Conduct disorder and attention-deficit/hyperactivity disorder as risk factors for prescription opioid use.

Background: Existing studies of attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance use or substance use disorders have produced mixed results, with some identifying a direct link between ADHD and general or disordered substance use and others suggesting that comorbid CD may explain this relationship. Insufficient research has addressed the issue, which is particularly relevant in the context of the opioid crisis. This study examined the association of probable ADHD and childhood CD with self-reported opioid use in a general-population sample.

A walk on the translational science bridge with leaders in integrated care: Where do we need to build?

Entrepreneurs in integrated care face some of the same challenges in empirically demonstrating impact, regardless of the model of care they espouse. In this editorial, 2 leading model developers reflect on the state of the science in primary care integration, including research gaps and promising research underway. We asked these leaders to discuss conceptual areas of shared concern, and we present those with reference to the metaphor of the translational research bridge.

Elevated fatty acid amide hydrolase in the prefrontal cortex of borderline personality disorder: a [C]CURB positron emission tomography study.

Amygdala-prefrontal cortex (PFC) functional impairments have been linked to emotion dysregulation and aggression in borderline personality disorder (BPD). Fatty acid amide hydrolase (FAAH), the major catabolic enzyme for the endocannabinoid anandamide, has been proposed as a key regulator of the amygdala-PFC circuit that subserves emotion regulation. We tested the hypothesis that FAAH levels measured with [C]CURB positron emission tomography in amygdala and PFC would be elevated in BPD and would relate to hostility and aggression.

Understanding the effects of chronic benzodiazepine use in depression: a focus on neuropharmacology.

Benzodiazepines are frequently prescribed on an ongoing basis to individuals with depression, mainly to alleviate anxiety or insomnia, despite current guideline recommendations that continuous use should not exceed 4 weeks. Currently, there are no efficacy trials published beyond 8 weeks. Several antidepressant trials demonstrate that the concomitant use of a benzodiazepine is associated with poorer depressive outcomes and functional status; however, it is unclear why this is the case.

Are long shifts, overtime and staffing levels associated with nurses' opportunity for educational activities, communication and continuity of care assignments? A cross-sectional study.

Background & Objectives: Previous research demonstrates the impact of workforce organisation variables on quality of care and nurse wellbeing. However, the extent to which these variables influence completion of important "ancillary" nursing work is unexplored. This type of work can include discussion of care information between colleagues, promoting continuity of care during shift changes, and participating in continuing professional development programs.

Are Owls and Larks Different When it Comes to Aggression? Genetics, Neurobiology, and Behavior.

This review focuses on the contribution of circadian rhythms to aggression with a multifaceted approach incorporating genetics, neural networks, and behavior. We explore the hypothesis that chronic circadian misalignment is contributing to increased aggression. Genes involved in both circadian rhythms and aggression are discussed as a possible mechanism for increased aggression that might be elicited by circadian misalignment.

Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

Background: Although highly effective in the treatment of obstructive sleep apnoea (OSA), continuous positive airway pressure (CPAP) is not universally accepted by users. Educational, supportive and behavioural interventions may help people with OSA initiate and maintain regular and continued use of CPAP.

Objectives: To assess the effectiveness of educational, supportive, behavioural, or mixed (combination of two or more intervention types) strategies that aim to encourage adults who have been prescribed CPAP to use their devices.

Post-traumatic Stress Disorder, Depression, Anxiety Symptoms and Help Seeking in Psychiatric Staff: Trouble de stress post-traumatique, dépression, symptômes d'anxiété et recherche d'aide chez le personnel psychiatrique.

Background And Methods: In this study, we surveyed 761 psychiatric hospital staff (69% women, 71% full-time, 56% nursing) regarding their exposure to trauma in the workplace; symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety; help seeking; and perceived barriers for help seeking.

Results: Significant proportions of staff met the screening cutoffs for probable PTSD (16%), depression (20%), and anxiety (16%). Comorbidity was high, with approximately half of those meeting the screening cutoff for PTSD also meeting the cutoffs for depression or anxiety.

