Our target audience includes psychiatrists, psychologists, nurses, social workers, occupational therapists, pharmacists, and other professionals whose work may be enhanced by up to date research. Evidence-Based Mental Health is multidisciplinary. It covers studies of adults, children, older adults, people who have developed psychiatric or psychological problems as a result of trauma, and people with learning disabilities, head injuries, drug and alcohol problems, and personality disorders.
Relevant articles which meet these criteria are summarised using a structured abstract. Articles are reviewed by experts in the field who provide commentaries...]]>
To address negative impacts, mental health and psychosocial support (MHPSS) programmes are increasingly a standard component of humanitarian response. MHPSS has...]]>
Are sociodemographic variables, childhood adversity or mental health disorders associated with incident drug use in adults who report no prior drug use?
26 935 community dwelling adults enrolled in the National Epidemiological Survey on Alcohol and Related Conditions. Participants had to report no history of illicit drug use during the first wave of the study (from 2001 to 2002) for inclusion in the current analysis. Incident drug use was assessed in a second wave of interviews (from 2004 to 2005).
Community setting, USA; from 2001 to 2005.
Sociodemographic variables: income, race, education, marital status, age, sex and region. Childhood traumatic events: physical abuse, witnessing violence in the home, neglect and sexual assault. Family history of substance use: first-degree relatives (siblings or parents) with a history of problem drinking or problem drug use. Mental health disorders (defined...]]>
Do child-, adolescent- and young adult-onset depression have distinct risk factors and is their effect time limited?
1004 children. A representative sample of 9 and 11-year-old children from the study areas were assessed with Child Behaviour checklist. Those scoring above a predefined cut-off designed to identify the most pathological 25% of the population were selected to take part, plus a random sample of 10% of other children and all eligible American Indian children.
Community setting, North Carolina, USA; study period not reported.
Psychosocial risk factors including poverty, loss (including death) and violence events, parental psychopathology, maltreatment and family dysfunction. Risk factors were assessed using the Child and Adolescent Psychiatric Assessment (CAPA) annually up to age 16, and then the Young Adult Psychiatric Assessment (YAPA) at ages 19 and 21. Risk factors were assessed at the time...]]>
Does use of first- or second-generation antipsychotics or other characteristics increase the risk of unexplained sudden death in psychiatric patients?
100 consecutive cases of sudden and unexpected death among adult patients (age 17–74 years) receiving outpatient or inpatient care at a behavioural health hospital. Deaths due to trauma, suicide, homicide, or intentional or accidental drug overdoses were excluded from the study. Cases were entered into the study in reverse chronological order, starting with the patients who died in 2009 and working backwards until a cohort of 100 was obtained.
One large psychiatric hospital, NewYork City, USA; from 1984 to 2009.
Demographic characteristics (age and sex), psychiatric diagnosis (psychotic disorders, mood disorders, anxiety disorders, substance use disorders and others), psychotropic medications (first-generation antipsychotics, second-generation antipsychotics, antidepressants, mood stabilisers, benzodiazepines, methadone and psychostimulants), and medical history.
What is the sibling recurrence risk of autism spectrum disorder?
664 infant siblings (≤18 months) of children with autism spectrum disorders (ASDs, including autistic disorder, Asperger's disorder or a pervasive development disorder not otherwise specified). Participants were recruited from ASD clinics and the community. Most sites verified the diagnosis of the older sibling using standardised diagnostic assessments and/or parent diagnostic interviews. Only one infant per family was included in the analysis, and the youngest eligible child was selected.
12 Canadian and USA university sites in the Baby Siblings Research Consortium; time period not stated.
An older sibling with ASD and no identified neurological or genetic condition that could account for ASD diagnosis. Analyses took into account significant demographic and child-specific predictors of outcome.
Diagnosis of ASD at 36 months, defined as scoring above...]]>
Is depression associated with an increased risk of developing stroke?
Incidence of stroke (fatal, non-fatal or both).
Systematic review with meta-analysis.
PubMed was searched up to May 2011 without restrictions. Reference lists of obtained articles were also reviewed.
