Are long working hours associated with incident symptoms of depression and anxiety?
2960 full-time British office staff aged 35–55 years taking part in the Whitehall II study who were free from depressive symptoms (n=2549) and anxiety symptoms (n=2618) at baseline. Baseline measurements for the current analyses were taken between 1997 and 1999, and follow-up was in 2001 and between 2002 and 2004.
Twenty civil service departments, London, England; from 1997 to 2004.
Hours worked per week (35–40 h, 41–55 h, or >55 h). Covariates were assessed at baseline and included sex, age, marital status, occupational grade, alcohol consumption, smoking and presence of chronic disease. Employment status at follow-up was also adjusted for in the analysis.
Depressive symptoms (30-item General Health Questionnaire, GHQ), and anxiety symptoms (28-item GHQ).
Cohort study.
Up to 7 years (mean 5.3 years for depression symptoms, 5.2 years for anxiety symptoms).
Is methylphenidate (MPH) or atomoxetine superior to the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD)?
Symptoms (assessed on the ADHDRS-IV Parent: Inv and Turgay DSM-IV-Based Child and Adolescent Behaviour Disorders Screening and Rating Scale (T-DSM-IV-S)); response (as defined in the individual studies); acceptability (all cause discontinuation).
Systematic review and meta-analysis.
PubMed, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic reviews were searched for papers published between January 1995 and December 2010. The reference lists of identified papers were also hand searched. Studies could be published in any language.
Randomised, open label and double blind trials comparing MPH versus atomoxetine for children and adolescents with DSM-IV ADHD diagnosed according to DSM-IV criteria were included. Meta-analyses were carried out using random-effects models in RevMan version 5. Standardised mean difference (SMD) was used for continuous outcomes, and RR...]]>
What is the efficacy of antidepressants for the treatment of late life major depressive disorder (MDD)?
Clinical response, defined as a 50% or greater reduction in the Hamilton Depression Rating Scale (HDRS) or the Montgomery-Asberg Depression Rating Scale (MADRS) scores, from baseline to endpoint, or a Clinical Global Impression-Improvement Scale (CGI-I) score <3 at the final visit.
Systematic review and meta-analysis.
PubMed/Medline was searched from 1 January 1980 to 3 March 2010. The search included antidepressants that had received a letter of approval by the USA, Canadian<EU, Japanese or Australian regulatory agencies for treatment of MDD.
Study selection and analysis: Double-blind, placebo controlled, randomised controlled trials (RCTs) of oral antidepressants used as monotherapy for the treatment of MDD in participants less than 65 years (adult MDD) or 55 years or older (late life MDD). RCTs had to be of a parallel design (crossover studies were excluded) and...]]>
How do genetic and environmental factors influence alcoholism in women?
13 595 female twins and 10 524 male twins aged 20–47 years, born in Sweden between 1959 and 1985. The study included monozygotic and same- and opposite-sex dizygotic twins, who were taking part in the Study of Twin Adults: Genes and Environment (STAGE). Participants were identified using the Swedish Twin Registry.
Sweden; 2005.
Genetic and environmental factors; gender; and childhood trauma (measured using the self-completed Life Stressor Checklist, LSC-R). A basic twin model was used to quantify genetic and environmental effects. Heritability (genetic effects) was compared in male and females. Childhood trauma was only assessed in women, and included emotional neglect, physical and sexual trauma.
Lifetime diagnosis of alcohol abuse or alcohol dependence, established using a standardised, computer-assisted Structured Clinical Interview for DSM-IV. Alcoholism was classified as late onset (type I) or early onset (type II) alcoholism,...]]>
Is stimulant treatment associated with an increased risk of cardiovascular events in young people with attention deficit hyperactive disorder (ADHD)?
