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1.
J Immigr Minor Health. 2018 Jul 31. doi: 10.1007/s10903-018-0797-3. [Epub ahead of print]

Prevalence of Possible Mental Disorders in Syrian Refugees Resettling in the United States Screened at Primary Care.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA. ajavanba@med.wayne.edu.
2
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. ajavanba@med.wayne.edu.
3
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA.

Abstract

Little is known about mental health problems among newly arrived Syrian refugees in the US. It is important to determine the prevalence of common consequences of exposure to trauma and high stress, and provide needed interventions, as these conditions if untreated, can be detrimental to mental and physical health. Adult Syrian refugees (n = 157, 47.1% women, 52.9% men) were screened at one-month mandatory primary care health visit for Posttraumatic Stress Disorder (PTSD), anxiety and depression using PTSD Checklist, and Hopkins Symptoms Checklist. Prevalence of possible diagnoses was high for PTSD (32.2%), anxiety (40.3%), and depression (47.7%). Possible prevalence of depression and anxiety were higher among women, but there was no gender difference for possible PTSD. We found a high prevalence of possible psychiatric disorders related to trauma and stress among Syrian refugees newly resettled in the US. Due to the high prevalence and feasibility of brief screening tools in primary care facilities, we recommend mental health screening during primary care health visits for resettled Syrian refugees.

KEYWORDS:

Anxiety; PTSD; Syrian refugees; Trauma

2.
J Am Acad Child Adolesc Psychiatry. 2018 Mar;57(3):209-211.e2. doi: 10.1016/j.jaac.2018.01.013.

Mental Health in Syrian Refugee Children Resettling in the United States: War Trauma, Migration, and the Role of Parental Stress.

Author information

1
Wayne State University School of Medicine, Detroit, MI; University of Michigan, Ann Arbor. Electronic address: ajavanba@med.wayne.edu.
2
Wayne State University School of Medicine, Detroit, MI.

Publication type

Publication type

3.
Health Soc Work. 2018 Feb 1;43(1):59-62. doi: 10.1093/hsw/hlx042.

Social Workers and Mobile Child Crisis Screening.

Author information

1
Audrey Gilliatt, LMSW, and Kelly Powell, LMSW, are clinical social workers, and Albert Pizzuti, ASN, is research assistant, Wayne State University Physician Group, Detroit. Cynthia L. Arfken, PhD, is professor of psychiatry, School of Medicine, Wayne State University, Detroit.
4.
Acad Psychiatry. 2018 Feb;42(1):176-178. doi: 10.1007/s40596-017-0845-7. Epub 2017 Nov 6.

Perspectives of Religion and Spirituality in Psychiatry: a Comparison of Students, Residents, and Attending Physicians.

Author information

1
Wayne State University School of Medicine, Detroit, MI, USA.
2
Wayne State University School of Medicine, Detroit, MI, USA. mmorreale@med.wayne.edu.

Publication type

Publication type

5.
Community Ment Health J. 2018 Jan;54(1):54-57. doi: 10.1007/s10597-017-0152-5. Epub 2017 Jul 28.

Training for Direct Support Staff at Group Homes for People with Chronic Mental Illness.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
2
Detroit Wayne Mental Health Authority, Detroit, MI, USA.
3
University of Michigan, Ann Arbor, USA.
4
IS-Care CLS, Inc., Detroit, USA.
5
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA. cynthia.arfken@wayne.edu.

Abstract

For people with chronic mental illness, their support system (including direct support staff at group homes) play a key role in ameliorating exacerbations leading to crisis care. However, little information exists on curriculum or training programs focused on reducing exacerbations while promoting compassionate care. We developed, implemented and evaluated such a program that featured role-playing and animated videos supplemented with limited didactics. During development phase, direct support staff reviewed videos and rated them as depicting realistic situations with high acceptability. During implementation, the 6-week course (at least one staff from six different group homes not involved in the development phase) using a 3-month pre-post design found reductions in total number of incident reports and pre-specified outcomes of recipient right complaints, emergency calls, and psychiatric hospitalizations. The program demonstrated acceptability, improved care and better outcomes on some but not all outcomes. Improved training of direct support staff is possible and has positive outcomes.