The inclusion criteria were (1) prospective community-based or population-based study; (2) depression or depressive symptoms were the exposure; (3) stroke incidence was the outcome; (4) participants free of stroke at enrolment; and (5) the risk estimate and the corresponding 95% CI of the depression-stroke association were reported. Two reviewers independently carried out the literature search, study selection and data extraction using a standardised data collection form. Disagreements were resolved through discussion. The selected measure of association between depression and stroke was RR. The most fully adjusted risk estimate from each...]]>
Is there an association between cognitive function and risk for schizophrenia?
Diagnosis of schizophreniform, schizoaffective, schizotypal or psychotic disorders or schizophrenia, using ICD or DSM criteria.
Systematic review and meta-analysis.
Medline-Pubmed, PsycINFO and Embase were searched from 1984 up to February 2011. Hand searches of selected publications' reference lists and related conference proceedings were also conducted. Prominent researchers in the field were contacted for unpublished work.
For inclusion studies had to be population-based cohort or nested case control studies that measured intelligence using standard psychometric tests in childhood or before the onset or diagnosis of schizophrenia, and identified cases using population-based registers or cohorts. Studies that used an estimation or indirect assessment of IQ were excluded. For populations reported in multiple publications, the publication with the longer follow-up...]]>
Is the Strengths and Difficulties Questionnaire (SDQ) hyperactivity-inattention subscale and predictive algorithm a valid screening tool for attention deficit hyperactivity disorder (ADHD) phenotype in Norwegian school children?
6233 children (7–9 years old). Questionnaires were sent to teachers and parents of all 9137 children enrolled in second through fourth grades in Bergen, Norway during 2002.
Public, private and special education schools in Bergen, Norway; 2002.
SDQ hyperactivity-inattention subscale, reported by both teachers and parents. The SDQ is a 25 item broad-band questionnaire designed for parents, teachers and self-report, and covers child behaviour, emotions, relationships and symptom impact. The inattention-hyperactivity subscale consists of 5 items, and is combined with impact scores using a prediction algorithm to predict ‘unlikely’, ‘possible’ and ‘probable’ cases of ADHD.
18-item SNAP-IV scale (teacher and parent report) for DSM-IV ADHD symptoms....]]>
Are there associations between psychological characteristics, life event and self-harm history among teenagers?
30 447 adolescents (14 to 17 years old) participating in the Child & Adolescent Self-harm in Europe (CASE) study. Adolescents attended secondary schools that were selected to be locally and nationally representative. Response rate varied from 81% to 91% in the participating countries.
Belgium, England, Hungary, Ireland, The Netherlands, Norway and Australia; time period not stated.
Anonymous school-based survey, including questions on self-harm, psychological characteristics and stressful-life events. Self-harm was defined as deliberate actions intended to cause self-harm that were non-fatal, regardless of motivation. Four psychological characteristics were measured: anxiety and depression (Hospital Anxiety and Depression scale), impulsivity (six item scale) and self-esteem (eight item abbreviated Robson self-concept scale). There were 10 categories of stressful-life events, which were categorised as occurring in the past...]]>
What is the incidence of written-language disorder (WLD), with and without reading disability (RD), among children with and without attention-deficit/hyperactivity disorder (ADHD)?
5699 children born between 1st January 1976 and 31st December 1982 in one school district, who still lived in the area after age 5 years, and who did not have clinical diagnoses of severe intellectual disability or full-scale IQ scores <50.
Rochester, Minnesota, USA; participants born from 1976 to 1982.
Children were assessed for ADHD, WLD and RD retrospectively from birth until death, emigration or graduation using school and medical records. Individuals with ADHD had to meet DSM-IV criteria of ADHD; have positive ADHD questionnaire results; or have a clinical diagnosis of ADHD. The date of ADHD diagnosis was either when clinical diagnosis was made, or in its absence the date of the first positive...]]>
Do children with social phobia (SP) and Asperger's disorder have similar social skill deficits and vocal characteristics?
