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King N, Rivera D, Cunningham S, Pickett W, Harkness K, McNevin SH, Milanovic M, Byun J, Khanna A, Atkinson J, Saunders KEA, Duffy A. Mental health and academic outcomes over the first year at university in international compared to domestic Canadian students. J Am Coll Health 2023; 71:2663-2672. [PMID: 34606410 DOI: 10.1080/07448481.2021.1982950] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/20/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To compare risk factors and associated mental health and academic outcomes between international and domestic students. PARTICIPANTS Canadian university undergraduate students. METHODS Electronic surveys were completed at university entry and the end of first year. Surveys assessed demographics, risk factors, symptoms of mental disorders, and access to support. Academic outcomes were obtained from university databases. RESULTS International students had comparable or lower rates of clinically significant anxiety, depression, and insomnia. Domestic female students reported the highest screening rates for common mental disorders. However, international students were more likely to report having attempted suicide. International students felt less connected to the university community and had lower academic performance. Psychosocial risk factor profiles and proportions accessing mental health services were similar. CONCLUSIONS The scope of mental health need appears more similar than different between international and domestic students; however, international students may benefit from targeted academic and social support initiatives.
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Affiliation(s)
- N King
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - D Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - S Cunningham
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - W Pickett
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - K Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - S H McNevin
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Kingston, ON, Canada
| | - M Milanovic
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - J Byun
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - A Khanna
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - J Atkinson
- Faculty of Arts and Science, Queen's University, Kingston, ON, Canada
| | - K E A Saunders
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - A Duffy
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Kingston, ON, Canada
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Bahji A, Forth E, Hargreaves T, Harkness K. Genetic markers of the stress generation model: A systematic review. Psychiatry Res 2021; 304:114139. [PMID: 34371296 DOI: 10.1016/j.psychres.2021.114139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/16/2021] [Accepted: 07/24/2021] [Indexed: 01/15/2023]
Abstract
AIM Robust evidence suggests that depression, and risk for depression, are associated with the generation of stressful life events. This tendency to generate stress may be genetically determined. This systematic review aimed to identify specific molecular genetic markers associated with the generation of interpersonal stressful life events, at least in part dependent on individuals' behavior. METHOD We followed the PRISMA guidelines in searching six electronic databases (PubMed, MEDLINE, PsycINFO, CINAHL, Cochrane, and EMBASE) from inception to January 2021, and we reviewed the reference lists of eligible articles for additional records. We restricted eligibility to empirical studies involving at least one genetic marker and including proximal life events. We evaluated the risk of bias using the Newcastle Ottawa Scale for observational studies. The outcome permitted a distinction between life events dependent on the individual's agency versus independent events. RESULTS Seven studies, including 3585 participants, met eligibility criteria. Three were longitudinal, and four were cross-sectional; six included adolescents and young adults, and one focused on middle adulthood. Four examined the serotonin-transporter-linked promoter region (5-HTTLPR), two examined the rs53576 single nucleotide polymorphism of the oxytocin receptor gene (OXTR), and one examined a multilocus genetic profile score including four hypothalamic-pituitary-adrenal (HPA) axis genes. There were no significant direct correlations between genotype and life events in any study. Instead, their relation was significantly moderated by symptoms, exposure to early adversity, or attachment. Consistent with the stress generation hypothesis, this moderation relation was significant in predicting exposure to dependent life events but was not significant in predicting independent life event exposure. CONCLUSIONS There is evidence that genetic variation in the serotonin, HPA axis, and oxytocin systems moderates the effects of psychosocial vulnerability markers on the generation of proximal, dependent life events. Future research should examine additional genetic markers in systems known to confer risk for stress generation. PROSPERO CRD42019136886.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Evan Forth
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Tegan Hargreaves
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Kate Harkness
