Evidence-Based Mental Health articles from August 2003

Evidence-Based Mental Health archives from August 2003

The internet and mental health practice.(EBMH Notebook)
August 1, 2003... The internet is one of the fastest growing technologies in the world. The number of web users worldwide is estimated at 513 million, (1) with approximately 100 million adult users in the United States (2) and 25 million in the United Kingdom....

Which treatments are effective for cognitive, behavioural and psychological symptoms in dementia?
August 1, 2003... This EBMH Notebook summarises key messages about the effects of treatments in dementia, sourced from: Warner JP, Butler R, Prabhakaran P. Dementia. Clin Evid 2003; 9:1010-33. The authors searched for evidence to October 2002. A full...

The number needed to treat: problems describing non-significant results.
August 1, 2003... The number needed to treat (NNT) and its counterpart, the number needed to harm (NNH), are commonly used measures of effect in studies of mental health treatments. The NNT is an absolute measure, which conveys a more direct and intuitive...

About 3 in every 1000 US children in large metropolitan areas may have autism or related developmental disorders.(Prevalence)
August 1, 2003... Yeargin-Allsopp M, Rice C, Karapurkar T et al. Prevalence of autism in a US metropolitan area. JAMA 2003 Jan;289: 49-55. QUESTION: What is the prevalence of autism among children in Atlanta, Georgia? Design Database and...

Review: lifetime prevalence of schizophrenia and related disorders is about 5.5 per 1000, but there is significant variation between regions.
August 1, 2003... Goldner E M et al. Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry. 2002 Nov;47:833-43. QUESTION: What is the prevalence of schizophrenia and related disorders in studies...

Review: there is marked socioeconomic inequality in persistent depression.
August 1, 2003... Lorant V, Deliege D, Eaton W et al. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 2003, Feb, 157:98-112. QUESTION: What is the size and nature of the relationship between socio-economic status and depression? ...

Review: black people are more likely than white people to be detained in psychiatric wards in the United Kingdom.
August 1, 2003... Bhui K, Stansfeld S, Hull S, Priebe S et al. Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. Brit J Psychiatry 2003 Feb, 182:105-16. QUESTION: Are there ethnic differences in...

Review: antenatal screening tools to predict postnatal depression generally have low specificity and sensitivity.
August 1, 2003... Austin M-P, Lumley J. Antenatal screening for postnatal depression: a systematic review. Acta Psychiatr Scand 2003 Jan, 107:10-7. QUESTION: What is the sensitivity and specificity of antenatal screening tools developed to predict depression...

Local adaptation of guidelines for identifying mental disorders in primary care may not improve patient outcomes.(Diagnosis)
August 1, 2003... Croudace T, Evans J, Harrison G et al. Impact of the ICD-10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care. Cluster randomised controlled trial. Br J Psychiatry 2003...

Review: atypical antipsychotics and psychosocial interventions, alone or in combination, may reduce youth aggression.
August 1, 2003... Schur SB, Sikich L, Findling RL et al. Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part 1: a review. J Am Acad Child Adolec Psychiatry, 2003 Feb;42:132-44. QUESTION: How safe and effective are...

Review: it is unclear whether treating internalising disorders in childhood prevents substance abuse in adolescence.
August 1, 2003... Compton SN, Burns BJ, Egger HL, Robertson E. Review of the evidence base for treatment of childhood psychopathology: internalizing disorders. J Consult Clin Psychol 2002 Dec;70:1240-65. QUESTION: Which psychological, psychopharmacological...

Review: parent training and community-based interventions may benefit children with disruptive behaviour disorders.
August 1, 2003... Farmer EM, Compton SN, Burns BJ, Robertson E. Review of the evidence base for treatment of childhood psychopathology: externalizing disorders. J Consult Clin Psychol. 2002 Dec;70:1267-302. QUESTION: Which interventions are effective for...

Problem solving programme implemented by teachers may prevent depression in the short term, but longer term benefits are unclear.
August 1, 2003... Spence SH, Sheffield JK, Donovan CL. Preventing adolescent depression. An evaluation of the Problem Solving for Life program. J Consult Clin Psychology 2003 Feb;71:3-13. QUESTION: Can a teacher-led intervention prevent depression among...

Review: electroconvulsive therapy may be an effective short term treatment for people with depression.
August 1, 2003... The UK ECT Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003, Mar;361:799-808. QUESTION: What is the efficacy and safety of electroconvulsive therapy (ECT)...

