22 results
Is Social Media Causing Anorexia? A Case Report on Kpop and Cultural Awareness
- J. Kim, K. Tran, P. Korenis, A. Sareen
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S819-S820
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
One of the most significant changes to society came with the advent of social media, and with it a cultural shift in whom people consider their actual friends. The cultural influence of entertainment figures is not a new phenomenon; however, there has a revolution in the way celebrities interact with their fans, specifically in the Korean Pop (Kpop) industry. In contrast with musicians who release an album and then disappear into mysterious obscurity, Kpop stars constantly interact with fans through meet and greets, live streams, variety tv shows, and most importantly, through social media. With a concomitant rise in parasocial interactions and relationships, Kpop blurs the line between what constitutes pathological delusions and healthy fan activity.
Objectives• To learn the assessment and management of patients with anorexia nervosa
• To understand changes in management to address suicidality in patients with anorexia nervosa
• To understand influences by media in perpetrating certain body types in impressionable adolescents
MethodsPatient is a 19 year-old Hispanic female with a Past Psychiatric History of Bipolar Disorder, who was brought in by EMS due for agitation and disorganized behavior. Patient presented manic, labile, and her delusions extended to beliefs that the Kpop group EXO has been communicating with her through morse code in their videos, and that certain members would wink at her through the computer screen in real time. The patient’s BMI at the time of admission was 15.4, and she continued to compare her own body to Kpop idols.
ResultsPatient shared a lifetime mix of both shame and trauma concerning her eating habits, with multiple incidents that may have contributed to her fear of eating, and simultaneously into her becoming obsessed with the Kpop group (“2018 and COVID were a miracle for me. I got closer to EXO”). Patient denies looking ugly or fat and seems mostly satisfied with her current appearance.
ConclusionsWith social isolation growing due to the pandemic, online parasocial relationships are becoming an increasingly normal part of people’s lives. We discuss a case where an unhealthy obsession with Kpop contributed to body dissatisfaction, and the precipitating factors that lead to these circumstances, as well as the challenges that are present in helping these adolescents and young adults in coping with social media use. As such, it is important to discuss the challenges faced by psychiatrists who must be sufficiently aware of the ever-changing face of contemporary cultural landscape when forming an accurate diagnosis.
Disclosure of InterestNone Declared
Tolerability of Ziprasidone Use in Children and Adolescents: A Prisma Model: Systematic Review and Meta-Analysis
- J. Jay, A. Sareen, N. Hassan, N. Dumlao, K. Jose, I. Haza, A. Wadhwa, S. Gunturu
-
- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S142
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Studies have demonstrated that Ziprasidone use may be beneficial in children. Determining its potential risks and benefits when used in children is therefore important.
ObjectivesTo examine the tolerability of Ziprasidone, an atypical antipsychotic, in children and adolescents.
MethodsWe conducted a literature search of open label or randomized control trials that report on Ziprasidone use in children on three databases: Embase, PsychInfo and PubMed using the PRISMA guidelines of Systematic review and Meta-analysis. Out of 1690 articles, 11 studies met inclusion criteria. Outcome measures included adverse effects such as weight gain, increase in BMI, QTc prolongation, changes in metabolic parameters, sedation, and dizziness. We conducted a random effects meta-analysis and meta-regression of potential moderators. Publication bias was assessed with funnel plots.
ResultsData from Eleven studies was meta-analyzed (Total n= 474, mean age=12.87 years, male= 68..37%) that reported the use of Ziprasidone in children and adolescents with Psychosis, Bipolar, Autism spectrum disorders and Tourettes syndrome. Mean Ziprasidone dose = 84.40 mg and mean study duration = 2.85 months). We found that Ziprasidone was not found to cause any significant weight gain (1.72, p>0.05) or change in BMI (0.58 , p>0.05). QTc prolongation was found to be significant (11.9 , p<0.05). Most common side effects were sedation (42.44%), Nausea(19.32%), Headache (22.92%), fatigue (16.67%) and Dizziness (16.96 %).
ConclusionsResults demonstrate that Ziprasidone does not cause significant weight gain, however QTc prolongation and sedation were found to be significant side effects of Ziprasidone use. Therefore, baseline EKG and thorough history must be obtained before prescribing Ziprasidone in children and adolescents.
DisclosureNo significant relationships.
952 – A Population-based Longitudinal Study On Work Environment And Major Depressive Disorder
- J. Wang, N. Schmitz, S. Patten, S. Currie, J. Sareen
-
- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E388
-
- Article
-
- You have access Access
- Export citation
-
Objectives
To investigate the relationships between work environmental factors and the risk of major depressive disorder (MDD) over one year and to identify factors associated with the outcomes of individuals with MDD.
MethodsWe conducted a population-based longitudinal study of employees who were randomly selected in Alberta (n = 4239). MDD was assessed using the World Health Organization's Composite International Diagnostic Interview - Auto 2.1.
