number variants and epigenetics is reviewed here. Method:, An overview of this area of psychiatric research is presented and discussed based on the relevant literature aiming at giving a recent status of the progress. Results:, Broadly speaking linkage and association are complementary approaches used to locate genes contributing to the genetic aetiology of psychopathology. Linkage can be detected over comparatively large distances, however power is problematic when searching for quantitative trait loci with small effect sizes. In contrast, association studies can detect small effects but only over very small distances. Therefore, while several genome-wide linkage studies in psychiatric disorders have been performed, the majority of association studies have investigated specific functional candidate genes. Conclusion:, Due to very recent technological advancements, genome-wide association studies have now become possible and have identified some completely novel susceptibility loci. Other recent advances include the discovery of epigenetic phenomena and copy number variants. [source] The use of population based registers in psychiatric researchACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009P. AllebeckArticle first published online: 6 OCT 200 Objective:, Much of the knowledge we now take for granted regarding major mental disorders such as schizophrenia, suicide and other disorders, would not exist without the use of population based registers. The use of population based registers in psychiatric epidemiology have enabled analyses of associations that otherwise would not have been possible to address. Method:, The use of registers in psychiatric research is described, exemplified, and discussed. Results:, Methodological and validity aspects depend to a large part on the type of register being considered. A classification is proposed of different types of registers, each one implying specific methodological issues. These can be addressed according to the dimensions coverage, attrition, representativity and validity. Specific methodological consideration has still to be taken in relation to each specific research question. Thus, special validity studies usually need to be performed when embarking on studies using population based registers. Conclusion:, With increasing burden of disease due to mental disorders worldwide, knowledge of the epidemiology of these disorders are of increasing interest. The Nordic countries have a strong history in this field of research, of great interest to the rest of the world. Universities and research funding agencies should recognize this valuable source of research capacity, and support fruitful continuation of a strong tradition. [source] Administrative registers in psychiatric research: a systematic review of validity studiesACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2005N. Byrne Objective:, To conduct a systematic review of studies investigating the validity of administrative registers for use in psychiatric research. Method:, Studies were identified using MEDLINE (1966,2004) and EMBASE (1980,2004) databases using keywords ,validity' or ,reliability' combined with ,register' or ,database$'. Studies reviewed by two raters blind to each other and quality assessed using a data extraction form devised by the authors. A narrative description of the findings is presented. Results:, Fourteen studies were identified, seven of which concerned Scandinavian registers. Ten studies were solely concerned with diagnostic validity and the most common single diagnosis studied was schizophrenia (five studies). Methods used and study quality varied widely. Conclusion:, Given the importance of the area, relatively little high-quality work exists into systematically measuring the diagnostic data validity of registers for research purposes. [source] The causes, consequences and detection of publication bias in psychiatryACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2000Simon M. Gilbody Objective: Publication bias threatens the validity of published research, although this topic has received little attention in psychiatry. The purpose of this article is to produce a systematic overview of the causes and consequences of publication bias and to summarize the available methods with which it is detected and corrected. Method: Empirical evidence for the existence of publication bias is reviewed and the following methods are applied to an illustrative case example from psychiatry: funnel plot analysis; the ,file drawer method'; linear regression techniques; rank correlation; ,trim and fill'. Results: Small studies are particularly susceptible to publication and related bias. All methods to detect publication bias depend upon the availability of a number of individual studies with a range of sample sizes. Unfortunately, large numbers of studies of varying sample size are not always available in many areas of psychiatric research. Conclusion: Where possible researchers should always test for the presence of publication bias. The problem of publication bias will not be solved by anything other than a prospective trials register. [source] Methylone and mCPP, two new drugs of abuse?ADDICTION BIOLOGY, Issue 4 2005M. Bossong Recently, two new ecstasy-like substances, methylone and mCPP, were found in street drugs in the Netherlands by the Drugs Information and Monitoring System (DIMS). Methylone (3,4-methylenedioxymethcathinone) is the main ingredient of a new liquid designer drug that appeared on the Dutch drug market, called ,Explosion'. mCPP (meta-chlorophenylpiperazine) is a substance often used as a probe for the serotonin function in psychiatric research, and has now been found in street drugs, both in tablets and powders. Methylone as well as mCPP act on monoaminergic systems, resembling MDMA (3,4-methylenedioxymethamphetamine), with mCPP mainly affecting the serotonin system. The subjective effects of both new substances exhibit subtle differences with those of MDMA. Only little is known about the harmfulness of both methylone and mCPP. However, because of similarities between