KEYWORDS:

Evaluation; Group homes; Serious mental illness; Training

6.
Acad Psychiatry. 2018 Feb;42(1):181-182. doi: 10.1007/s40596-017-0767-4. Epub 2017 Jul 13.

Secondary Traumatic Stress in Medical Students.

Author information

1
Wayne State University School of Medicine, Detroit, MI, USA.
2
Wayne State University School of Medicine, Detroit, MI, USA. mmorreale@med.wayne.edu.

Publication type

Publication type

7.
Case Rep Psychiatry. 2017;2017:6296423. doi: 10.1155/2017/6296423. Epub 2017 May 29.

Home-Based Telepsychiatry in US Urban Area.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA.

Abstract

Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex trauma. The treatment plan included adding an antidepressant and therapy plan, eliminating one psychiatric medication, and reducing dosage of pain medication. The outcomes were improved function and quality of life. The patient and caregiver were both highly satisfied with the services. This hybrid telepsychiatry is a reasonable option for homebound elderly patients living in urban areas and less expensive than nursing home admission.

8.
J Gambl Stud. 2017 Dec;33(4):1263-1275. doi: 10.1007/s10899-017-9677-3.

Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Suite 2A, 3901 Chrysler Drive, Detroit, MI, 48201, USA. dledgerw@med.wayne.edu.
2
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Suite 2A, 3901 Chrysler Drive, Detroit, MI, 48201, USA.

Abstract

Most treatment for gambling disorder is provided on an outpatient basis. Only a small number of jurisdictions in North America provide higher levels of gambling treatment, such as residential or intensive outpatient (IOP) care, despite the potential need for these services. Further, there appear to be few guidelines for determining appropriate level of gambling treatment. The aim of the present study was to assess the appropriateness of higher levels of problem gambling care among clients receiving outpatient treatment. Problem gamblers and their therapists independently completed questionnaires that assessed the need and desire for residential and IOP treatment. About 42% of problem gambling outpatients noted that they would be "probably" or "definitely" willing to attend residential treatment, and about half indicated they would be equally likely to attend IOP. Therapists recommended about a third of their clients as appropriate for higher levels of care. For both client and therapist assessments, there was a significant association between desire or recommendation for level of treatment and severity of gambling and co-occurring problems. Further, therapist recommendations for level of care were significantly associated with client willingness to attend higher levels of treatment. Our data reveal the potential need for higher levels of care for problem gambling, as evaluated by clients and their therapists. Policy implications for the funding of residential and IOP treatment are discussed.

KEYWORDS:

Gambling disorder; Level of care; Outpatient treatment; Residential treatment

PMID:
28255939
DOI:
10.1007/s10899-017-9677-3
[Indexed for MEDLINE]
Icon for Springer
9.
Am J Orthopsychiatry. 2018;88(1):38-47. doi: 10.1037/ort0000240. Epub 2017 Mar 2.

Acculturation and post-migration psychological symptoms among Iraqi refugees: A path analysis.

Author information

1
Department of Family Medicine, Family Medicine Research Division, University of Kansas.
2
Division of Social Sciences, Kentucky Wesleyan College.
3
Department of Psychology, Wayne State University.
4
Department of Family Medicine and Public Health Sciences, Wayne State University.
5
Department of Psychiatry and Behavioral Neurosciences, Wayne State University.
6
Department of Family Medicine, University of Michigan.
7
Department of Psychology, Smith College.

