Journal articles: 'How women respond to psychiatric diagnosis'

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Mehl-Madrona, Lewis, Patrick McFarlane, and Barbara Mainguy. "Epigenetics, Gender, and Sex in the Diagnosis of Depression." Current Psychiatry Research and Reviews 15, no. 4 (January 15, 2020): 277–89. http://dx.doi.org/10.2174/2666082215666191029141418.

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Background : A marked sexual dimorphism exists in psychiatric diagnoses. Culture derived gender bias in diagnostic criteria is one explanation. Adverse childhood events, including sexual and physical abuse, are more reliable and consistent predictors of later psychiatric diagnoses, including depression and post-traumatic stress disorder. Some interesting interactions between genes and experience have been uncovered, but the primary effect appears to be epigenetic with life experience altering gene expression and being transmitted to subsequent generations. Objectives : To determine if reconceptualizing depression as encompassing both internalizing and externalizing strategies would eliminate gender differences in the diagnosis of depression Methods : We reviewed 74 life stories of patients, collected during a study of the effect of physicians’ knowing patients’ life stories on the quality of the doctor-patient relationship. Looking at diagnoses, the prevalence of women to men was 2.9 to 1. We redefined depression as a response to being in a seemingly hopeless situation accompanied by despair, either externalizing ((more often diagnosed as substance use disorders, impulse control disorders, antisocial personality disorder, or bipolar disorder) or internalizing (the more standard diagnosis of depression). Then we reviewed these life stories from that perspective to determine how many would be diagnosed as depressed. Results : With this reconceptualization of depression, the sex ratio changed to 1.2 to 1. Conclusions: From this perspective, men and women are equally likely to respond to hopelessness, though men are more socialized to externalize and women to internalize. Considering depression in this way may help to better identify men at risk for suicide.

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Strauss Swanson, Charlotte, and Tracy Schroepfer. "Personal reactions to sexual assault disclosures made by female clients diagnosed with serious mental illness." Journal of Mental Health Training, Education and Practice 13, no. 4 (July 9, 2018): 248–56. http://dx.doi.org/10.1108/jmhtep-10-2017-0057.

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Purpose Mental health practitioners working with female clients diagnosed with a serious mental illness (SMI) often face client disclosures of sexual assault. Research has shown that practitioners’ responses can be complicated by the diagnosis and lack of professional training; however, less is known about the role their personal factors may play. The purpose of this paper is twofold: to further understanding of practitioners’ personal reactions and investigate how these reactions affect their professional response. Design/methodology/approach Nine mental health practitioners participated in face-to-face interviews, in which they were asked to describe their personal reactions when faced with a disclosure and to discuss how these reactions influence client assessment, treatment and referral. Findings The study results show that lacking training, practitioners expressed feelings of uncertainty, fear and worry about how best to respond without causing further harm. Findings serve to inform future training to support practitioners and, as a result, improve care and treatment for this population. Originality/value This study is unique because it explores the personal reactions mental health practitioners’ experience when responding to disclosures of sexual assault among women diagnosed with an SMI and how these reactions may impact their professional response.

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Roselló Peñaloza, Miguel, Pablo Gómez Fuentealba, and Patricia Castillo Gallardo. "Sex differences and the influence of social factors in a Chilean urban psychiatric hospital population." International Journal of Social Psychiatry 64, no. 2 (December 25, 2017): 166–79. http://dx.doi.org/10.1177/0020764017748343.

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Background: The epidemiological literature has reported differences by sex in the prevalence of psychiatric diagnoses. However, we know little about how other socio-demographic factors participate in these differences. Aim: To identify the socio-demographic factors that correlate with prevalent psychiatric diagnoses in women and men in a Chilean urban psychiatric hospital population. Method: Socio-demographic information (age, educational level, marital status, family group and work status), psychiatric diagnoses and sex of the population were collected for 3,920 patients of a tertiary care hospital during a period of 8 years (2007–2014). The data were subjected to bivariate and multivariate analyses comparing the results by sex. Results: Among the most prevalent psychiatric diagnoses, those significantly correlated with sex were eating disorders and major depression (women) and schizophrenia (men). Socio-demographic factors behave differently in men and women regarding those diagnoses. Among the differences, working and being married correlated directly with the diagnosis of depression only among women. Living alone correlated directly with the diagnosis of schizophrenia among men, but correlated inversely among women. Conclusion: Dissimilar associations between sex, psychiatric diagnosis and socio-demographic factors found in this Latin American sample invite us to reflect on how social conditions crosscut the relation between sex and psychopathology and to include gender perspectives in psychiatric practices.

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Smith, Annette R. "Alcoholism and Gender: Patterns of Diagnosis and Response." Journal of Drug Issues 16, no. 3 (July 1986): 407–20. http://dx.doi.org/10.1177/002204268601600307.

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Through in-depth interviews with 10(ten) male and 10(ten) female self-identified recovering alcoholics, this study examines the gender-related differences in pathways to alcoholism diagnosis and treatment. Respondents' stories suggest that while denial of the diagnosis delays appropriate treatment for both men and women, gender-related differences in the nature of the denial systems, such as who makes the diagnosis, who responds to it and how, keep women from such treatment more often than men. This applies irrespective of other gender differences in actual drinking behavior or rationale, symptoms (including psychopathology), time of onset or course of illness.

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Mace, Chris, and Sharon Binyon. "Teaching psychodynamic formulation to psychiatric trainees: Part 1: Basics of formulation." Advances in Psychiatric Treatment 11, no. 6 (November 2005): 416–23. http://dx.doi.org/10.1192/apt.11.6.416.

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All psychiatrists should be able to construct a psychodynamic formulation of a case. A key advantage of formulation over diagnosis is that it can be used to predict how an individual might respond in certain situations and to various psychotherapies. This article looks in some depth at what psychiatric trainees need to be taught about psychodynamic formulation. We introduce formulation in terms of four levels, each level corresponding to a different degree of theoretical and clinical sophistication and therefore to different trainees' needs. We use a case vignette to illustrate how a clinical situation might be formulated at each of these levels.

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Casarotti, Humberto L. "The "mental feature" in mental illness: difficulties that this reality poses for diagnosis and classification." Trends in Psychiatry and Psychotherapy 35, no. 2 (2013): 87–98. http://dx.doi.org/10.1590/s2237-60892013000200001.

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Four points are considered in this article. In the first place, it is argued that the "settings" of psychiatric care express the need to respond to the degree of decrease in personal freedom of the patient. Then, the issue of how "the mental feature" of the mental pathology has been recognized and categorized since the 18th century is examined, pointing out the difficulties involved in considering the mental nature of the subject of psychiatry. In the third place, the issue of how current systems of diagnosis and classification are posed regarding this reality is briefly looked at. Finally, the characteristics of a working hypothesis that allows organizing consistent clinical facts providing a heuristic perspective are analyzed.

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Gaalema, Diann E., Jennifer W. Tidey, Danielle R. Davis, Stacey C. Sigmon, Sarah H. Heil, Maxine L. Stitzer, Michael J. Desarno, Valeria Diaz, John R. Hughes, and Stephen T. Higgins. "Potential Moderating Effects of Psychiatric Diagnosis and Symptom Severity on Subjective and Behavioral Responses to Reduced Nicotine Content Cigarettes." Nicotine & Tobacco Research 21, Supplement_1 (December 2019): S29—S37. http://dx.doi.org/10.1093/ntr/ntz139.

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Abstract Introduction Given FDA’s authority to implement a cigarette nicotine reduction policy, possible outcomes of this regulation must be examined, especially among those who may be most affected, such as those with comorbid psychiatric disorders. Methods In this secondary analysis of a multisite, randomized, clinical laboratory study, we used analyses of variance to examine the effects of nicotine dose (0.4, 2.4, 5.2, and 15.8 mg/g of tobacco), depressive and anxiety diagnoses (depression only, anxiety only, both, or neither), and depressive and anxiety symptom severity on cigarette choice, smoke exposure, craving, and withdrawal across three vulnerable populations: socioeconomically disadvantaged women of reproductive age, opioid-dependent individuals, and those with affective disorders (n = 169). Results Diagnosis and symptom severity largely had no effects on smoking choice, total puff volume, or CO boost. Significant main effects on craving and withdrawal were observed, with higher scores in those with both anxiety and depression diagnoses compared with depression alone or no diagnosis, and in those with more severe depressive symptoms (p’s < .001). These factors did not interact with nicotine dose. Cigarettes with <15.8 mg/g nicotine were less reinforcing, decreased total puff volume, and produced significant but lower magnitude and shorter duration reductions in craving and withdrawal than higher doses (p’s < .01). Conclusions Reducing nicotine dose reduced measures of cigarette addiction potential, with little evidence of moderation by either psychiatric diagnosis or symptom severity, providing evidence that those with comorbid psychiatric disorders would respond to a nicotine reduction policy similarly to other smokers. Implications Thus far, controlled studies in healthy populations of smokers have demonstrated that use of very low nicotine content cigarettes reduces cigarette use and dependence without resulting in compensatory smoking. These analyses extend those findings to a vulnerable population of interest, those with comorbid psychiatric disorders. Cigarettes with very low nicotine content were less reinforcing, decreased total puff volume, and produced significant but lower magnitude and shorter duration reductions in craving and withdrawal than higher doses. These nicotine dose effects did not interact with psychiatric diagnosis or mood symptom severity suggesting that smokers in this vulnerable population would respond to a nicotine reduction strategy similarly to other smokers.

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Townsend, Tiffany G., Stacey Kaltman, Farzana Saleem, Dionne S. Coker-Appiah, and Bonnie L. Green. "Ethnic Disparities in Trauma-Related Mental Illness: Is Ethnic Identity a Buffer?" Journal of Interpersonal Violence 35, no. 11-12 (April 5, 2017): 2164–88. http://dx.doi.org/10.1177/0886260517701454.

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Despite evidence that racial and ethnic characteristics influence the impact of traumatic exposure on psychological health, little is known about how race and ethnic identity can alter, and possibly protect against, the effects of trauma on the psychiatric diagnoses of women. Therefore, the present study examined the moderating role of race/ethnicity and ethnic identity in the link between trauma exposure and psychiatric diagnosis for African American and Caucasian college women. Participants were a sample of 242 women from the Mid-Atlantic region of the United States who self-identified as African American or Black (31%) and European American or Caucasian (69%; M age = 19.5 years). Interviews were conducted over the phone to screen for trauma, followed by longer in-person interviews. Each of the interviewers was supervised, and interviews were reviewed to control for quality. Regression analyses revealed that the number of traumatic events was a stronger predictor of lifetime psychiatric diagnoses for Caucasian women. In addition, ethnic identity served as a protective factor against trauma exposure among participants. The findings suggest that ethnic identity is a relevant buffer against potential psychiatric diagnoses as result of exposure to traumatic events for both Caucasian and African American women.

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Rivis, I., I. Papavă, M. Minciună, A. Bredicean, and S. Ursoniu. "The emotional schemas of psychiatric patients- a case-control study." European Psychiatry 64, S1 (April 2021): S468—S469. http://dx.doi.org/10.1192/j.eurpsy.2021.1251.

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IntroductionOur Emotional Schemas dictate how we deal with our own emotions, therefore, how we interpret and face different events that occur in our everyday life. Maladaptive schemas have been proven to be at fault for the inability to face different challenges.ObjectivesThis study aims to find the differences in emotional schemas between subjects with history of psychiatric disorder and subjects without a psychiatric disorder.MethodsWe realized a case-control study matched for age and gender, and analyzed the answers of 28 subjects (14 women and 14 men) to Leahy Emotional Schema Scale (LESS); 14 of which have a personal history of psychiatric disorders, while the remaining 14 had no such history. The LESS evaluation was part of a bigger study and was addressed to the general population, over 18 years old. The test was applied online, with the informed consent of the subjects.ResultsThe mean age of the participants was 40.28±13.98. Out of the 14 subjects with a psychiatric diagnosis, 71,43% have a job, 21,43% are retired and 1% are still studying. There was a significant difference between the two groups regarding the Higher Values dimension of the Emotional Schemas (p=0.0419). Also, the question regarding the feeling of shame when it comes to their own feeling, showed significant difference between the two groups (p=0.0211).ConclusionsAs opposed to the subjects without a history of psychiatric disorder, those who do have a psychiatric diagnosis, feel more often devalued and ashamed, therefore having a lower self-esteem.

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Sceusa, F., A. Mauro, S. Pompili, L. Orsolini, and U. Volpe. "The impact of a regional training program on peripartum depression in territorial psychiatric services." European Psychiatry 64, S1 (April 2021): S181—S182. http://dx.doi.org/10.1192/j.eurpsy.2021.481.

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IntroductionThe Unit of Clinical Psychiatry of the University Hospital “Ospedali Riuniti – Ancona”, in collaboration with the Marche Region Health System, is conducting a national observational project entitled “Measures related to the prevention, diagnosis, treatment and assistance of postpartum depressive syndrome”, aiming at promoting women’s Mental Health, particularly in pregnancy and peripartum period.ObjectivesThe primary objective is implementing all measures/interventions needed to promptly screening, early diagnosising, and supporting/caring women with mental health disease during pregnancy and peripartum period. A dedicated training program was performed by our clinical team belonging to the Peripartum Psychiatry Outpatient Service of the Unit of Clinical Psychiatry, at the University Hospital “Ospedali Riuniti”, Ancona, Italy, to a selected audience of Gynecologists/Obstetricians/Nurses/Psychologists/Psychiatrists/GPs and Pediatricians.MethodsThe training program is a 2-days residential course, held on 21-22th September, 2020. After the training program, all participants (n= 70) were asked to provide an informed consent and complete an online questionnaire to evaluate knowledge/opinions/experiences and clinical practices in the field of depression in pregnancy and postpartum.ResultsA 40-items questionnaire investigated: a) general attitude in performing screening of depression/anxiety during pregnancy; b) overall knowledge about peripartum depression; c) overall knowledge about management/treatment; d) how physicians manage patients with peripartum depression/anxiety (i.e., how they perform screening/diagnosis/treatment during pregnancy, their levels of knowledge/confidence about psychopharmacology in pregnancy).ConclusionsThe findings of the residential course may allow clinicians to adequately inform and help in drafting a preventive, screening and management program able to assist regional stakeholders in the prevention, diagnosis, treatment and assistance of perinatal depression.DisclosureNo significant relationships.

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Giorgio, G., and F. Marmo. "Which Type Of Management Is Most Suited For Patients With A Diagnosis Of False Self Personality (FSP) Within A Psychodynamically-Oriented Institutional Day Hospital? A Study." European Psychiatry 33, S1 (March 2016): S530. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1960.

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IntroductionOur work team have already found that our Institutional Psychiatric Open Light Treatment (IPOLT) model allows the patient affected by severe mental illness (SMI) to more easily express her/his personal coping skills rather than behaving passively thanks to the “real free spaces” separating a structured intervention from another. Our work consisted in evaluating how patients with FSP respond to IPOLT.ObjectivesThis paper describes observations of psychotic patients operating from the position of FSP in order to evaluate how they respond to IPOLT compared with other patients according to three standards (day hospital attendance, psychotic episodes and hospital admissions).AimsIdentify the core factors for management of patients with FSP in the context of IPOLT.MethodsWe isolated a sample including patients affected by severe mental illness (SMI); within this sample, we selected a small group of patients with FSP. During the last three years, we have been evaluating patients with FSP in terms of day hospital attendance, number of psychotic episodes and number of hospital admissions compared with data obtained from other patients with SMI without diagnosis of FSP.ResultsThe two data sets revealed no statistically significant differences in terms of the three standards.ConclusionsOur preliminary study showed a good effect for IPOLT treatment on patients with SMI. We expected that patients affected by SMI with FSP would have a different response to IPOLT, but it was not. We do not know whether such results depend on a too small sample of patients or inappropriate descriptors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Gesi, Camilla, Federico Grasso, Filippo Dragogna, Marco Vercesi, Silvia Paletta, Pierluigi Politi, Claudio Mencacci, and Giancarlo Cerveri. "How Did COVID-19 Affect Suicidality? Data from a Multicentric Study in Lombardy." Journal of Clinical Medicine 10, no. 11 (May 29, 2021): 2410. http://dx.doi.org/10.3390/jcm10112410.

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The aim of the study was to describe the characteristics of subjects accessing the emergency rooms for suicidal behavior during the first epidemic wave of COVID-19 in three Emergency Departments (EDs) in Lombardy (Italy). A retrospective chart review was conducted for the period 8 March–3 June 2020, and during the same time frame in 2019. For all subjects accessing for suicidality, socio-demographic and clinical data were collected and compared between the two years. The proportion of subjects accessing for suicidality was significantly higher in 2020 than in 2019 (13.0 vs. 17.2%, p = 0.03). No differences between the two years were found for sex, triage priority level, history of substance abuse, factor triggering suicidality and discharge diagnosis. During 2020 a greater proportion of subjects did not show any mental disorders and were psychotropic drug-free. Women were more likely than men to receive inpatient psychiatric treatment, while men were more likely to be discharged with a diagnosis of acute alcohol/drug intoxication. Our study provides hints for managing suicidal behaviors during the still ongoing emergency and may be primary ground for further studies on suicidality in the course of or after massive infectious outbreaks.