these substances and MDMA, risks common to MDMA cannot be excluded. [source] The effect of misclassification on the estimation of association: a reviewINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2005Michael Höfler Abstract Misclassification, the erroneous measurement of one or several categorical variables, is a major concern in many scientific fields and particularly in psychiatric research. Even in rather simple scenarios, unless the misclassification probabilities are very small, a major bias can arise in estimating the degree of association assessed with common measures like the risk ratio and the odds ratio. Only in very special cases , for example, if misclassification takes place solely in one of two binary variables and is independent of the other variable (,non-differential misclassification') , is it guaranteed that the estimates are biased towards the null value (which is 1 for the risk ratio and the odds ratio). Furthermore, misclassification, if ignored, usually leads to confidence intervals that are too narrow. This paper reviews consequences of misclassification. A numerical example demonstrates the problem's magnitude for the estimation of the risk ratio in the easy case where misclassification takes place in the exposure variable, but not in the outcome. Moreover, uncertainty about misclassification can broaden the confidence intervals dramatically. The best way to overcome misclassification is to avoid it by design, but some statistical methods are useful for reducing bias if misclassification cannot be avoided. Copyright © 2005 Whurr Publishers Ltd. [source] Validation of a new diagnostic procedure for DSM IV axis I disordersINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2002Jean-Yves Loze Abstract Despite the fact that, in today's psychiatric research and especially in epidemiological studies, diagnostic assessments are made with reliable standardized clinical interviews, recent articles have shown discrepancies in prevalence rates of DSM IV axis I disorders assessed with different, yet reliable, clinical standardized interviews, raising the problem of the clinical relevance of some of these instruments. Within an epidemiological study, we developed a simple method for evaluating DSM IV axis I disorders with the aim of improving the clinical relevance of assessed diagnoses. This method is based on an evaluation performed by two clinicians. The first one used a short structured clinical interview (MINI v 5.0) and the second one completed the procedure with an open clinical interview, intended to be more clinically relevant. Finally, a consensus diagnosis is given by the two investigators. We conducted a survey in order to validate this method by measuring the agreement of diagnoses reported by two pairs of clinicians on a population of 20 inpatients. Results show that this double evaluation led to a high agreement (kappa ranging between 0.76 and 1.00) suggesting that the proposed evaluation procedure, which is intended to be more clinically relevant, is also highly reliable. Copyright © 2002 Whurr Publishers Ltd. [source] Development of a quality assessment instrument for trials of treatments for depression and neurosisINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2001Joanna Moncrieff Abstract There is evidence that the quality of controlled clinical trials affects the results that are obtained. A systematic approach to the assessment of quality is required for psychiatric research. This study set out to develop an instrument for the assessment of the quality of controlled trials of interventions for depressive and non-psychotic conditions. A pilot study led to the development of a scale containing 23 items covering a wide range of aspects of quality including objective formulation, design, presentation of results, analysis and quality of conclusions. Scoring criteria were devised and the scale was then subjected to reliability testing using a random sample of trials of treatment for depression and ,neurosis'. The scale showed moderate inter-rater reliability and results were comparable to those obtained with shorter instruments. It was quick and easy to use. There were significant correlations between year of publication and overall quality score with later studies showing higher quality. The instrument developed here provides a systematic approach to the assessment of quality for use in critical appraisal of individual studies and meta-analysis. However, the scoring process should be used cautiously since inter-rater agreement was only moderate. Copyright © 2001 Whurr Publishers Ltd. [source] Randomization in psychiatric intervention research in the general practice settingINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000CM Van Der Feltz-Cornelis Faculty of Medicine Abstract Most studies of psychiatric interventions in general practice settings conform only in part to the requirements of randomization, placebo control and blinding as formulated by the Cochrane Collaboration. It is possible, nonetheless, to develop experimental research designs that are sufficiently near to this standard. These must deal with certain methodological issues specific to psychiatric research. This article discusses scientific standards of psychiatric research with special consideration of interventions in general practice settings. These issues are accompanied by concrete examples and suggestions on how to confront the problems. In psychiatric intervention research, equivalence studies with single-blind outcome assessment, a tested and ethically justified method, are generally used in place of placebo-controlled studies. The article also examines randomization procedures in greater depth. Randomization can be applied across trial subjects or across doctors' practices. Practical consequences of randomizing across subjects, and specific implementations of it such as crossover and pre-post designs in general practice settings, are clarified. Overall, a research design using randomization across doctors' practices is judged preferable to one that randomizes across trial subjects. One