Abstract

Refugees frequently experience symptoms of posttraumatic stress and depression, which impede their acculturation in the new host country where they are resettling. There are few longitudinal studies investigating predictors of mental health and acculturation during the early postmigration period. We conducted a longitudinal study of 298 Iraqi refugees, assessing them upon arrival to the U.S. and 1 year after migration. Premigration trauma was associated with increased PTSD and depressive symptoms at baseline, and with decreased acculturation 1 year later. Resilience was associated with depressive symptoms at 1-year follow-up, but not with other resettlement outcomes (PTSD symptoms, English-language skills, or acculturation). PTSD and depressive symptoms at baseline predicted the same symptoms at 1-year follow-up, but not any other resettlement outcomes. The number of chronic diseases at baseline predicted worse PTSD and depressive symptoms, acculturation, and English language skills at 1-year follow up. Postmigratory exposure to daily stressors and less social support predicted worse 1-year outcomes. Results suggest that interventions that aim to improve mental health and promote acculturation among refugees should assess their history of trauma, chronic disorders, and psychological symptoms soon after migration, and promptly provide opportunities for social support. (PsycINFO Database Record.

PMID:
28253013
PMCID:
PMC5581735
[Available on 2019-01-01]
DOI:
10.1037/ort0000240
[Indexed for MEDLINE]
Icon for American Psychological Association
10.
J Subst Abuse Treat. 2017 Apr;75:17-21. doi: 10.1016/j.jsat.2017.01.004. Epub 2017 Jan 14.

Characterizing fentanyl use in methadone-maintained clients.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA. Electronic address: cynthia.arfken@wayne.edu.
2
School of Medicine, Wayne State University, Detroit, MI 48201, USA.
3
Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA.

Abstract

AIMS:

Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl.

METHODS:

A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Urine drug screens (UDS) including fentanyl (and its metabolite norfentanyl) were conducted clinically. To obtain additional data, 113 clients in this clinic subsequently completed an anonymous survey.

RESULTS:

Of 368 unique clients with UDS, 38.0% had at least one and 26.1% had ≥2 fentanyl-positive UDS results. None had a fentanyl prescription. Clients ever testing positive for fentanyl were significantly (p<0.05) more likely to use cocaine, have multiple treatment admissions to the clinic, and leave treatment sooner. Fentanyl-positive UDS results coincided most commonly with metabolites of cocaine- and heroin-positive UDS results. Of the anonymously surveyed clients, most (67.3%) reported they did not know anyone seeking fentanyl, a proportion significantly higher than for heroin, cocaine, alprazolam, hydrocodone and morphine.

CONCLUSIONS:

Fentanyl was commonly detected during this period with some clients having multiple fentanyl-positive UDS. Most clients did not know anyone seeking to obtain fentanyl. Regardless, the high exposure underscores that naloxone training and distribution is needed.

KEYWORDS:

Cocaine; Fentanyl; Methadone maintenance; Urine drug screens

PMID:
28237050
DOI:
10.1016/j.jsat.2017.01.004
[Indexed for MEDLINE]
Icon for Elsevier Science
11.
Am J Orthopsychiatry. 2016;86(4):384-92. doi: 10.1037/ort0000186. Epub 2016 May 19.

Potentially traumatic events and mental health problems among children of Iraqi refugees: The roles of relationships with parents and feelings about school.

Author information

1
Department of Psychology, Wayne State University.
2
Department of Psychiatry and Behavioral Neurosciences, Wayne State University.

Abstract

This study examined mental health problems among children of Iraqi refugees, most of whom were Christian. Exposure to potentially traumatic events was hypothesized to predict more symptoms of depression and traumatic stress. Moreover, youth reports of supportive relationships with parents and positive feelings about school were examined in relation to mental health problems. These promotive factors were expected to mitigate the hypothesized association between traumatic event exposure and mental health problems. Participants were 211 youth recruited from agencies and programs serving Iraqi refugees in a large metropolitan area in the United States. The hypotheses were partially supported. Youth who reported experiencing more potentially traumatic events endorsed more traumatic stress and depression symptoms. After accounting for exposure to potentially traumatic events and other covariates, youth who reported more positive feelings about school endorsed fewer symptoms of traumatic stress, and youth who reported more supportive relationships with parents endorsed fewer symptoms of depression. In addition, there was an interaction between potentially traumatic events and relationships with parents when predicting depression symptoms. Youth endorsed higher levels of depression symptoms when they reported less supportive relationships, regardless of the amount of traumatic event exposure, whereas youth endorsed lower levels of depression symptoms when they reported more supportive relationships with parents, but only at low levels of traumatic event exposure. Otherwise, the main effects were not qualified by interactions between potentially traumatic event exposure and the promotive factors. The findings from this study have implications for future research, policy, and practice with children of refugees. (PsycINFO Database Record.