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Cardoso, L. "Systematization of collection of relevant information about community maintenance treatment of people egress of psychiatric hospitalization." European Psychiatry 26, S2 (March 2011): 519. http://dx.doi.org/10.1016/s0924-9338(11)72226-x.

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In therapeutic advances context of mental care patients, community services are essential to maintenance treatment of people with severe mental disorders especially in people egress of psychiatric hospitalization cases. This research aim was to evaluate use of instruments to collect relevant information about maintenance treatment in a community mental health service.A two years quantitative and cross-sectional study developed in a community mental health service in Ribeirao Preto city- Sao Paulo - Brazil. The sample was egress patients and their family caregivers. It was utilizing a monthly nursing interview with following during six months with each patient and caregiver, to apply: sociodemographic and clinical questions; Structured Clinical Interview for Brief Psychiatric rating Scale (SIG-BPRS); Brief Psychiatric rating Scale (SIG-BPRS); Morisky-Green Adhesion Test; Family Burden Rating Scale (brazilian version - FIBS-BR).In this satudy participated 40 patients and 15 family caregivers. Between patients majority was women and diagnosis most prevalent was Schizophrenia and mood disorders. The psychiatric symptoms manifestation presents low degrees and medication adhesion treatment was low in 78% of patients. Family care givers was women in 96% of sample and 80% presents medium to high degrees of burden.The instruments utilized was important to evidence how patients and their caregivers was in maintenance of community treatment and collaborate to mental health professionals assistance systematization. The use of validated instruments can offer important information to mental health care in community services and maintenance treatments.

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Clark, L., C. Holcombe, J. Fisher, and P. Salmon. "Breast cancer survivors’ perspectives on whether clinical staff should ask breast cancer patients about childhood abuse." Annals of The Royal College of Surgeons of England 96, no. 5 (July 2014): 364–68. http://dx.doi.org/10.1308/003588414x13946184901407.

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Introduction Recent studies have shown that women who recall childhood abuse are at increased risk of emotional problems following a breast cancer diagnosis. How services should respond is unclear given the risk of compounding the emotional trauma of cancer with questioning about abuse. Our aim was to present the research findings to women with experience of breast cancer so as to obtain their perspective on how this evidence should influence clinical practice. Methods Participants were women who had been treated for breast cancer at one of the study units and women with a history of breast cancer who were members of a local patient support group. Three focus groups were conducted (with six, five and three participants respectively). The interview transcripts were analysed qualitatively. Results Participants emphasised the importance of the research findings for cancer care. The consensus was that abuse and its consequences for patients being treated for cancer should not be a ‘taboo’ area, and that patients should be given the opportunity and choice to disclose abuse as part of a holistic programme of care. Conclusions Services should examine how to include prompts about abuse as part of routine holistic assessment by clinical staff, who will need to be trained in eliciting and managing disclosures of abuse.

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Williamson, Richard J., Benjamin M. Neale, Abram Sterne, Martin Prince, and Pak Sham. "The Value of Four Mental Health Self-Report Scales in Predicting Interview-Based Mood and Anxiety Disorder Diagnoses in Sibling Pairs." Twin Research and Human Genetics 8, no. 2 (April 1, 2005): 101–7. http://dx.doi.org/10.1375/twin.8.2.101.

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AbstractQuestionnaire-based dimensional measures are often employed in epidemiological studies to predict the presence of psychiatric disorders. The present study sought to determine how accurately 4 dimensional mental health measures, the 12-item General Health Questionnaire (GHQ-12), Neuroticism (EPQ-N), the high positive affect and anxious arousal scales from the Mood and Anxiety Symptoms Questionnaire (MASQ-HPA and MASQ-AA) and a composite of all 4, predicted psychiatric caseness as diagnosed by the University of Michigan Composite International Diagnostic Interview (UM-CIDI). Community subjects were recruited through general practitioners; those who agreed to participate were sent a questionnaire containing the above measures. Subsequently, the UM-CIDI was administered by telephone to 469 subjects consisting of sibling pairs who scored most discordantly or concordantly on a composite index of the 4 measures. Logistic Regression and Receiver Operating Characteristic (ROC) curve analyses were carried out to assess the predictive accuracy of the dimensional measures on UM-CIDI diagnosis. A total of 179 subjects, 62 men and 117 women with an average age of 42 years, were diagnosed with at least one of the following psychiatric disorders: depression, dysthymia, generalized anxiety disorder (GAD), social phobia, agoraphobia and panic attack. The six disorders showed high comorbidity. EPQ-N and the Composite Index were found to be very strong and accurate predictors of psychiatric caseness; they were however unable to differentiate between specific disorders. The results from the present study therefore validated the four mental health measures as being predictive of psychiatric caseness.

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Copp, Tessa, Erin Cvejic, Kirsten McCaffery, Jolyn Hersch, Jenny Doust, Ben W. Mol, Anuja Dokras, Gita Mishra, and Jesse Jansen. "Impact of a diagnosis of polycystic ovary syndrome on diet, physical activity and contraceptive use in young women: findings from the Australian Longitudinal Study of Women’s Health." Human Reproduction 35, no. 2 (January 31, 2020): 394–403. http://dx.doi.org/10.1093/humrep/dez274.

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Abstract STUDY QUESTION Do diet, physical activity and contraceptive use change after receiving a diagnosis of polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Using longitudinal data 12 months apart, young women newly diagnosed with PCOS were more likely to stop using contraception but did not change their physical activity or vegetable intake. WHAT IS KNOWN ALREADY Diagnostic criteria for PCOS have widened to capture more women, despite limited evidence of the benefits and harms. Possible benefits of a PCOS diagnosis are that it may help women with family planning and motivate them to implement healthy lifestyle changes to reduce the reproductive, metabolic and cardiovascular risks associated with PCOS. However, there are no empirical studies investigating how women respond to a diagnosis of PCOS with respect to their health behaviour, and longitudinal population-based studies are lacking. STUDY DESIGN, SIZE, DURATION This is a longitudinal analysis of two waves of data collected 12 months apart from the cohort born 1989–1995 in the Australian Longitudinal Survey on Women’s Health, a population-based cohort study. Women in this cohort were first surveyed in 2012-2013, aged 18-23 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Women who responded to the 2014 survey (aged 19–24, n = 11 344) and 2015 survey (aged 20–25, n = 8961) were included. Using logistic regression, multinomial logistic regression and linear regression, change in vegetable intake, physical activity and contraceptive use were compared for women newly diagnosed with PCOS to women not reporting a diagnosis of PCOS. Changes in psychological distress and BMI were also examined. MAIN RESULTS AND THE ROLE OF CHANCE Young women reporting a new diagnosis of PCOS were no more likely to increase their vegetable intake or physical activity than women not reporting a PCOS diagnosis. Women newly diagnosed with PCOS were 3.4 times more likely to stop using contraception during the 12-month study period than women without PCOS (14% versus 4%, 95% CI = 2.3 to 5.1, P < 0.001). This difference remained significant after controlling for demographics, chronic conditions associated with PCOS, endometriosis, BMI and psychological distress (P < 0.001). LIMITATIONS, REASONS FOR CAUTION All data was self-reported including PCOS diagnosis, assessment of diet quality was limited to vegetable intake only. The exact timing of diagnosis within the 12-month period and whether the women intended to conceive are unknown. The number of women reporting a new diagnosis of PCOS was also relatively small. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that a diagnosis of PCOS may not produce short-term benefits by way of improving health behaviour. The observed reduction in contraception use suggests some women may be at increased risk of unplanned pregnancies, highlighting the importance of counselling about contraceptive needs. Both potential benefits and harms must be considered when determining the appropriateness of a PCOS diagnosis. STUDY FUNDING/COMPETING interest(s) The Australian Longitudinal Study on Women’s Health is funded by the Australian Government Department of Health. BWM reports consultancy for ObsEva, Merck, Merck KGaA and Guerbet. No further competing interests exist. TRIAL REGISTRATION NUMBER N/A

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Mohammed, Ghedaa Jassim, Salwa Hazim Al-Mukhtar, and Margoob Hussein YAS. "Profile of Women Mental Health in Kirkuk Governorate." Pakistan Journal of Medical and Health Sciences 15, no. 9 (September 30, 2021): 2683–86. http://dx.doi.org/10.53350/pjmhs211592683.

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The terms mental health refer to the cognitive, behavioral, and emotional well-being of people. It all comes down to how people think, feel, and act. The word "mental health" is occasionally used to refer to the absence of a mental disease. Mental illness can have a negative impact on daily life, relationships, and physical health. (World Health Organization, 2019) . the aim of the study is to review prevalence rate of the mental health problems among women in Kirkuk city ,and To find out the relationship between incidence of cases and their demographical characterizes such as (age, occupation, residence) A descriptive study design and non-probability sample conducts for this study that includes data for women suffering of mental health problem were obtained from official records of specialized center for psychiatry at Azadi Teaching hospital of Kirkuk governorate this data includes of (401) inpatient and (1027) outpatient , Statistical data analysis is performed using SPSS version 26. the result shows the highest percentage of the studied cases were aged of 15-34 years old and was (58,8%), regarding their occupation ; (71.1%) were Housewife . (72.1%) of the cases were found to be urban residents. As for their medical diagnosis , (22.7%) of females have psychotic disorder. (52.6%) of women stay in the hospital for period from (1-4)days and (48.1%) of women was improved when discharge from the hospital; (81.5%) receive Medical treatment .As for their medical diagnosis of outpatient ; (20.1%) of females with Depression and (49.1%) of women visit the remedial committee . It was concluded through this study that a young housewives women and who are from the urban area represented the majority sample of this study. The study discovers that most common mental illnesses are Depression, psychosis, hysteria, schizophrenia, and anxiety. Another specialized psychiatric center need to be open due to the urgent need for psychological care services and health educational program should be adopted to encourage women to seek psychological counseling when needed, and raise awareness Keywords: women, health, mental, Kirkuk

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Moyes, Hattie Catherine Ann, Lana MacNaboe, and Kate Townsend. "The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK." Advances in Dual Diagnosis 14, no. 4 (November 12, 2021): 198–216. http://dx.doi.org/10.1108/add-06-2021-0008.

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Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

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Munkner, Runa, Soeren Haastrup, Torben Joergensen, and Peter Kramp. "Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system." European Psychiatry 20, no. 4 (June 2005): 321–26. http://dx.doi.org/10.1016/j.eurpsy.2005.01.008.

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AbstractThe study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice the risk of schizophrenic women of committing both violent and non-violent offences. A registered substance use disorder increased the risk 1.9- to 3.7-fold, depending on the starting point for the analyses, while increasing age on first contact or when diagnosed with schizophrenia diminished the risk. Previous non-violent criminality increased the risk for later violent criminality 2.5- to 2.7-fold, depending on the starting point for the analyses. The results suggest that the psychiatric treatment system can play an active role in preventing criminality among individuals with schizophrenia. The preventive measures should be based on a thorough assessment including criminal history at intake and alertness toward young psychotic men with substance use disorders and especially if they also have a criminal history.

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Pate, Leigh, Christine Desmedt, Otto Metzger, Laurie Burgess Hutcheson, Claire Turner, Siobhán Freeney, and Steffi Oesterreich. "How Researchers, Clinicians and Patient Advocates Can Accelerate Lobular Breast Cancer Research." Cancers 13, no. 13 (June 22, 2021): 3094. http://dx.doi.org/10.3390/cancers13133094.

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Breast cancer research and therapies have significantly advanced in recent years. However, Invasive Lobular Carcinoma (ILC), the second most common histological type of breast cancer and the sixth most frequently diagnosed cancer of women, has not always benefited from critical analysis, missing opportunities to better understand this important subtype. Recent progress understanding the biological and behavioral differences of ILC demonstrates that it is a unique subtype of breast cancer which can respond differently to common therapies. These new insights have increased interest in researching lobular breast disease. Concurrently, the formation of motivated patient-led advocacy organizations working in partnership with basic, translational and clinical researchers creates new opportunities, including connecting a dispersed patient population to research, encouraging new research funding and connecting patient advocates to researchers to advance common goals. This commentary will explore the unprecedented opportunity to drive multidisciplinary, multicenter and international collaborative research into lobular breast cancer that builds on recent research progress. Collaborative research partnerships that include advocates can result in a better understanding of ILC, identify targeted therapies and refine standard of care therapies that are currently equally applied to all breast cancers, resulting in improvements in the diagnosis, treatment and follow-up care for patients with ILC.

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Markham, Sarah. "Diagnosis and treatment of ASD in women in secure and forensic hospitals." Advances in Autism 5, no. 1 (March 12, 2019): 64–76. http://dx.doi.org/10.1108/aia-09-2018-0027.

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Purpose The purpose of this paper is to explore the experience and possibilities for misdiagnosis of women with ASD in secure and forensic hospitals, via the medium of a lived experience case study. To consider the clinical value of the patient perspective of and insight into their disorder. The case study is supplemented by relevant associations to the MHA Code of Practice, the CQC report, Monitoring the Mental Health Act (MHA) 2016–2017, published on 27 February 2018 and current research findings in the fields of service provision, quality of care and treatment of female patients with a diagnosis of ASD. Design/methodology/approach A review and commentary of the author’s lived experience of a formal diagnostic assessment for ASD as a female patient in a secure and forensic hospital. In reviewing aspects of the author’s clinical assessment, the author has made contextual reference to the MHA Code of Practice, the CQC report, Monitoring the MHA 2016–2017, published on 27 February 2018, and current research findings. The account focuses on aspects of the author’s recent experience assessment and treatment for ASD which the author believes may be of use in informing clinical practice. Findings Open-ended exploration of a lived experience account/case study of a diagnostic assessment of an adult female patient for ASD, demonstrating the possible ambiguity of responses to questionnaire-based assessment tools and other deficiencies inherent to the assessment process and care and treatment of adult female ASD sufferers in secure and forensic hospitals. Research limitations/implications The author uses the lived experience as a patient to review and provide commentary on the clinical assessment for ASD. This review is, therefore, informed by an authentic patient perspective and not clinical perspectives. This paper highlights the need for further research into the diagnostic assessment of females for ASD in a secure and forensic hospitals. Practical implications First, to encourage practitioners to extend their range of thinking to be more inclusive of the patient perspective when performing a diagnostic assessment. Second, to increase practitioner awareness of the deficiencies in the current service provision for adult female patients diagnosed with ASD in secure and forensic hospitals. Social implications To improve patient experience of diagnostic assessment for ASD and the quality of the assessment and patient outcomes in secure and forensic hospitals. Originality/value The paper is original in concept in that it considers the inclusion of patient experience/views in assessment and formulation and links them to wider social policy and practice guidance. The case study is an authentic patient account informed by the author’s experience of secure and forensic psychiatric hospitals. The value of the paper may be determined by the extent to which the paper encourages practitioners to consider the patient perspective and experience of the diagnostic assessment and how this and subsequent care and treatment may affect the adult female patient in secure and forensic hospitals.

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Baptista, B., A. Aguiar, S. Melo, and M. Araujo. "Regulation Disorders of Sensory Processing–Understanding the Complexities of Child-parents Relationship." European Psychiatry 41, S1 (April 2017): S121—S122. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1920.

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IntroductionMany authors have agreed on the clinical importance of sensory regulation for a child's cognitive, affective and social development. Sensory regulation abilities are fundamental for an efficient modulation of internal states and the development of appropriately graded responses to the constantly changing sensory experiences. Sensory modulation deficit is an essential feature of regulation disorders of sensory processing (RDSP), that is characterized by difficulties in regulating emotions, behaviors and motor abilities, in response to sensory stimulation and lead to impairment in functioning. We also know that, through daily interactions and early relationship (child's attachment), parents play a crucial role on child's regulation in terms of their emotional and physical availability and how they interpret and respond to child needs.ObjectiveThe authors will present a clinical case of a two-year child who has been diagnosed with RDSP, highlighting the main features, types (hypersensitive; hyposensitive/under-responsive; sensory-stimulation seeking/impulsive) and challenges of this disturb.AimsExplore the association between sensory regulation difficulties, RDSP and child attachment.MethodsSystematic literature review.ResultsRecent studies showed the high prevalence of sensory regulation difficulties (33–76%) and insecure attachment (80%) in children with psychiatric disorders. Results also revealed that children with greater sensory impairment were significantly more likely to show elevated scores of insecurity (avoidance and dependence) to their caregiver.ConclusionsThis work underscores the caregiver's role as a facilitator of child integration and response to sensory stimuli and its importance on the development of behavioral and emotional disorders. This can help early diagnosis and better treatment who prevent future psychiatric conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Hendry, Natalie Ann. "Young Women’s Mental Illness and (In-)visible Social Media Practices of Control and Emotional Recognition." Social Media + Society 6, no. 4 (October 2020): 205630512096383. http://dx.doi.org/10.1177/2056305120963832.

