Incremental effects of comorbidity on quality of life in patients with psoriatic arthritis.

Objective: To assess the added effect of comorbidity on quality of life (QOL) in psoriatic arthritis (PsA).

Methods: Between 2006 and 2012, 631 patients were recruited from the University of Toronto PsA Clinic. Using the clinical database, we ascertained the frequency of 15 comorbidities.

Early environmental exposures influence schizophrenia expression even in the presence of strong genetic predisposition.

There are few studies of environmental factors in familial forms of schizophrenia. We investigated whether childhood adversity or environmental factors were associated with schizophrenia in a familial sample where schizophrenia is associated with the NOSA1P gene. We found that a cumulative adversity index including childhood illness, family instability and cannabis use was significantly associated with narrow schizophrenia, independent of NOSA1P risk genotype, previously measured childhood trauma, covariates and familial clustering (adjusted odds ratio (95% confidence interval)=1.

Longitudinal study of the bidirectional association between pain and depressive symptoms in patients with psoriatic arthritis.

Objective: To test the bidirectional hypothesis that depressive symptoms influence changes in pain over time, and pain influences changes in depressive symptoms.

Methods: A total of 394 patients attending the University of Toronto Psoriatic Arthritis clinic were followed over a mean period of 7.5 years with annual assessments, including number of swollen joints (SJC), Health Assessment Questionnaire (HAQ), and the Medical Outcomes Survey Short Form 36 (SF-36).

Influence of discipline of provider and model of care on an arthritis educational intervention in primary care.

Objective: To identify both provider and organizational characteristics that predicted outcomes following an educational intervention (9-hour workshop and followup reinforcement activities) developed to improve the management of arthritis in primary care.

Methods: Providers completed a survey at baseline and at 6 months postworkshop, including a case scenario for early rheumatoid arthritis. Providers were asked how they would manage the case and their responses were coded to calculate a best practice score, ranging from 0-7.

Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis.

Objective: To determine whether the presence of psoriatic arthritis (PsA) is associated with greater comorbidity, in particular cardiovascular morbidity, compared to psoriasis without arthritis.

Methods: Six hundred eleven patients with PsA were recruited from the University of Toronto Psoriatic Arthritis Clinic and 449 psoriasis without arthritis patients were recruited from the University of Toronto Psoriasis Cohort. The clinical database was used to identify the prevalence of cardiovascular and other comorbidities in both PsA and psoriasis without arthritis patients.

Longitudinal analysis of fatigue in psoriatic arthritis.

Objective: To describe the longitudinal course of fatigue in psoriatic arthritis (PsA).

Methods: Our study included 390 patients who attended the University of Toronto Psoriatic Arthritis Clinic between 1998 and 2006 and who completed 2 or more administrations of the modified Fatigue Severity Scale (mFSS) at yearly intervals. Clinical data were used that corresponded to visits in which mFSS was administered.

Educational interventions for implementation of arthritis clinical practice guidelines in primary care: effects on health professional behavior.

Objective: The dissemination and adoption of clinical practice guidelines (CPG) has been suggested as one method for improving arthritis care delivery. This article provides a review and synthesis of studies evaluating the influence of educational programs designed to implement CPG for osteoarthritis (OA) and rheumatoid arthritis (RA) in primary care.

Methods: A systematic literature search was conducted to identify relevant educational interventions that reported behavioral outcomes that ensured actual knowledge utilization in primary care.

Childhood trauma and genetic factors in familial schizophrenia associated with the NOS1AP gene.

There is some evidence that childhood adversity may be associated with the expression of schizophrenia but whether genetic risk affects this finding is unknown. We investigated the history of early trauma in 194 subjects from 24 multiply affected families where schizophrenia was previously shown to be associated with a functional allele in the NOS1AP gene. In subjects with schizophrenia (n=79), only events prior to the onset of psychosis were considered.

Heritability of neurocognitive traits in familial schizophrenia.

Neurocognitive deficits are considered promising endophenotypes for gene discovery in schizophrenia. Understanding the heritability and genetic inter-relationships of neurocognitive traits could support their use as alternatives to diagnosis. Participants were 85 adults from 17 multiplex Canadian families with familial schizophrenia linked to 1q23 who had neurocognitive testing results available.

A longitudinal study of the effect of disease activity and clinical damage on physical function over the course of psoriatic arthritis: Does the effect change over time?

Objective: To investigate whether there are differential effects of disease activity and damage on physical functioning as measured by the Health Assessment Questionnaire (HAQ) over the course of psoriatic arthritis (PsA).

Methods: Between June 1993 and March 2005, 382 patients attending the University of Toronto PsA clinic had completed > or =2 HAQs on an annual basis. At the time of each HAQ assessment, clinical and laboratory measures of disease activity and damage were recorded.

Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects.

It remains unclear whether age at onset for major psychiatric disorders is a useful marker of etiologic and genetic heterogeneity. The authors examined how heritability of schizophrenia and major affective disorders varied with age at onset. The sample was drawn from a large archival data set collected by Lionel Penrose, comprising 3,109 families with two or more members first hospitalized in Ontario between 1874 and 1944.

Description and prediction of physical functional disability in psoriatic arthritis: a longitudinal analysis using a Markov model approach.

Objective: To describe the longitudinal course of physical functioning in patients with psoriatic arthritis.

Methods: Between June 1993 and June 2003, 341 patients attending the University of Toronto Psoriatic Arthritis Clinic completed 2 or more Health Assessment Questionnaires (HAQs). At the time of administration of each HAQ, patients were assigned to 1 of 3 physical functional disability states, based on their HAQ score.