90 children aged 7–13 years old: 30 with a primary diagnosis of SP, 30 with Asperger's disorder and 30 typically developing peer group controls with no psychiatric diagnoses. Children with Asperger's disorder also had to have high social anxiety on the SP and Anxiety Inventory for Children (SPAI-C; score ≥14 for boys and ≥18 for girls).
One university anxiety disorders clinic, Florida, USA; time period not stated.
The social skills and vocal characteristics of the participants were assessed using a Behavioural Assessment Task. Participants were scored for their responses during brief interactions with a same-age peer over five scenarios: starting a conversation with an unfamiliar child, offering help, giving a compliment, receiving a compliment and responding assertively to inappropriate behaviour....]]>
Are children and adolescents in the child welfare system at increased risk for suicide and attempted suicide compared with those not in care, and do rates differ before and after entry into care?
8279 children and adolescents (aged 5–17 years) in the care of Manitoba's child and family services for the first time between 1997 and 2006, and a population-based control cohort of all 353 050 similarly aged children and adolescents in the region not in care. Those in care had to have been removed for the home, spent more than 30 days in care, be resident in Manitoba and be covered by Manitoba Health for the duration of the study period.
Manitoba, Canada; from 1997 to 2008.
Being in or entry into the care of child and family services. The model included in care status,...]]>
Is statin use associated with a reduced risk of developing depression after hospital discharge in individuals who have experienced a cardiac event or intervention?
193 adults (mean age 64.14 years; 80.8% male; 34.7% with a history of depression), admitted to hospital for angioplasty, myocardial infarction or coronary artery bypass surgery.
A regional tertiary hospital in Geelong, Australia; recruitment from 2005 to 2006.
Statin prescription at discharge, as recorded in medical records. Analyses were adjusted for age, sex, functional status (assessed as effort tolerance measured with the physical functioning items in the Short Form-36), neuroticism (assessed using the International Personality Item Pool Representation of the Revised NEO Personality Inventory), history of depression, smoking, diabetes, body mass index, disease severity (defined using left ventricular ejection fraction) and aspirin therapy.
Major depressive disorder (MDD), or any...]]>
Does parental attention-deficit/hyperactivity disorder (ADHD) predict child and parent outcomes of parental friendship coaching?
62 children (6–10 years old) with confirmed diagnoses of ADHD and one parent for each of the children. Children with a pervasive developmental disorder, full Scale IQ<70 or verbal IQ<75 were excluded. Participants had taken part in a randomised controlled trial comparing parental friendship coaching versus control (no coaching). Parental friendship coaching was a parent training intervention aimed at improving the children's friendship skills. The participating families were recruited from local schools, clinics and paediatrics offices.
USA; time period not stated.
Parental ADHD symptoms and parent-child interactions. The parents completed an 18-item Current Symptoms Scale to provide a measure of ADHD symptoms (inattention, impulsivity and hyperactivity) at baseline. Parent-child interactions were observed in laboratory-based playgroups.
Children's social functioning and...]]>
What effect does a continuing care model and its components have on remission status in people with substance use disorders?
991 people with substance use disorders (alcohol or drugs or both). These individuals were selected from 1953 people who were taking part in two large randomised studies assessing day hospital treatment and integrated care. Participants had to have been Kaiser Permanente members for at least 5.4 years in the study period, and have had at least one follow-up interview.
Kaiser Permanente Sacramento Chemical Dependency Recovery Program, USA; from 1994 to 2007.
Type of service use (including primary care, specialty substance abuse treatments and psychiatric services, as well as continuing care). The initial model included demographic characteristics, baseline alcohol and drug dependence, completion of index treatment, severity of substance use and psychiatric problems (Addiction Severity Index, ASI),...]]>
Are people with schizophrenia in low- and middle-income countries at increased risk of mortality?
321 community dwelling adults (aged between 15 and 49 years) resident in the rural Butajira district of Ethiopia meeting the International Classification of Diseases-10 diagnostic criteria for schizophrenia. To identify participants, an initial screen targeted the estimated 83 282 adults in the district. 68 378 individuals completed the screening survey to identify those potentially having severe mental disorders. 2878 of these screened positive and underwent diagnostic interview. 321 individuals were diagnosed with schizophrenia.