171 126 youths between the age of 6 and 21 years without known cardiovascular risk factors, who had ADHD and were enrolled in a health plan with pharmacy coverage. Participants were those who had an initial first or second listed service claim for ADHD (ICD-9 code 314) after a period of eligibility of at least 180 days without an ADHD medical claim diagnosis and without any prescriptions for stimulants. Individuals were excluded if they had received a diagnosis of any of a list of ‘high-risk exclusion conditions’ or ‘high-risk censored events’ during the 180-day eligibility period. These conditions and events related to underlying general medical disorders that might increase risk of cardiovascular events or might affect the availability of information on the individual.
MarketScan Research Databases, privately insured...]]>
Does exercise reduce depressive symptoms in patients with a chronic illness?
Depressive symptoms.
Systematic review and meta-analysis.
Physical Activity Guidelines for American Scientific Database, Google Scholar, MEDLINE, PsycINFO, PubMed and Web of Science were searched up to 1 June 2011. Reference lists of retrieved articles were hand-searched for additional articles.
Randomised control trials (RCTs) comparing exercise training versus a non-exercise comparison in sedentary adults with a chronic illness and assessing depression at baseline and during or after the intervention were included. Studies were excluded if they were in patients with a clinical diagnosis of depression; included exercise as a part of a multi-component intervention but did not include the additional components in the comparison group; had an active treatment comparison group; assessed education or promotion interventions aimed at increasing physical activity but failed to show increased physical activity; did not use a screening...]]>
Do parent training programmes reduce symptoms and associated problems in children with attention-deficit hyperactivity disorder (ADHD)?
Primary outcomes: changes in the child's ADHD symptom-related behaviour at home and school; changes in the child's general behaviour.
Systematic review and meta-analysis.
CENTRAL (2010, Issue 3), MEDLINE, EMBASE, CINAHL, PsycINFO, Dissertation Abstracts International and the metaRegister of Controlled Trials were searched in September 2010. The reviewers also contacted experts in the field to ask for details of unpublished or ongoing research. No language restrictions were applied.
Randomised controlled trials (RCTs), including quasi-randomised trials, that compared parent training with no treatment, a waiting list or treatment as usual were included. Trials with interventions administered directly to children and those that did not include any outcome data on children's own behaviour or well-being were excluded. Participants were aged 5–18 years and their main problem had to be clinically...]]>
Are group-based behavioural and cognitive-behavioural parenting interventions effective and cost-effective in reducing early-onset child conduct problems?
Primary outcomes: child behaviour; parental skills; parental mental health; cost-effectiveness. Effects on short-term outcomes (up to 3 months post-treatment) were assessed.
Systematic review and meta-analysis.
CENTRAL (2011, Issue 1), MEDLINE (1950 onwards), EMBASE (1980 onwards), CINAHL (1982 onwards), PsycINFO (1872 onwards), Social Science Citation index (1956 onwards), ASSIA (1987 onwards), ERIC (1966 onwards), Sociological Abstracts (1963 onwards), Academic Search Premier (1970 onwards), Econlit (1969 onwards), PEDE (1980 onwards), Dissertations and Theses Abstracts (1980 onwards), NHS EED (searched 31 January 2011), HEED (searched 31 January 2011), DARE (searched 31 January 2011), HTA (searched 31 January 2011) and randomised controlled trials (mRCT) (searched 29 January 2011) were searched in January 2011. The following parent training websites were searched on 31 January 2011: Triple P Library, Incredible Years Library and Parent Management Training....]]>
Is sertraline (SRT), cognitive behavioural therapy (CBT) or a combination of the two, effective at inducing remission among children and adolescents with anxiety disorders compared with placebo?
488 children and adolescents aged between 7 and 17 years who met DSM-IV criteria for generalised anxiety disorder, social phobia and/or separation anxiety disorder.
Six sites, USA; from 2003 to 2008.
SRT only, CBT only, SRT and CBT (COMB) or placebo pill treatment for 12 weeks.
