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402 - An audit of Lithium Prescribing Practices in an Old Age PsychiatryService highlighting renal impairment in this cohort
- L. Valentine, J. Cannon, S. Marmion, M. Corcoran, M. Cryan, G. Mc Carthy, C. Dolan
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 29-30
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Aims:
To compare Lithium prescribing practices in a Psychiatry of Old Age (POA) Service in the North-West ofIreland among adults aged 65 years and over with best practice guidelines.
Methods:Review of the literature informed development of audit standards for Lithium prescribing. These included National Institute for Clinical Excellent (NICE) 2014 guidelines, The British National Formulary(2019) and Maudsley Prescribing Guidelines (2018). Data was collected retrospectively, using an audit-specific data collection tool, from clinical files of POA team caseload, aged 65 years or more and prescribed Lithium over the past year.
Results:At the time of audit in February 2020, 18 patients were prescribed lithium, 67% female, average age 74.6 years. Of those prescribed Lithium; 50% (n=9) had depression, 44% (n=8) had bipolar affective disorder (BPAD) and 6% (n=1) schizoaffective disorder.
78% (n= 14) of patients met the NICE standard of 3-monthly lithium level. Lithium levels were checkedon average 4.5 times in past year, average lithium level was 0.61mmol/L across the group and 39% (n=7) had lithium level within recommended therapeutic range (0.6-0.8mmol/L).
83% of patients (n=15) met the NICE standards of 3 monthly renal tests. Taking into consideration mostrecent blood test results, 100% (n=18) had abnormal renal function.
Half (n=9) were initiated on lithium by POA service and of these, 56% (n=5) had documented renal impairment prior to initiation. Of patients on long term lithium at time of referral (n=9), almost half (n=4) had a documented history of lithium toxicity.
Conclusions:The results of this audit highlight room for improvement in lithium monitoring of older adults attending POA service. Furthermore, all patients prescribed lithium had impaired renal function. This is an important finding given the associations between those admitted to hospital with COVID-19 and co- morbid kidney disease and increased risk of inpatient death.
Our findings highlight the need for three monthly renal function monitoring in elderly prescribed lithiumgiven the additive adverse effects of increasing age and lithium on the kidney. Close working with specialised renal services to provide timely advice on renal management for those with renal impairment prescribed lithium is important to minimise adverse patient outcomes.
513 - Lithium monitoring in Old Age Psychiatry – a quality improvement project
- E. Herridge, L. Valentine, J. Cannon, R. Novac, S. Marmion, M. Corcoran, G. Sweeney, M. Cryan, G. McCarthy, C. Dolan
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- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 63-64
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INTRODUCTION:
Lithium has a narrow therapeutic index with a risk of toxicity and potential to increase morbidity and mortality, particularly in the elderly with co-morbid illness and polypharmacy. Lithium therapy and monitoring of lithium levels require precision and several guidelines have been issued including recommendations for strict control of lithium levels in the elderly population.
RESEARCH OBJECTIVE:We evaluated the effect of implementation of a multifaceted management programme on the compliance with international practice standards for lithium monitoring in patients under the care of Psychiatry of Old Age (POA), Sligo Leitrim Mental Health Services in the North West of Ireland.
METHODS:Results from a prior audit performed in February 2020 involving a cohort of 18 patients prescribed lithium under the care of POA were analysed and compared to accepted standards. The guideline used as the benchmark for compliance was the National Institute for Clinical Excellence (NICE) guidelines on the use and monitoring of lithium therapy, as published in 2014. Several deficits were found and therefore a designated Lithium Management Programme was established. A subsequent audit, performed using a simplified audit tool incorporating the NICE guidelines, delivered results which were directly compared to the initial findings and analysed to evaluate the effect of the implemented management programme.
PRELIMINARY RESULTS OF THE ONGOING STUDY:In comparison with findings from 2020, there had been a significant improvement in most facets of lithium management and compliance to practice standards. Of particular note was the improvement of biochemical monitoring, side effect screening, polypharmacy surveillance, patient education and interdisciplinary communication.
CONCLUSION:The launch of a dedicated Lithium Management Programme with specific features aimed at identifying and addressing poor compliance with monitoring guidelines has led to improved adherence to accepted international practice standards. Our model provides a dynamic, multi-layered system which paves the way for better patient outcomes, timely access to care and furthering education for patients and staff members.