ResultsThe one-year incidence of MDD was 3.6% (95% CI: 2.8%-4.6%) overall. It was 2.9% (95% CI: 1.9% - 4.2%) in men and 4.5% (95% CI: 3.3% - 6.2%) in women. The relationships between work environmental factors and MDD differed by sex. In men, high job strain increased the risk of MDD in those who worked 35-40 hours per week; job insecurity and family-work conflict were predictive of MDD. Women who worked 35-40 hours, who reported job insecurity, high effort-reward imbalance and work-family conflict were at higher risk of MDD. Long working hours, negative thinking and having comorbid social phobia were predictive of MDD. Perceived work-family conflict, severity of major depressive episode and symptom of depressed mood were significantly associated with recurrence of MDD.
ConclusionsJob strain, effort-reward imbalance, job insecurity and work-family conflicts are important risk factors for the onset of MDD, and should be targets of primary prevention. However, these work environmental factors appear to operate differently in men and in women. Clinical and psychosocial factors are important in the prognosis of MDD. The factors associated with persistence and recurrence of MDD may be different.
EPA-0944 - Development and Validation of A Prediction Algorithm for Recurrence of Major Depression
- J.L. Wang, S.B. Patten, J. Sareen, J. Bolton, N. Schmitz, G. MacQueen
-
- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Objectives:
To develop and validate a prognostic model for predicting recurrence of major depression using data from a population-based, nationally representative cohort.
Methods:Wave 1 and wave 2 longitudinal data from the US National Epidemiological Survey on Alcohol and Related Condition. Participants with a major depressive disorder at baseline and who had visited health professionals for depression were included in this analysis. Mental disorders were assessed based on the DSM-IV criteria. For this study, we included the wave 1 (baseline) participants who reported current or lifetime major depressive episode. We included eligible participants from South and West region in the training data (n = 1,518). Eligible participants from Northeast and Mid-West region were kept in validation data (n = 1,195).
Results:With the training data, a prediction model with 19 unique factors had a C statistics of 0.7504 and excellent calibration. The model had a C statistics of 0.7195 in external validation data (n = 1195) and 0.7365 in combined data. The algorithm calibrated very well in validation data. In the combined data, the 3-year observed and predicted risk of recurrence was 25.40% and 25.34%, respectively.
Conclusions:The developed prediction model for recurrence of major depression has acceptable discrimination and excellent calibration and is feasible to be used by physicians. The prognostic model may assist physicians and patients in quantifying the probability of recurrence so that physicians can develop specific treatment plans for those who are at high risk of recurrence, leading to personalized treatment and better use of resources.
Newer substances and their effects: A case report
- I. Peñuelas Calvo, J. Sevilla Llewellyn-Jones, A. Sareen, C. Cervesi, A. González Moreno
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S402
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Due to constant flow of people in and out of Europe several drugs are now days appearing in European markets that were previously unknown. There is a need to gain awareness and knowledge about these new substances and to recognize their use and learn about their effects and management.
Aims/objectivesAyahuascais commonly called yagé is a traditional spiritual medicine in ceremonies among the Indigenous peoples of Amazonian Peru. It is undetected in urine or blood and therefore it is important to understand and ask about its usage during clinical assessment.
Methods/resultsThirty-six years old woman immigrant from South America came to us with auditory hallucinations. About three years ago she was introduced who introduced her to a community of Euto poeple that performed daily rituals of spiritual awareness involving the use of Ayahuasca. She became a part of it and started consuming Ayahuasca daily. She started becoming socially isolated accompanied by delusional and mystical religious ideations. She later began having persecutory delusions and auditory hallucinations that Archangels speak to her about how to create music. Patient was involuntary admitted in a mental health unit and started on risperidone. Gradually her condition improved and she stopped having auditory hallucinations. After being discharged from the hospital, patient was followed on an outpatient basis with injectable risperidone.
ConclusionsDue to the blend of different cultures in Europe, it is necessary to have a better understanding about the cultures, rituals and the substances that are relatively new and are currently been used.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction to systemic family therapy
- I. Peñuelas Calvo, J. Sevilla Llewellyn-Jones, C. Cervesi, A. Sareen, A. Gonzalez Moreno
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S559-S560
-
- Article
-
- You have access Access
- Export citation
-
Introduction
In the past six decades, extensive research has been done on family therapy from different areas of knowledge such as psychology, psychiatry and social work. Leading to development of different intervention techniques and optimal clinical evaluation with families.
AimsThe systemic perspective focus on the study of the dimensions that contribute to the stability and consistency of the members of the family system. The family is an interrelated system, dependent on each other, where there is an influence of the group over the individual, which is why each of its members plays a pivotal role in family therapy. Throughout all these years of evolution of systemic family therapy, many different concepts and techniques have been used, including the ones currently used today.
MethodsKnowing the evolution of the different techniques allows us to understand the functioning of families, for example, their links and the elements that constitute it: their roles, the functions performed by each member in the family, communication, standards and power relations.