Remission, defined in three different ways: (A) loss of all targeted anxiety disorders, assessed using the Anxiety Disorders Interview Schedule; (B) Clinical Global Impression Severity Scale (CGI-S) score of 1 (no symptoms) or 2 (minimal symptoms); (C) Clinical Global Impression Improvement Scale (CGI-I) score of 1 (very much improved).
90% completed the study; 100% included in the analysis.
Randomised controlled trial (the Child/Adolescent Anxiety Multimodal Study, CAMS).
Unclear.
The SRT and PBO arms...]]>
What are the characteristics of individuals in the USA who experience suicidal thoughts or attempt suicide but do not receive specialty psychiatric treatment?
75 690 adults taking part in the National Survey on Drug Use and Health (NHSUH) in 2008 and 2009. The sample populations are representative of the US population.
The USA; 2008 and 2009.
Participants completed an audio computer-assisted self-interview. This included single-item yes–no response questions to assess suicidal thoughts and suicide attempts in the preceding 12 months. Further questions were also asked to identify: utilisations of specialty psychiatric treatment (including alcohol, drug abuse or mental health specialty treatment), drug use, psychological distress, depression and demographic information. Descriptive analyses were applied to generate the weighted percentage of suicidal thoughts or attempts by sociodemographic variables of interest and treatment participation. Logistic regressions were then applied to investigate odds of non-receipt of specialty psychiatric treatment among those who...]]>
Does method of most recent non-fatal self-harm predict risk of future suicide?
30 202 individuals who presented to the emergency departments of six hospitals with non-fatal self-harm between January 2000 and December 2007, and for whom follow-up information was available. The median age was 27 years and 41.3% of the cohort were male.
Three centres involved in the Multicentre Study of Self-harm, England; from 2000 to 2010.
Non-fatal self-harm, defined as intentional self-poisoning or self-injury, irrespective of motivation.
Suicide, defined as death where the underlying cause was intentional self-harm (ICD10 codes X60-85) or undetermined intent (Y10-Y34). Mortality information was obtained from the Medical Research Information Service of the NHS (MRIS). Analyses were adjusted for gender, age, unemployment/sickness/disability status and psychiatric treatment at the time of the last non-fatal episode of self-harm.
Prospective cohort study.
Range 3–11 years (median 1938 days).
The majority of individuals...]]>
Are tobacco, alcohol and cannabis use associated with delusional-like experiences (DLE)?
8773 residents of Australia aged between 16 and 85 years that took part in the Australian National Survey of Mental Health and Wellbeing. Samples were selected randomly from a stratified, multistage area probability sample of private dwellings. The survey represents an estimated population of 16 015 000 adults.
Private households, Australia; 2007.
Participants had face to face interviews that assessed DLEs, mental health disorders and physical disorders and exposure to cannabis, tobacco and alcohol. A modified version of the World Mental Health Survey Initiative of the Composite International Diagnostic Interview (WMH-CIDI 3.0) was used to identify lifetime DLEs and lifetime DSM-IV diagnoses of mental health disorders, including anxiety disorders, depressive disorders and alcohol or drug abuse or dependence. People who answered positively on initial screening questions for these disorders were asked further ‘probe’ questions to determine diagnoses....]]>
Do life skills programmes effectively enhance independent living and quality of life for people with chronic mental health problems?
Primary Outcomes: Clinically important changes in general life skills (defined as a ≥50% improvement on any scale); relapse; clinically important changes in general mental state. Secondary Outcomes: General and specific life skills; global state; service outcome (hospitalisation); mental state; general functioning; behaviour; adverse effects; engagement in services; satisfaction with treatment; quality of life.
Systematic review and meta-analysis.
The Cochrane Schizophrenia Group Trials Register (June 2010) was searched with supplemental hand searching of included studies' reference lists.
Randomised or quasi-randomised controlled trials of life skills programmes versus comparable therapies or standard care in adults between the ages of 18 and 60 years with chronic mental illness diagnosed by any criteria. Trials enrolling people with dementia, alcoholism, organic brain syndrome or those at serious suicidal risk...]]>