potential problem is that the control group may become too small, especially when considerable effects are expected from the intervention being studied. One might consider making the control condition smaller in the first place, or, if indicated on ethical grounds, performing an intermediate analysis and then breaking off the study as soon as a statistically significant effect has been demonstrated. Multilevel statistical techniques offer new opportunities for analysis within such designs. Copyright © 2000 Whurr Publishers Ltd. [source] Individual quality of life of people with severe mental disordersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2009A. PITKÄNEN mnsc People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0,69.1 (scale 0,100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6,89.6; scale 0,100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions. [source] Is DSM widely accepted by Japanese clinicians?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2001Toshiyuki Someya MD Abstract The Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III), a new standardized diagnostic system with multiaxial diagnosis, operational criteria and renewed definitions of mental disorders, was introduced in 1980 and prompted movements to reform conventions in Japanese psychiatry. This review overviews the initial response of Japanese clinicians to accept DSM-III, and its effects on the development of systematic research of psychiatric diagnosis. These new research activities include those on reliability of psychiatric diagnosis, application of various evaluation tools, discussion on the concept of mental disorders, relation of personality disorders with depressive disorders, and Taijin-kyofusho, or culturally distinctive phobia in Japan. A reference database search to survey the latest trend on psychiatric research indicated that the number of papers published by Japanese workers increased sharply after 1987, and DSM apparently greatly influenced their internationalization. Twenty years after the publication of DSM-III, a questionnaire on the use of DSM-IV was set out in 2000 to survey how widely DSM is utilized in clinical practice in Japan. Two hundred and twelve psychiatrists answered the questionnaire, and the results show that DSM has been accepted positively by the younger generation, while the older generation (over 40s) has still less interest in DSM, and DSM is used mainly for research purposes rather than in daily practice. [source] A survival analysis for recurrent events in psychiatric researchBIPOLAR DISORDERS, Issue 2 2004Christopher Baethge Objectives:, Time to first recurrence, as analyzed by the Kaplan,Meier (KM) survival analysis, is a commonly applied statistical method in psychiatric research. However, many psychiatric disorders are characterized not by a single event, but rather by recurrent events, such as multiple affective episodes. This study aims to demonstrate a method of survival analysis that takes multiple recurrences into account. Methods:, We examined data on sex differences in a sample of 181 patients undergoing prophylactic treatment with lithium or carbamazepine (serum level assayed) for bipolar disorder (ICD-10). The classical KM method was compared with an approach developed by Peña, Strawderman and Hollander (PSH) that uses recurrent event data to estimate survival function. Results:, The results obtained with the multiple events method differed considerably from those acquired using the standard KM analysis. When taking recurrent event data into account, the probability of remaining well was lower and survival times were longer. In addition, whereas the standard KM analysis indicated that male patients had a higher likelihood of remaining well, the alternative method revealed that both sexes were similarly likely to remain well. Conclusions:, Survival analysis techniques that take recurrent events into account are potentially important instruments for the study of psychiatric conditions characterized by multiple recurrences. In many cases, the standard KM analysis appears to provide only a rough approximation of the course of illness. [source] Do psychotherapies produce neurobiological effects?ACTA NEUROPSYCHIATRICA, Issue 2 2006Veena Kumari Background:, An area of recent interest in psychiatric research is the application of neuroimaging techniques to investigate neural events associated with the development and the treatment of symptoms in a number of psychiatric disorders. Objective:, To examine whether psychological therapies modulate brain activity and, if so, to examine whether these changes similar to those found with relevant pharmacotherapy in various mental disorders. Methods:, Relevant data were identified from Pubmed and PsycInfo searches up to July 2005 using combinations of keywords including ,psychological therapy', ,behaviour therapy', ,depression', ,panic disorder', ,phobia', ,obsessive compulsive disorder', ,schizophrenia', ,psychosis', ,brain activity', ,brain metabolism', ,PET', ,SPECT' and ,fMRI'. Results:, There was ample evidence to demonstrate that psychological therapies produce changes at the neural level. The data, for example in depression, panic disorder, phobia and obsessive compulsive disorder (OCD), clearly suggested that a change in patients' symptoms and maladaptive behaviour at the mind level with psychological techniques is accompanied with functional brain changes in relevant brain circuits. In many studies, cognitive therapies and drug therapies achieved therapeutic gains through the same neural pathways although the two forms of treatment may still have different mechanisms of action. Conclusions:, Empirical research indicates a close association between the ,mind' and the ,brain' in showing that changes made at the mind level in a psychotherapeutic context produce changes at the brain level. The investigation of changes in neural activity with psychological therapies is a novel area which is likely to enhance our understanding of the mechanisms for therapeutic changes across a range of disorders. [source] | ||||||||||