Review: continuing antidepressants for 12 months following acute treatment may reduce the risk of relapse in depression.
August 1, 2003... Geddes JR, Carney SM, Davies C et al. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 2003; Feb,361:653-61. QUESTION: In people with depressive disorders, how long should...

Adjunctive cognitive therapy is more effective, but more costly, than standard clinical management for relapse prevention in depression.
August 1, 2003... Scott J, Palmer S, Paykel E et al. Use of cognitive therapy for relapse prevention in chronic depression. Brit J Psychiatry 2003 Mar;182:221-7. QUESTION: How cost effective is cognitive therapy for preventing relapse in depression? ...

Collaborative care may improve depression management in older adults.
August 1, 2003... Unutzer J, Katon W, Callahan CM et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA 2002 Dec;288:2836-45. QUESTION: Does collaborative care management improve late...

Review: counselling in primary care may have short term benefits for people with common mental disorders.
August 1, 2003... Bower P, Rowland N, Hardy R. The clinical effectiveness of counselling in primary care: a systematic review and meta-analysis. Psychological Med 2003 Feb;33:203-15. QUESTION: Is counselling people with common mental disorders in primary...

Advance directives about treatment preferences had little impact on compulsory readmissions for people with serious mental illness.(Therapeutics)
August 1, 2003... Papageorgiou A, King M, Janmohamed A et al. Advance directives for patients compulsorily admitted to hospital with serious mental illness. Randomised controlled trial. Br J Psychiatry 2002 Dec;181:513-9. QUESTION: Do advance directives...

Review: women with schizophrenia have poorer pregnancy outcomes than other women, but it is unclear whether antipsychotic medications affect their infants.
August 1, 2003... Patton SW, Misiri S, Corral MR et al. Antipsychotic medication during pregnancy and lactation in women with schizophrenia: evaluating the risk. Can J Psych 2003, Dec;47:959-65. QUESTION: Does exposing infants to antipsychotic medication...

The benefits of exposure therapy alone may last longer than sertraline alone or sertraline plus exposure therapy in social phobia.(Therapeutics)
August 1, 2003... Haug TT, Blomhoff S, Hellstrom K et al. Exposure therapy and sertraline in social phobia: 1-year follow up of a randomised control trial. Br J Psychiatry 2003, Apr;182:312-8. QUESTION: Do the benefits of exposure therapy and sertraline for...

Hydroxyzine may be safe and effective in generalised anxiety disorder.(Therapeutics)
August 1, 2003... Llorca PM, Spadone C, Sol O et al. Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study. J Clin Psychiatry 2002 Nov;63:1020-7. QUESTION: Is hydroxyzine safe and effective for...

Buprenorphine may be more effective than clonidine and other symptomatic medications for short term ambulatory heroin withdrawal.(Therapeutics)
August 1, 2003... Lintzeris N, Bell J, Bammer G et al. A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal. Addiction 2002 Nov;97:1395-404. QUESTION: How effective is buprenorphine for managing...

Clozapine may be more effective than olanzapine for reducing suicidal behaviour in people with schizophrenia at high risk.(Therapeutics)
August 1, 2003... Meltzer HY, Alphs L, Green AI et al. Clozapine treatment for suicidality in schizophrenia. International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry 2003, Jan;60:82-91. QUESTION: Compared with olanzapine, how effective is...

Review: cholinesterase inhibitors have a modest effect on neuropsychiatric and functional outcomes in Alzheimer's disease.
August 1, 2003... Trinh NH, Hoblyn J, Mohanty S, Yaffe K. Efficacy of cholinesterase inhibitors in the treatment of neuropsychiatric symptoms and functional impairment in Alzheimer disease: a meta-analysis. JAMA 2003 Jan;280:210-6. QUESTION: How effective...

Ethnicity may be linked to thin body preoccupation and social pressure in the development of eating disorders.(Aetiology)
August 1, 2003... The McKnight Investigators. Risk factors for the onset of eating disorders in adolescent girls: results of the McKnight Longitudinal Risk Factor Study. Am J Psychiatry 2003 Feb;160:248-54. QUESTION: What are the risk factors for eating...

People with schizophrenia believe that they are stigmatised at work and in the community.(Qualitative)
August 1, 2003... Schulze B, Angermeyer MC. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sc Med 2003 Feb;56:299-312. QUESTION: How does stigma affect the everyday lives...