ConclusionsThe descriptive diagnosis of family ties, help us implement intervention strategies that could improve clinical care and diagnostic approach.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mental Illness and Sexual Disease Transmission. A Case Report
- I. Peñuelas Calvo, J. Sevilla Llewellyn-Jones, A. Sareen, C. Cervesi, A. Gonzalez Moreno
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S484
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Published rates of HIV infection among psychiatric patients are 3.1% to 23.9%, at least eight times higher than general population. (Nebhinan et al., 2013)
AimsDefects in judgment and insight in patients with psychosis is often associated with lot of anger and impulsiveness, risky behavior and lower treatment adherence. This often led to worsening of clinical status and prognosis. (Uruchurtu, 2013)
MethodsA 31-year-old man diagnosed with schizophrenia and HIV four years ago. At the beginning of last year, the patient was hospitalized in the Acute Psychiatry Hospital Unit because of decompensation. Two years after diagnosis of HIV, he stopped taking his medications and was arrested several times because misdemeanours. Furthermore, patient was highly sexually active in the form of unprotected sex with multiple partners, as he had no concept of his disease. In addition to this, he made a delusional interpretation about HIV (known as VIH in Spanish) as Immortal human life (Vida Immortal Humana). He was admitted in the hospital for a month and was treated with medications and psychotherapy, which led to good stabilization, and he gained insight of both of his illnesses. At the moment, one year after this episode, the patient is stable, taking both medications regularly and followed up by his psychiatrist in the Mental Health team.
ConclusionIt is of extreme importance that psychotic patients with HIV receive a good follow-up during life, as decompensation can affect the patients’ health and health of others, with the implicit consequences that it carries. (Uruchurtu, 2013)
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Encopresis: A medical and family approach
- I. Peñuelas Calvo, J. Sevilla Llewellyn-Jones, L. Poggio Lagares, C. Cervesi, A. Sareen, A. Gonzalez Moreno
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S356-S357
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Encopresis is a not very common disorder. The prevalence of this disorder is about 1.5% after the age of 5 years old and decreased even more as age increased, being very rare in adolescence.
AimHere we present a clinical case of an 11-year-old girl, with a diagnosis of functional encopresis with constipation and overflow incontinence for 4 years.
MethodIn this case, we followed a program consisted of 12 sessions combining different techniques that are on experimental phase. The program we designed consist of toilet training, stablishment-token economy- of a diet high in fiber with a progressive remove of laxative medication and a family intervention with both parents that got divorced 4 years ago.
ResultsHaving both parents the same frame the patient's problem easily started to decrease. In follow-up (6 and 12 months), we observed good toilet habits and not constipations episodes.
ConclusionsEven though all the techniques used were in experimental phase, we considered that because of the chronicity of this problem a multidisciplinary approach was the best option.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
The importance of establishing a good differential diagnosis in bipolar disorder
- I. Peñuelas Calvo, J. Sevilla Llewellyn-Jones, C. Cervesi, A. Sareen, A. González Moreno
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S338
-
- Article
-
- You have access Access
- Export citation
-
Diagnosis plays a key role in identification of a disease, learn about its course, management and predicting prognosis. In mental health, diseases are often complex and coalesce of different symptoms. Diagnosing a mental health condition requires careful evaluation of the symptoms and excluding other differential disorders that may share common symptoms. Diagnose hastily can lead to misdiagnosis. A premature diagnosis or misdiagnosis has clear negative consequences. This is one of the problems related to mental health and one needs to optimize the diagnostic process to achieve a balance between sensitivity and specificity. Currently, the diagnosis of bipolar disorder (BD) is one of the major mental health conditions that is often misdiagnosed.
To differentiate BD from unipolar depression with recurrent episodes or with personality disorder (PD), especially type Cluster B – with features shared with mania/hypomania like mental instability or impulsivity, it is important to differentiate between a diagnosis and its comorbidity. BD is often misdiagnosed as personality disorder and vice versa specially when both are coexisting (almost 20% of patients with bipolar disorder type II are misdiagnosed as personality disorders). This is common especially with borderline PD, although in some cases the histrionic PD may also be misdiagnosed as mania.
Due to the inconsistency in patient care involving different psychiatrists combined with difficulty in obtaining a precise patient history and family history leads to loss of key information which in turn leads to misdiagnosis of the condition. The time delay in making the correct diagnosis cause by such inconsistencies may worsen the prognosis of the disease in the patient.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Incidence and temporal trends of co-occurring personality disorder diagnoses in immune-mediated inflammatory diseases
- C. Blaney, J. Sommer, R. El-Gabalawy, C. Bernstein, R. Walld, C. Hitchon, J. Bolton, J. Sareen, S. Patten, A. Singer, L. Lix, A. Katz, J. Fisk, R. A. Marrie, for the CIHR Team in Defining the Burden and Managing the Impact of Psychiatric Comorbidity in Immune-Mediated Inflammatory Disease
-
- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 09 January 2020, e84
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Aims
Although immune-mediated inflammatory diseases (IMID) are associated with multiple mental health conditions, there is a paucity of literature assessing personality disorders (PDs) in these populations. We aimed to estimate and compare the incidence of any PD in IMID and matched cohorts over time, and identify sociodemographic characteristics associated with the incidence of PD.