PMID:
27196388
DOI:
10.1037/ort0000186
[Indexed for MEDLINE]
Icon for American Psychological Association
12.
J Behav Health Serv Res. 2017 Apr;44(2):289-295. doi: 10.1007/s11414-016-9501-3.

Implementing Level of Care Criteria for Supported Housing in One Urban County.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA.
2
Gateway Community Health, Brewery Park Blvd, Detroit, MI, 48207, USA.
3
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA. carfken@med.wayne.edu.
13.
J Nerv Ment Dis. 2015 Aug;203(8):641-5. doi: 10.1097/NMD.0000000000000341.

Barriers to and Reasons for Treatment Initiation Among Gambling Help-line Callers.

Author information

1
*Department of Psychology, University of Windsor, Windsor, Ontario, Canada; and †Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI.

Abstract

Identifying barriers to seeking treatment is essential for increasing problem gambler treatment initiation in the community, given that as few as 1 in 10 problem gamblers ever seek treatment. Further, many problem gamblers who take the initial step of contacting problem gambling help-lines do not subsequently go on to attend face-to-face treatment. There is limited research examining reasons for attending treatment among this population. This study addressed these gaps in the literature by examining barriers and attractions to treatment among callers to the State of Michigan Problem Gambling Help-line. In total, 143 callers (n = 86 women) completed the Barriers to Treatment for Problem Gambling (BTPG) questionnaire and responded to open-ended questions regarding barriers to and reasons for treatment initiation, as part of a telephone interview. Greater endorsement of barriers to treatment was associated with a lower likelihood of initiating treatment, especially perceived absence of problem and treatment unavailability. Correspondingly, problem gamblers who identified more reasons to attend treatment were more likely to attend, with positive treatment perceptions being the most influential. These findings can help get people into treatment by addressing barriers and fostering reasons for attending treatment, as well as reminding clinicians of the importance of identifying and addressing individual treatment barriers among patients with problem gambling.

PMID:
26230649
DOI:
10.1097/NMD.0000000000000341
[Indexed for MEDLINE]
Icon for Wolters Kluwer
14.
Psychiatr Serv. 2014 Jul;65(7):850-2. doi: 10.1176/appi.ps.201400075.

Economic grand rounds: experience with mandated use of generic medications for patients covered by the mental health safety net.

Author information

1
Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.

Abstract

Reducing pharmacy costs without increasing adverse outcomes would relieve some pressure on mental health budgets. This column describes the experience of a publicly funded provider network in a Michigan county that mandated generic use of psychotropic medications to address financial challenges. The percentage of brand-name medications and cost per prescription declined with the policy change, resulting in lower total pharmacy expenditures. No increase was noted in prescriptions per patient or psychiatric hospitalizations. Changes were sustained after the initial implementation period. Mandating generic use may be feasible as a tool for constraining pharmacy costs in mental health budgets.

PMID:
26037001
DOI:
10.1176/appi.ps.201400075
[Indexed for MEDLINE]
Icon for Atypon
15.
J Psychoactive Drugs. 2014 Nov-Dec;46(5):362-8. doi: 10.1080/02791072.2014.959214.

Exploratory comparative study on the diffusion of synthetic cannabinoids and synthetic cathinones.

Author information

1
a Professor, Department of Psychiatry and Behavioral Neurosciences , Wayne State University , Detroit , MI.