- Department of Psychiatry, Queen's University, Kingston, ON, Canada; Department of Psychology, Queen's University, Kingston, ON, Canada
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King N, Pickett W, McNevin SH, Bowie CR, Rivera D, Keown-Stoneman C, Harkness K, Cunningham S, Milanovic M, Saunders KEA, Goodday S, Duffy A. Mental health need of students at entry to university: Baseline findings from the U-Flourish Student Well-Being and Academic Success Study. Early Interv Psychiatry 2021; 15:286-295. [PMID: 32048460 DOI: 10.1111/eip.12939] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/19/2019] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
AIM Transition to university is associated with unique stressors and coincides with the peak period of risk for onset of mental illness. Our objective in this analysis was to estimate the mental health need of students at entry to a major Canadian university. METHODS After a student-led engagement campaign, all first year students were sent a mental health survey, which included validated symptom rating scales for common mental disorders. Rates of self-reported lifetime mental illness, current clinically significant symptoms and treatment stratified by gender are reported. The likelihood of not receiving treatment among those symptomatic and/or with lifetime disorders was estimated. RESULTS Fifty-eight per cent of all first-year students (n = 3029) completed the baseline survey, of which 28% reported a lifetime mental disorder. Moreover, 30% of students screened positive for anxiety symptoms, 28% for depressive symptoms, and 18% for sleep problems with high rates (≅45%) of associated impairment. Only 8.5% of students indicated currently receiving any form of treatment. Females were more likely to report a lifetime diagnosis, anxiety and depressive symptoms, as well as current treatment. Over 25% of students reported lifetime suicidal thoughts and 6% suicide attempt(s). Current weekly binge drinking (25%) and cannabis use (11%) were common, especially in males. CONCLUSIONS There is limited systematically collected data describing the mental health needs of young people at entry to university. Findings of this study underscore the importance of timely identification of significant mental health problems as part of a proactive system of effective student mental health care.
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Affiliation(s)
- Nathan King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Steven H McNevin
- Division of Student Mental Health, Queen's University, Kingston, Ontario, Canada
| | - Chris R Bowie
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Daniel Rivera
- Life Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Kate Harkness
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Simone Cunningham
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Melissa Milanovic
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Kate E A Saunders
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sarah Goodday
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Anne Duffy
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Kingston, Ontario, Canada
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Duffy A, Keown-Stoneman C, Goodday S, Horrocks J, Lowe M, King N, Pickett W, McNevin SH, Cunningham S, Rivera D, Bisdounis L, Bowie CR, Harkness K, Saunders KEA. Predictors of mental health and academic outcomes in first-year university students: Identifying prevention and early-intervention targets. BJPsych Open 2020; 6:e46. [PMID: 32381150 PMCID: PMC7331085 DOI: 10.1192/bjo.2020.24] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although there is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts. AIMS To longitudinally examine the extent and persistence of mental health symptoms and the importance of psychosocial and lifestyle factors for student mental health and academic outcomes. METHOD Undergraduates at a Canadian university were invited to complete electronic surveys at entry and completion of their first year. The baseline survey measured important distal and proximal risk factors and the follow-up assessed mental health and well-being. Surveys were linked to academic grades. Multivariable models of risk factors and mental health and academic outcomes were fit and adjusted for confounders. RESULTS In 1530 students surveyed at entry to university 28% and 33% screened positive for clinically significant depressive and anxiety symptoms respectively, which increased to 36% and 39% at the completion of first year. Over the academic year, 14% of students reported suicidal thoughts and 1.6% suicide attempts. Moreover, there was persistence and overlap in these mental health outcomes. Modifiable psychosocial and lifestyle factors at entry were associated with positive screens for mental health outcomes at completion of first year, while anxiety and depressive symptoms were associated with lower grades and university well-being. CONCLUSIONS Clinically significant mental health symptoms are common and persistent among first-year university students and have a negative impact on academic performance and well-being. A comprehensive mental health strategy that includes a whole university approach to prevention and targeted early-intervention measures and associated research is justified.