MethodsWe used population-based administrative data from Manitoba, Canada to identify persons with incident inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) using validated case definitions. Unaffected controls were matched 5:1 on sex, age and region of residence. PDs were identified using hospitalisation or physician claims. We used unadjusted and covariate-adjusted negative binomial regression to compare the incidence of PDs between the IMID and matched cohorts.
ResultsWe identified 19 572 incident cases of IMID (IBD n = 6,119, MS n = 3,514, RA n = 10 206) and 97 727 matches overall. After covariate adjustment, the IMID cohort had an increased incidence of PDs (incidence rate ratio [IRR] 1.72; 95%CI: 1.47–2.01) as compared to the matched cohort, which remained consistent over time. The incidence of PDs was similarly elevated in IBD (IRR 2.19; 95%CI: 1.69–2.84), MS (IRR 1.79; 95%CI: 1.29–2.50) and RA (IRR 1.61; 95%CI: 1.29–1.99). Lower socioeconomic status and urban residence were associated with an increased incidence of PDs, whereas mid to older adulthood (age 45–64) was associated with overall decreased incidence. In a restricted sample with 5 years of data before and after IMID diagnosis, the incidence of PDs was also elevated before IMID diagnosis among all IMID groups relative to matched controls.
ConclusionsIMID are associated with an increased incidence of PDs both before and after an IMID diagnosis. These results support the relevance of shared risk factors in the co-occurrence of PDs and IMID conditions.
The effect of imposed rotary oscillation on the flow-induced vibration of a sphere
- A. Sareen, J. Zhao, J. Sheridan, K. Hourigan, M. C. Thompson
-
- Journal:
- Journal of Fluid Mechanics / Volume 855 / 25 November 2018
- Published online by Cambridge University Press:
- 19 September 2018, pp. 703-735
-
- Article
- Export citation
-
This experimental study investigates the effect of imposed rotary oscillation on the flow-induced vibration of a sphere that is elastically mounted in the cross-flow direction, employing simultaneous displacement, force and vorticity measurements. The response is studied over a wide range of forcing parameters, including the frequency ratio $f_{R}$ and velocity ratio $\unicode[STIX]{x1D6FC}_{R}$ of the oscillatory forcing, which vary between $0\leqslant f_{R}\leqslant 5$ and $0\leqslant \unicode[STIX]{x1D6FC}_{R}\leqslant 2$. The effect of another important flow parameter, the reduced velocity, $U^{\ast }$, is also investigated by varying it in small increments between $0\leqslant U^{\ast }\leqslant 20$, corresponding to the Reynolds number range of $5000\lesssim Re\lesssim 30\,000$. It has been found that when the forcing frequency of the imposed rotary oscillations, $f_{r}$, is close to the natural frequency of the system, $f_{nw}$, (so that $f_{R}=f_{r}/f_{nw}\sim 1$), the sphere vibrations lock on to $f_{r}$ instead of $f_{nw}$. This inhibits the normal resonance or lock-in leading to a highly reduced vibration response amplitude. This phenomenon has been termed ‘rotary lock-on’, and occurs for only a narrow range of $f_{R}$ in the vicinity of $f_{R}=1$. When rotary lock-on occurs, the phase difference between the total transverse force coefficient and the sphere displacement, $\unicode[STIX]{x1D719}_{total}$, jumps from $0^{\circ }$ (in phase) to $180^{\circ }$ (out of phase). A corresponding dip in the total transverse force coefficient $C_{y\,(rms)}$ is also observed. Outside the lock-on boundaries, a highly modulated amplitude response is observed. Higher velocity ratios ($\unicode[STIX]{x1D6FC}_{R}\geqslant 0.5$) are more effective in reducing the vibration response of a sphere to much lower values. The mode I sphere vortex-induced vibration (VIV) response is found to resist suppression, requiring very high velocity ratios ($\unicode[STIX]{x1D6FC}_{R}>1.5$) to significantly suppress vibrations for the entire range of $f_{R}$ tested. On the other hand, mode II and mode III are suppressed for $\unicode[STIX]{x1D6FC}_{R}\geqslant 1$. The width of the lock-on region increases with an increase in $\unicode[STIX]{x1D6FC}_{R}$. Interestingly, a reduction of VIV is also observed in non-lock-on regions for high $f_{R}$ and $\unicode[STIX]{x1D6FC}_{R}$ values. For a fixed $\unicode[STIX]{x1D6FC}_{R}$, when $U^{\ast }$ is progressively increased, the response of the sphere is very rich, exhibiting characteristically different vibration responses for different $f_{R}$ values. The phase difference between the imposed rotary oscillation and the sphere displacement $\unicode[STIX]{x1D719}_{rot}$ is found to be crucial in determining the response. For selected $f_{R}$ values, the vibration amplitude increases monotonically with an increase in flow velocity, reaching magnitudes much higher than the peak VIV response for a non-rotating sphere. For these cases, the vibrations are always locked to the forcing frequency, and there is a linear decrease in $\unicode[STIX]{x1D719}_{rot}$. Such vibrations have been termed ‘rotary-induced vibrations’. The wake measurements in the cross-plane $1.5D$ downstream of the sphere position reveal that the sphere wake consists of vortex loops, similar to the wake of a sphere without any imposed rotation; however, there is a change in the timing of vortex formation. On the other hand, for high $f_{R}$ values, there is a reduction in the streamwise vorticity, presumably leading to a decreased total transverse force acting on the sphere and resulting in a reduced response.