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What “counts” as a mental illness–related image matters. Most research attention has focused on distressing or recognizable mental illness–related visual practices, yet this offers partial insight into youth mental health. Using visibility and practice theories, I share an in-depth case study exploring the social media practices of four young women, aged 14–17 years, engaged with an Australian adolescent psychiatric service. They describe how being visible to others on social media potentially produces anxiety and burdens them to respond to others’ questions or unhelpful support. In response, they engage in practices of control to manage the vulnerability of mental illness and burdensome sociality. Their mental illness–related media practices are often invisible; they rework mental illness through ambiguous, supportive or humorous practices or, through imagined intimacy, engage with images that feel relatable to them even if the images do not depict recognizable mental illness content or employ recognizable hashtags or titles. These insights complicate “what counts” as mental illness–related content or practices on social media and challenge researchers and practitioners to consider the sociotechnical contexts that shape young people’s mental health.

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Brodaty, H., and M. Connors. "337 - Pseudodementia, pseudopseudodementia and pseudodepression." International Psychogeriatrics 32, S1 (October 2020): 96. http://dx.doi.org/10.1017/s1041610220002379.

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While most older people who develop problems with their memory and thinking that are severe enough to impair their ability to function in everyday life typically, are found to have Alzheimer’s disease or other neurodegenerative diseases, some have an undiagnosed and treatable psychiatric disorder masquerading as dementia. These conditions including depression can affect memory and thinking and, when severe, create a clinical picture similar to dementia. This phenomenon, known as “pseudodementia”, is encountered in clinical practice. It is important to identify because it may be reversible with appropriate treatment.There is controversy about what the longer-term prognosis is for people diagnosed with pseudodementia. This has implications for how to manage patients, what advice to give to patients and their family, and how to conceptualise the disorder. Some studies found that people with pseudodementia eventually develop organic dementia, so called pseudo-pseudodementia. To address this, we conducted a systematic review of studies that had been conducted on pseudodementia and which followed up patients over time.Eighteen studies followed patients from several weeks to 18 years. Overall, patients with pseudodementia were at greater risk of later developing organic dementia. Importantly, not all patients did; many patients remained stable or improved, albeit some still impaired by their psychiatric disorder. Our review showed possible treatment benefits and differences with age; patients diagnosed with pseudodementia at a younger age had better outcomes.Finally, people with apathy (which is the commonest behavioural symptom in dementia) can be misdiagnosed as having depression, so called pseudo-depression and then often treated for the wrong condition. Patients with apathy do not respond to antidepressants.Receiving the correct clinical diagnoses are crucial to patients receiving the correct treatment for their condition. A missed diagnosis of a potentially reversible depressive pseudodementia can have tragic consequence for the patient and family.Recent research has neglected the study of pseudodementia. Our findings reveal a clear need for better diagnostic skills, further research with modern investigative tools, such as neuroimaging and genetic sequencing, and clinical trials to better understand underlying mechanisms and determine effective treatment strategies.

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Heidrich. "Frequency of non-vascular accompanying diseases in patients with peripheral arterial disease." Vasa 33, no. 3 (August 1, 2004): 155–58. http://dx.doi.org/10.1024/0301-1526.33.3.155.

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Background: Since there are so far no relevant figures on the frequency of non-vascular associated diseases in patients with peripheral arterial disease (PAD), an analysis was carried out to determine how frequently co-morbidity is found in such patients. Patients and methods: In the course of a retrospective analysis, 1693 patients (55.4% men, 44.6% women/average 68.6 years) with peripheral arterial diseases (PAD) of Fontaine stage II to IV were examined to find out how often cardiopulmonary, gastrointestinal, haematological, endocrinological, neurological, orthopaedic, urological-nephrological, psychiatric diseases and tumours were seen. Result: Coronary ischaemic heart disease was present in 63.1% of the cases, heart failure existed in 20.7%, hypertension in 57.9%, endocrine and metabolic diseases in 60.4%, gastrointestinal diseases in 14.8%, pulmonary diseases in 14.5%, psychological and behavioural deficiencies in 16.2%, orthopaedic diseases in 21.6%, haematological diseases in 9.0%, urological diseases in 16.9%, chronic renal insufficiency in 7.3% and malignant tumours in 5.8%. Conclusions: The frequency of non-vascular co-morbidity in patients with PAD necessitates systematic interdisciplinary diagnosis prior to any therapy decision to take into account the patient’s associated diseases, life expectancy and current quality of life.

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Mohd Yusuf, Salma Yasmin, Mazapuspavina Md Yasin, Akmal Zulayla Mohd Zahid, Akmal Hisham Arshad, and Khariah Mat Nor. "Complete Androgen Insensitivity Syndrome: Diagnosis and Psychological Impact in Adolescence, A Case Report." International Journal of Human and Health Sciences (IJHHS) 5, no. 0-2 (September 23, 2021): 12. http://dx.doi.org/10.31344/ijhhs.v5i0-2.330.

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This case report illustrates the case of complete androgen insensitivity syndrome (CAIS) which is a rare form of sexual development disorders (DSD). Complex critical thinking is needed for pathophysiology of primary amenorrhea causes and sex chromosomes differences of sexual development, such as primary ovarian failure, Mullerian Agenesis or disorders with abnormal androgen synthesis or response. This is a phenotypically female who presented with primary amenorrhea at the age of 19 years old. Normal levels of thyroid function test, serum prolactin and follicle stimulating hormone ruled out hypothyroidism, hyperprolactinemia, and primary ovarian failure. Magnetic resonance imaging showed absence of uterus, fallopian tubes, ovaries, but presence of proximal 1/3rd of the vagina. There is a single testis in the left inguinal region with unknown status of spermatogenesis. The chromosomal analysis revealed 46, XY karyotype conveying the patient is genotypically male. The testis-determining factor (TDF) test or sex-determining region Y (SRY) protein for male sex determination was not done. Similar presentation of primary amenorrhea diagnosis of CAIS was made to her 18-year-old sister. Women with CAIS are vulnerable to various psychological conditions caused by the appalling fact of being genotypically male when they have been raised female all their life. The gender confusion, reproductive issues and how others perceive them in the outside world require sensitive support. Hence, accentuate the need to address the emotional, psychological, and psychiatric vulnerabilities in issues pertaining to relationships, infertility and conception.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S12

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Gibson, Kirstian, Shelley Peacock, and Melanie Bayly. "Qualitative exploration of emotional and social changes from diagnosis to bereavement for spousal caregivers of persons with dementia." BMJ Open 9, no. 9 (September 2019): e031423. http://dx.doi.org/10.1136/bmjopen-2019-031423.

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ObjectivesTo understand how bereaved spousal caregivers of persons with dementia perceive and respond to changes over the course of their spouse’s disease, from diagnosis into bereavement.DesignQualitative interview study with convenience sampling and thematic analysis approach.ParticipantsParticipants included eight women and two men (n=10) who had been spousal caregivers for a person with dementia prior to his/her death. Participants were older adults who self-reported good health and were bereaved longer than a year.SettingData collected in a small Canadian prairie city between fall 2014 and winter 2015.FindingsTwo overarching themes were developed as important components of participants’ caregiving journey: emotional reactions to change and variation in social connectedness throughout the caregiving and bereavement journey. Four key sub-themes developed through the analysis of emotional reactions to events: memorable grief overshadows persistent grief, a progressive feeling of hopelessness and overwhelmed, relief is common but hidden and gratitude is a milestone in a constructive bereavement. Three key variations of social connectedness throughout the caregiving and bereavement journey were developed: the importance of social inclusion throughout a caregiving and bereavement journey, the repeated loss of companionship and withdrawing from social interactions is contingent on needs.ConclusionsThe findings suggest that emotional changes throughout caregiving and bereavement are not linear. The need for support from family, friends and new social supports is influential in enabling the caregiver to move forward during caregiving and bereavement.

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Lexchin, Joel, and Nicolas Rasmussen. "The Rise and Fall of the Neurotic Housewife: Patient Sex in Psychotropic Drug Advertising to Physicians 1946–1990." International Journal of Health Services 50, no. 3 (March 25, 2020): 292–98. http://dx.doi.org/10.1177/0020731420912999.

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Previous studies have demonstrated a sex bias when it comes to the portrayal of men and women in medical journal advertisements for prescription drugs for psychiatric conditions. However, these studies have typically looked at ads over a restricted time period and often for a single diagnosis. Here we focus on ads for 3 diagnoses – anxiety, depression, and a combination of anxiety and depression – and cover nearly half a century to examine how the portrayal of patients changed over that time period with respect to sex. We sampled ads for products treating anxiety, depression, and anxiety/depression published in the Journal of the American Medical Association between 1946 and 1990. Our findings confirm other studies showing a marked preponderance of female patient representation during the 1960s in psychotropic drug advertising. However, we also show that from the mid-1970s to the mid-1980s, the proportion of ads for drugs featuring depression and/or anxiety indications depicted male patients significantly more than prior years in which females predominated, demonstrating advertisers’ reaction to the critique of gender stereotyping.

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Jensen, M. E., K. Andreasson, M. Vinberg, and L. Oestergaard. "“Care is needed the most, when it is deserved the least” – the experience of BPD-women." European Psychiatry 65, S1 (June 2022): S618. http://dx.doi.org/10.1192/j.eurpsy.2022.1583.

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Introduction BPD are often characterized by dependence, affectability, unpredictability, impulsivity and self-destructiveness. Paradoxically, the symptoms associated with BPD are the same behaviors that makes them difficult to accommodate by health professionals. They constitute the most excluded and stigmatized patient group. Objectives To gain knowledge on how BPD patients felt acknowledged when they experienced the need for professional help. Methods We conducted semi-structured interviews with six BPD-women, aged between 18 to 46, all inpatient at different psychiatric units in the Capital Region of Denmark. The data were analyzed and interpreted through meaning condensation. We entered the philosophical hermeneutic framework of Hans-Georg Gadamer. Results We found that the women experienced that; the diagnosis was a filter, in which they were always viewed and judged through as “just another BPD-patient” and not a unique individual. their cry for help was expected to be verbalized in a certain manner and therefore was often not understood nor heard, but instead they experienced to be scolded by health professionels. the emergency plan became a legitimate way for the health care professionals to avoid spending to many resources, rather than a helpful tool. the psychiatry as a unit was largely characterized by stigmatization and a distrustful attitude towards them. Therefore they felt deeply dependent on meeting that one special health professional who were experienced to have a genuine interest and desire to help them. Conclusions Findings correspond with the findings of existing research. Hence, there also seems to be significant barriers nationally for patients with BPD to experience being acknowledged and helped, when in need of professional help. Disclosure No significant relationships.

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Erfanian, M., J. Jo Brout, and A. Keshavarz. "Misophonia and affective disorders: The relationship and clinical perspective." European Psychiatry 41, S1 (April 2017): S471. http://dx.doi.org/10.1016/j.eurpsy.2017.01.539.

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Misophonia is characterized by aversive reactivity to repetitive and pattern based auditory stimuli [1]. Misophonic sufferers demonstrate autonomic nervous system arousal, accompanied by heightened emotional distress. Sufferers describe extreme irritation, anger, and aggressive urge with physiological reactions including hypertonia, diaphoresis and tachycardia [2]. Some studies have found comorbidity with psychiatric disorders. However, most of these studies used small samples and few experimental methodologies [3]. This study identifies the possible relationship between misophonia and affective disorders, and any difference between the severity of misophonia in male and female patients. Fifty misophonic patients (female = 25, mean age = 46.28) were evaluated with Amsterdam Misophonia Scale (A-MISO-S) for the diagnosis of misophonia and with the M.I.N.I International Neuropsychiatric Interview for the diagnosis of affective disorders. Among n = 50 misophonic patients, we found major depression (MDD) = 11, melancholic depression = 5, dysthymia = 11, suicidality = 10, manic = 3, panic disorder = 8, agoraphobia = , social phobia = , obsessive compulsive disorder (OCD) = 14, post-traumatic stress disorder (PTSD) = 15. Misophonia was associated with MDD (U = 76, P = .001), suicidality (U = 67, P = .001), OCD (U = 115, P = .002) and PTSD (U = 142.5, P = .008). There was an indication of a significant difference between men and women in severity of misophonia (U = 160.5, P = .002). The presence of these varying affective disorders suggests that the sufferers are at high risk for affective disorders. Investigation of the co-morbidity will assist researchers to better understand the nature of the symptoms and how they may be interacting.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Pérez-Sales, Pau, and Chris Dominey. "Introduction to Volume 29, Issue 3." Torture Journal 29, no. 3 (January 20, 2020): 1–2. http://dx.doi.org/10.7146/torture.v29i3.117774.

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We close Volume 29 with an issue of Torture Journal focused on measuring processes and results, a subject that has always been considered a priority for the sector. There is a dearth of studies on long-term follow-up to assess rehabilitation success. The paper by Martin Hill and Mary Lynn Everson, “Indicators likely to contribute to clinical and functional improvement among survivors of politically-sanctioned torture” is unique in the length of post-treatment follow-up, and provides an innovative approach in the measurement of rehabilitation outcomes through a structured measure of functional aspects with an instrument designed at the Kovler Center in Chicago. In addition, in the framework of the interminable debate over whether clinical categories of psychiatric classifications respond effectively to the experience of torture victims, Marie Louison Vang and colleagues present in their paper “Testing the validity of ICD-11 PTSD and CPTSD among refugees in treatment using latent class analysis,” a validation study through multivariate models to distinguish between the classic Post-Traumatic Stress Disorder (PTSD) diagnosis and the new Complex Post Traumatic Stress Disorder in refugee and torture survivor populations. The results show that this new diagnosis not only complements the previous one but both approaches represent an improved nosological classification and definition of the experiences of torture survivors. Kim Baranowski and collaborators, in their paper, “Experiences of gender-violence in women asylum seekers from Honduras, El Salvador, and Guatemala” propose, supported by the evidence gathered, that types of violence experienced by these women are multi-intersectional, and that restricted categorisation of the concept of torture can ignore the experiences of asylum-seeking women, whose lives, both in their countries of origin, in transit and in the host country, are persistently affected by structural, psychological and physical violence perpetrated by state and nonstate actors alike. Finally, Kristi Rendahland Pamela Kriege Santoso offer in their contribution “Organizational development with torture rehabilitation programs: An applied perspective,” a personal, non-data-driven text representing their experience in supporting the creation of torture victim centres in different countries within the framework of the CVT’s Partners in Trauma Healing (PATH) Project.In this last issue of the journal we would like to thank all the authors that have chosen Torture Journal as the platform to share their research. In particular, we extend our thanks to those anonymous reviewers who have devoted hours and effort to the indispensable task of giving us their critical and constructive view of the journal’s articles. Without them the publication would not be possible.We believe that this issue of the Torture Journal will undoubtedly provide many elements of reflection for our readers. We hope you enjoy reading it as much as we enjoyed preparing it.Torture Journal Editorial Team

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Houston-Ludlam, Alexandra N., Julia D. Grant, Kathleen K. Bucholz, Pamela A. F. Madden, and Andrew C. Heath. "2266 Big data approaches in translational science: The influence of psychiatric and trauma history in predicting smoking during pregnancy in a cohort of female like-sex twin pairs." Journal of Clinical and Translational Science 2, S1 (June 2018): 38. http://dx.doi.org/10.1017/cts.2018.156.

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OBJECTIVES/SPECIFIC AIMS: Smoking during pregnancy (SDP) is associated with negative health outcomes, both proximal (e.g., preterm labor, cardiovascular changes, low birth weight) and distal (e.g., increased child externalizing behaviors and attention deficit/hyperactivity disorder (ADHD) symptoms, increased risk of child smoking). As pregnancy provides a unique, strong incentive to quit smoking, investigating SDP allows analysis of individual predictive factors of recalcitrant smoking behaviors. Utilizing a female twin-pair cohort provides a model system for characterizing genotype×environment interactions using statistical approaches. METHODS/STUDY POPULATION: Using women from the Missouri Adolescent Female Twin Study, parental report of twin ADHD inattentive and hyperactive symptoms at twin median age 15, and twin report of DSM-IV lifetime diagnosis of major depressive disorder, trauma exposure (physical assault and childhood sexual abuse), collected at median age 22, were merged with Missouri birth record data for enrolled twins, leading to 1553 individuals of European ancestry and 163 individuals of African-American ancestry included in final analyses. A SDP propensity score was calculated from sociodemographic variables (maternal age, marital status, educational attainment, first born child) and used as a 6-level ordinal covariate in subsequent logistic regressions. RESULTS/ANTICIPATED RESULTS: For European ancestry individuals, parental report of hyperactive ADHD symptoms and exposure to childhood sexual abuse were predictive of SDP, while a lifetime diagnosis of major depressive disorder, parental report of inattentive ADHD symptoms, and exposure to assaultive trauma were all not significantly predictive of future SDP. For African-American individuals, none of these variables were significant in predicting future SDP. DISCUSSION/SIGNIFICANCE OF IMPACT: Understanding this relationship of risk-mechanisms is important for clinical understanding of early predictors of SDP and tailoring interventions to at risk individuals. Ultimately, the focus of this research is to mitigate risk to pregnant smokers and their children. Additionally, the cohort-ecological approach informs how well research and administrative (vital record) data agree. This allows for evaluation of whether administrative data improve prediction in research cohorts, and conversely if research data improve prediction over standard sociodemographic variables available in administrative data.