Butajira district, Ethiopia; time period not stated.
Schizophrenia diagnosis. Diagnoses were made in two stages: first a door-to-door screening survey using the affective and psychoses modules of the WHO's Composite International Diagnostic Interview – version 2.1; second, a confirmatory diagnostic interview of all screen positive participants, using the WHO...]]>
Are children and young adults using attention deficit hyperactivity disorder (ADHD) medication are at increased risk for serious cardiovascular adverse events?
1 200 438 children and young people (aged 2–24 years; mean age 11.1 years at baseline). Patients with congenital heart disease were included.
Four health plans, USA; from 1986 to 2005.
Current use of ADHD medication (methylphenidate, dexmethylphenidate, dextroamphetamines, amphetamine salts, atomoxetine or pemoline). Individuals using these medications were identified from medical records, and could leave and re-enter the cohort as long as they continued to meet eligibility criteria. For each ADHD medication user up to two non-users were selected at random from the same site. Controls were matched by calendar year, age and gender and could have previous non-qualifying use of ADHD medications. Time spent in hospital and 30 days after discharge was not...]]>
Is there an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department?
72 765 people born in Denmark between 1983 and 1989 (3465 cases and 69 300 controls). Data for every individual born in the eligible period were extracted from Danish national registers (403 431 individuals). Of the total number, 3465 had attempted suicide (cases) between their 10th birthday and 31 December 2005, when they would be up to the age of 22 years. Each of these cases was matched with 20 non-suicidal controls for age, gender and being alive at the time of the suicide attempt.
General population, Denmark; from 1983 to 2005.
The focal prognostic factor was contact with a psychiatric department. This was defined as use of psychiatric services provided by psychiatric hospital units, including hospitalisation,...]]>
What is the efficacy and acceptability of antimanic pharmacotherapy for acute mania?
Primary outcomes: change in manic symptoms (mean change on the Young Mania Rating Scale, YMRS); drop-out rates during the first 3 weeks of treatment.
Systematic review and meta analysis.
Medline, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycInfo, the Cochrane Central Register of Controlled Trials and main regulatory agency databases were searched for publications between 1980 and November 2010. Study authors and main manufacturers were contacted to identify unpublished studies and additional data on published studies.
All randomised, double-blind trials comparing an antimanic oral drug with another antimanic drug or placebo in people with acute mania. Participants had to be above the age of 18 years, with a primary diagnosis of bipolar I disorder...]]>
Is -3 fatty acid supplementation effective in treating attention deficit hyperactivity disorder (ADHD) symptoms in children?
Primary outcome: change in ADHD severity (standardised mean difference in change between intervention and placebo). Secondary outcome: relationship between dose of different -3 fatty acids in supplements and effectiveness.
Systematic review and meta-analysis.
PUBMED was searched from 1965 up to December 2010. Unpublished or ongoing trials were searched for using the ClinicalTrials.gov website. Hand searches of the reference lists of relevant meta-analyses or reviews were also conducted.
Randomised placebo-controlled trials which examined the efficacy of -3 fatty acid supplementation in children with ADHD or targeting ADHD symptoms in undiagnosed children or those with comorbidities were included. Studies were required to have used a validated rating scale to measure ADHD symptom severity....]]>
Are the second-generation antipsychotic drugs (SGAs) different in their capacity to induce extrapyramidal side effects (EPS)?
Primary outcome: use of antiparkinson medication at least once (used as a global measure for EPS).
Systematic review and meta-analysis.
The register of the Cochrane Schizophrenia Group was searched up to May 2007, and MEDLINE was searched up to July 2009, with no language restrictions. The search terms used were all 36 possible combinations of the names of the SGAs, including trade names. The SGAs in question were amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone and zotepine. Manufacturers were contacted for details of published and unpublished studies, and study authors were contacted for missing data in their studies.
Blinded randomised controlled trials (RCTs) directly comparing different orally administered SGAs for the...]]>
Is multisystemic therapy (MST) more effective than current statutory UK services at reducing youth offending among urban young offenders?