Vortex-induced vibrations of a sphere close to a free surface
- A. Sareen, J. Zhao, J. Sheridan, K. Hourigan, M. C. Thompson
-
- Journal:
- Journal of Fluid Mechanics / Volume 846 / 10 July 2018
- Published online by Cambridge University Press:
- 11 May 2018, pp. 1023-1058
-
- Article
- Export citation
-
Results are presented from an experimental investigation into the effects of proximity to a free surface on vortex-induced vibration (VIV) experienced by fully and semi-submerged spheres that are free to oscillate in the cross-flow direction. The VIV response is studied over a wide range of reduced velocities: $3\leqslant U^{\ast }\leqslant 20$ , covering the mode I, mode II and mode III resonant response branches and corresponding to the Reynolds number range of $5000\lesssim Re\lesssim 30\,000$ . The normalised immersion depth of the sphere is varied in small increments over the range $0\leqslant h^{\ast }\leqslant 1$ for the fully submerged case and $0\leqslant h^{\ast }\leqslant -0.75$ for the semi-submerged case. It is found that for a fully submerged sphere, the vibration amplitude decreases monotonically and gradually as the immersion ratio is decreased progressively, with a greater influence on the mode II and III parts of the response curve. The synchronisation regime becomes narrower as $h^{\ast }$ is decreased, with the peak saturation amplitude occurring at progressively lower reduced velocities. The peak response amplitude decreases almost linearly over the range of $0.5\leqslant h^{\ast }\leqslant 0.185$ , beyond which the peak response starts increasing almost linearly. The trends in the total phase, $\unicode[STIX]{x1D719}_{total}$ , and the vortex phase, $\unicode[STIX]{x1D719}_{vortex}$ , reveal that the mode II response occurs for progressively lower $U^{\ast }$ values with decreasing $h^{\ast }$ . On the other hand, when the sphere pierces the free surface, there are two regimes with different characteristic responses. In regime $\text{I}$ ( $-0.5<h^{\ast }<0$ ), the synchronisation region widens and the vibration amplitude increases, surprisingly becoming even higher than for the fully submerged case in some cases, as $h^{\ast }$ decreases. However, in regime $\text{II}$ ( $-0.5\leqslant h^{\ast }\leqslant -0.75$ ), the vibration amplitude decreases with a decrease in $h^{\ast }$ , showing a very sharp reduction beyond $h^{\ast }<-0.65$ . The response in regime II is characterised by two distinct peaks in the amplitude response curve. Careful analysis of the force data and phase information reveals that the two peaks correspond to modes I and II seen for the fully submerged vibration response. This two-peak behaviour is different to the classic VIV response of a sphere under one degree of freedom (1-DOF). The response was found to be insensitive to the Froude number ( $Fr=U/\sqrt{gD}$ , where $U$ is the free-stream velocity, $D$ is the sphere diameter and $g$ is the acceleration due to gravity) in the current range of $0.05\leqslant Fr\leqslant 0.45$ , although higher Froude numbers resulted in slightly lower peak response amplitudes. The wake measurements in the cross-plane $1.5D$ downstream of the rear of the sphere reveal a reduction in the vorticity of the upper vortex of the trailing vortex pair, presumably through diffusion of vorticity into the free surface. For the piercing sphere case, the near-surface vorticity completely diffuses into the free surface, with only the opposite-signed vortex visible in the cross-plane at this downstream position. Interestingly, this correlates with an even higher oscillation amplitude than the fully submerged case. Finally, the effects of immersion ratio and diameter ratio ( $D^{\ast }$ $=$ sphere diameter/support-rod diameter) are quantified, showing care needs to be taken with these factors to avoid unduly influencing VIV predictions.
