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Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups.

https://arctichealth.org/en/permalink/ahliterature214788
Source
Am J Psychiatry. 1995 Jul;152(7):1052-8
Publication Type
Article
Date
Jul-1995
Author
P E Garfinkel
E. Lin
P. Goering
C. Spegg
D S Goldbloom
S. Kennedy
A S Kaplan
D B Woodside
Author Affiliation
Clarke Institute of Psychiatry, Toronto, Ont., Canada.
Source
Am J Psychiatry. 1995 Jul;152(7):1052-8
Date
Jul-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Bulimia - diagnosis - epidemiology
Comorbidity
Female
Humans
Male
Mental Disorders - diagnosis - epidemiology
Ontario - epidemiology
Prevalence
Sex Factors
Abstract
Previous epidemiological studies of bulimia nervosa have generated differing estimates of the incidence and prevalence of the disorder. These differences are attributable, in part, to varying definitions of the illness and a range of methodologies. The authors sought to define the prevalence of bulimia nervosa in a nonclinical community sample, examine the clinical significance of DSM-III-R threshold criteria, and examine comorbidity.
Subjects across Ontario (N = 8,116) were assessed with a structured interview, the World Health Organization Composite International Diagnostic Interview, with specific questions added for bulimia nervosa. Subjects who met DSM-III-R criteria for bulimia nervosa were compared with those who were missing only the frequency criterion (two or more binge-eating episodes per week for 3 months).
In this sample, the lifetime prevalence of bulimia nervosa was 1.1% for female subjects and 0.1% for male subjects. The subjects with full- and partial-syndrome bulimia nervosa showed significant vulnerability for mood and anxiety disorders. Lifetime rates of alcohol dependence were high in the full-syndrome group. Rates of parental psychopathologies were high in both bulimic groups but tended to be higher in the subjects with full-syndrome bulimia nervosa. Both bulimic groups were significantly more likely to experience childhood sexual abuse than a normal female comparison group.
This study confirms other prevalence estimates of bulimia nervosa and its comorbid diagnoses from studies that were based on sound methodologies. It also points to the arbitrary aspects of the frequency of binge eating as a diagnostic threshold criterion for the disorder.
PubMed ID
7793442 View in PubMed
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Classifying psychiatric inpatients: seeking better measures.

https://arctichealth.org/en/permalink/ahliterature202354
Source
Med Care. 1999 Apr;37(4):415-23
Publication Type
Article
Date
Apr-1999
Author
J. Durbin
P. Goering
G. Pink
M. Murray
Author Affiliation
Health Systems Research Unit, Clarke Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. jdurbin@hsru.clarke-inst.on.ca
Source
Med Care. 1999 Apr;37(4):415-23
Date
Apr-1999
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups - classification - statistics & numerical data
Hospitals, Psychiatric - utilization
Humans
Inpatients - classification
Length of Stay
Medical Records
Mental Disorders - classification
Ontario
Psychiatric Department, Hospital - utilization
Regression Analysis
Retrospective Studies
Severity of Illness Index
Abstract
Use of case-mix reimbursement in psychiatric inpatients has been limited as a result of a lack of systems which effectively group patients according to required resource needs. In recognition of the fact that many patient factors, in addition to diagnosis influence delivery of care in psychiatry, new measures of patient need are emerging.
This study compared improvement realized by using a multidimensional measure of patient severity, the Computerized Severity Index (CSI), to predict length of stay (LOS) in psychiatric inpatients over that achieved by using patient variables routinely collected in the discharge abstract.
Through retrospective chart review, severity ratings were made on 355 psychiatric discharges with primary diagnoses of psychotic or major depressive disorders. Those ratings were combined with demographic and diagnostic data available in discharge abstracts and were then entered into multivariate regression analyses to model LOS.
CSI ratings significantly contributed to prediction models, which accounted for an additional 9% to 11% of variation in LOS over discharge abstract data. Among patients with psychotic disorders, maximum severity during hospitalization was the best predictor of LOS, whereas among patients with depressive disorders, it was an increase in severity following admission.
Severity ratings, based on chart review, improved prediction of LOS over discharge abstract variables for psychiatric inpatients in two diagnostic groups. Further research is needed to estimate the impact of incorporating severity ratings into a grouping system for all psychiatric inpatients. Estimation of predictive accuracy is important to determine the amount of risk passed on to providers in a payment system based on psychiatric case mix.
PubMed ID
10213022 View in PubMed
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Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community.

