Browsing by Author "Patten, Scott B."

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    A descriptive study of the Canadian population with schizophrenia
    (2009) Yelland, Jennifer T.; Patten, Scott B.
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    Abstracts from the 2015 Sebastian K. Littmann Research Day
    (2015-03-13) Patten, Scott B.
    These are the Abstracts from the 2015 Sebastian K. Littmann Research Day
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    Abstracts from the 2018 Sebastian K. Littmann Research Day
    (2018-03-02) Patten, Scott B.
    These are the abstracts from the 2018 research day, held on March 2nd 2018.
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    Abstracts from the 2020 Sebastian K. Littmann Research Day
    (2020-03-06) Patten, Scott B.
    These are the abstracts from the 33rd Annual Sebastian K. Littmann Research Day, held on March 6, 2020.
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    Adult patient perspectives of the unknowns of living with epilepsy - results from a focus group study.
    (2019-11-24) Lee, Jeanie Y. Y.; Gelfand, Jennifer; Khan, Sundus; Crooks, Rachel E.; Josephson, Colin B.; Wiebe, Samuel; Patten, Scott B.; Korngut, Lawrence; Smith, Eric Edward; Roach, Pamela M.
    Background/Objectives: Epilepsy is one of the most common and debilitating neurological conditions that affects nearly 50 million people worldwide, yet there remains a stigma around this condition, which can impact the information-seeking behaviours of patients. As the Brain and Mental Health Research Clinics develop a website about registry-based research, including patient-facing areas, it is important to understand how patients look for information, and the types of information they are seeking out. The objective of this study was to encourage conversation and understand the patient perspectives of existing knowledge gaps between epilepsy patients and the resources they use to obtain information. Methods: A total of thirteen patients (mean (SD) age = 46.4 (16.1) years) from the Calgary Comprehensive Epilepsy Program Registry and four caregivers participated in one of the three focus groups completed in order to meet our aims. There were eight female and five male patients. A semi-structured guide was used to understand the patients’ experiences, top concerns, informational resources currently used, and resources or knowledge that patients felt are lacking. The focus groups were audio-recorded and transcribed verbatim. Thematic content analysis was conducted by two researchers who independently open-coded the transcripts using NVivo 11. The final analysis was done by team discussion and ongoing analysis of the codes to create themes and sub-themes. Results: The major themes that emerged from the data included: 1) daily management; 2) resources; and 3) medications and treatment. For daily management, the participants reported concerns about the effects of epilepsy on day-to-day activities such as driving, working, and the barriers they face in society due to their perceived lack of awareness and education about seizure management in the general public. The participants felt negatively impacted by the stigma and compared their experience with epilepsy with other disorders such as cancer or diabetes which they feel are much more accepted in society. The geographical location of the patient also plays a role in the support they receive for epilepsy management, with participants citing challenges and feelings of isolation in rural areas. To acquire more information about epilepsy, participants reported that they primarily asked their physicians or searched online. However, despite the conveniences of the internet, some individuals felt the volume and variation of quality of online information was overwhelming. Instead, they would prefer to go to trusted resources that are provided by healthcare professionals or websites affiliated with hospitals or universities. Updated information on medication, side effects, and research are examples of resources the patients would like to see provided on such websites. Conclusion: Overall, it is clear from our focus groups that resources and support for self-management and day-to-day living for individuals with epilepsy is paramount to reduce knowledge gaps. Not only is it important to provide daily management and medication information to patients through trusted organizational resources, but it is equally important to increase public awareness about epilepsy and seizure disorders to reduce the stigma attached to these conditions.
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    Adverse health behaviours are associated with depression and anxiety in multiple sclerosis: A prospective multisite study
    (SAGE PUBLICATIONS LTD, 2016) McKay, Kyla A.; Tremlett, Helen; Fisk, John D.; Patten, Scott B.; Fiest, Kirsten; Berrigan, Lindsay; Marrie, Ruth Ann
    Background: Depression and anxiety are common among people with multiple sclerosis (MS), as are adverse health behaviours, but the associations between these factors are unclear. Objective: To evaluate the associations between cigarette smoking, alcohol use, and depression and anxiety in MS in a cross-Canada prospective study. Methods: From July 2010 to March 2011 we recruited consecutive MS patients from four MS clinics. At three visits over two years, clinical and demographic information was collected, and participants completed questionnaires regarding health behaviours and mental health. Results: Of 949 participants, 75.2% were women, with a mean age of 48.6 years; most had a relapsing-remitting course (72.4%). Alcohol dependence was associated with increased odds of anxiety (OR: 1.84; 95% CI: 1.32-2.58) and depression (OR: 1.53; 95% CI: 1.05-2.23) adjusting for age, sex, Expanded Disability Status Scale (EDSS), and smoking status. Smoking was associated with increased odds of anxiety (OR: 1.29; 95% CI: 1.02-1.63) and depression (OR: 1.37; 95% CI: 1.04-1.78) adjusting for age, sex, EDSS, and alcohol dependence. Alcohol dependence was associated with an increased incidence of depression but not anxiety. Depression was associated with an increased incidence of alcohol dependence. Conclusion: Alcohol dependence and smoking were associated with anxiety and depression. Awareness of the effects of adverse health behaviours on mental health in MS might help target counselling and support for those 'at risk'.