Vortex-induced vibration of a rotating sphere
- A. Sareen, J. Zhao, D. Lo Jacono, J. Sheridan, K. Hourigan, M. C. Thompson
-
- Journal:
- Journal of Fluid Mechanics / Volume 837 / 25 February 2018
- Published online by Cambridge University Press:
- 20 December 2017, pp. 258-292
-
- Article
- Export citation
-
Vortex-induced vibration (VIV) of a sphere represents one of the most generic fundamental fluid–structure interaction problems. Since vortex-induced vibration can lead to structural failure, numerous studies have focused on understanding the underlying principles of VIV and its suppression. This paper reports on an experimental investigation of the effect of imposed axial rotation on the dynamics of vortex-induced vibration of a sphere that is free to oscillate in the cross-flow direction, by employing simultaneous displacement and force measurements. The VIV response was investigated over a wide range of reduced velocities (i.e. velocity normalised by the natural frequency of the system): $3\leqslant U^{\ast }\leqslant 18$, corresponding to a Reynolds number range of $5000<Re<30\,000$, while the rotation ratio, defined as the ratio between the sphere surface and inflow speeds, $\unicode[STIX]{x1D6FC}=|\unicode[STIX]{x1D714}|D/(2U)$, was varied in increments over the range of $0\leqslant \unicode[STIX]{x1D6FC}\leqslant 7.5$. It is found that the vibration amplitude exhibits a typical inverted bell-shaped variation with reduced velocity, similar to the classic VIV response for a non-rotating sphere but without the higher reduced velocity response tail. The vibration amplitude decreases monotonically and gradually as the imposed transverse rotation rate is increased up to $\unicode[STIX]{x1D6FC}=6$, beyond which the body vibration is significantly reduced. The synchronisation regime, defined as the reduced velocity range where large vibrations close to the natural frequency are observed, also becomes narrower as $\unicode[STIX]{x1D6FC}$ is increased, with the peak saturation amplitude observed at progressively lower reduced velocities. In addition, for small rotation rates, the peak amplitude decreases almost linearly with $\unicode[STIX]{x1D6FC}$. The imposed rotation not only reduces vibration amplitudes, but also makes the body vibrations less periodic. The frequency spectra revealed the occurrence of a broadband spectrum with an increase in the imposed rotation rate. Recurrence analysis of the structural vibration response demonstrated a transition from periodic to chaotic in a modified recurrence map complementing the appearance of broadband spectra at the onset of bifurcation. Despite considerable changes in flow structure, the vortex phase ($\unicode[STIX]{x1D719}_{vortex}$), defined as the phase between the vortex force and the body displacement, follows the same pattern as for the non-rotating case, with the $\unicode[STIX]{x1D719}_{vortex}$ increasing gradually from low values in Mode I of the sphere vibration to almost $180^{\circ }$ as the system undergoes a continuous transition to Mode II of the sphere vibration at higher reduced velocity. The total phase ($\unicode[STIX]{x1D719}_{total}$), defined as the phase between the transverse lift force and the body displacement, only increases from low values after the peak amplitude response in Mode II has been reached. It reaches its maximum value (${\sim}165^{\circ }$) close to the transition from the Mode II upper plateau to the lower plateau, reminiscent of the behaviour seen for the upper to lower branch transition for cylinder VIV. Hydrogen-bubble visualisations and particle image velocimetry (PIV) performed in the equatorial plane provided further insights into the flow dynamics near the sphere surface. The mean wake is found to be deflected towards the advancing side of the sphere, associated with an increase in the Magnus force. For higher rotation ratios, the near-wake rear recirculation zone is absent and the flow is highly vectored from the retreating side to the advancing side, giving rise to large-scale shedding. For a very high rotation ratio of $\unicode[STIX]{x1D6FC}=6$, for which vibrations are found to be suppressed, a one-sided large-scale shedding pattern is observed, similar to the shear-layer instability one-sided shedding observed previously for a rigidly mounted rotating sphere.
Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease
- R. A. Marrie, R. Walld, J. M. Bolton, J. Sareen, J. R. Walker, S. B. Patten, A. Singer, L. M. Lix, C. A. Hitchon, R. El-Gabalawy, A. Katz, J. D. Fisk, C. N. Bernstein, for the CIHR Team in Defining the Burden and Managing the Effects of Psychiatric Comorbidity in Chronic Immunoinflammatory Disease
-
- Journal:
- Epidemiology and Psychiatric Sciences / Volume 28 / Issue 3 / June 2019
- Published online by Cambridge University Press:
- 03 November 2017, pp. 333-342
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Aims.
After the diagnosis of immune-mediated inflammatory diseases (IMID) such as inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA), the incidence of psychiatric comorbidity is increased relative to the general population. We aimed to determine whether the incidence of psychiatric disorders is increased in the 5 years before the diagnosis of IMID as compared with the general population.
Methods.Using population-based administrative health data from the Canadian province of Manitoba, we identified all persons with incident IBD, MS and RA between 1989 and 2012, and cohorts from the general population matched 5 : 1 on year of birth, sex and region to each disease cohort. We identified members of these groups with at least 5 years of residency before and after the IMID diagnosis date. We applied validated algorithms for depression, anxiety disorders, bipolar disorder, schizophrenia, and any psychiatric disorder to determine the annual incidence of these conditions in the 5-year periods before and after the diagnosis year.
Results.We identified 12 141 incident cases of IMID (3766 IBD, 2190 MS, 6350 RA) and 65 424 matched individuals. As early as 5 years before diagnosis, the incidence of depression [incidence rate ratio (IRR) 1.54; 95% CI 1.30–1.84) and anxiety disorders (IRR 1.30; 95% CI 1.12–1.51) were elevated in the IMID cohort as compared with the matched cohort. Similar results were obtained for each of the IBD, MS and RA cohorts. The incidence of bipolar disorder was elevated beginning 3 years before IMID diagnosis (IRR 1.63; 95% CI 1.10–2.40).