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Kirkpatrick, Helen Beryl, Jennifer Brasch, Jacky Chan, and Shaminderjot Singh Kang. "A Narrative Web-Based Study of Reasons To Go On Living after a Suicide Attempt: Positive Impacts of the Mental Health System." Journal of Mental Health and Addiction Nursing 1, no. 1 (February 15, 2017): e3-e9. http://dx.doi.org/10.22374/jmhan.v1i1.10.

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Background and Objective: Suicide attempts are 10-20X more common than completed suicide and an important risk factor for death by suicide, yet most people who attempt suicide do not die by suicide. The process of recovering after a suicide attempt has not been well studied. The Reasons to go on Living (RTGOL) Project, a narrative web-based study, focuses on experiences of people who have attempted suicide and made the decision to go on living, a process not well studied. Narrative research is ideally suited to understanding personal experiences critical to recovery following a suicide attempt, including the transition to a state of hopefulness. Voices from people with lived experience can help us plan and conceptualize this work. This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. Material and Methods: A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery, a process which enabled participation from a large and diverse group of participants. The only direction given was “if you have made a suicide attempt or seriously considered suicide and now want to go on living, we want to hear from you.” The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Over 5 years, data analysis occurred in several phases over the course of the study, resulting in the identification of data that were inputted into an Excel file. This analysis used stories where participants described positive involvement with the mental health system (50 stories). Results: Several participants reflected on experiences many years previous, providing the privilege of learning how their life unfolded, what made a difference. Over a five-year period, 50 of 226 stories identified positive experiences with mental health care with sufficient details to allow analysis, and are the focus of this paper. There were a range of suicidal behaviours in these 50 stories, from suicidal ideation only to medically severe suicide attempts. Most described one or more suicide attempts. Three themes identified included: 1) trust and relationship with a health care professional, 2) the role of friends and family and friends, and 3) a wide range of services. Conclusion: Stories open a window into the experiences of the period after a suicide attempt. This study allowed for an understanding of how mental health professionals might help individuals who have attempted suicide write a different story, a life-affirming story. The stories that participants shared offer some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers, including immediately after a suicide attempt. Results of this study reinforce that just one caring professional can make a tremendous difference to a person who has survived a suicide attempt. Key Words: web-based; suicide; suicide attempt; mental health system; narrative research Word Count: 478 Introduction My Third (or fourth) Suicide AttemptI laid in the back of the ambulance, the snow of too many doses of ativan dissolving on my tongue.They hadn't even cared enough about meto put someone in the back with me,and so, frustrated,I'd swallowed all the pills I had with me— not enough to do what I wanted it to right then,but more than enough to knock me out for a good 14 hours.I remember very little after that;benzodiazepines like ativan commonly cause pre- and post-amnesia, says Google helpfullyI wake up in a locked rooma woman manically drawing on the windows with crayonsthe colors of light through the glassdiffused into rainbows of joy scattered about the roomas if she were coloring on us all,all of the tattered remnants of humanity in a psych wardmade into a brittle mosaic, a quilt of many hues, a Technicolor dreamcoatand I thoughtI am so glad to be able to see this. (Story 187)The nurse opening that door will have a lasting impact on how this story unfolds and on this person’s life. Each year, almost one million people die from suicide, approximately one death every 40 seconds. Suicide attempts are much more frequent, with up to an estimated 20 attempts for every death by suicide.1 Suicide-related behaviours range from suicidal ideation and self-injury to death by suicide. We are unable to directly study those who die by suicide, but effective intervention after a suicide attempt could reduce the risk of subsequent death by suicide. Near-fatal suicide attempts have been used to explore the boundary with completed suicides. Findings indicated that violent suicide attempters and serious attempters (seriousness of the medical consequences to define near-fatal attempts) were more likely to make repeated, and higher lethality suicide attempts.2 In a case-control study, the medically severe suicide attempts group (78 participants), epidemiologically very similar to those who complete suicide, had significantly higher communication difficulties; the risk for death by suicide multiplied if accompanied by feelings of isolation and alienation.3 Most research in suicidology has been quantitative, focusing almost exclusively on identifying factors that may be predictive of suicidal behaviours, and on explanation rather than understanding.4 Qualitative research, focusing on the lived experiences of individuals who have attempted suicide, may provide a better understanding of how to respond in empathic and helpful ways to prevent future attempts and death by suicide.4,5 Fitzpatrick6 advocates for narrative research as a valuable qualitative method in suicide research, enabling people to construct and make sense of the experiences and their world, and imbue it with meaning. A review of qualitative studies examining the experiences of recovering from or living with suicidal ideation identified 5 interconnected themes: suffering, struggle, connection, turning points, and coping.7 Several additional qualitative studies about attempted suicide have been reported in the literature. Participants have included patients hospitalized for attempting suicide8, and/or suicidal ideation,9 out-patients following a suicide attempt and their caregivers,10 veterans with serious mental illness and at least one hospitalization for a suicide attempt or imminent suicide plan.11 Relationships were a consistent theme in these studies. Interpersonal relationships and an empathic environment were perceived as therapeutic and protective, enabling the expression of thoughts and self-understanding.8 Given the connection to relationship issues, the authors suggested it may be helpful to provide support for the relatives of patients who have attempted suicide. A sheltered, friendly environment and support systems, which included caring by family and friends, and treatment by mental health professionals, helped the suicidal healing process.10 Receiving empathic care led to positive changes and an increased level of insight; just one caring professional could make a tremendous difference.11 Kraft and colleagues9 concluded with the importance of hearing directly from those who are suicidal in order to help them, that only when we understand, “why suicide”, can we help with an alternative, “why life?” In a grounded theory study about help-seeking for self-injury, Long and colleagues12 identified that self-injury was not the problem for their participants, but a panacea, even if temporary, to painful life experiences. Participant narratives reflected a complex journey for those who self-injured: their wish when help-seeking was identified by the theme “to be treated like a person”. There has also been a focus on the role and potential impact of psychiatric/mental health nursing. Through interviews with experienced in-patient nurses, Carlen and Bengtsson13 identified the need to see suicidal patients as subjective human beings with unique experiences. This mirrors research with patients, which concluded that the interaction with personnel who are devoted, hope-mediating and committed may be crucial to a patient’s desire to continue living.14 Interviews with individuals who received mental health care for a suicidal crisis following a serious attempt led to the development of a theory for psychiatric nurses with the central variable, reconnecting the person with humanity across 3 phases: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.15 Other research has identified important roles for nurses working with patients who have attempted suicide by enabling the expression of thoughts and developing self-understanding8, helping to see things differently and reconnecting with others,10 assisting the person in finding meaning from their experience to turn their lives around, and maintain/and develop positive connections with others.16 However, one literature review identified that negative attitudes toward self-harm were common among nurses, with more positive attitudes among mental health nurses than general nurses. The authors concluded that education, both reflective and interactive, could have a positive impact.17 This paper is one part of a larger web-based narrative study, the Reasons to go on Living Project (RTGOL), that seeks to understand the transition from making a suicide attempt to choosing life. When invited to tell their stories anonymously online, what information would people share about their suicide attempts? This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. The focus on the positive impact reflects an appreciative inquiry approach which can promote better practice.18 Methods Design and Sample A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery. Participants were required to read and agree with a consent form before being able to submit their story through a text box or by uploading a file. No demographic information was requested. Text submissions were embedded into an email and sent to an account created for the Project without collecting information about the IP address or other identifying information. The content of the website was reviewed by legal counsel before posting, and the study was approved by the local Research Ethics Board. Stories were collected for 5 years (July 2008-June 2013). The RTGOL Project enabled participation by a large, diverse audience, at their own convenience of time and location, providing they had computer access. The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Of the 226 submissions to the website, 112 described involvement at some level with the mental health system, and 50 provided sufficient detail about positive experiences with mental health care to permit analysis. There were a range of suicidal behaviours in these 50 stories: 8 described suicidal ideation only; 9 met the criteria of medically severe suicide attempts3; 33 described one or more suicide attempts. For most participants, the last attempt had been some years in the past, even decades, prior to writing. Results Stories of positive experiences with mental health care described the idea of a door opening, a turning point, or helping the person to see their situation differently. Themes identified were: (1) relationship and trust with a Health Care Professional (HCP), (2) the role of family and friends (limited to in-hospital experiences), and (3) the opportunity to access a range of services. The many reflective submissions of experiences told many years after the suicide attempt(s) speaks to the lasting impact of the experience for that individual. Trust and Relationship with a Health Care Professional A trusting relationship with a health professional helped participants to see things in a different way, a more hopeful way and over time. “In that time of crisis, she never talked down to me, kept her promises, didn't panic, didn't give up, and she kept believing in me. I guess I essentially borrowed the hope that she had for me until I found hope for myself.” (Story# 35) My doctor has worked extensively with me. I now realize that this is what will keep me alive. To be able to feel in my heart that my doctor does care about me and truly wants to see me get better.” (Story 34). The writer in Story 150 was a nurse, an honours graduate. The 20 years following graduation included depression, hospitalizations and many suicide attempts. “One day after supper I took an entire bottle of prescription pills, then rode away on my bike. They found me late that night unconscious in a downtown park. My heart threatened to stop in the ICU.” Then later, “I finally found a person who was able to connect with me and help me climb out of the pit I was in. I asked her if anyone as sick as me could get better, and she said, “Yes”, she had seen it happen. Those were the words I had been waiting to hear! I quickly became very motivated to get better. I felt heard and like I had just found a big sister, a guide to help me figure out how to live in the world. This person was a nurse who worked as a trauma therapist.” At the time when the story was submitted, the writer was applying to a graduate program. Role of Family and Friends Several participants described being affected by their family’s response to their suicide attempt. Realizing the impact on their family and friends was, for some, a turning point. The writer in Story 20 told of experiences more than 30 years prior to the writing. She described her family of origin as “truly dysfunctional,” and she suffered from episodes of depression and hospitalization during her teen years. Following the birth of her second child, and many family difficulties, “It was at this point that I became suicidal.” She made a decision to kill herself by jumping off the balcony (6 stories). “At the very last second as I hung onto the railing of the balcony. I did not want to die but it was too late. I landed on the parking lot pavement.” She wrote that the pain was indescribable, due to many broken bones. “The physical pain can be unbearable. Then you get to see the pain and horror in the eyes of someone you love and who loves you. Many people suggested to my husband that he should leave me in the hospital, go on with life and forget about me. During the process of recovery in the hospital, my husband was with me every day…With the help of psychiatrists and a later hospitalization, I was actually diagnosed as bipolar…Since 1983, I have been taking lithium and have never had a recurrence of suicidal thoughts or for that matter any kind of depression.” The writer in Story 62 suffered childhood sexual abuse. When she came forward with it, she felt she was not heard. Self-harm on a regular basis was followed by “numerous overdoses trying to end my life.” Overdoses led to psychiatric hospitalizations that were unhelpful because she was unable to trust staff. “My way of thinking was that ending my life was the only answer. There had been numerous attempts, too many to count. My thoughts were that if I wasn’t alive I wouldn’t have to deal with my problems.” In her final attempt, she plunged over the side of a mountain, dropping 80 feet, resulting in several serious injuries. “I was so angry that I was still alive.” However, “During my hospitalization I began to realize that my family and friends were there by my side continuously, I began to realize that I wasn't only hurting myself. I was hurting all the important people in my life. It was then that I told myself I am going to do whatever it takes.” A turning point is not to say that the difficulties did not continue. The writer of Story 171 tells of a suicide attempt 7 years previous, and the ongoing anguish. She had been depressed for years and had thoughts of suicide on a daily basis. After a serious overdose, she woke up the next day in a hospital bed, her husband and 2 daughters at her bed. “Honestly, I was disappointed to wake up. But, then I saw how scared and hurt they were. Then I was sorry for what I had done to them. Since then I have thought of suicide but know that it is tragic for the family and is a hurt that can never be undone. Today I live with the thought that I am here for a reason and when it is God's time to take me then I will go. I do believe living is harder than dying. I do believe I was born for a purpose and when that is accomplished I will be released. …Until then I try to remind myself of how I am blessed and try to appreciate the wonders of the world and the people in it.” Range of Services The important role of mental health and recovery services was frequently mentioned, including dialectical behavioural therapy (DBT)/cognitive-behavioural therapy (CBT), recovery group, group therapy, Alcoholics Anonymous, accurate diagnosis, and medications. The writer in Story 30 was 83 years old when she submitted her story, reflecting on a life with both good and bad times. She first attempted suicide at age 10 or 12. A serious post-partum depression followed the birth of her second child, and over the years, she experienced periods of suicidal intent: “Consequently, a few years passed and I got to feeling suicidal again. I had pills in one pocket and a clipping for “The Recovery Group” in the other pocket. As I rode on the bus trying to make up my mind, I decided to go to the Recovery Group first. I could always take the pills later. I found the Recovery Group and yoga helpful; going to meetings sometimes twice a day until I got thinking more clearly and learned how to deal with my problems.” Several participants described the value of CBT or DBT in learning to challenge perceptions. “I have tools now to differentiate myself from the illness. I learned I'm not a bad person but bad things did happen to me and I survived.”(Story 3) “The fact is that we have thoughts that are helpful and thoughts that are destructive….. I knew it was up to me if I was to get better once and for all.” (Story 32): “In the hospital I was introduced to DBT. I saw a nurse (Tanya) every day and attended a group session twice a week, learning the techniques. I worked with the people who wanted to work with me this time. Tanya said the same thing my counselor did “there is no study that can prove whether or not suicide solves problems” and I felt as though I understood it then. If I am dead, then all the people that I kept pushing away and refusing their help would be devastated. If I killed myself with my own hand, my family would be so upset. DBT taught me how to ‘ride my emotional wave’. ……….. DBT has changed my life…….. My life is getting back in order now, thanks to DBT, and I have lots of reasons to go on living.”(Story 19) The writer of Story 67 described the importance of group therapy. “Group therapy was the most helpful for me. It gave me something besides myself to focus on. Empathy is such a powerful emotion and a pathway to love. And it was a huge relief to hear others felt the same and had developed tools of their own that I could try for myself! I think I needed to learn to communicate and recognize when I was piling everything up to build my despair. I don’t think I have found the best ways yet, but I am lifetimes away from that teenage girl.” (Story 67) The author of story 212 reflected on suicidal ideation beginning over 20 years earlier, at age 13. Her first attempt was at 28. “I thought everyone would be better off without me, especially my children, I felt like the worst mum ever, I felt like a burden to my family and I felt like I was a failure at life in general.” She had more suicide attempts, experienced the death of her father by suicide, and then finally found her doctor. “Now I’m on meds for a mood disorder and depression, my family watch me closely, and I see my doctor regularly. For the first time in 20 years, I love being a mum, a sister, a daughter, a friend, a cousin etc.” Discussion The 50 stories that describe positive experiences in the health care system constitute a larger group than most other similar studies, and most participants had made one or more suicide attempts. Several writers reflected back many years, telling stories of long ago, as with the 83-year old participant (Story 30) whose story provided the privilege of learning how the author’s life unfolded. In clinical practice, we often do not know – how did the story turn out? The stories that describe receiving health care speak to the impact of the experience, and the importance of the issues identified in the mental health system. We identified 3 themes, but it was often the combination that participants described in their stories that was powerful, as demonstrated in Story 20, the young new mother who had fallen from a balcony 30 years earlier. Voices from people with lived experience can help us plan and conceptualize our clinical work. Results are consistent with, and add to, the previous work on the importance of therapeutic relationships.8,10,11,14–16 It is from the stories in this study that we come to understand the powerful experience of seeing a family members’ reaction following a participant’s suicide attempt, and how that can be a potent turning point as identified by Lakeman and Fitzgerald.7 Ghio and colleagues8 and Lakeman16 identified the important role for staff/nurses in supporting families due to the connection to relationship issues. This research also calls for support for families to recognize the important role they have in helping the person understand how much they mean to them, and to promote the potential impact of a turning point. The importance of the range of services reflect Lakeman and Fitzgerald’s7 theme of coping, associating positive change by increasing the repertoire of coping strategies. These findings have implications for practice, research and education. Working with individuals who are suicidal can help them develop and tell a different story, help them move from a death-oriented to life-oriented position,15 from “why suicide” to “why life.”9 Hospitalization provides a person with the opportunity to reflect, to take time away from “the real world” to consider oneself, the suicide attempt, connections with family and friends and life goals, and to recover physically and emotionally. Hospitalization is also an opening to involve the family in the recovery process. The intensity of the immediate period following a suicide attempt provides a unique opportunity for nurses to support and coach families, to help both patients and family begin to see things differently and begin to create that different story. In this way, family and friends can be both a support to the person who has attempted suicide, and receive help in their own struggles with this experience. It is also important to recognize that this short period of opportunity is not specific to the nurses in psychiatric units, as the nurses caring for a person after a medically severe suicide attempt will frequently be the nurses in the ICU or Emergency departments. Education, both reflective and interactive, could have a positive impact.17 Helping staff develop the attitudes, skills and approach necessary to be helpful to a person post-suicide attempt is beginning to be reported in the literature.21 Further implications relate to nursing curriculum. Given the extent of suicidal ideation, suicide attempts and deaths by suicide, this merits an important focus. This could include specific scenarios, readings by people affected by suicide, both patients themselves and their families or survivors, and discussions with individuals who have made an attempt(s) and made a decision to go on living. All of this is, of course, not specific to nursing. All members of the interprofessional health care team can support the transition to recovery of a person after a suicide attempt using the strategies suggested in this paper, in addition to other evidence-based interventions and treatments. Findings from this study need to be considered in light of some specific limitations. First, the focus was on those who have made a decision to go on living, and we have only the information the participants included in their stories. No follow-up questions were possible. The nature of the research design meant that participants required access to a computer with Internet and the ability to communicate in English. This study does not provide a comprehensive view of in-patient care. However, it offers important inputs to enhance other aspects of care, such as assessing safety as a critical foundation to care. We consider these limitations were more than balanced by the richness of the many stories that a totally anonymous process allowed. Conclusion Stories open a window into the experiences of a person during the period after a suicide attempt. The RTGOL Project allowed for an understanding of how we might help suicidal individuals change the script, write a different story. The stories that participants shared give us some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers immediately after a suicide attempt. While we cannot know the experiences of those who did not survive a suicide attempt, results of this study reinforce that just one caring professional can make a crucial difference to a person who has survived a suicide attempt. We end with where we began. Who will open the door? References 1. World Health Organization. Suicide prevention and special programmes. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/index.html Geneva: Author; 2013.2. Giner L, Jaussent I, Olie E, et al. Violent and serious suicide attempters: One step closer to suicide? J Clin Psychiatry 2014:73(3):3191–197.3. Levi-Belz Y, Gvion Y, Horesh N, et al. Mental pain, communication difficulties, and medically serious suicide attempts: A case-control study. Arch Suicide Res 2014:18:74–87.4. Hjelmeland H and Knizek BL. Why we need qualitative research in suicidology? Suicide Life Threat Behav 2010:40(1):74–80.5. Gunnell D. A population health perspective on suicide research and prevention: What we know, what we need to know, and policy priorities. Crisis 2015:36(3):155–60.6. Fitzpatrick S. Looking beyond the qualitative and quantitative divide: Narrative, ethics and representation in suicidology. Suicidol Online 2011:2:29–37.7. Lakeman R and FitzGerald M. How people live with or get over being suicidal: A review of qualitative studies. J Adv Nurs 2008:64(2):114–26.8. Ghio L, Zanelli E, Gotelli S, et al. Involving patients who attempt suicide in suicide prevention: A focus group study. J Psychiatr Ment Health Nurs 2011:18:510–18.9. Kraft TL, Jobes DA, Lineberry TW., Conrad, A., & Kung, S. Brief report: Why suicide? Perceptions of suicidal inpatients and reflections of clinical researchers. Arch Suicide Res 2010:14(4):375-382.10. Sun F, Long A, Tsao L, et al. The healing process following a suicide attempt: Context and intervening conditions. Arch Psychiatr Nurs 2014:28:66–61.11. Montross Thomas L, Palinkas L, et al. Yearning to be heard: What veterans teach us about suicide risk and effective interventions. Crisis 2014:35(3):161–67.12. Long M, Manktelow R, and Tracey A. The healing journey: Help seeking for self-injury among a community population. Qual Health Res 2015:25(7):932–44.13. Carlen P and Bengtsson A. Suicidal patients as experienced by psychiatric nurses in inpatient care. Int J Ment Health Nurs 2007:16:257–65.14. Samuelsson M, Wiklander M, Asberg M, et al. Psychiatric care as seen by the attempted suicide patient. J Adv Nurs 2000:32(3):635–43.15. Cutcliffe JR, Stevenson C, Jackson S, et al. A modified grounded theory study of how psychiatric nurses work with suicidal people. Int J Nurs Studies 2006:43(7):791–802.16. Lakeman, R. What can qualitative research tell us about helping a person who is suicidal? Nurs Times 2010:106(33):23–26.17. Karman P, Kool N, Poslawsky I, et al. Nurses’ attitudes toward self-harm: a literature review. J Psychiatr Ment Health Nurs 2015:22:65–75.18. Carter B. ‘One expertise among many’ – working appreciatively to make miracles instead of finding problems: Using appreciative inquiry as a way of reframing research. J Res Nurs 2006:11(1): 48–63.19. Lieblich A, Tuval-Mashiach R, Zilber T. Narrative research: Reading, analysis, and interpretation. Sage Publications; 1998.20. Braun V and Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006:3(2):77–101.21. Kishi Y, Otsuka K, Akiyama K, et al. Effects of a training workshop on suicide prevention among emergency room nurses. Crisis 2014:35(5):357–61.