Abstract

The use of synthetic cannabinoids and cathinones in southeastern Michigan was explored using Roger's Diffusion of Innovation theory. A mixed methods approach after specific synthetic cannabinoids and cathinone compounds were scheduled was used that included analysis of treatment admissions for two years, surveys of 15 substance abuse treatment providers, and qualitative interviews with a purposive sample of 24 participants. The participant system norm supported trying new drugs, and both drugs were confirmed to have been easier to access than traditional drugs. The participants had negative views of synthetic cathinones due to one sensational news story without counterbalancing positive experiences in their social environment. Although synthetic cannabinoids were also linked to a sensational news story, it was counterbalanced by positive personal experiences. These differences contributed to greater use of synthetic cannabinoids compared to synthetic cathinones as evidenced by admissions, providers' reports, and participants' reports. All participants expressed a preference for traditional drugs, indicating that novel drugs had no relative advantage over other drugs of abuse. Diffusion of Innovation theory can provide a framework for understanding the differential use of novel drugs.

KEYWORDS:

Diffusion of Innovation; epidemiology; mixed methods; qualitative study; synthetic cannabinoids; synthetic cathinones

PMID:
25364986
DOI:
10.1080/02791072.2014.959214
[Indexed for MEDLINE]
16.
Community Ment Health J. 2015 Feb;51(2):185-9. doi: 10.1007/s10597-014-9735-6. Epub 2014 May 11.

Intervention to reduce inpatient psychiatric admission in a metropolitan city.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Drive, Detroit, MI, 48201, USA.

Abstract

When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89% for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59% compared to the preceding year. Costs declined 78.7% per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care.

PMID:
24817259
DOI:
10.1007/s10597-014-9735-6
[Indexed for MEDLINE]
Icon for Springer
17.
J Relig Health. 2015 Oct;54(5):1543-54. doi: 10.1007/s10943-014-9871-x.

Pilot Study of Waterpipe Tobacco Smoking Among US Muslim College Students.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, Ste 1B, Rm 156, Detroit, MI, 48201, USA, carfken@med.wayne.edu.

Abstract

Waterpipe smoking is common among the young in Muslim-majority countries despite recent Islamic rulings on tobacco. US Muslim college students, especially immigrants, may be at high risk for smoking, but information is lacking. In this pilot study, respondent-driven sampling was used to sample 156 Muslim college students. Waterpipe smoking was common (44.3%). Leading motivations to smoke were social and perceived low tobacco harm. Independent risk factors among the Muslim students were perception that friends and other students smoked, and ever drank alcohol. Personal belief that waterpipe smoking is prohibited in Islam was not significant. This pilot suggests that Muslim students are at high risk for waterpipe smoking and more definitive studies are needed.

PMID:
24797155
DOI:
10.1007/s10943-014-9871-x
[Indexed for MEDLINE]
Icon for Springer
18.
Drug Alcohol Depend. 2014 Jul 1;140:208-12. doi: 10.1016/j.drugalcdep.2014.03.032. Epub 2014 Apr 13.

Prize contingency management for smoking cessation: a randomized trial.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Drive, Detroit, MI 48201, USA. Electronic address: dledgerw@med.wayne.edu.
2
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Drive, Detroit, MI 48201, USA.
3
Department of Medicine, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030, USA.

Abstract

BACKGROUND:

Adjunctive behavioral smoking cessation treatments have the potential to improve outcomes beyond standard care. The present study had two aims: (1) compare standard care (SC) for smoking (four weeks of brief counseling and monitoring) to SC plus prize-based contingency management (CM), involving the chance to earn prizes on days with demonstrated smoking abstinence (carbon monoxide (CO) ≤6 ppm); and (2) compare the relative efficacy of two prize reinforcement schedules-one a traditional CM schedule, and the second an early enhanced CM schedule providing greater reinforcement magnitude in the initial week of treatment but equal overall reinforcement.

METHODS:

Participants (N=81 nicotine-dependent cigarette smokers) were randomly assigned to one of the three conditions.