108 youths aged between 13 and 17 years old on court referral for treatment with a supervision order of at least 3 months, or on license in the community for a minimum of 6 months following imprisonment. Participants had to be living in the home of and being raised by a parent or principal caretaker. Exclusion criteria: sex offenders; presenting with only substance misuse; psychotic illness; risk to study personnel; or involvement of an incompatible agency (eg, ongoing care proceedings).
Two local youth offending services in North London, UK; from 2003 to 2009.
MST or usual care from youth offending teams (YOT) for 6 months. MST is an intensive family- and community-based that targets the drivers of serious...]]>
How effective is online delivery of cognitive-behaviour therapy (CBT) compared with clinic-based CBT for treatment of anxiety disorders in adolescents?
115 adolescents aged between 12 and 18 years with a primary diagnosis of separation anxiety disorder, social phobia, generalised anxiety disorder or specific phobia and at least one of their parents.
Three academic sites in Australia; from 2006 to 2008.
Internet-based CBT (NET), clinic-based CBT (CLIN) or wait list control (WLC). The NET group completed the ‘BRAVEfor Teenagers – ONLINE’ programme, which is designed to be equivalent to the clinic-based programme, ‘BRAVE-CLINIC’. Sessions lasted about 60 min, and adolescents received 10 weekly sessions and their parents received five. A therapist monitored progress and provided email feedback following each NET session. The CLIN group received the programme via face-to-face sessions with their therapist within a clinic setting. Booster...]]>
Are 16 psychotherapy sessions more effective than eight sessions in improving social functioning of patients with major depression receiving pharmacotherapy?
463 community-dwelling adults (aged 18–60 years) with DSM-IV major depressive disorder (with or without dysthymia) and baseline score ≥14 on the Hamilton Depression Rating Scale (HDRS). Exclusion criteria: presence of a mental disorder due to a medical condition, drug abuse, psychotic and/or dissociative disorder, communication barrier, adequate treatment with antidepressants during the present depressive episode, use of psychotropic medication other than those prescribed by the protocol, pregnancy or intention to become pregnant, being considered ‘too ill’, ‘too suicidal’ or not reliable enough to participate.
Outpatient clinic at a teaching hospital, Amsterdam; time period not stated.
Eight or 16, 45-min sessions of short psychodynamic supportive pscyhotherapy. The first eight sessions were weekly for both groups, then the remaining...]]>
Are -3 fatty acids effective in improving the core features and associated symptoms of autism spectrum disorders (ASD)?
Improvements in ASD core features (social interaction, communication and stereotypy) on any scale. Secondary outcomes included improvements in aggression, hyperactivity, insomnia, self-injury and quality of life for individuals and families.
Systematic review and meta-analysis.
CENTRAL, MEDLINE, EMBASE, PsycINFO, BIOSIS, CINAHL, Science Citation Index, Social Science Citation Index and clinicaltrials.gov were searched up to 2 June 2010 and metaRegister of Controlled Trials and Dissertation Abstracts International searched up to 10 December 2008. Reference lists of retrieved articles and the internet were also searched, and authors of included trials contacted.
Randomised controlled trials (RCT) of any type of -3 fatty acid supplement compared with placebo in people with ASD diagnosed...]]>
Is a family-centred distance intervention delivered by non-professionals effective in children with mild or moderate oppositional-defiant (ODD), attention deficit hyperactivity (ADHD) or anxiety disorders?
243 children with a mild or moderate diagnosis of ODD, ADHD or an anxiety disorder based on the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Versions parental interview (K-SADS-PL); with impairment in ≥2 domains, symptoms for ≥6 months, and stable medication in the month before baseline. Of the participants, 80 children (3–7 years old) had a primary diagnosis of ODD; 72 children (8–12 years old) had ADHD; and 91 children (6–12 years old) had an anxiety disorder.
Home settings, Nova Scotia, Canada; from May 2003 to September 2007.
The Strongest Families intervention or usual care alone. The intervention consisted of evidence-based handbooks and videos promoting skill-focused learning, and weekly telephone coaching sessions...]]>