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Gagnon, Daniel, Bruno B. Lemire, Ollie Jay, and Glen P. Kenny. "Aural Canal, Esophageal, and Rectal Temperatures During Exertional Heat Stress and the Subsequent Recovery Period." Journal of Athletic Training 45, no. 2 (March 1, 2010): 157–63. http://dx.doi.org/10.4085/1062-6050-45.2.157.

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Abstract Context: The measurement of body temperature is crucial for the initial diagnosis of exertional heat injury and for monitoring purposes during a subsequent treatment strategy. However, little information is available about how different measurements of body temperature respond during and after exertional heat stress. Objective: To present the temporal responses of aural canal (Tac), esophageal (Tes), and rectal (Tre) temperatures during 2 different scenarios (S1, S2) involving exertional heat stress and a subsequent recovery period. Design: Randomized controlled trial. Setting: University research laboratory. Patients or Other Participants: Twenty-four healthy volunteers, with 12 (5 men, 7 women) participating in S1 and 12 (7 men, 5 women) participating in S2. Intervention(s): The participants exercised in the heat (42°C, 30% relative humidity) until they reached a 39.5°C cut-off criterion, which was determined by Tre in S1 and by Tes in S2. As such, participants attained different levels of hyperthermia (as determined by Tre) at the end of exercise. Participants in S1 were subsequently immersed in cold water (2°C) until Tre reached 37.5°C, and participants in S2 recovered in a temperate environment (30°C, 30% relative humidity) for 60 minutes. Main Outcome Measure(s): We measured Tac, Tes, and Tre throughout both scenarios. Results: The Tes (S1 = 40.19 ± 0.41°C, S2 = 39.50 ± 0.02°C) was higher at the end of exercise compared with both Tac (S1 = 39.74 ± 0.42°C, S2 = 38.89 ± 0.32°C) and Tre (S1 = 39.41 ± 0.04°C, S2 = 38.74 ± 0.28°C) (for both comparisons in each scenario, P < .001). Conversely, Tes (S1 = 36.26 ± 0.74°C, S2 = 37.36 ± 0.34°C) and Tac (S1 = 36.48 ± 1.07°C, S2 = 36.97 ± 0.38°C) were lower compared with Tre (S1 = 37.54 ± 0.04°C, S2 = 37.78 ± 0.31°C) at the end of both scenarios (for both comparisons in each scenario, P < .001). Conclusions: We found that Tac, Tes, and Tre presented different temporal responses during and after both scenarios of exertional heat stress and a subsequent recovery period. Although these results may not have direct practical implications in the field monitoring and treatment of individuals with exertional heat injury, they do quantify the extent to which these body temperature measurements differ in such scenarios.

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Allers, Eugene, Christer Allgulander, Sean Exner Baumann, Charles L. Bowden, P. Buckley, David J. Castle, Beatrix J. Coetzee, et al. "13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004." South African Journal of Psychiatry 10, no. 3 (October 1, 2004): 17. http://dx.doi.org/10.4102/sajpsychiatry.v10i3.150.

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List of abstacts and authors:1. Integrating the art and science of psychiatryEugene Allers2. Chronic pain as a predictor of outcome in an inpatient Psychiatric populationEugene Allers and Gerhard Grundling3. Recent advances in social phobiaChrister Allgulander4. Clinical management of patients with anxiety disordersChrister Allgulander5. Do elephants suffer from Schizophrenia? (Or do the Schizophrenias represent a disorder of self consciousness?) A Southern African perspectiveSean Exner Baumann6. Long term maintenance treatment of Bipolar Disorder: Preventing relapseCharles L. Bowden7. Predictors of response to treatments for Bipolar DisorderCharles L. Bowden8. Aids/HIV knowledge and high risk behaviour: A Geo-graphical comparison in a schizophrenia populationP Buckley, S van Vuuren, L Koen, J E Muller, C Seller, H Lategan, D J H Niehaus9. Does Marijuana make you go mad?David J Castle10. Understanding and management of Treatment Resistant SchizophreniaDavid J Castle11. Workshop on research and publishingDavid J Castle12. From victim to victor: Without a self-help bookBeatrix Jacqueline Coetzee13. The evaluation of the Gender Dysphoric patientFranco Colin14. Dissociation: A South African modelA M Dikobe, C K Mataboge, L M Motlana, B F Sokudela, C Kruger15. Designated smoking rooms...and other "Secret sins" of psychiatry: Tobacco cessation approaches in the severely mentally illCharl Els16. Dual diagnosis: Implications for treatment and prognosisCharl Els17. Body weight, glucose metabolism and the new generation antipsychoticsRobin Emsley18. Neurological abnormalities in first episode Schizophrenia: Temporal stability and clinical and outcome correlatesRobin Emsley, H Jadri Turner, Piet P Oosthuizen, Jonathan Carr19. Mythology of depressive illnesses among AfricansSenathi Fisha20. Substance use and High school dropoutAlan J. Flisher, Lorraine Townsend, Perpetual Chikobvu, Carl Lombard, Gary King21. Psychosis and Psychotic disordersA E Gangat 22. Vulnerability of individuals in a family system to develop a psychiatric disorderGerhard Grundling and Eugene Allers23. What does it Uberhaupt mean to "Integrate"?Jürgen Harms24. Research issues in South African child and adolescent psychiatryS M Hawkridge25. New religious movements and psychiatry: The Good NewsV H Hitzeroth26. The pregnant heroin addict: Integrating theory and practice in the development and provision of a service for this client groupV H Hitzeroth, L Kramer27. Autism spectrum disorderErick Hollander28. Recent advances and management in treatment resistanceEric Hollander29. Bipolar mixed statesM. Leigh Janet30. Profile of acute psychiatric inpatients tested for HIV - Helen Jospeh Hospital, JohannesburgA B R Janse van Rensburg31. ADHD - Using the art of film-making as an education mediumShabeer Ahmed Jeeva32. Treatment of adult ADHD co-morbiditiesShabeer Ahmed Jeeva33. Needs and services at ward one, Valkenberg HospitalDr J. A. Joska, Prof. A.J. Flisher34. Unanswered questions in the adequate treatment of depressionModerator: Dr Andre F JoubertExpert: Prof. Tony Hale35. Unanswered questions in treatment resistant depressionModerator: Dr Andre F JoubertExpert: Prof. Sidney Kennedy36. Are mentally ill people dangerous?Sen Z Kaliski37. The child custody circusSean Z. Kaliski38. The appropriatenes of certification of patients to psychiatric hospitalsV. N. Khanyile39. HIV/Aids Psychosocial responses and ethical dilemmasFred Kigozi40. Sex and PsychiatryB Levinson41. Violence and abuse in psychiatric in-patient institutions: A South African perspectiveMarilyn Lucas, John Weinkoove, Dean Stevenson42. Public health sector expenditure for mental health - A baseline study for South AfricaE N Madela-Mntla43. HIV in South Africa: Depression and CD4 countM Y H Moosa, F Y Jeenah44. Clinical strategies in dealing with treatment resistant schizophreniaPiet Oosthuizen, Dana Niehaus, Liezl Koen45. Buprenorphine/Naloxone maintenance in office practice: 18 months and 170 patients after the American releaseTed Parran Jr, Chris Adelman46. Integration of Pharmacotherapy for Opioid dependence into general psychiatric practice: Naltrexone, Methadone and Buprenorphine/ NaloxoneTed Parran47. Our African understanding of individulalism and communitarianismWillie Pienaar48. Healthy ageing and the prevention of DementiaFelix Potocnik, Susan van Rensburg, Christianne Bouwens49. Indigenous plants and methods used by traditional African healers for treatinf psychiatric patients in the Soutpansberg Area (Research was done in 1998)Ramovha Muvhango Rachel50. Symptom pattern & associated psychiatric disorders in subjects with possible & confirmed 22Q11 deletional syndromeJ.L. Roos, H.W. Pretorius, M. Karayiorgou51. Duration of antidepressant treatment: How long is long enough? How long is too longSteven P Roose52. A comparison study of early non-psychotic deviant behaviour in the first ten years of life, in Afrikaner patients with Schizophrenia, Schizo-affective disorder and Bipolar disorderMartin Scholtz, Melissa Janse van Rensburg, J. Louw Roos53. Treatment, treatment issues, and prevention of PTSD in women: An updateSoraya Seedat54. Fron neural networks to clinical practiceM Spitzer55. Opening keynote presentation: The art and science of PsychiatryM Spitzer56. The future of Pharmacotherapy for anxiety disordersDan J. Stein57. Neuropsychological deficits pre and post Electro Convulsive Therapy (ECT) thrice a week: A report of four casesUgash Subramaney, Yusuf Moosa58. Prevalence of and risk factors for Tradive Dyskinesia in a Xhosa population in the Eastern CapeDave Singler, Betty D. Patterson, Sandi Willows59. Eating disorders: Addictive disorders?Christopher Paul Szabo60. Ethical challenges and dilemmas of research in third world countriesGodfrey B. Tangwa61. The interface between Neurology and Psychiatry with specific focus on Somatoform dissociative disordersMichael Trimble62. Prevalence and correlates of depression and anxiety in doctors and teachersH Van der Bijl, P Oosthuizen63. Ingrid Jonker: A psychological analysisL. M. van der Merwe64. The strange world we live in, and the nature of the human subjectVasi van Deventer65. Art in psychiatry: Appendix or brain stem?C W van Staden66. Medical students on what "Soft skills" are about before and after curriculum reformC W van Staden, P M Joubert, A-M Bergh, G E Pickworth, W J Schurink, R R du Preez, J L Roos, C Kruger, S V Grey, B G Lindeque67. Attention deficit hyperactivity disorder (ADHD) - Medical management. Methylphenidate (Ritalin) or Atomoxetine (Strattera)Andre Venter68. A comprehensive guide to the treatment of adults with ADHDW J C Verbeeck69. Treatment of Insomnia: Stasis of the Art?G C Verster70. Are prisoners vulnerable research participants?Merryll Vorster71. Psychiatric disorders in the gymMerryl Vorster72. Ciprales: Effects on anxiety symptoms in Major Depressive DisorderBruce Lydiard

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Siqveland, Johan, Edvard Hauff, Torleif Ruud, and Timothy J. Brennen. "Posttraumatic stress and autobiographical memory in chronic pain patients." Scandinavian Journal of Pain 19, no. 2 (April 24, 2019): 337–43. http://dx.doi.org/10.1515/sjpain-2018-0044.

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Abstract Background and aims Posttraumatic stress disorder (PTSD) is related to more severe pain among chronic pain patients. PTSD is also related to dysfunctions or biases in several cognitive processes, including autobiographical memory. The autobiographical memories are our memories of specific personal events taking place over a limited amount of time on a specific occasion. We investigated how two biases in autobiographical memory, overgeneral memory style and negative emotional bias were related to pain, PTSD and trauma exposure in chronic pain patients. Methods Forty-three patients with diverse chronic pain conditions were recruited from a specialist pain clinic. The patients were evaluated for psychiatric diagnosis, with a diagnostic interview Mini-International Neuropsychiatric Interview (M.I.N.I) and for exposure to the most common types of traumatic events with the Life Event Checklist (LEC). The patients were tested with the 15-cue-words version of the Autobiographical Memory Test (AMT). In this test the participants are presented verbally to five positive, five neutral and five negative cue words and asked to respond with a personal, episodic memory associated with the cue word. The participant’s responses were coded according to level of specificity and emotional valence. Pain intensity was assessed on a Visual Analogy Scale (VAS) and extent of pain by marking affected body parts on a pre-drawn body figure. Comparisons on autobiographical memory were made between PTSD and non-PTSD groups, and correlations were computed between pain intensity and extent of pain, trauma exposure and autobiographical memory. Results PTSD and extent of pain were significantly related to more negatively emotionally valenced memory responses to positive and negative cue words. There were no significant difference in response to neutral cue words. PTSD status and pain intensity were unrelated to overgeneral autobiographical memory style. Conclusions A memory bias towards negatively emotionally valenced memories is associated with PTSD and extent of pain. This bias may sustain negative mood and thereby intensify pain perception, or pain may also cause this memory bias. Contrary to our expectations, pain, trauma exposure and PTSD were not significantly related to an overgeneral memory style. Implications Cognitive therapies that have an ingredient focusing on amending memory biases in persons with comorbid pain and PTSD might be helpful for this patient population. Further investigations of negative personal memories and techniques to improve the control over these memories could potentially be useful for chronic pain treatment.

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West, Thomas, Bruna Scaggiante, Rita Ceccherini, Silva Foladore, Daniele Generali, Francesco Versace, and Corrado Cavallero. "Abstract P4-10-12: The relevance of chemobrain in breast cancer survivors: An Italian exploratory study to measure incidence and psycho-social impact." Cancer Research 82, no. 4_Supplement (February 15, 2022): P4–10–12—P4–10–12. http://dx.doi.org/10.1158/1538-7445.sabcs21-p4-10-12.