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Affiliation(s)
- A Duffy
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Kingston, Canada; and Department of Psychiatry, University of Oxford, UK
| | - C Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - S Goodday
- Department of Psychiatry, University of Oxford, UK
| | - J Horrocks
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - M Lowe
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - N King
- Department of Public Health Sciences, Queen's University, Canada
| | - W Pickett
- Department of Public Health Sciences, Queen's University, Canada
| | - S H McNevin
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Canada
| | - S Cunningham
- Department of Psychology, Queen's University, Canada
| | - D Rivera
- Department of Psychiatry, Division of Student Mental Health, Queen's University, Canada
| | - L Bisdounis
- Department of Psychiatry, University of Oxford, UK
| | - C R Bowie
- Department of Psychology, Queen's University, Canada
| | - K Harkness
- Department of Psychology, Queen's University, Canada
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McKelvie R, Harkness K, Sherrard H, Iverson A, Leung J, Woodward G. A SYSTEMS APPROACH TO INTEGRATING HEART FAILURE CARE: A ‘HOW TO’ ROAD MAP BASED ON LIVED EXPERIENCE. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Goodday SM, Rivera D, Foran H, King N, Milanovic M, Keown-Stoneman CD, Horrocks J, Tetzlaff E, Bowie CR, Pickett W, Harkness K, Saunders KE, Cunningham S, McNevin S, Duffy A. U-Flourish university students well-being and academic success longitudinal study: a study protocol. BMJ Open 2019; 9:e029854. [PMID: 31455708 PMCID: PMC6720248 DOI: 10.1136/bmjopen-2019-029854] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Over 30% of Canadians between the ages of 16 and 24 years attend university. This period of life coincides with the onset of common mental illnesses. Yet, data to inform university-based mental health prevention and early intervention initiatives are limited. The U-Flourish longitudinal study based out of Queen's University, Canada and involving Oxford University in the UK, is a student informed study funded by the Canadian Institute for Health Research Strategy for Patient Oriented Research (CIHR-SPOR). The primary goal of U-Flourish research is to examine the contribution of risk and resiliency factors to outcomes of well-being and academic success in first year students transitioning to university. METHODS AND ANALYSIS The study is a longitudinal survey of all first-year undergraduate students entering Queen's University in the fall term of 2018 (and will launch at Oxford University in fall of 2019). In accordance with the CIHR-SPOR definitions, students represent the target population (ie, patient equivalent). Student peer health educators were recruited to inform the design, content and implementation of the study. Baseline surveys of Queen's first year students were completed in the fall of 2018, and follow-up surveys at the end of first year in the spring of 2019. Extensive student-led engagement campaigns were used to maximise participation rates. The baseline survey included measures of personal factors, family factors, environmental factors, psychological and emotional health, and lifestyle factors. Main outcomes include self-reported indicators of mental health at follow-up and mental health service access, as well as objective measures of academic success through linkage to university administrative and academic databases. A combination of mixed effects regression techniques will be employed to determine associations between baseline predictive factors and mental health and academic outcomes. ETHICS AND DISSEMINATION Ethical approval was obtained by the Health Sciences and Affiliated Teaching Hospitals Research Ethics Board (HSREB) (#6023126) at Queen's University. Findings will be disseminated through international and national peer-reviewed scientific articles and other channels including student-driven support and advocacy groups, newsletters and social media.
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Affiliation(s)
| | | | | | - Nathan King
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | | | | | | | | | | | - William Pickett
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kate Harkness
- Psychology, Queens University, Kingston, Ontario, Canada
| | | | | | - Steven McNevin
- Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Anne Duffy
- Psychiatry, Queen's University, Kingston, Ontario, Canada
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Harkness K, Estrella-Holder E, Morris S, Nixon S, Pike R. OPTIMIZING MEDICATIONS IN PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION- PRACTICAL TIPS FOR CARDIOVASCULAR NURSES. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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8
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Dupéré V, Dion E, Harkness K, McCabe J, Thouin É, Parent S. Adaptation and Validation of the Life Events and Difficulties Schedule for Use With High School Dropouts. J Res Adolesc 2017; 27:683-689. [PMID: 28776844 DOI: 10.1111/jora.12296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Life Events and Difficulties Schedule (LEDS) is considered the standard for measuring psychosocial stressor exposure, but it has not been used with academically at-risk adolescents, including high school dropouts. The goal of this study was to (1) adapt the LEDS for use with this population, and (2) examine the reliability (interrater) and validity (concurrent and predictive) of this adaptation among a sample of vulnerable adolescents (N = 545). Good reliability coefficients (.79-.90) were obtained, and stressor exposure was associated with concurrent criteria indexing mental health outcomes (depression) and major risk factors for dropout (administratively recorded and self-reported). Also, LEDS scores predicted dropout beyond these risk factors. The adapted LEDS appears useful for describing academically struggling adolescents' stressor exposure.