Linking language features to clinical symptoms and multimodal imaging in individuals at clinical high risk for psychosis
- S. S. Haas, G. E. Doucet, S. Garg, S. N. Herrera, C. Sarac, Z. R. Bilgrami, R. B. Shaik, C. M. Corcoran
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- Journal:
- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 11 August 2020, e72
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Background.
Abnormalities in the semantic and syntactic organization of speech have been reported in individuals at clinical high-risk (CHR) for psychosis. The current study seeks to examine whether such abnormalities are associated with changes in brain structure and functional connectivity in CHR individuals.
Methods.Automated natural language processing analysis was applied to speech samples obtained from 46 CHR and 22 healthy individuals. Brain structural and resting-state functional imaging data were also acquired from all participants. Sparse canonical correlation analysis (sCCA) was used to ascertain patterns of covariation between linguistic features, clinical symptoms, and measures of brain morphometry and functional connectivity related to the language network.
Results.In CHR individuals, we found a significant mode of covariation between linguistic and clinical features (r = 0.73; p = 0.003), with negative symptoms and bizarre thinking covarying mostly with measures of syntactic complexity. In the entire sample, separate sCCAs identified a single mode of covariation linking linguistic features with brain morphometry (r = 0.65; p = 0.05) and resting-state network connectivity (r = 0.63; p = 0.01). In both models, semantic and syntactic features covaried with brain structural and functional connectivity measures of the language network. However, the contribution of diagnosis to both models was negligible.
Conclusions.Syntactic complexity appeared sensitive to prodromal symptoms in CHR individuals while the patterns of brain-language covariation seemed preserved. Further studies in larger samples are required to establish the reproducibility of these findings.
Baseline demographics, clinical features and predictors of conversion among 200 individuals in a longitudinal prospective psychosis-risk cohort
- G. Brucato, M. D. Masucci, L. Y. Arndt, S. Ben-David, T. Colibazzi, C. M. Corcoran, A. H. Crumbley, F. M. Crump, K. E. Gill, D. Kimhy, A. Lister, S. A. Schobel, L. H. Yang, J. A. Lieberman, R. R. Girgis
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- Journal:
- Psychological Medicine / Volume 47 / Issue 11 / August 2017
- Published online by Cambridge University Press:
- 02 March 2017, pp. 1923-1935
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Background
DSM-5 proposes an Attenuated Psychosis Syndrome (APS) for further investigation, based upon the Attenuated Positive Symptom Syndrome (APSS) in the Structured Interview for Psychosis-Risk Syndromes (SIPS). SIPS Unusual Thought Content, Disorganized Communication and Total Disorganization scores predicted progression to psychosis in a 2015 NAPLS-2 Consortium report. We sought to independently replicate this in a large single-site high-risk cohort, and identify baseline demographic and clinical predictors beyond current APS/APSS criteria.
MethodWe prospectively studied 200 participants meeting criteria for both the SIPS APSS and DSM-5 APS. SIPS scores, demographics, family history of psychosis, DSM Axis-I diagnoses, schizotypy, and social and role functioning were assessed at baseline, with follow-up every 3 months for 2 years.
ResultsThe conversion rate was 30% (n = 60), or 37.7% excluding participants who were followed under 2 years. This rate was stable across time. Conversion time averaged 7.97 months for 60% who developed schizophrenia and 15.68 for other psychoses. Mean conversion age was 20.3 for males and 23.5 for females. Attenuated odd ideas and thought disorder appear to be the positive symptoms which best predict psychosis in a logistic regression. Total negative symptom score, Asian/Pacific Islander and Black/African-American race were also predictive. As no Axis-I diagnosis or schizotypy predicted conversion, the APS is supported as a distinct syndrome. In addition, cannabis use disorder did not increase risk of conversion to psychosis.
ConclusionsNAPLS SIPS findings were replicated while controlling for clinical and demographic factors, strongly supporting the validity of the SIPS APSS and DSM-5 APS diagnosis.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Effects of general medical health on Alzheimer's progression: the Cache County Dementia Progression Study
- Jeannie-Marie S. Leoutsakos, Dingfen Han, Michelle M. Mielke, Sarah N. Forrester, JoAnn T. Tschanz, Chris D. Corcoran, Robert C. Green, Maria C. Norton, Kathleen A. Welsh-Bohmer, Constantine G. Lyketsos
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- International Psychogeriatrics / Volume 24 / Issue 10 / October 2012
- Published online by Cambridge University Press:
- 12 June 2012, pp. 1561-1570
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Background: Several observational studies have suggested a link between health status and rate of decline among individuals with Alzheimer's disease (AD). We sought to quantify the relationship in a population-based study of incident AD, and to compare global comorbidity ratings to counts of comorbid conditions and medications as predictors of AD progression.