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Abstract Breast Cancer is the most frequently diagnosed cancer among women. Despite the decreasing death-rate, a large portion of patients experience long-term side effects. One of the most common is “chemobrain”: a series of subtle but persistent cognitive deficits that affect attention, memory, and speed of processing. There is a lack of consensus regarding the exact rate of “chemobrain” incidence(from 12% to 86% of patients complaining cognitive sequelae after adjuvant-therapies) primarily due to the heterogeneity of assessment measures used to quantify it. Our first aim was to estimate the prevalence of perceived cognitive deficits in breast cancer-survivors, and to address the relevance of psycho-social factors that might affect perceived cognitive functioning. The second aim was to better understand the specific impact on patients comparing possible differences in perceived cognitive functioning between a cohort of breast cancer-survivors and an age-matched group of women without oncologic diagnosis. A total of 216 subjects submitted an anonymous online questionnaire that included FACTCog v.3and 41 items investigating clinical history, cognitive reserve, sleep quality, dietary and health habits. Inclusion criteria were being female, aged between 25 and 75, lack of known psychiatric or neurological diseases. The study was approved by the Ethical Committee of University of Trieste. The study sample comprised 90 oncological patients, recruited through clinical oncology practices between Trieste - ASU GI and Cremona - ASST Breast Cancer Units, and 126 age-matched controls enrolled through LILT (Lega Italiana Lotta Tumori) - Trieste (Italy). To perform within and between groups comparisons, both populations (Breast-cancer patients’ and age-matched controls’) were subdivided in two subgroups each, based on FACTCog PCI18 score according to Van Dyk et al.(2020), cutpoints: Subjective Cognitive Complaints - SCC (PCI18<54) and No Subjective Cognitive Complaints - NSCC (PCI18 ≥54).Statistical analysis revealed that 36% of breast-cancer patients reported perceived cognitive deficits, while only for 18% of the age-matched control group this was the case (p<.001). We found a significant difference in perceived cognitive abilities (CogPCA p<.001), quality of life (CogQOL p<.001) and frequency of aerobic activity (moderate physical activity p<.01) between SCC versus NSCC patients with the former group showing worse scores in all reported measures. Between group analysis performed on breast-cancer group versus age-matched control group revealed a significant interaction of oncological diagnosis and SCC on measures of perceived cognitive abilities (CogPCA p<.001) and quality of life (CogQOL p<.001), indicating that SCC patients had worse scores on these measures. On the other hand, NSCC patients had higher scores on measures regarding how others (e.g., family members or close friends) perceived their cognitive abilities (p<.05).A significant effect of oncological diagnosis but not of SCC (or interaction between the two) was found on measures concerning sleep (Sleep quality index p<.05), indicating a strong effect of cancer diagnosis on sleep quality. Conversely when comparing the effect of cancer diagnosis on measures of physical activity no significant effect was found, instead a strong effect of SCC emerged (Physical activity index p<.01). Subjective perceived cognitive deficit affects the quality of life of breast cancer survivors, thus suggesting the usefulness of specific educational interventions to prevent stress-related effects. Citation Format: Thomas West, Bruna Scaggiante, Rita Ceccherini, Silva Foladore, Daniele Generali, Francesco Versace, Corrado Cavallero. The relevance of chemobrain in breast cancer survivors: An Italian exploratory study to measure incidence and psycho-social impact [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-12.

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James, Nicole, Katrin Eurich, Erin Lips, Payton De La Cruz, Morgan Woodman, and Jennifer Ribeiro. "31 Serum LAG-3 is associated with improved patient prognosis in high grade serous ovarian cancer." Journal for ImmunoTherapy of Cancer 9, Suppl 2 (November 2021): A36. http://dx.doi.org/10.1136/jitc-2021-sitc2021.031.

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BackgroundHigh grade serous ovarian cancer (HGSOC) is a lethal gynecologic malignancy with a five-year survival rate of only 39 percent.1 Despite the fact that ovarian tumors are considered immunologic, HGSOC patients respond poorly to PD-1 based immunotherapy. Hence, the need to identify novel prognostic and therapeutic immunologic factors is crucial. Our previous investigation uncovered intratumoral levels of immune co-inhibitory receptor LAG-3 as a marker of improved HGSOC patient survival. For this current study we sought to evaluate the prognostic utility of serum-based LAG-3, as well as determine how these circulating levels change in response to HGSOC standard of care therapy.MethodsThis study was approved by the Women and Infants Institutional Review Board; approval number 1057626. HGSOC serum samples were obtained from the Department of Special Testing and the Program in Women’s Oncology Gynecologic Tissue Bank at Women and Infants Hospital. A total of 43 HGSOC treatment naïve serum samples were tested for serum LAG-3 and in 20 of these patients, samples from on- and post- frontline platinum-based chemotherapy were also analyzed. A commercially available ELISA kit was employed to detect serum LAG-3.ResultsThere was no statistically significant change in pre-, on-, and post- serum LAG-3 levels following frontline chemotherapy, however median levels of LAG-3 decreased once patients initiated therapy and remained stable post-treatment. Spearman Rank Correlation analysis revealed a significant relationship between progression-free survival (PFS) and pre-treatment serum LAG-3 levels (r=0.36, p=0.017). Furthermore, it was found that patients with a PFS of 6 months or less exhibited a significantly (p=0.0031) lower mean rank of pre-treatment serum LAG-3 levels, compared to patients with a PFS of 18 months or longer. Finally, Kaplan Meier curve analysis revealed a statistically significant association between longer patient PFS and higher pre-treatment LAG-3 concentrations, when stratified by both median(HR=0.4916, log-rank p=0.022) and quartile LAG-3 serum levels (HR=0.2679, log-rank p=0.0031).ConclusionsThis study demonstrates for the first time that circulating immune checkpoint receptors have prognostic capabilities in ovarian cancer. Our findings suggest that LAG-3 is a marker for improved patient PFS. Future directions include an expansion of this original cohort in order to validate and further assess the clinical prognostic utility of serum LAG-3 in HGSOC.ReferenceSurvival Rates for Ovarian Cancer, American Cancer Society, [https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/survival-rates.html]

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Gerhart, W., M. T. Duruöz, J. Lowe, D. Webb, L. Wermskog, J. Davies, R. Howard, M. Mallinson, and C. L. Koehn. "OP0275-PARE THE UNACCEPTABLE DELAY TO DIAGNOSIS IN AXIAL SPONDYLOARTHRITIS; DEVELOPING A CALL TO ACTION FOR A GLOBAL HEALTHCARE CHALLENGE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 167.1–167. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2368.

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Background:The current delay to diagnosis from symptom onset represents one of the greatest challenges in axial spondyloarthritis (axSpA). Research shows an average global delay of almost 7 years1 – and as long as 15 years in some cases2 – during which time the condition can progress considerably and lead to irreversible damage. Data indicates that women wait longer than men for a diagnosis3, and there has been very limited progress in reducing the time to axSpA diagnosis. The axSpA diagnosis delay has a hugely detrimental impact on an individual’s quality of life. Because the disease frequently has early onset1, individuals are left with untreated or incorrectly-treated symptoms at a formative period in their life course, whilst they await their diagnosis.Objectives:The Axial Spondyloarthritis International Federation (ASIF) set out to coordinate a comprehensive evidence-based global review of the factors influencing the current axSpA diagnosis delay and to produce a definitive report that shines a light on these barriers, as well as providing a resource that can ultimately empower a range of international stakeholders to reduce this delay.Methods:A full literature review was carried out to identify relevant available global evidence exploring the axSpA diagnosis delay. In autumn 2020 ASIF held two virtual global forum events, involving patients and patient group representatives, researchers, rheumatologists and other healthcare professionals, to methodically explore key diagnosis challenges across different healthcare systems and the opportunities for addressing these. Break-out discussions were held and participants were asked to identify the personal and societal effects of the diagnostic delay; the reasons it occurs; and initiatives to tackle the challenge. Alongside key stakeholder testimonies, best practices from around the world were also identified. 92 stakeholders participated in the events; they represented patients and healthcare professionals from 23 countries across five continents.Results:The findings from these activities were incorporated within a new ‘Delay to Diagnosis’ report, which for the first time definitively sets out the lived realities from a global perspective of the axSpA diagnosis delay. The report identified important commonalities across different countries and healthcare systems contributing to the current average global 7-year diagnosis delay, including: •Poor awareness of axSpA, particularly in primary care services •Complexities in diagnosing the disease •Poorly defined referral pathways •Insufficient patient access to rheumatologists and appropriate diagnosticsThe report also highlights the significant impact this delay has on individuals and wider society, providing a foundation for future advocacy work. A series of recommendations have also been identified, the implementation of which will help to instigate tangible progress in reducing the current delay.Conclusion:Despite longstanding challenges, there are now clear opportunities for transforming how axSpA is diagnosed around the world. This message needs to be heard and acted upon urgently by all those involved in the management and delivery of axSpA care. The future programme of work for ASIF’s Delay to Diagnosis project will respond to these findings and be centred around supporting axSpA patient associations globally to take this call to action forward throughout 2021 and beyond.References:[1]Zhao et al; Diagnostic delay in axial spondyloarthritis: a systematic review and meta-analysis; Rheumatology, 2021[2]Garrido-Cumbrera, M., Poddubnyy, D., Gossec, L. et al. The European Map of Axial Spondyloarthritis: Capturing the Patient Perspective—an Analysis of 2846 Patients Across 13 Countries. Curr Rheumatol Rep 21, 19 (2019)[3]Jovani et al; Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis; The Journal of Rheumatology December 2016Disclosure of Interests:Wendy Gerhart Employee of: I was employed by Janssen Canada from 1992 - 2017, Mehmet Tuncay Duruöz: None declared, Jo Lowe Grant/research support from: No financial grants received individually. However, my role as Project Manager at ASIF is currently funded partially by UCB Global and partially by Novartis Global, Dale Webb Speakers bureau: Janssen and Novartis, Grant/research support from: Individually, no. But NASS receives grants from AbbVie, Biogen, Eli Lilly, Janssen, Novartis and UCB, Lillann Wermskog Grant/research support from: Individually, no. But Spafo Norge receives a small amount of funding for ongoing projects from Novartis., Jo Davies Grant/research support from: Individually, no. However, ASIF are currently funded by UCB, Lilly, Boehringer Ingelheim, Janssen and Novartis; this funding partially covers staff salaries as well as a range of projects, the content and outputs of which are not influenced by the funders., Richard Howard Shareholder of: AbbVie, Amgen, Bristol-Myers Squibb, GSK, Johnson & Johnson, Eli Lilly, Merck, Novartis, Pfizer, and Teva. I own <20 shares of any one stock and these stocks represent <4% of personal investments, Consultant of: Yes, GSK, Novartis - but then donated to Spondylitis Association of America, Grant/research support from: I have not personally received financial grants. SAA has received financial support from AbbVie, Amgen, BI, J&J, Lilly, Novartis, Pfizer, UCB., Michael Mallinson Consultant of: No. But, for full disclosure: I have received honoraria in the past, for participating in patient advisory board activities, from Abbvie, Novartis, Pfizer and UCB., Cheryl L Koehn Grant/research support from: OUR ORGANIZATION, ARTHRITIS CONSUMER EXPERTS, HAS. I HAVE NOT AS AN INDIVIDUAL. HERE IS OUR PUBLICLY AVAILABLE DISCLOSURE ON ALL ONLINE AND PRINT MATERIALS, PRESENTATIONS, MEETINGS, GOVERNMENT CONSULTATIONS:https://jointhealth.org/about-principles.cfm?locale=en-CAOver the past 12 months, ACE received grants-in-aid from: Arthritis Research Canada, Amgen Canada, Canadian Institutes of Health Research, Canadian Rheumatology Association, Eli Lilly Canada, Hoffman-La Roche Canada Ltd., Knowledge Translation Canada, Merck Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi Canada, St. Paul’s Hospital (Vancouver), UCB Canada, and the University of British Columbia.

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Fonti, G. L., M. S. Chimenti, P. Conigliaro, P. Triggianese, E. Bianciardi, G. Tarantino, M. Coviello, et al. "AB0821 PSYCHOMETRIC PROFILE OF PATIENTS WITH CHRONIC INFLAMMATORY ARTHRITIS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1434.2–1435. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1725.

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Background:Psoriatic Arthritis (PsA) is a chronic inflammatory disease characterized by a condition of inflammation of joint and periarticular tissues with progressive destruction of bone and cartilage tissues and consequent disability. Numerous studies suggest that the systemic inflammation that characterizes this disease is the basis of the onset of numerous comorbidities, including anxiety and depression.Objectives:This prospective study aims to examine the psychometric profile of patients with chronic inflammatory arthritis to investigate possible correlations with psychiatric comorbidities and disease status.Methods:from October 2018 to March 2019, consecutive out-patients with PsA (according to CASPAR criteria) referred to the Rheumatology Unit of the University of Rome Tor Vergata, were evaluated by a dedicated psychiatrist for attachment style (Relationship Questionnaire - RQ), alexithymia (Toronto Alexithymia Scale - TAS20), perceived stress (Perceived Stress Scale - PSS) and depressive symptoms (Beck Depression Inventory - BDI). These indices were then correlated with clinimetric indices, indices of inflammation and therapy taken by the patient. Statistical analysis was performed using Fisher’s exact test and Pearson’s correlation coefficient.Results:33 patients affected by PsA and 40 healthy individuals as control group were enrolled. The RQ test showed that in patients an insecure “avoidant” attachment style prevails (51.5%) compared to the control group (10%) (p<0.0008)[Figure 1]. This result correlates with the presence of alexithymia and with the duration of illness, showing that patients with an “insecure” profile at the RQ test are those who have higher scores on the TAS-20 scale (p=0.035) and a longer duration of illness (p<0.0001). Regarding the perception of stress, at the PSS test women have mean values (18.12±7.31) statistically superior to the values of the male population (11.69±7.79)(p=0.0015). PSS values of the overall study population were directly proportional to RQ values (p<0.0068) and TAS-20 values (p<0.0001). The correlation between PSS and TAS-20 was further confirmed in the analysis of the individual subgroups “patients” (p<0.0001) and control group (p<0.0001)[Figure 2]. No correlation was shown with phlogosis and clinimetric indices.Conclusion:This study suggests how PsA patients are a more vulnerable subtype of patient from the psychological point of view, with an avoidant attachment style, characterized by the difficulty to express emotions and to rely on others in times of need. These characteristics can influence the adherence to pharmacological therapies and the doctor-patient relationship. This profile is manifested more frequently in female patients, with long duration of illness, high perception of stress. The state of disease activity does not influence these elements, suggesting that the insecure attachment style is not related to the single inflammatory flare, but is the result of years of illness and long-standing disease. Our results support the relevance of early diagnosis in PsA.Disclosure of Interests:None declared

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Allgulander, Christer, Orlando Alonso Betancourt, David Blackbeard, Helen Clark, Franco Colin, Sarah Cooper, Robin Emsley, et al. "16th National Congress of the South African Society of Psychiatrists (SASOP)." South African Journal of Psychiatry 16, no. 3 (October 1, 2010): 29. http://dx.doi.org/10.4102/sajpsychiatry.v16i3.273.