Urgent Outpatient Care Following Mental Health ED Visits: A Population-Based Study.

Objective: Follow-up after psychiatric emergency department (ED) contact is key to optimizing outcomes for vulnerable patients. We aimed to quantify the likelihood of receiving outpatient mental health care after psychiatric ED visits in a population-level sample.

Methods: Among individuals who presented for a psychiatric ED visit in Ontario, Canada (2010-2012) and were not admitted to hospital (N=143,662), the authors estimated the likelihood of outpatient physician mental health care within 14 days post-ED visit and compared this across presenting diagnoses.

Workplace characteristics of forensic and nonforensic psychiatric units associated with posttraumatic stress disorder (PTSD) symptoms.

Workplace factors associated with the development of posttraumatic stress disorder (PTSD) in inpatient psychiatric settings have received limited attention. In this study, we examined critical exposures, patient care stressors, and aspects of workplace environment that are potentially associated with PTSD symptoms in a sample of 633 clinical staff (68% nursing staff, 70% female) who provided direct day-to-day care for patients, and indicated they worked in either forensic (57%) or nonforensic units (43%). Forensic staff reported more direct exposure (74%) to a wider variety of potentially traumatic events and chronic stressors than nonforensic staff (66%).

Preferred ways of giving birth in non-pregnant and pregnant nulliparous women: the role of control beliefs.

Purpose: To explore the association between delivery-specific, health-related control beliefs and preferred ways of delivery in nulliparous Hungarian women. Moreover, since data about the delivery-specific control beliefs and delivery-related preferences of non-pregnant nulliparous women are lacking, the present study also seeks to provide descriptive information in this regard.

Methods: A total of 984 Hungarian nulliparous women (26.

Evaluating time in health care: What are we busy about?

At the end of the day, there are both economic and less tangible benefits to having predictable clinic operations in which people's medical and behavioral health needs are met. These different benefits, stemming from changes in how time is used, are relevant to a wide range of stakeholders including administrators, clinicians, and patients. In short, time is one of our most important resources in health care.

Right to Appeal, Non-Treatment, and Violence Among Forensic and Civil Inpatients Awaiting Incapacity Appeal Decisions in Ontario.

Mental health legislation in Ontario, Canada, permits inpatients to refuse treatment while appealing their incapacity finding to the Consent and Capacity Board (CCB). Lack of treatment during this period poses safety concerns, as inpatients who remain untreated are at higher risk of engaging in violent behavior. The present study explored the relationship between non-treatment and violence among forensic and civil inpatients awaiting their CCB hearing at the largest psychiatric hospital in Canada.

Patient access: How do we measure it?

The aim of this article is to introduce key definitions to patient access and a measurement approach, translated for a clinic-based research study or program evaluation. The authors hope this piece will provide those seeking to improve access with some basic starting points and replace rhetoric with rigor in evaluation. Issues discussed include defining access for measurement, measuring access, starting with the end point in mind, and using a logic model.

Challenges in conducting research on collaborative mental health care: a qualitative study.

Background: We sought to understand poor uptake of the Primary Care Assessment and Research of a Telephone Intervention for Neuropsychiatric Conditions with Education and Resources study (PARTNERs), a pragmatic randomized controlled trial of a collaborative care intervention for people experiencing depression, anxiety or at-risk drinking. We explored primary care providers' experience with PARTNERs, and preferences regarding collaborative care models and trials.

Methods: In this qualitative study, we interviewed primary care providers across Ontario who had participated in PARTNERs, using stratified sampling to reach high-, low- and nonreferring providers in urban and rural settings.

A recipe for assessing fidelity in family and health systems.

Following recipes is an analogy for maintaining intervention integrity, or, fidelity. Fidelity is the extent to which an intervention is implemented as intended. This editorial presents a recipe for assessing fidelity in family and health systems.

Differential levels of prefrontal cortex glutamate+glutamine in adults with antisocial personality disorder and bipolar disorder: A proton magnetic resonance spectroscopy study.