Methods: This was a case-only cohort study arising from a population-based longitudinal study of memory and aging, in Cache County, Utah. Participants comprised 335 individuals with incident AD followed for up to 11 years. Patient descriptors included sex, age, education, dementia duration at baseline, and APOE genotype. Measures of health status made at each visit included the General Medical Health Rating (GMHR), number of comorbid medical conditions, and number of non-psychiatric medications. Dementia outcomes included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating – sum of boxes (CDR-sb), and the Neuropsychiatric Inventory (NPI).
Results: Health status tended to fluctuate over time within individuals. None of the baseline medical variables (GMHR, comorbidities, and non-psychiatric medications) was associated with differences in rates of decline in longitudinal linear mixed effects models. Over time, low GMHR ratings, but not comorbidities or medications, were associated with poorer outcomes (MMSE: β = –1.07 p = 0.01; CDR-sb: β = 1.79 p < 0.001; NPI: β = 4.57 p = 0.01).
Conclusions: Given that time-varying GMHR, but not baseline GMHR, was associated with the outcomes, it seems likely that there is a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications. Since health status is a potentially modifiable risk factor, further study is warranted.
Experience Sampling Methodology studies of depression: the state of the art
- C. Telford, S. McCarthy-Jones, R. Corcoran, G. Rowse
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- Journal:
- Psychological Medicine / Volume 42 / Issue 6 / June 2012
- Published online by Cambridge University Press:
- 19 October 2011, pp. 1119-1129
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Background
Experience Sampling Methodology (ESM) is ideally suited to test the predictions, and inform the development of contemporary cognitive models of depression. Yet there has been no systematic examination of ESM in depression research.
MethodA search of databases (PsychARTICLES, PsycINFO, AMED, Ovid Medline and CINAHL) was conducted to identify studies published within the last 25 years investigating major depressive disorder (MDD) using ESM.
ResultsAltogether, 19 studies using ESM, or comparable methodologies, with clinically depressed individuals were identified and critically reviewed. The identified studies examined six aspects of MDD: methodological issues; positive and negative affect; cortisol secretion; antidepressant treatment; work performance; genetic risk factors.
ConclusionsDespite some methodological limitations of existing studies, ESM has made a significant contribution to our current understanding of depression by consolidating existing theories, uncovering new and clinically relevant findings and identifying questions for future research. This review concludes by introducing the possibility of using ESM as an intervention tool in clinical practice and proposing that ESM could be useful for furthering knowledge of the causes of MDD.
Contributors
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- By Kateri Berasi, Carol A. Boyer, Diane R. Brown, Robyn Lewis Brown, Tony N. Brown, Padraic J. Burns, Cleopatra Howard Caldwell, Daniel L. Carlson, Cheryl Corcoran, Manuela Costa, Stephen Crystal, Gary S. Cuddeback, William W. Eaton, Adrianne Frech, Virginia Aldigé Hiday, Stevan E. Hobfoll, Allan V. Horwitz, Robert J. Johnson, Verna M. Keith, Ronald C. Kessler, Corey L. M. Keyes, Jacinta P. Leavell, Harriet P. Lefley, Mary Clare Lennon, Laura Limonic, Bruce G. Link, Athena McLean, David Mechanic, Elizabeth G. Menaghan, Barret Michalec, John Mirowsky, Shirin Montazer, Joseph P. Morrissey, Carles Muntaner, Bernice A. Pescosolido, Christopher Peterson, Jo C. Phelan, Michael Polgar, Sarah Rosenfield, Catherine E. Ross, Ebony Sandusky, Jaime C. Sapag, Teresa L. Scheid, Mark F. Schmitz, Sharon Schwartz, Dena Smith, David T. Takeuchi, Peggy A. Thoits, R. Jay Turner, Edwina S. Uehara, Jerome C. Wakefield, James Walkup, Emily Walton, Blair Wheaton, David R. Williams, Kristi Williams
- Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Tony N. Brown, Vanderbilt University, Tennessee
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- A Handbook for the Study of Mental Health
- Published online:
- 05 June 2012
- Print publication:
- 16 November 2009, pp xi-xiv
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Simulating the Invariant Measures of Markov Chains Using Backward Coupling at Regeneration Times
- S. G. Foss, R. L. Tweedie, J. N. Corcoran
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- Probability in the Engineering and Informational Sciences / Volume 12 / Issue 3 / July 1998
- Published online by Cambridge University Press:
- 27 July 2009, pp. 303-320
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We develop an algorithm for simulating approximate random samples from the invariant measure of a Markov chain using backward coupling of embedded regeneration times. Related methods have been used effectively for finite chains and for stochastically monotone chains: here we propose a method of implementation which avoids these restrictions by using a “cycle-length” truncation. We show that the coupling times have good theoretical properties and describe benefits and difficulties of implementing the methods in practice.
Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study
- Katherine A. Treiber, Constantine G. Lyketsos, Chris Corcoran, Martin Steinberg, Maria Norton, Robert C. Green, Peter Rabins, David M. Stein, Kathleen A. Welsh-Bohmer, John C. S. Breitner, JoAnn T. Tschanz
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- Journal:
- International Psychogeriatrics / Volume 20 / Issue 3 / June 2008
- Published online by Cambridge University Press:
- 21 February 2008, pp. 538-553
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Objective: To examine, in an exploratory analysis, the association between vascular conditions and the occurrence of neuropsychiatric symptoms (NPS) in a population-based sample of incident Alzheimer's disease (AD).
Methods: The sample consisted of 254 participants, identified through two waves of assessment. NPS were assessed using the Neuropsychiatric Inventory. Prior to the onset of AD, data regarding a history of stroke, hypertension, hyperlipidemia, heart attack or coronary artery bypass graft (CABG), and diabetes were recorded. Logistic regression procedures were used to examine the relationship of each vascular condition to individual neuropsychiatric symptoms. Covariates considered were age, gender, education, APOE genotype, dementia severity, and overall health status.
Results: One or more NPS were observed in 51% of participants. Depression was most common (25.8%), followed by apathy (18.6%), and irritability (17.7%). Least common were elation (0.8%), hallucinations (5.6%), and disinhibition (6.0%). Stroke prior to the onset of AD was associated with increased risk of delusions (OR = 4.76, p = 0.02), depression (OR = 3.87, p = 0.03), and apathy (OR = 4.48, p = 0.02). Hypertension was associated with increased risk of delusions (OR = 2.34, p = 0.02), anxiety (OR = 4.10, p = 0.002), and agitation/aggression (OR = 2.82, p = 0.01). No associations were observed between NPS and diabetes, hyperlipidemia, heart attack or CABG, or overall health.
Conclusions: Results suggest that a history of stroke and hypertension increase the risk of specific NPS in patients with AD. These conditions may disrupt neural circuitry in brain areas involved in NPS. Findings may provide an avenue for reduction in occurrence of NPS through the treatment or prevention of vascular risk conditions.
A transdiagnostic investigation of ‘theory of mind’ and ‘jumping to conclusions’ in patients with persecutory delusions
- R. Corcoran, G. Rowse, R. Moore, N. Blackwood, P. Kinderman, R. Howard, S. Cummins, R. P. Bentall
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- Journal:
- Psychological Medicine / Volume 38 / Issue 11 / November 2008
- Published online by Cambridge University Press:
- 16 November 2007, pp. 1577-1583
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Background
A tendency to make hasty decisions on probabilistic reasoning tasks and a difficulty attributing mental states to others are key cognitive features of persecutory delusions (PDs) in the context of schizophrenia. This study examines whether these same psychological anomalies characterize PDs when they present in the context of psychotic depression.
MethodPerformance on measures of probabilistic reasoning and theory of mind (ToM) was examined in five subgroups differing in diagnostic category and current illness status.
ResultsThe tendency to draw hasty decisions in probabilistic settings and poor ToM tested using story format feature in PDs irrespective of diagnosis. Furthermore, performance on the ToM story task correlated with the degree of distress caused by and preoccupation with the current PDs in the currently deluded groups. By contrast, performance on the non-verbal ToM task appears to be more sensitive to diagnosis, as patients with schizophrenia spectrum disorders perform worse on this task than those with depression irrespective of the presence of PDs.
ConclusionsThe psychological anomalies associated with PDs examined here are transdiagnostic but different measures of ToM may be more or less sensitive to indices of severity of the PDs, diagnosis and trait- or state-related cognitive effects.