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List of abstracts and authors:1. Antipsychotics in anxiety disordersChrister Allgulander2. Anxiety in somatic disordersChrister Allgulander3. Community rehabilitation of the schizophrenic patientOrlando Alonso Betancourt, Maricela Morales Herrera4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative careDavid Blackbeard5. The emotional language of the gut - when 'psyche' meets 'soma'Helen Clark6. The Psychotherapy of bipolar disorderFranco Colin7. The Psychotherapy of bipolar disorderFranco Colin8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and ZambiaSara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund9. The importance of relapse prevention in schizophreniaRobin Emsley10. Mental Health care act: Fact or fiction?Helmut Erlacher, M Nagdee11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?Lennart Eriksson12. The incidence and risk factors for dementia in the Ibadan study of ageingOye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona13. Is depression a disease of inflammation?Angelos Halaris14. Paediatric bipolar disorder: More heat than light?Sue Hawkridge15. EBM: Anova ConundrumElizabeth L (Hoepie) Howell16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unitBernard Janse van Rensburg17. Dual diagnosis units in psychiatric facilities: Opportunities and challengesYasmien Jeenah18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophreniaGerhard Jordaan, D G Nel, R Hewlett, R Emsley19. Anxiety disorders: the first evidence for a role in preventive psychiatryAndre F Joubert20. The end of risk assessment and the beginning of startSean Kaliski21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern UgandaE Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern CapeN K Kirimi, C Visser23. Mental Health service user priorities for service delivery in South AfricaSharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium24. The nature and extent of over-the-counter and prescription drug abuse in cape townLiezl Kramer25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies HospitalChrista Kruger26. Suicide risk in Schizophrenia - 20 Years later, a cohort studyGian Lippi, Ean Smit, Joyce Jordaan, Louw Roos27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-NatalCrick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution28. Mental health aspects of South African emigrationMaria Marchetti-Mercer29. What services SADAG can offer your patientsElizabeth Matare30. Culture and language in psychiatryDan Mkize31. Latest psychotic episodePovl Munk-Jorgensen32. The Forensic profile of female offendersMo Nagdee, Helmut Fletcher33. The intra-personal emotional impact of practising psychiatryMargaret Nair34. Highly sensitive persons (HSPs) and implications for treatmentMargaret Nair35. Task shifting in mental health - The Kenyan experienceDavid M Ndetei36. Bridging the gap between traditional healers and mental health in todya's modern psychiatryDavid M Ndetei37. Integrating to achieve modern psychiatryDavid M Ndetei38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinicA Parkinson39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future researchCharles Parry40. Global mental health - A new global health discipline comes of ageVikram Patel41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South AfricaInge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium42. Personality disorders -The orphan child in axis I - Axis II DichotomyWillie Pienaar43. Case Studies in Psychiatric EthicsWillie Pienaar44. Coronary artery disease and depression: Insights into pathogenesis and clinical implicationsJanus Pretorius45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trialsSuvira Ramlall, Jennifer Chipps46. Biological basis of addicationSolomon Rataemane47. Genetics of SchizophreniaLouw Roos48. Management of delirium - Recent advancesShaquir Salduker49. Social neuroscience: Brain research on social issuesManfred Spitzer50. Experiments on the unconsciousManfred Spitzer51. The Psychology and neuroscience of musicManfred Spitzer52. Mental disorders in DSM-VDan Stein53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal studyUgashvaree Subramaney54. Eating disorders: An African perspectiveChristopher Szabo55. An evaluation of the WHO African Regional strategy for mental health 2001-2010Thandi van Heyningen, M Majavu, C Lund56. A unitary model for the motor origin of bipolar mood disorders and schizophreniaJacques J M van Hoof57. The origin of mentalisation and the treatment of personality disordersJacques J M Hoof58. How to account practically for 'The Cause' in psychiatric diagnostic classificationC W (Werdie) van StadenPOSTER PRESENTATIONS59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz61. Lessons learnt from a modified assertive community-based treatment programme in a developing countryUlla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen62. Perceptions of psychologists regarding the use of religion and spirituality in therapyOttilia Brown, Diane Elkonin63. Resilience in families where a member is living with schizophreniOttilia Brown, Jason Haddad, Greg Howcroft64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the selfWilliam Griffiths, D Macklin, Loray Daws65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the selfWilliam Griffiths, D Macklin, Loray Daws66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programmeVolker Hitzeroth67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case seriesTerri Henderson68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literatureBernard Janse van Rensburg69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenariosBernard Janse van Rensburg70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder populationMarinda Joubert, J L Roos, J Jordaan71. A role for structural equation modelling in subtyping schizophrenia in an African populationLiezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley72. Caregivers of disabled elderly persons in NigeriaLola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profileChristina Kruger, M P Henning, L Fletcher74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profileChristina Kruger, M P Henning, L Fletcher75. 'The Great Suppression'Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes76. Not being allowed to grow up - The Mastersonian approach to the borderline personalityDaleen Macklin, W Griffiths77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system studyDaleen Macklin, Loray Daws, M Aronstam78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital T G Magagula, M M Mamabolo, C Kruger, L Fletcher79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies HospitalM M Mamabolo, T G Magagula, C Kruger, L Fletcher80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelinesCarina Marsay, C P Szabo81. Reported rapes at a hospital rape centre: Demographic and clinical profilesLindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatryMpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan83. Trends of suicide in the Transkei region of South AfricaBanwari Meel84. Functional neuro-imaging in survivors of tortureThriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South AfricaDinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilienceUgashvaree Subramaney88. Drugs and other therapies under investigation for PTSD: An international databaseSharain Suliman, Soraya Seedat89. Frequency and correlates of HIV Testing in patients with severe mental illnessHendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric HospitalStephan van Wyk, Zukiswa Zingela91. A brief report on the current state of mental health care services in the Eastern CapeStephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso92. An integrated mental health care service model for the Nelson Mandela Bay MetroStephan van Wyk, Zukiswa Zingela, Kiran Sukeri93. Traditional and alternative healers: Prevalence of use in psychiatric patientsZukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche

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Fayez, R., A. AlMuntashery, G. Bodie, A. Almamar, R. S. Gill, I. Raîche, C. L. Mueller, et al. "Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m²): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection." Canadian Journal of Surgery 55, no. 4 Suppl 1 (August 2012): S63—S135. http://dx.doi.org/10.1503/cjs.016712.

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Selim, Yasser, Élise Di Lena, Nawaf Abu-Omar, Zarrukh Baig, Kevin Verhoeff, Julie La, Kieran Purich, et al. "2022 Canadian Surgery Forum Sept. 15–17, 202201. Operative classification of ventral abdominal hernias: new and practical classification02. Watchful waiting for large primary splenic cysts03. Transversus abdominis plane (TAP) blocks with and without dexamethasone in colorectal surgery04. What factors determine publication of resident research day projects?05. Characterization of near-infrared imaging and indocyanine green use amongst general surgeons06. Variation in opioid prescribing after outpatient breast surgery: Time for a streamlined approach?07. Trends in graduate degree types and research output for Canadian academic general surgeons08. Would you prefer to undergo breast-conserving therapy or a mastectomy for early breast cancer? Comparison of perceptions of general and plastic surgeons09. Lack of representation of women and BIPOC individuals in Canadian academic surgery10. Medical student interest and perspectives on pursuing surgical careers: a multicentre survey evaluating 5-year trends11. Difficult cholecystectomy with cholecystogastric fistula12. Surviving nonsurvivable injuries: patients who elude the “lethal” Abbreviated Injury Scale (AIS) score of six13. Gunshot wounds sustained during legal intervention v. those inflicted by civilians: a comparative analysis14. The impact of delayed time to first head CT on functional outcomes after blunt head trauma with moderately depressed GCS15. Contemporary utility of diagnostic peritoneal aspiration in trauma16. Impact of delayed time to first head CT in traumatic brain injury17. Radiologic predictors of in-hospital mortality after traumatic craniocervical dissociation18. Measurement properties of a patient-reported instrument to evaluate functional status after major surgery19. The safety of venous thromboembolism chemoprophylaxis use in endoscopic retrograde cholangiopancreatography20. Characterizing Canadian rural surgeons: trends over time and 10-year replacement needs21. Contextual interference for skills development and transfer in laparoscopic surgery: a randomized controlled trial22. Evaluating the accuracy and design of visual backgrounds in academic surgical journals23. Defining rural surgery in Canada24. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy25. Examining the equity and diversity characteristics of academic general surgeons in Canada26. Video-based coaching for surgical residents: a systematic review and meta-analysis27. Very-low-energy diets prior to nonbariatric surgery: a systematic review and meta-analysis28. Factors associated with resident research success: a descriptive analysis of Canadian general surgery trainees29. Global surgery pilot curriculum in Canadian undergraduate medical education: a novel approach30. How useful is ultrasound in predicting surgical findings of “mild cholecystitis”?31. Implementing a colorectal surgery “virtual hospital”: description of a novel outpatient care pathway to advance surgical care32. Trends in training and workforce planning for Canadian pediatric surgeons: a 10-year model33. Patient perspectives on intraoperative blood transfusion: results of semistructured interviews with perioperative patients34. Understanding intraoperative transfusion decision-making variability: a qualitative study using the Theoretical Domains Framework35. Effectiveness of preoperative oscillating positive expiratory pressure (OPEP) therapy in reduction of postoperative respiratory morbidity in patients undergoing surgery: a systematic review37. Accuracy of point-of-care testing devices for hemoglobin in the operating room: a systematic review and meta-analysis38. Opioid-free analgesia after outpatient general surgery: a qualitative study focused on the perspectives of patients and clinicians involved in a pilot trial39. The impact of the COVID-19 pandemic on general surgery residency: an analysis of operative volumes by residents at a Canadian general surgery residency program40. Postoperative care protocols for elderly emergency surgical patients: a quality improvement initiative42. Adverse events following robotic compared to laparoscopic and open surgery: a population-based analysis43. Is accrual higher for patients randomized to pragmatic v. exploratory randomized clinical trials? A systematic review and meta-analysis44. Effect of preoperative proton-pump inhibitor use on postoperative infectious and renal complications after elective general surgery45. The early burden of COVID-19 in emergency general surgery care across Canada46. Laparoscopic subtotal cholecystectomy for the difficult gallbladder: evolution of technique at a single teaching hospital and retrospective review47. The demand for emergency general surgery in Canada: a public health crisis48. Attitudes of Canadian general surgery staff and residents toward point-of-care ultrasound49. Psychological impact of COVID-19 on Canadian surgical residents50. Validation of an artificial intelligence platform for the guidance of safe laparoscopic cholecystectomy51. Predictors of recurrent appendicitis after nonoperative management: a prospective cohort study52. The effect of the first wave of the COVID-19 pandemic on colorectal and hepatobiliary oncologic outcomes at a tertiary care centre53. Trends in training and workforce representation for Canadian general surgeons working in critical care: a descriptive study54. White presentation: teaching safe opioid prescription and opioid use disorder management in Canadian universities56. How bad is really bad, eh? Impact of the first wave of the COVID-19 pandemic on residents’ operative volume: the experience of a Canadian general surgery program57. Surgeon-specific encounters within a multidisciplinary care pathway: Is there a role for shared care models in surgery?59. A pan-Canadian analysis of approach to treatment for acute appendicitis60. Appendix neoplasm stratified by age: understanding the best treatment for appendicitis61. Predicting acute cholecystitis on final pathology to prioritize surgical urgency: an evaluation of the Tokyo criteria and development of a novel predictive score62. Obesity is an independent predictor of acute renal failure after surgery64. Validation of a clinical decision-making assessment tool in general surgery65. Moral distress in the provision of palliative care delivery for surgical patients in British Columbia: lessons learned from the perspectives of general surgeons66. Delays in presentation and severity of illness predict adverse surgical outcomes among patients transferred from rural Indigenous communities for acute care surgery67. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial68. Modified Delphi consensus on appropriate use of laboratory investigations in acute care surgery patients72. Impacts of inpatient food at a tertiary care centre on patient satisfaction, nutrition and planetary health73. Racial disparities in health outcomes for oncological surgery in Canada75. Risk of recurrent laryngeal nerve injury from thyroidectomy is lower when intraoperative nerve monitoring (IONM) is used: an analysis of 17 688 patients from the NSQIP database01. The impact of the COVID-19 pandemic on non-smallcell lung cancer pathologic stage and presentation02. Screening criteria evaluation for expansion in pulmonary neoplasias (screen)03. Robotic-assisted lobectomy for early-stage lung cancer provides better patient-reported quality of life than video-assisted lobectomy: early results of the RAVAL trial04. Breathe Anew: designing and testing the feasibility of a novel intervention for lung cancer survivorship05. Learning objectives for thoracic surgery: developing a national standard for undergraduate medical education06. Plasma cell-free DNA as a point-of-care well-being biomarker for early-stage non-small-cell lung cancer patients07. Sarcopenia determined by skeletal muscle index predicts overall survival, disease-free survival and postoperative complications in resectable esophageal cancer: a systematic review and meta-analysis08. The short- and long-term effects of open v. minimally invasive thymectomy in myasthenia gravis patients: a systematic review and meta-analysis09. Optimizing opioid prescribing practices following minimally invasive lung resections through a structured quality improvement process10. Effects of virtual postoperative postdischarge care in patients undergoing lung resection during the COVID-19 pandemic11. Initiating Ethiopia’s first minimally invasive surgery program: a novel approach for collaborations in global surgical education12. Patient outcomes following salvage lung cancer surgery after definitive chemotherapy or radiation13. Replacing chest X-rays after chest tube removal with clinical assessment in postoperative thoracic surgery patients14. Updating the practice of thoracic surgery in Canada: a survey of the Canadian Association of Thoracic Surgeons15. The impact of COVID-19 on the diagnosis and treatment of lung cancer16. Development of a prediction model for survival time in esophageal cancer patients treated with resection17. The development and validation of a mixed reality thoracic surgical anatomy atlas18. Routine placement of feeding tubes should be avoided in esophageal cancer patients undergoing surgery19. Nodal count is no different during robotic segmentectomy compared with robotic lobectomy20. Point-of-care ultrasound-guided percutaneous biopsy of solid masses in the thoracic outpatient clinic: a safe, high-yield procedure to accelerate tissue diagnosis for patients with advanced thoracic malignancy21. Sarcopenia and modified frailty index are not associated with adverse outcomes after esophagectomy for esophageal cancer: a retrospective cohort study22. Near-infrared-guided segmental resection for lung cancer: an analysis of the learning curve23. Routine use of feeding jejunostomy tubes in patients undergoing esophagectomy for esophageal malignancy is safe and associated with low complication rates01. Ghost ileostomy versus loop ileostomy following total mesorectal excision for rectal cancer: a systematic review and meta-analysis02. Analysis of 100 consecutive colorectal cancers presenting at a Canadian tertiary care centre: delayed diagnosis and advanced disease03. Clinical delays and comparative outcomes in younger and older adults with colorectal cancer: a systematic review04. Recurrence rates of rectal cancer after transanal total mesorectal excision (taTME): a systematic review and meta-analysis05. Transanal total mesorectal excision for abdominoperineal resection (taTME-APR) is associated with poor oncological outcomes in rectal cancer patients: a word of caution from a multicentric Canadian cohort study06. Association between survival and receipt of recommended and timely treatment in locally advanced rectal cancer: a population-based study07. Trends and the impact of incomplete preoperative staging in rectal cancer08. Postoperative outcomes after elective colorectal surgery in patients with cirrhosis09. Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicentre, single-blinded, randomized controlled trial10. Recurrence following perineal rectosigmoidectomy ( Altemeier) with levatorplasty: a systematic review and meta-analysis11. Nonmodifiable risk factors and receipt of surveillance investigations following treatment of rectal cancer12. Safety and effectiveness of endoscopic full-thickness resection for the management of colorectal lesions: a systematic review and meta-analysis13. Impact of preoperative carbohydrate loading before colectomy: a systematic review and meta-analysis of randomized controlled trials14. Statin therapy in patients undergoing short-course neoadjuvant radiotherapy for rectal cancer15. Feasibility of targeted lymphadenectomy during complete mesocolic excision for colon cancer using indocyanine green immunofluorescence lymphatic mapping16. Feasibility of expanding an ambulatory colectomy protocol: a retrospective analysis of early discharge following minimally invasive colectomy in an enhanced recovery pathway17. Impact of rectal cancer on bowel dysfunction before treatment and its relationship with post-treatment function18. Canadian cost–utility analysis of artificial-intelligence-assisted colonoscopy for adenoma detection in fecal immunochemical-based colorectal cancer screening19. A comparison of outcomes following intracorporeal and extracorporeal anastomotic techniques in laparoscopic right colectomies20. Assessment of metabolic signatures using desorption electrospray ionization mass spectrometry (DESI) and rapid evaporative ionization mass spectrometry (REIMS) of rectal cancer samples to assist in determining treatment response21. The association between hospital characteristics and minimally invasive rectal cancer surgery: a population-based study22. Cancer centre level designation and the impact on treatment and outcomes in those with rectal cancer: a population-based study23. Oncological outcomes after colorectal cancer in patients with liver cirrhosis: a systematic review and meta-analysis24. Optimal preoperative nutrition for penetrating Crohn disease: a systematic review and meta-analysis25. Lymph node ratio as a predictor of survival for colon cancer: a systematic review and meta-analysis26. Barriers and facilitators for use of new recommendations for optimal endoscopic localization of colorectal neoplasms according to gastroenterologists and surgeons27. Emergency colorectal surgery in patients with cirrhosis: a population-based descriptive study28. Local recurrence rates and associated risk factors after transanal endoscopic microsurgery for benign polyps and adenocarcinomas29. Bowel dysfunction impacts mental health after restorative proctectomy for rectal cancer30. Evolution of psychological morbidity following restorative proctectomy for rectal cancer: a systematic review and meta-analysis31. Frailty predicts LARS and quality of life in rectal cancer survivors after restorative proctectomy32. Low anterior resection syndrome in a reference North American population: prevalence and predictive factors33. The evolution of enhanced recovery: same day discharge after laparoscopic colectomy34. Effect of ERAS protocols on length of stay after colorectal surgery: an interrupted time series analysis35. Practice patterns and outcomes in individuals with cirrhosis and colorectal cancer: a population-based study36. Understanding the impact of bowel function on quality of life after rectal cancer surgery37. Right-sided colectomies for diverticulitis have worse outcomes compared with left-sided colectomies38. Symptom burden and time from symptom onset to cancer diagnosis in patients with early-onset colorectal cancer39. The impact of access to robotic rectal surgery at a tertiary care centre: a Canadian perspective40. Management of rectal neuroendocrine tumours by transanal endoscopic microsurgery41. The gut microbiota modulates colorectal anastomotic healing in patients undergoing surgery for colorectal cancer42. Is there added risk of complications for concomitant procedures during an ileocolic resection for Crohn disease?43. Cost of stoma-related hospital readmissions for rectal cancer patients following restorative proctectomy with a diverting loop ileostomy: a nationwide readmissions database analysis44. Older age associated with quality of rectal cancer care: an ACS-NSQIP database study45. Outcomes of patients undergoing elective bowel resection before and after implementation of an anemia screening and treatment program47. Loop ileostomy closure as a 23-hour stay procedure: a randomized controlled trial48. Extended duration perioperative thromboprophylaxis with low-molecular-weight heparin to improve disease-free survival following surgical resection of colorectal cancer: a multicentre randomized controlled trial (PERIOP-01 Trial)49. Three-stage versus modified 2-stage ileal pouch anal anastomosis: perioperative outcomes, function and quality of life50. Compliance with extended venous thromboembolism prophylaxis in rectal cancer51. Extended-duration venous thromboembolism prophylaxis after diversion in rectal cancer52. Financial and occupational impact of low anterior resection syndrome: a qualitative study53. Nonoperative management for rectal cancer: patient perspectives54. Trends in ileostomy-related emergency department visits for rectal cancer patients55. Long-term implications of treatment of fecal incontinence: a single Canadian centre’s retrospective cohort study: a 17-year follow-up56. Externally benchmarking colorectal resection outcomes in our province against the ACS NSQIP risk calculator: identifying opportunities for improvement57. Externally benchmarking our provincial colectomy outcomes against the ACS NSQIP using the Codman Score: to identify possible opportunities for improvement of outcomes58. Rural v. urban documentation of recommended practices for optimal endoscopic colorectal lesion localization01. Incidence of in-hospital opioid use and pain after inguinal hernia repair02. Ventral hernia repair following liver transplantation: outcome of repair techniques and risk factors for recurrence01. Impact of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834 647 patients02. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47 375 patients03. New persistent opioid use following bariatric surgery: a systematic review and pooled proportion meta-analysis04. Bariatric surgery should be offered to active-duty military personnel: a retrospective study of the Canadian Armed Forces experience05. Opioid prescribing practices and use following bariatric surgery: a systematic review and pooled summary of data06. Sacred sharing circles: urban Indigenous Manitobans’ experiences with bariatric surgery07. Gastrogastric hernia after laparoscopic gastric great curve plication: a video presentation08. Characterization of comorbidities predictive of bariatric surgery09. Efficacy of preoperative high-dose liraglutide in patients with superobesity10. The effect of linear stapled gastrojejunostomy size in Roux-en-Y gastric bypass11. Fragility of statistically significant outcomes in randomized trials comparing bariatric surgeries12. Weight loss outcomes for patients undergoing conversion to Roux-en-Y gastric bypass after sleeve gastrectomy13. Are long waiting lists for bariatric surgery detrimental to patients? A single-centre experience14. Does upper gastrointestinal swallow study after bariatric surgery lead to earlier detection of leak?15. Pharmaceutical utilization before and after bariatric surgery16. Same-day discharge Roux-en-Y gastric bypass at a Canadian bariatric centre: pathway implementation and early experiences17. Safety and efficiency of performing primary bariatric surgery at an ambulatory site of a tertiary care hospital: a 5-year experience18. Impact of psychiatric diagnosis on weight loss outcomes 3 years after bariatric surgery19. Ursodeoxycholic acid (UDCA) for prevention of gallstone disease after laparoscopic sleeve gastrectomy (LSG): an Atlantic Canada perspective20. Fecal microbial transplantation and fibre supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial01. Incidence, timing and outcomes of venous thromboembolism in patients undergoing surgery for esophagogastric cancer: a population-based cohort study04. Omission of axillary staging and survival in elderly women with early-stage breast cancer: a population-based cohort study05. Patients’ experiences receiving cancer surgery during the COVID-19 pandemic: a qualitative study06. Cancer surgery outcomes are better at high-volume centres07. Attitudes of Canadian colorectal cancer care providers toward liver transplantation for colorectal liver metastases: a national survey08. Quality of narrative central and lateral neck dissection reports for thyroid cancer treatment suggests need for a national standardized synoptic operative template09. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications and technique10. Temporal trends in lymph node assessment as a quality indicator in colorectal cancer patients treated at a high-volume Canadian centre11. Molecular landscape of early-stage breast cancer with nodal metastasis12. Beta testing of a risk-stratified patient decision aid to facilitate shared decision making for postoperative extended thromboprophylaxis in patients undergoing major abdominal surgery for cancer13. Breast reconstruction use and impact on oncologic outcomes among inflammatory breast cancer patients: a systematic review14. Association between patient-reported symptoms and health care resource utilization: a first step to develop patient-centred value measures in cancer care15. Complications after colorectal liver metastases resection in Newfoundland and Labrador16. Why do patients with nonmetastatic primary retroperitoneal sarcoma not undergo resection?17. Loss ofFAM46Cexpression predicts inferior postresection survival and induces ion channelopathy in gastric adenocarcinoma18. Liver-directed therapy of neuroendocrine liver metastases19. Neoadjuvant pembrolizumab use in microsatellite instability high (MSI-H) rectal cancer: benefits of its use in lynch syndrome20. MOLLI for excision of nonpalpable breast lesions: a case series22. Patients awaiting mastectomy report increased depression, anxiety, and decreased quality of life compared with patients awaiting lumpectomy for treatment of breast cancer23. Is microscopic margin status important in retroperitoneal sarcoma (RPS) resection? A systematic review and meta-analysis24. Absence of benefit of routine surveillance in very-low-risk and low-risk gastric gastrointestinal stromal tumors25. Effect of intraoperative in-room specimen radiography on margin status in breast-conserving surgery26. Active surveillance for DCIS of the breast: qualitative interviews with patients and physicians01 Outcomes following extrahepatic and intraportal pancreatic islet transplantation: a comparative cohort study02. Cholang-funga-gitis03. Evaluating the effect of a low-calorie prehepatectomy diet on perioperative outcomes: a systematic review and meta-analysis04. Toxicity profiles of systemic therapy for advanced hepatocellular carcinoma: a systematic review to guide neoadjuvant trials05. Should cell salvage be used in liver resection and transplantation? A systematic review and meta-analysis06. The association between surgeon and hospital variation in use of laparoscopic liver resection and short-term outcomes07. Systematic review and meta-analysis of prognostic factors for early recurrence in intrahepatic cholangiocarcinoma after curative-intent resection08. Impact of neoadjuvant chemotherapy on postoperative outcomes of patients undergoing hepatectomy for intrahepatic cholangiocarcinoma: ACS-NSQIP propensity-matched analysis09. The impact of prophylactic negative pressure wound therapy on surgical site infections in pancreatic resection: a systematic review and meta-analysis10. Does hepatic pedicle clamping increase the risk of colonic anastomotic leak after combined hepatectomy and colectomy? Analysis of the ACS NSQIP database11. Development of a culture process to grow a full-liver tissue substitute12. Liver transplantation for fibrolamellar hepatocellular carcinoma: an analysis of the European Liver Transplant Registry13. Arming beneficial viruses to treat pancreatic cancer14. Hepaticoduodenostomy versus hepaticojenunostomy for biliary reconstruction: a retrospective review of a single-centre experience15. Feasibility and safety of a “shared care” model in complex hepatopancreatobiliary surgery: a 5-year analysis of pancreaticoduodenectomy16. Laparoscopic v. open pancreaticoduodenectomy: initial institutional experience and NSQIP-matched analysis17. Laparoscopic spleen-preserving distal pancreatectomy: Why not do a Warshaw?18. The impact of COVID-19 on pancreaticoduodenectomy outcomes in a high-volume hepatopancreatobiliary centre19. Transitioning from open to minimally invasive pancreaticoduodenectomy: the learning curve factor in an academic centre20. Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis." Canadian Journal of Surgery 65, no. 6 Suppl 2 (November 30, 2022): S33—S111. http://dx.doi.org/10.1503/cjs.014322.