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    Age-specific lifetime prevalence simulation
    (2009-09-05T23:46:20Z) Patten, Scott B.
    This is a flash video presentation with animation depicting age-specific lifetime prevalence of Major Depressive Disorder. The goal of this project was to explore the puzzling pattern of lifetime prevalence by age - contrary to expectation the lifetime prevalence has been observed to decline with age. This has usually been interpreted as a cohort effect. The simulations (which derive from a steady state incidence-prevalence-mortality model) indicate that the puzzling pattern of declining lifetime prevalence with age does not necessarily represent a cohort effect - the simulations suggest that various factors may contribute: declining incidence with age, recall failure and differential mortality.
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    Allergies and major depression: a longitudinal community study
    (BioMed Central, 2009-01-26) Patten, Scott B.; Williams, Jeanne V.A.; Lavorato, Dina H.; Eliasziw, Michael
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    An Epidemiological Study on Risk Factors for the Development of Serious Mental Illness In At-Risk Youth
    (2023-08) Jalali, Sara; Addington, Jean; Patten, Scott B.; Wang, JianLi
    Usually, mental illnesses begin in adolescence and early adulthood, and for many, persist over time. Consequently, mental illnesses lead to significant personal and societal burden. In response, there has been increasing effort in early intervention strategies that may help with delaying or stopping the progression of a mental illness to a more serious state. Aside from finding early intervention strategies best suited for young people, it is imperative to understand the psychosocial, biological and environmental factors that may lead to the development of a mental illness. Research on these early factors in youth mental illness development is limited. The aim of this study was to determine which clinical factors might be related to the development of a serious mental illness (SMI) in at-risk youth. A total of 162 participants aged 12-26 years and at various stages of risk for SMI were included in the study. Out of these participants, 31 developed a SMI. Comparisons were made on a range of baseline clinical and functional measures between two groups; those that made a transition to a SMI (n=31) and those that did not (n=131). A cox regression analysis was used to assess the relationship between measures and SMI development. Female sex, attenuated psychotic symptoms as assessed with the Scale of Psychosis-risk Symptoms (SOPS), and higher ratings on the K-10 Distress Scale were found to be significantly related to later transition to a SMI. Female participants were 2.77 times more likely to transition to SMI compared to the males. There was a 14% increased risk of transition with each one-point increase in the SOPS, and a 7% increase with a one-point increase in the K-10 scale. Results from this longitudinal study may help improve understanding of illness trajectory and aid with early detection in mental illnesses.
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    An Animation of Major Depression Epidemiology
    (2006-09-22T20:03:14Z) Patten, Scott B.; Community Health Sciences and Psychiatry; Medicine; University of Calgary
    This is an animation of major depression epidemiology. The animation includes an introduction to the layout of the simulation, followed by depiction of the epidemiology in a steady state.
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    Animation of Major Depression Epidemiology
    (2006-08-28T21:21:40Z) Patten, Scott B.; Community Health Sciences and Psychiatry; Medicine; University of Calgary
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    Appendices: Antidepressant Treatment for Major Depression in Multiple Sclerosis: the Evolving Efficacy Literature
    (2009-10-23T02:57:40Z) Patten, Scott B.
    Background: Major depression is now widely acknowledged as being an important clinical issue in multiple sclerosis. Antidepressant medications are generally regarded as being efficacious treatments. Unfortunately, the literature of treatment studies is small. Recently a randomized controlled trial reported negative results, raising new questions about the efficacy of these medications. The objective of this study was to revisit the question of whether antidepressant medications are efficacious in the treatment of major depression in MS. Results: A literature search uncovered only three randomized controlled trials. These studies had methodological differences including the approach to the analysis (2 of three used intention to treat analyses), measures of depression (two evaluated response as a 50% reduction in HAM-D, and 2 included the Beck Depression Inventory), methodological features (2 used blinding, one included cases of dysthymia) and duration of follow-up (ranging from one to four months). Despite this, all of the results were in the same direction, suggesting modest therapeutic benefits for the medications evaluated: desipramine, sertraline and paroxetine. Conclusions: The current literature in this field is inadequate. However, the best available evidence continues to point towards a modest positive effect of certain medications for acute treatment of depression in MS.