Formation of nanoporous platinum by selective dissolution of Cu from Cu0.75Pt0.25
- D. V. Pugh, A. Dursun, S. G. Corcoran
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- Journal:
- Journal of Materials Research / Volume 18 / Issue 1 / January 2003
- Published online by Cambridge University Press:
- 31 January 2011, pp. 216-221
- Print publication:
- January 2003
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This paper gives results demonstrating the production of nanoporous platinum through the de-alloying of Cu0.75Pt0.25 alloy in 1 M H2SO4. Both field emission scanning electron microscopy and small angle neutron scattering confirm the presence of porosity with a diameter of approximately 3.4 nm. This is the smallest porosity quantitatively reported from a de-alloying process to date. The small size is attributed to the extremely small values of surface diffusivity expected for Pt at room temperature, effectively eliminating room-temperature coarsening processes. The results also show that larger length scales can be achieved through coarsening at elevated temperatures. The ease of production of porous platinum makes it attractive for possible applications, such as high surface area electrodes for biomedical devices or as catalyst materials.
Nanoindentation of Viscoelastic Materials: Mechanical Properties of Polymer Coatings on Aluminum Substrates
- K. B. Yoder, S. Ahuja, K. T. Dihn, D. A. Crowson, S. G. Corcoran, L. Cheng, W. W. Gerberich
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- Journal:
- MRS Online Proceedings Library Archive / Volume 522 / 1998
- Published online by Cambridge University Press:
- 10 February 2011, 205
- Print publication:
- 1998
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The mechanical properties of four polymer coatings on aluminum foil substrates are examined using nanoindentation with a Hysitron Triboscope, an add-on to an AFM. In addition to static hardness and modulus measurements, the viscoelastic properties of the films, which differ in Tg and extent of crosslinking, are investigated by employing two techniques: using nanoindentation parameters to fit the creep response of the material to a one-dimensional equation based on a three-element Zener model of the viscoelastic behavior of the polymer; and fitting the creep response of the material to a previously developed, three-dimensional model of the response of a viscoelastic material to indentation by a spherical indenter. It is found that the measured static moduli are about 1.5 times greater than results of fitting creep data to the 1-D model, and are a factor of 3–6 times greater than those obtained by fits of the 3-D model.
Nanoindentation Studies of Yield Point Phenomena on Gold Single Crystals
- S. G. Corcoran, R. J. Colton, E. T. Lilleodden, W. W. Gerberich
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- Journal:
- MRS Online Proceedings Library Archive / Volume 436 / 1996
- Published online by Cambridge University Press:
- 15 February 2011, 159
- Print publication:
- 1996
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Nanoindentation studies often show an instantaneous displacement-excursion in the loaddisplacement curve. This anomaly is generally associated with a surface contamination effect, dislocation emission, a phase transition, or an oxide break-through event. The determination of which effect is operative is often difficult when investigating oxide covered surfaces. We have performed a detailed nanoindentation study on clean, flame annealed single-crystal Au thus eliminating the effects of a surface oxide or contamination layer. Multiple displacement excursions were observed exhibiting a new phenomenon of “staircase” yielding. Owing to the fact that our radius of contact is more than an order of magnitude smaller than the average dislocation spacing expected for well annealed Au, the excursions are explained in terms of multiple dislocation nucleation events on parallel slip bands. Indentation data were taken on Au (111), (110), and (100) single crystal surfaces.
An In Situ STM Investigation of Stranski - Krastanov Growth of Ag on Au (111) Electrodes
- S. G. Corcoran, G. S. Chakarova, K. Sieradzki
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- Journal:
- MRS Online Proceedings Library Archive / Volume 317 / 1993
- Published online by Cambridge University Press:
- 15 February 2011, 103
- Print publication:
- 1993
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We present in situ scanning tunneling Microscopy (STM) results which show the morphological aspects of Ag electrodeposition on Au (111). The experimental conditions enabled us to follow, in real time, with monolayer resolution, the morphological details of Stranski-Krastanov (SK) growth under a fixed electrochemical potential (constant supersaturation). Two epitaxial layers of Ag were sequentially formed prior to the heterogeneous nucleation of three-dimensional Ag crystallites. STM images are presented showing that the second silver monolayer has a coarsened (surface) diffusion-limited-aggregation growth front. IMMediately after the completion of the second silver monolayer which took approximately five Minutes, we observed the formation of 3D clusters preferentially at step edges. Our analysis of the SK growth process indicates that it is not well described by heterogeneous-nucleation thermodynamics owing to the almost identical lattice parameters of Ag and Au. Instead, we argue that the wetting-nonwetting transition we observed was kinetically stabilized by the relatively high activation energy involved with the motion of Ag adatoms over a descending Ag step.