As the main excitatory neurotransmitter in the central nervous system, glutamate, as measured in combination with glutamine (Glx), is implicated in several psychopathologies when levels are aberrant. One illness that shows heightened Glx levels is bipolar disorder (BD), an illness characterized by high impulsivity. In addition, although animal studies have reported elevated levels of Glx in aggressive and impulsive phenotypes, no study, to our knowledge, has reported Glx in the human cortex in relation to aggression.

Single-Photon Emission Computed Tomography and Positron Emission Tomography Studies of Antisocial Personality Disorder and Aggression: a Targeted Review.

Purpose Of Review: This paper aims to provide a comprehensive discussion of single-photon emission computed tomography (SPECT) and positron emission tomography (PET) studies of antisocial personality disorder (ASPD) and aggression.

Recent Findings: Among ASPD males with high impulsivity, the density of brainstem serotonin (5-HT) transporters shows a relationship with impulsivity, aggression, and ratings of childhood trauma. 5-HT receptor (R) binding in the striatum, anterior cingulate cortex, and orbitofrontal cortex (OFC) correlated with anger, aggression, and psychopathic traits in another study of violent offenders, most of whom were diagnosed with ASPD.

The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study.

Background/objective: The aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events.

Method: The sample comprised of 816 individuals (65.3% female,  = 43.

Protocol for a randomized controlled trial of the Breaking Free Online Health and Justice program for substance misuse in prison settings.

Background: Substance misuse, including problematic drug and alcohol use, are significant issues in society that can have multiple detrimental effects. Many people access support for their substance misuse during prison sentences, due to the associations between substance misuse and offending, and the high proportion of the prison population who have drug and alcohol issues. Breaking Free Online Health and Justice is a computer-assisted therapy program that has been developed to support substance-involved offenders to address their substance misuse and associated offending within prison settings.

A Long-Term Outcome Assessment of the Effects on Subsequent Reoffense Rates of a Prison-Based CBT/RNR Sex Offender Treatment Program With Strength-Based Elements.

This article describes an evaluation of the effects of an early version (1991-2001) of Rockwood's prison-based Cognitive Behavioral Therapy/Risk-Needs-Responsivity (CBT/RNR) sex offender program that had emerging elements of a strength-based approach. This program was implemented under contract to Correctional Service of Canada (CSC) and continued to evolve in response to emerging evidence until it closed in 2013. Thus, the program as evaluated here did not involve a fixed approach as did the comparison CSC program (hereafter referred to as SOTP).

The Use of Leuprolide Acetate in the Management of High-Risk Sex Offenders.

The present study investigates whether leuprolide acetate (Lupron) adds to the efficacy of traditional sex offender treatment. A group of sex offenders receiving both Lupron and cognitive behavioral therapy (CBT; = 25) were compared with a group of sex offenders receiving only CBT ( = 22). Treated subjects were compared with norms available with reference to the Static-99R, as well as compared with a sample of untreated, nonsexual violent offenders ( = 81), to provide baseline data regarding risk of violent recidivism.

Validation of the Hungarian version of Carlson's Work-Family Conflict Scale.

Background And Purpose: Work-family conflict has been associated with adverse individual (e.g., cardiovascular diseases, anxiety disorders), organizational (e.

Attention deficit hyperactivity disorder and arrest history: Differential association of clinical characteristics by sex.

Attention deficit hyperactivity disorder (ADHD) is often cited as a risk factor for criminality. However, many studies do not take other criminogenic variables into account when reporting on this relationship. It is even less clear whether models that include ADHD as a potential risk factor for criminality consider the importance of sex differences.

Staff and patient accounts of PRN medication administration and non-pharmacological interventions for anxiety.

Most psychiatric inpatients will receive psychotropic PRN medication during their hospital stay for agitation, anxiety, and/or insomnia. While helpful in some cases, caution is warranted with regard to PRN use due to inherent risks of additional medication; therefore, experts advise that non-pharmacological interventions should be attempted first where indicated. However, research to date highlights that, in practice, non-pharmaceutical approaches are attempted in a minority of cases.