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    Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study
    (2023-10-18) Bhattarai, Asmita; Dimitropoulos, Gina; Bulloch, Andrew G.; Tough, Suzanne C.; Patten, Scott B.
    Abstract Background The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. Methods The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994–2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). Results During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. Conclusion The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.
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    Benzodiazepine and similar sedative-hypnotic use in Canada
    (2005) Kassam, Aliya; Patten, Scott B.
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    Can the adverse childhood experiences (ACEs) checklist be utilized to predict emergency department visits among children and adolescents?
    (2021-09-25) Bhattarai, Asmita; Dimitropoulos, Gina; Marriott, Brian; Paget, Jaime; Bulloch, Andrew G. M.; Tough, Suzanne C.; Patten, Scott B.
    Abstract Background Extensive literature has shown an association of Adverse Childhood Experiences (ACEs) with adverse health outcomes; however, its ability to predict events or stratify risks is less known. Individuals with mental illness and ACE exposure have been shown to visit emergency departments (ED) more often than those in the general population. This study thus examined the ability of the ACEs checklist to predict ED visits within the subsequent year among children and adolescents presenting to mental health clinics with pre-existing mental health issues. Methods The study analyzed linked data (n = 6100) from two databases provided by Alberta Health Services (AHS). The Regional Access and Intake System (RAIS 2016–2018) database provided data on the predictors (ACE items, age, sex, residence, mental health program type, and primary diagnosis) regarding children and adolescents (aged 0–17 years) accessing addiction and mental health services within Calgary Zone, and the National Ambulatory Care Reporting System (NACRS 2016–2019) database provided data on ED visits. A 25% random sample of the data was reserved for validation purposes. Two Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression models, each employing a different method to tune the shrinkage parameter lambda (namely cross-validated and adaptive) and performing 10-fold cross-validation for a set of 100 lambdas in each model were examined. Results The adaptive LASSO model had a slightly better fit in the validation dataset than the cross-validated model; however, it still demonstrated poor discrimination (AUC 0.60, sensitivity 37.8%, PPV 49.6%) and poor calibration (over-triaged in low-risk and under-triaged in high-risk subgroups). The model’s poor performance was evident from an out-of-sample deviance ratio of − 0.044. Conclusion The ACEs checklist did not perform well in predicting ED visits among children and adolescents with existing mental health concerns. The diverse causes of ED visits may have hindered accurate predictions, requiring more advanced statistical procedures. Future studies exploring other machine learning approaches and including a more extensive set of childhood adversities and other important predictors may produce better predictions. Furthermore, despite highly significant associations being observed, ACEs may not be deterministic in predicting health-related events at the individual level, such as general ED use.
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    Cannabinoids in the management of behavioral, psychological, and motor symptoms of neurocognitive disorders: a mixed studies systematic review
    (2022-03-14) Bahji, Anees; Breward, Natasha; Duff, Whitney; Absher, Nafisa; Patten, Scott B.; Alcorn, Jane; Mousseau, Darrell D.
    Abstract Aim We undertook this systematic review to determine the efficacy and safety of cannabis-based medicine as a treatment for behavioral, psychological, and motor symptoms associated with neurocognitive disorders. Methods We conducted a PRISMA-guided systematic review to identify studies using cannabis-based medicine to treat behavioral, psychological, and motor symptoms among individuals with Alzheimer's disease (AD) dementia, Parkinson’s disease (PD), and Huntington’s disease (HD). We considered English-language articles providing original data on three or more participants, regardless of design. Findings We identified 25 studies spanning 1991 to 2021 comprised of 14 controlled trials, 5 pilot studies, 5 observational studies, and 1 case series. In most cases, the cannabinoids tested were dronabinol, whole cannabis, and cannabidiol, and the diagnoses included AD (n = 11), PD (n = 11), and HD (n = 3). Primary outcomes were motor symptoms (e.g., dyskinesia), sleep disturbance, cognition, balance, body weight, and the occurrence of treatment-emergent adverse events. Conclusions A narrative summary of the findings from the limited number of studies in the area highlights an apparent association between cannabidiol-based products and relief from motor symptoms in HD and PD and an apparent association between synthetic cannabinoids and relief from behavioral and psychological symptoms of dementia across AD, PD, and HD. These preliminary conclusions could guide using plant-based versus synthetic cannabinoids as safe, alternative treatments for managing neuropsychiatric symptoms in neurocognitive vulnerable patient populations.