Conclusion.The incidence of psychiatric comorbidity is elevated in the IMID population as compared with a matched population as early as 5 years before diagnosis. Future studies should elucidate whether this reflects shared risk factors for psychiatric disorders and IMID, a shared final common inflammatory pathway or other aetiology.
Risk of suicide and suicide attempts associated with physical disorders: a population-based, balancing score-matched analysis
- J. M. Bolton, R. Walld, D. Chateau, G. Finlayson, J. Sareen
-
- Journal:
- Psychological Medicine / Volume 45 / Issue 3 / February 2015
- Published online by Cambridge University Press:
- 17 July 2014, pp. 495-504
-
- Article
- Export citation
-
Background
The association between physical disorders and suicide remains unclear. The aim of this study was to examine the relationship between physical disorders and suicide after accounting for the effects of mental disorders.
MethodIndividuals who died by suicide (n = 2100) between 1996 and 2009 were matched 3:1 by balancing score to general population controls (n = 6300). Multivariate conditional logistic regression compared the two groups across physician-diagnosed physical disorders [asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease, hypertension, diabetes, cancer, multiple sclerosis and inflammatory bowel disease], adjusting for mental disorders and co-morbidity. Secondary analyses examined the risk of suicide according to time since first diagnosis of each physical disorder (1–90, 91–364, ⩾ 365 days). Similar analyses also compared individuals with suicide attempts (n = 8641) to matched controls (n = 25 923).
ResultsCancer was associated with increased risk of suicide [adjusted odds ratio (AOR) 1.40, 95% confidence interval (CI) 1.03–1.91, p < 0.05] even after adjusting for all mental disorders. The risk of suicide with cancer was particularly high in the first 90 days after initial diagnosis (AOR 4.10, 95% CI 1.71–9.82, p < 0.01) and decreased to non-significance after 1 year. Women with respiratory diseases had elevated risk of suicide whereas men did not. COPD, hypertension and diabetes were each associated with increased odds of suicide attempts in adjusted models (AORs ranged from 1.20 to 1.73).
ConclusionsPeople diagnosed with cancer are at increased risk of suicide, especially in the 3 months following initial diagnosis. Increased support and psychiatric involvement should be considered for the first year after cancer diagnosis.
Common mental disorder diagnosis and need for treatment are not the same: findings from a population-based longitudinal survey
- J. Sareen, C. A. Henriksen, M. B. Stein, T. O. Afifi, L. M. Lix, M. W. Enns
-
- Journal:
- Psychological Medicine / Volume 43 / Issue 9 / September 2013
- Published online by Cambridge University Press:
- 07 December 2012, pp. 1941-1951
-
- Article
- Export citation
-
Background
Controversy exists regarding whether people in the community who meet criteria for a non-psychotic mental disorder diagnosis are necessarily in need of treatment. Some have argued that these individuals require treatment and that policy makers need to develop outreach programs for them, whereas others have argued that the current epidemiologic studies may be diagnosing symptoms of distress that in many cases are self-limiting and likely to remit without treatment. All prior studies that have addressed this issue have been cross-sectional. We examined the longitudinal outcomes of individuals with depressive, anxiety and substance use (DAS) disorder(s) who had not previously received any treatment.
MethodData came from a nationally representative US sample. A total of 34 653 non-institutionalized adults (age ≥20 years) were interviewed at two time points, 3 years apart. DAS disorders, mental health service use and quality of life (QoL) were assessed at both time points.
ResultsIndividuals with a DAS disorder who had not previously received any treatment were significantly more likely than those who had been previously treated to have remission of their index disorder(s) without subsequent treatment, to be free of co-morbid disorder(s) and not to have attempted suicide during the 3-year follow-up period (50.7% v. 33.0% respectively, p < 0.05). At wave 2, multiple linear regression demonstrated that people with a remission of their baseline DAS disorder(s) had levels of functioning similar to those without a DAS disorder.
ConclusionsIndividuals with an untreated DAS disorder at baseline have a substantial likelihood of remission without any subsequent intervention.
Subsyndromal depression in the United States: prevalence, course, and risk for incident psychiatric outcomes
- R. H. Pietrzak, J. Kinley, T. O. Afifi, M. W. Enns, J. Fawcett, J. Sareen
-
- Journal:
- Psychological Medicine / Volume 43 / Issue 7 / July 2013
- Published online by Cambridge University Press:
- 31 October 2012, pp. 1401-1414
-
- Article
- Export citation
-
Background
Subsyndromal depression (SD) may increase risk for incident major depressive and other disorders, as well as suicidality. However, little is known about the prevalence, course, and correlates of SD in the US general adult population.