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Harkness K, Arthur H. 1303: Anxiety, depression and caregiver burden in patients with heart failure and their primary caregivers — a longitudinal pilot study. Eur J Cardiovasc Nurs 2017. [DOI: 10.1177/14745151060050s103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- K. Harkness
- Strategic Training Fellow in the FUTURE Program for Cardiovascular Nurse Scientists
| | - H. Arthur
- McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Harkness K, Li L, Berry E, Woodward G, Kingsbury K. PROVINCIAL IMPLANTABLE CARDIOVERTER DEFIBRILLATOR UTILIZATION AND CAPACITY PLANNING. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Harkness K, Buck H, Wion R. CAREGIVER SUPPORT FOR SELF-CARE ACTIVITIES- BUILDING AN INSTRUMENT. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Boyd L, Harkness K. NURSING THE FAILING HEART: A SKILL SET REFRESHER ON CHRONIC HEART FAILURE MANAGEMENT. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Ramezani M, Johnsrude I, Rasoulian A, Bosma R, Tong R, Hollenstein T, Harkness K, Abolmaesumi P. Temporal-lobe morphology differs between healthy adolescents and those with early-onset of depression. Neuroimage Clin 2014; 6:145-55. [PMID: 25379426 PMCID: PMC4215529 DOI: 10.1016/j.nicl.2014.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/01/2014] [Accepted: 08/12/2014] [Indexed: 01/07/2023]
Abstract
Major depressive disorder (MDD) has previously been linked to structural changes in several brain regions, particularly in the medial temporal lobes (Bellani, Baiano, Brambilla, 2010; Bellani, Baiano, Brambilla, 2011). This has been determined using voxel-based morphometry, segmentation algorithms, and analysis of shape deformations (Bell-McGinty et al., 2002; Bergouignan et al., 2009; Posener et al., 2003; Vasic et al., 2008; Zhao et al., 2008): these are methods in which information related to the shape and the pose (the size, and anatomical position and orientation) of structures is lost. Here, we incorporate information about shape and pose to measure structural deformation in adolescents and young adults with and without depression (as measured using the Beck Depression Inventory and Diagnostic and Statistical Manual of Mental Disorders criteria). As a hypothesis-generating study, a significance level of p < 0.05, uncorrected for multiple comparisons, was used, so that subtle morphological differences in brain structures between adolescent depressed individuals and control participants could be identified. We focus on changes in cortical and subcortical temporal structures, and use a multi-object statistical pose and shape model to analyze imaging data from 16 females (aged 16-21) and 3 males (aged 18) with early-onset MDD, and 25 female and 1 male normal control participants, drawn from the same age range. The hippocampus, parahippocampal gyrus, putamen, and superior, inferior and middle temporal gyri in both hemispheres of the brain were automatically segmented using the LONI Probabilistic Brain Atlas (Shattuck et al., 2008) in MNI space. Points on the surface of each structure in the atlas were extracted and warped to each participant's structural MRI. These surface points were analyzed to extract the pose and shape features. Pose differences were detected between the two groups, particularly in the left and right putamina, right hippocampus, and left and right inferior temporal gyri. Shape differences were detected between the two groups, particularly in the left hippocampus and in the left and right parahippocampal gyri. Furthermore, pose measures were significantly correlated with BDI score across the whole (clinical and control) sample. Since the clinical participants were experiencing their very first episodes of MDD, morphological alteration in the medial temporal lobe appears to be an early sign of MDD, and is unlikely to result from treatment with antidepressants. Pose and shape measures of morphology, which are not usually analyzed in neuromorphometric studies, appear to be sensitive to depressive symptomatology.