RESULTS:

Prize CM resulted in significant reductions in cigarette smoking relative to SC. These reductions were not apparent at follow-up. We found no meaningful differences between the traditional and enhanced CM conditions.

CONCLUSIONS:

Our findings reveal that prize CM leads to significant reductions in smoking during treatment relative to a control intervention, but the benefits did not extend long-term.

KEYWORDS:

Cigarette; Contingency management; Prize; Tobacco; Treatment efficacy

PMID:
24793364
PMCID:
PMC5020416
DOI:
10.1016/j.drugalcdep.2014.03.032
[Indexed for MEDLINE]
Free PMC Article
Icon for Elsevier Science Icon for PubMed Central
19.
J Affect Disord. 2014 Mar;156:36-45. doi: 10.1016/j.jad.2013.12.007. Epub 2013 Dec 16.

The status of sleep abnormalities as a diagnostic test for major depressive disorder.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA. Electronic address: carfken@med.wayne.edu.
2
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA.
3
Henry Ford Sleep Disorders & Research Center, Henry Ford Health System & Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA.
4
(c)University of Ottawa, Department of Psychiatry and Royal Ottawa Mental Health Center, Ottawa, ON, Canada.

Abstract

BACKGROUND:

Psychiatry lags other fields in development of diagnostic tests.

METHODS:

A literature review and meta-analysis was conducted to ascertain if polysomnographic abnormalities (REM density, REM latency, sleep efficiency, slow wave sleep, stage 1 and stage 2 sleep) warrant additional effort to develop them into a clinical diagnostic test for major depressive disorder (MDD). The 31 publications meeting inclusion criteria were then classified into one of three progressive steps using guidelines for evaluating the clinical usefulness of a diagnostic test.

RESULTS:

Most of the abnormalities found in MDD patients, when compared to healthy controls, occurred in the expected direction with moderate effect sizes but with substantial publication bias and heterogeneity. Eleven studies compared abnormalities in MDD to other psychiatric disorders (step 2a), and four studies provided data on the sensitivity or specificity of the findings in differentiating among the psychiatric disorders that frequently appear on the same differential diagnostic list as MDD (step 2b). No multicenter trial has been conducted prospectively to test the clinical utility of the diagnostic test (step 3).

LIMITATIONS:

Only published articles in the English language were used.

CONCLUSIONS:

Sleep studies for the detection of MDD appear replicable with a moderate effect size. However, additional step 1 studies are needed to define the sensitivity and specificity. The heterogeneity of sleep recording, scoring techniques, and MDD must also be addressed.

KEYWORDS:

Diagnosis; Major depressive disorder; Polysomnography; REM sleep; Sleep efficiency; Slow-wave sleep

PMID:
24412322
DOI:
10.1016/j.jad.2013.12.007
[Indexed for MEDLINE]
Icon for Elsevier Science
20.
J Immigr Minor Health. 2014 Dec;16(6):1303-6. doi: 10.1007/s10903-013-9960-z.

Immigrant Arab Americans and alcohol use: longitudinal study.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Drive, Detroit, MI, 48201, USA, carfken@med.wayne.edu.

Abstract

English proficiency is associated with alcohol use in some immigrants groups, but little is known about its association among Arab Americans. Ethnographic work suggests gender, religion, education, and age influence prevalence of alcohol use among Arab Americans. Two years prospective study of recent Iraqi refugees and non-Iraqi Arab immigrants in Michigan using bilingual surveys and interviewers. At Time 1, prevalence of lifetime alcohol use was 20.5 % with males, Christians, better educated, older, and those with greater proficiency in English more likely to report ever drank. At Time 2, lifetime prevalence of drinking had increased to 34.0 %. In analysis of male new drinkers, risk factors were Christian, older age and greater proficiency in English. This study confirms drinking among recent immigrant Arab Americans varies by subgroups and suggests English proficiency may contribute to the increase in prevalence over time.

PMID:
24322655
PMCID:
PMC4051867
DOI:
10.1007/s10903-013-9960-z
[Indexed for MEDLINE]
Free PMC Article
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