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Moran, James K., Joachim Bretz, Johanna Winkler, Stefan Gutwinski, Eva J. Brandl, and Meryam Schouler-Ocak. "The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients – A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany." Frontiers in Psychiatry 12 (May 28, 2021). http://dx.doi.org/10.3389/fpsyt.2021.642784.

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The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

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Yoon, Isabel A., Rosemary Busch Conn, and David Galarneau. "The Relationship between Body Image, Demographics, and Medication Adherence among Women with Psychiatric Conditions." Current Psychiatry Research and Reviews 18 (May 18, 2022). http://dx.doi.org/10.2174/2666082218666220518152339.

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Background: Given the side effect of weight gain in many psychiatric medications, a patient’s body image concerns may influence medication compliance, which can be critical in the psychiatric population. Objective: The aim of this study was to investigate whether demographic factors including age, race, and BMI have specific associations with body image satisfaction and medication adherence among women with severe psychiatric disorders. Clinical factors such as diagnosis and type of current psychiatric medications were also examined. Method: Study participants included 112 women aged 18 to 88 who were admitted to a psychiatric inpatient unit in New Orleans, Louisiana. Participants completed a brief questionnaire on body image and medication adherence, specifically developed for this study. Collected data were analyzed using T-tests, analysis of variance, correlations, and multivariable regression analysis to compare differences in body image score and medication adherence score by demographic and clinical factors. Results: Age was associated with significant differences in body image score (F(2, 109) = 5.736, p = 0.004). African American race was associated with higher average BMI (t(39.99) = 3.375, p = 0.002) and self-esteem subscore (t(106) = 2.254, p = 0.026) but not associated with differences in body image score or medication adherence. Regression analysis showed that body image score significantly predicted medication adherence ( = 0.208, p = 0.037). Conclusion: Assessing how a patient feels about their weight while considering the potential differences in demographic groups may facilitate optimal medication selections and communication of treatment plans with psychiatric patients, which has implications on treatment adherence, disease course, and prognosis.

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Algaows, Faisal Suliman, Anas Murad Abdou Elrahwan, Ashjan Fouad Gholam, Yasir Nasser Aloufi, Mohammed Abdullh Mutlaqah, Rajab, Hadeer Abdulhamid, Mohammed Mousa Alammari, et al. "History and Mental Status Examination in Primary Care in Saudi Arabia: A Review." Journal of Pharmaceutical Research International, October 21, 2021, 206–12. http://dx.doi.org/10.9734/jpri/2021/v33i46b32934.

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The mental state assessment is an important tool for doctors when determining psychiatric diagnosis. Physicians can better identify and differentiate psychiatric diseases if they are familiar with the components of the examination. A thorough medical history entails a more in-depth investigation into the patient's medical problems, including all diseases and illnesses that are currently being treated, as well as those that have left any lasting consequences on the patient's health. A major source of worry is the patient's health literacy, as well as how questions to acquire histories are asked in such a way that the patient understands and can respond appropriately. Medical record practices have a long history of criticism, despite their usefulness. Records that are untimed or outdated, use imprecise language or are illegible, lack a logical structure, are poorly synthesized, are difficult to access and prone to loss, lack information relevant to clinical treatment goals, or are plain incorrect are all common concerns. In this review we will be looking at approaches for mental and history examination, as well as the importance of such reports.

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Harper, David J., Edward O’Donnell, and Simon Platts. "A “trigger”, a cause or obscured? How trauma and adversity are constructed in psychiatric stress-vulnerability accounts of “psychosis”." Feminism & Psychology, October 6, 2020, 095935352095431. http://dx.doi.org/10.1177/0959353520954313.

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How do mental health professionals link adverse life experiences with the kinds of beliefs and experiences which attract a diagnosis of psychosis and what implications does this have for women with these diagnoses? Drawing on a broadly critical realist framework, we present data from two studies relevant to these questions. First, we analyse the discursive practices engaged in during a staff-only discussion of a female in-patient with a psychosis diagnosis who had been raped some years previously. Staff oriented to the irrationality and factuality of her ostensibly delusional statements about rape and pregnancy in the present and formulated adverse experience as a “stress factor” triggering a manic episode, thereby precluding alternative contextualising interpretations. In a second, interview-based, study, psychiatrists drew on a range of discursive resources which differentiated “psychosis” from other forms of distress, constructed trauma as a stressor which could trigger psychosis because of a genetic predisposition, and constructed medication as the primary intervention whilst trauma was de-emphasised. We discuss the implications of these findings for the kinds of explanations and forms of help offered and suggest ways in which distress might be contextualised as well as possible future directions for feminist research and practice.

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Kimmell, Jacqueline, Emily Mendenhall, and Elizabeth A. Jacobs. "Deconstructing PTSD: Trauma and emotion among Mexican immigrant women." Transcultural Psychiatry, February 11, 2020, 136346152090312. http://dx.doi.org/10.1177/1363461520903120.

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The symptomatology for Post-Traumatic Stress Disorder (PTSD) narrowly focuses on particular diagnostic frames and a single triggering event. Such narrow definitions of trauma and recovery have been heavily critiqued by anthropologists and cultural psychiatrists for overlooking cultural complexity as well as the effects of multiple and overlapping events that may cause someone to become “traumatized” and thereby affect recovery. This article investigates how subjective reporting of traumatic experience in life history narratives relates to depressive and PTSD symptomatology, cultural idioms, and repeated traumatic experiences among low-income Mexican immigrant women in Chicago. We interviewed 121 Mexican immigrant women and collected life history narratives and psychiatric scales for depression and PTSD. Most women spoke of the detrimental effects of repeated traumatic experiences, reported depressive (49%) and PTSD (38%) symptoms, and described these experiences through cultural idioms. These data complicate the PTSD diagnosis as a discrete entity that occurs in relation to a single acute event. Most importantly, these findings reveal the importance of cumulative trauma and cultural idioms for the recognition of suffering and the limitation of diagnostic categories for identifying the needs of those who experience multiple social and psychological stressors.

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Pietkiewicz, Igor Jacob, Anna Bańbura-Nowak, Radosław Tomalski, and Suzette Boon. "Revisiting False-Positive and Imitated Dissociative Identity Disorder." Frontiers in Psychology 12 (May 6, 2021). http://dx.doi.org/10.3389/fpsyg.2021.637929.

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ICD-10 and DSM-5 do not provide clear diagnosing guidelines for DID, making it difficult to distinguish ‘genuine’ DID from imitated or false-positive cases. This study explores meaning which patients with false-positive or imitated DID attributed to their diagnosis. 85 people who reported elevated levels of dissociative symptoms in SDQ-20 participated in clinical assessment using the Trauma and Dissociation Symptoms Interview, followed by a psychiatric interview. The recordings of six women, whose earlier DID diagnosis was disconfirmed, were transcribed and subjected to interpretative phenomenological analysis. Five main themes were identified: (1) endorsement and identification with the diagnosis. (2) The notion of dissociative parts justifies identity confusion and conflicting ego-states. (3) Gaining knowledge about DID affects the clinical presentation. (4) Fragmented personality becomes an important discussion topic with others. (5) Ruling out DID leads to disappointment or anger. To avoid misdiagnoses, clinicians should receive more systematic training in the assessment of dissociative disorders, enabling them to better understand subtle differences in the quality of symptoms and how dissociative and non-dissociative patients report them. This would lead to a better understanding of how patients with and without a dissociative disorder report core dissociative symptoms. Some guidelines for a differential diagnosis are provided.

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Cumin, Julie, Sandra Pelaez, and Laurent Mottron. "Positive and differential diagnosis of autism in verbal women of typical intelligence: A Delphi study." Autism, September 11, 2021, 136236132110427. http://dx.doi.org/10.1177/13623613211042719.

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Diagnostic criteria for autism are relatively vague, and may lead to over and underdiagnosis when applied without clinical expertise. Indeed, autism is best reliably identified by experienced clinicians who take into account qualitative aspects of the condition. When assessing for autism in women, little guidance exists to support clinicians deciding whether to attribute adaptive difficulties to autism, a psychiatric condition, or both. The purpose of this study was therefore to propose guidelines for clinicians assessing for autism in women. To do this, we aimed to describe the clinical expertise involved in making positive and differential diagnoses of autism in adult women of typical intelligence. We interviewed 20 experienced clinicians from seven countries. We then elaborated Delphi statements summarizing participant views on the topic, which our participants rated. We obtained a final list of 37 suggested clinical guidelines to improve specificity and sensitivity of autism diagnosis in women. Participants had developed individual assessment strategies, although much overlap existed across participants. Participants provided insight to differentiate autism from post-traumatic stress disorder and Borderline Personality Disorder, and underlined the importance of being able to make differential diagnoses particularly in cases where non-autistic people had strongly self-identified with the spectrum. Lay abstract The diagnostic criteria for autism are relatively vague and can lead to both under- and over-diagnosis if applied as a checklist. The highest level of agreement that a person is autistic occurs when experienced clinicians are able to make use of their clinical judgment. However, it is not always clear what this judgment consists of. Given that particular issues exist when assessing for autism in adult women, we wanted to explore how expert clinicians address difficult diagnostic situations in this population. We interviewed 20 experienced psychologists and psychiatrists from seven countries and discussed how they conducted autism assessments in adult women. We then came up with a list of 35 statements that described participant views. Our participants completed an online survey where they rated their agreement with these statements and provided feedback on how the statements were worded and organized. We obtained a final list of 37 suggested clinical guidelines. Participants agreed that diagnostic tools and questionnaires had to be coupled with judgment and expertise. Participants felt that trauma and Borderline Personality Disorder could be difficult to differentiate from autism, and agreed on some ways to address this issue. Participants agreed that self-identification to the autism spectrum was frequent, and that it was important to provide alternative support when they did not ultimately diagnose autism.

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Journal articles on the topic 'How women respond to psychiatric diagnosis'

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