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Affiliation(s)
- Mahdi Ramezani
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ingrid Johnsrude
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada
- Department of Behavioural Sciences and Learning, Linnaeus Centre for Hearing and Deafness, Linköping University, Linköping SE-581 83, Sweden
| | - Abtin Rasoulian
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Rachael Bosma
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Ryan Tong
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Tom Hollenstein
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Kate Harkness
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Purang Abolmaesumi
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Harkness K, MacLean E, Heckman G, Demers C, McKelvie R. N008 New Insight Into Predictors of Self-Care Confidence in Older Patients With Heart Failure. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Harkness K, Heckman G, Demers C, McKelvie R. 656 The Association Between Cognitive Function and Self-Care in Older Patients With Heart Failure. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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17
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Pohl J, Olmstead MC, Wynne-Edwards KE, Harkness K, Menard JL. Repeated exposure to stress across the childhood-adolescent period alters rats' anxiety- and depression-like behaviors in adulthood: The importance of stressor type and gender. Behav Neurosci 2007; 121:462-74. [PMID: 17592937 DOI: 10.1037/0735-7044.121.3.462] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This research tests the hypothesis that specific forms of adversity in early life map onto behavioral signs analogous to depression versus anxiety in later life. Male and female rats were exposed to either severe sporadic stress or chronic mild stress during the childhood-adolescent period, and their behavior was tested in adulthood. Males in the severe sporadic stress group showed exaggerated anxiety-related behaviors, as indicated by increases in shock-probe burying and escape-like responses (jumps) from the open arms of the elevated plus-maze. Females exposed to severe sporadic stress displayed no change in burying behavior but did display increases in escape behavior. These same females also exhibited behaviors analogous to depression that manifested as decreased sucrose consumption. The chronic mild stress regime produced effects only in females, including reduced burying, decreased sucrose consumption, and an exaggerated corticosterone response to cold-water immersion stress. Findings reiterate the importance of early life experience to the development of adult psychopathologies and emphasize the need to consider both the type of early experience and gender differences in these analyses.
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Affiliation(s)
- Joanna Pohl
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Madan V, Harkness K, Brien EO, Warburton EA. Lone atrial septal aneurysm and stroke--a case report and review of the literature. Eur J Intern Med 2005; 16:520-2. [PMID: 16275551 DOI: 10.1016/j.ejim.2005.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 03/03/2005] [Accepted: 09/05/2005] [Indexed: 10/25/2022]
Abstract
The aetiology of stroke in young patients is usually difficult to establish. Despite extensive investigations, the cause of stroke remains unknown in a large percentage of these patients. We report a case of stroke in a young patient in whom the only associated aetiological factor was a lone atrial septal aneurysm. We discuss the investigational tools in the diagnosis of atrial septal aneurysms and study the aetiopathogenesis of strokes and the risk of recurrent strokes associated with their presence. We also review the evidence for the presently available therapies for prevention of further strokes in such patients.
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Affiliation(s)
- V Madan
- Department of Medicine, Addenbrooke's Hospital, Cambridge, UK
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U-King-Im JM, Trivedi RA, Graves MJ, Harkness K, Eales H, Joubert I, Koo B, Antoun N, Warburton EA, Gillard JH, Baron JC. Utility of an ultrafast magnetic resonance imaging protocol in recent and semi-recent strokes. J Neurol Neurosurg Psychiatry 2005; 76:1002-5. [PMID: 15965212 PMCID: PMC1739722 DOI: 10.1136/jnnp.2004.046201] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the technical feasibility of an integrated ultrafast head magnetic resonance (MR) protocol using a sensitivity encoding (SENSE) technique for depicting parenchymal ischaemia and vascular compromise in patients with suspected recent stroke. METHODS 23 patients were evaluated with the ultrafast MR protocol using T2, T1, fluid attenuated inversion recovery (FLAIR), 3D time of flight magnetic resonance angiography (MRA), and diffusion weighted imaging (DWI) sequences. These were compared with routine conventional MR sequences. RESULTS One patient could not tolerate conventional imaging, although imaging using the three minute head SENSE protocol was diagnostic. Both conventional and ultrafast protocols were of similar diagnostic yield in the remaining patients. There were no significant differences in clinical diagnostic quality for the T1, T2, FLAIR, and DWI sequences. One MRA examination was of better quality when SENSE was used, owing to reduced motion artefacts and shorter imaging time. CONCLUSIONS It is possible to undertake a comprehensive MR examination in stroke patients in approximately three to five minutes. Ultrafast imaging may become a useful triage tool before thrombolytic therapy. It may be of particular benefit in patients unable to tolerate longer sequences. Further work is necessary to confirm these findings in hyperacute stroke.