MethodStructured diagnostic interviews were conducted to assess DSM-IV Axis I and II disorders in a nationally representative sample of 34 653 US adults who were interviewed at two time-points 3 years apart.
ResultsA total of 11.6% of US adults met study criteria for lifetime SD at Wave 1. The majority (9.3%) had <5 total symptoms required for a diagnosis of major depression; the remainder (2.3%) reported ⩾5 symptoms required for a diagnosis of major depression, but denied clinically significant distress or functional impairment. SD at Wave 1 was associated with increased likelihood of developing incident major depression [odds ratios (ORs) 1.72–2.05], as well as dysthymia, social phobia, and generalized anxiety disorder (GAD) at Wave 2 (ORs 1.41–2.92). Among respondents with SD at Wave 1, Cluster A and B personality disorders, and worse mental health status were associated with increased likelihood of developing incident major depression at Wave 2.
ConclusionsSD is prevalent in the US population, and associated with elevated rates of Axis I and II psychopathology, increased psychosocial disability, and risk for incident major depression, dysthymia, social phobia, and GAD. These results underscore the importance of a dimensional conceptualization of depressive symptoms, as SD may serve as an early prognostic indicator of incident major depression and related disorders, and could help identify individuals who may benefit from preventive interventions.
Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel
- J. Sareen, C. A. Henriksen, S.-L. Bolton, T. O. Afifi, M. B. Stein, G. J. G. Asmundson
-
- Journal:
- Psychological Medicine / Volume 43 / Issue 1 / January 2013
- Published online by Cambridge University Press:
- 21 May 2012, pp. 73-84
-
- Article
- Export citation
-
Background
Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders.
MethodData were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI).
ResultsEven after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure.
ConclusionsACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.
Predictors of 1-year outcomes of major depressive disorder among individuals with a lifetime diagnosis: a population-based study
- J. L. Wang, S. B. Patten, S. Currie, J. Sareen, N. Schmitz
-
- Journal:
- Psychological Medicine / Volume 42 / Issue 2 / February 2012
- Published online by Cambridge University Press:
- 11 July 2011, pp. 327-334
-
- Article
- Export citation
-
Background
Examining predictors of the outcomes of major depressive disorder (MDD) is important for clinical practice and population health. There are few population-based longitudinal studies on this topic. The objectives of this study were to (1) estimate the proportions of persistent and recurrent MDD among those with MDD over 1 year, and (2) identify demographic, socio-economic, workplace psychosocial and clinical factors associated with the outcomes.
MethodFrom a population-based longitudinal study of the working population, participants with a lifetime diagnosis of MDD were selected (n=834). They were classified into two groups: those with and those without current MDD. The proportions of 1-year persistence and recurrence of MDD were estimated. MDD was assessed by the World Health Organization (WHO) Composite International Diagnostic Interview, CIDI-Auto 2.1, by telephone.
ResultsThe proportions of persistent and recurrent MDD in 1 year were 38.5% [95% confidence interval (CI) 31.1–46.5] and 13.3% (95% CI 10.2–17.1) respectively. Long working hours, negative thinking and having co-morbid social phobia were predictive of persistence of MDD. Perceived work–family conflict, the severity of a major depressive episode and symptoms of depressed mood were significantly associated with the recurrence of MDD.
ConclusionsClinical and psychosocial factors are important in the prognosis of MDD. The factors associated with persistence and recurrence of MDD may be different. More large longitudinal studies on this topic are needed so that clinicians may predict potential outcomes based on the clinical profile and provide interventions accordingly. They may also take clinical action to change relevant psychosocial factors to minimize the chance of persistence and/or recurrence of MDD.
Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication
- A. M. Ruscio, T. A. Brown, W. T. Chiu, J. Sareen, M. B. Stein, R. C. Kessler
-
- Journal:
- Psychological Medicine / Volume 38 / Issue 1 / January 2008
- Published online by Cambridge University Press:
- 02 November 2007, pp. 15-28
-
- Article
- Export citation
-
Background
Despite heightened awareness of the clinical significance of social phobia, information is still lacking about putative subtypes, functional impairment, and treatment-seeking. New epidemiologic data on these topics are presented from the National Comorbidity Survey Replication (NCS-R).
MethodThe NCS-R is a nationally representative household survey fielded in 2001–2003. The World Health Organization (WHO) Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was used to assess 14 performance and interactional fears and DSM-IV social phobia.
ResultsThe estimated lifetime and 12-month prevalence of social phobia are 12.1% and 7.1% respectively. Performance and interactional fears load onto a single latent factor, and there is little evidence for distinct subtypes based either on the content or the number of fears. Social phobia is associated with significant psychiatric co-morbidity, role impairment, and treatment-seeking, all of which have a dose–response relationship with number of social fears. However, social phobia is the focus of clinical attention in only about half of cases where treatment is obtained. Among non-co-morbid cases, those with the most fears were least likely to receive social phobia treatment.
ConclusionsSocial phobia is a common, under-treated disorder that leads to significant functional impairment. Increasing numbers of social fears are associated with increasingly severe manifestations of the disorder.