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Affiliation(s)
- J M U-King-Im
- Department of Radiology, Addenbrooke's Hospital and the University of Cambridge, Cambridge CB2 2QQ, UK
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Abstract
BACKGROUND Venous sinus disease must be excluded before diagnosing idiopathic intracranial hypertension but is found only rarely in typical cases. Magnetic resonance venography (MRV) is the technique of choice for investigating this, and provides images that are diagnostic and easy to interpret. However, recent work using more invasive techniques has documented pressure gradients and stenoses in the lateral venous sinuses in many cases of idiopathic intracranial hypertension. OBJECTIVE To examine the reason for this discrepancy and to establish whether there are characteristic appearances on MRV in idiopathic intracranial hypertension that are routinely overlooked in clinical practice. METHODS MRVs from 20 patients with idiopathic intracranial hypertension were reviewed, unblinded, by two neuroradiologists, and their appearances rated for focal narrowings and signal gaps. A control group of 40 asymptomatic volunteers, matched for age and sex with the patient group, was recruited prospectively for MRV, and their scans rated in the same way. RESULTS The lateral sinuses presented a range of appearances with quite different distributions in the two groups (p<0.001). Bilateral lateral sinus flow gaps were seen in 13 of 20 patients with idiopathic intracranial hypertension and in none of 40 controls. CONCLUSIONS A historical failure to use normal healthy controls to establish the boundaries between imaging artefact, normal anatomical variant, and disease means that the pathological significance of the different appearances of the lateral sinuses on MRV has not so far been appreciated.
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Affiliation(s)
- J N P Higgins
- Department of Radiology, Box 219, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
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22
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Affiliation(s)
- J M Schott
- Dementia Research Group, Institute of Neurology, University College WC1N 3BG, London, UK
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23
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Abstract
Life stress has been found to be associated with onset of depression and with greater severity of depressive symptoms. It is unclear, though, if life stress is related to particular classes or specific symptoms in depression. The association between severe life events and depressive symptoms was tested in 59 individuals diagnosed by Research Diagnostic Criteria with endogenous primary nonpsychotic major depression. As predicted, life stress was associated principally with cognitive-affective symptoms, not somatic symptoms. There also was a consistent association across different assessment methods between severe events and suicidal ideation. Finally, associations held specifically for severe events occurring before onset, not for severe events occurring after onset. Symptom variation in major depression is related specifically to severe stressors before onset and includes primarily cognitive-affective types of symptoms. There is an especially pronounced association of prior severe stress with suicidal ideation. The implications of stress-symptom associations are addressed for enlarging understanding of symptom heterogeneity and subtype distinctions in major depression.
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Affiliation(s)
- S M Monroe
- Department of Psychology, University of Oregon, Eugene 97403-1227, USA
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Jillella AP, Britt GW, Litaker MS, Kallab AM, Harkness K, Garner GD. Ototoxicity after high-dose chemotherapy with cyclophosphamide, thiotepa and carboplatin followed by stem cell transplantation in patients with breast cancer. Med Oncol 2000; 17:287-92. [PMID: 11114707 DOI: 10.1007/bf02782193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our purpose was to determine the risk of ototoxicity in breast cancer patients receiving a myeloablative regimen consisting of cyclophosphamide 6000 mg/m2, thiotepa 500 mg/m2 and carboplatin 800 mg/m2 (CTCb) followed by stem cell transplantation. Fourteen consecutive patients with breast cancer were treated with high dose chemotherapy consisting of the CTCb regimen followed by stem cell transplantation. A pretransplant complete hearing study was obtained which consisted of hearing case history, audiometry and tympanometry. In addition, DPOAE (Distortion Product Otoaccoustic Emissions) was done to evaluate measurable changes in the cochlear (outer hair cell) functioning. Pre-transplant, all patients had no clinical evidence of hearing impairment and hearing studies were normal. Eleven patients had hearing studies and a telephone interview posttransplant. One patient was lost to follow-up and two patients died. One of the 11 patients tested had an abnormal post-transplant hearing study but none of them had clinically detectable hearing impairment. In our prospective study of breast cancer patients treated with the CTCb regimen, we did not observe clinically detectable hearing impairment in any of the patients tested.
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Affiliation(s)
- A P Jillella
- Department of Medicine, Medical College of Georgia, Augusta 30912, USA.
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25
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Affiliation(s)
- N Woodroofe
- Biomedical Research Centre, Sheffield Hallam University, South Yorkshire, U.K.
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Harkness K, Howell SJ, Davies-Jones GA. Encephalopathy associated with intravenous immunoglobulin treatment for Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 1996; 60:586. [PMID: 8778270 PMCID: PMC486379 DOI: 10.1136/jnnp.60.5.586] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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