https://arctichealth.org/en/permalink/ahliterature195153
Source
Am J Psychiatry. 2001 Apr;158(4):570-4
Publication Type
Article
Date
Apr-2001
Author
D B Woodside
P E Garfinkel
E. Lin
P. Goering
A S Kaplan
D S Goldbloom
S H Kennedy
Author Affiliation
Department of Psychiatry, The Toronto Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4. b.woodside@utoronto.ca
Source
Am J Psychiatry. 2001 Apr;158(4):570-4
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anorexia Nervosa - diagnosis - epidemiology
Bulimia - diagnosis - epidemiology
Comorbidity
Eating Disorders - diagnosis - epidemiology
Female
Health Surveys
Humans
Male
Marital status
Mental Disorders - diagnosis - epidemiology
Middle Aged
Ontario - epidemiology
Psychiatric Status Rating Scales - statistics & numerical data
Quality of Life
Risk factors
Sampling Studies
Sex Factors
Abstract
The authors compared 62 men who met all or most of the DSM-III-R criteria for eating disorders with 212 women who had similar eating disorders and 3,769 men who had no eating disorders on a wide variety of clinical and historical variables.
The groups of subjects were derived from a community epidemiologic survey performed in the province of Ontario that used the World Health Organization's Composite International Diagnostic Interview.
Men with eating disorders were very similar to women with eating disorders on most variables. Men with eating disorders showed higher rates of psychiatric comorbidity and more psychosocial morbidity than men without eating disorders.
These results confirm the clinical similarities between men with eating disorders and women with eating disorders. They also reveal that both groups suffer similar psychosocial morbidity. Men with eating disorders show a wide range of differences from men without eating disorders; the extent to which these differences are effects of the illness or possible risk factors for the occurrence of these illnesses in men is not clear.
PubMed ID
11282690 View in PubMed
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The economic burden of schizophrenia in Canada.

https://arctichealth.org/en/permalink/ahliterature201668
Source
Can J Psychiatry. 1999 Jun;44(5):464-72
Publication Type
Article
Date
Jun-1999
Author
R. Goeree
B J O'Brien
P. Goering
G. Blackhouse
K. Agro
A. Rhodes
J. Watson
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario. goereer@fhs.csu.mcmaster.ca
Source
Can J Psychiatry. 1999 Jun;44(5):464-72
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada - epidemiology
Cost of Illness
Efficiency
Employment
Female
Humans
Male
Mental Health Services - economics
Middle Aged
Prevalence
Prisoners - statistics & numerical data
Schizophrenia - economics - epidemiology - therapy
Abstract
To estimate the financial burden of schizophrenia in Canada in 1996.
Using a prevalence-based approach, all direct health care costs, administrative costs of income assistance plans, and costs of incarceration attributable to schizophrenia were determined. Also included was the value of lost productivity associated with premature mortality and morbidity. In addition to using published papers and documents, direct contact was made with representatives from various provincial and federal programs for estimates of the direct health care and non-health care costs.
The estimated number of persons with schizophrenia in Canada in 1996 was 221,000, with equal distribution between males and females. The direct health care and non-health care cost was estimated to be $1.12 billion in 1996. In addition, another $1.23 billion in lost productivity associated with morbidity and premature mortality was attributable to schizophrenia.
The total financial burden of schizophrenia in Canada was estimated to be $2.35 billion in 1996. The largest category of cost was morbidity (52%), followed by acute care and psychiatric hospital admissions (14% and 10% respectively). Given the magnitude of these cost estimates, there are large potential cost savings with more effective management and control of this debilitating disease.
PubMed ID
10389607 View in PubMed
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Effects of client interviewers on client-reported satisfaction with mental health services.

https://arctichealth.org/en/permalink/ahliterature201527
Source
Psychiatr Serv. 1999 Jul;50(7):961-3
Publication Type
Article
Date
Jul-1999
Author
C C Clark
E A Scott
K M Boydell
P. Goering
Author Affiliation
Clarke Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. clarkc@cs.clarke-inst.on.ca
Source
Psychiatr Serv. 1999 Jul;50(7):961-3
Date
Jul-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Case Management
Community Mental Health Services - standards
Data Collection - methods
Female
Health Personnel
Humans
Interviews as Topic - methods
Male
Middle Aged
Ontario
Patient Satisfaction - statistics & numerical data
Peer Group
Abstract
A study at two outpatient facilities compared two methods of collecting data on client satisfaction with mental health services provided by case managers and by physicians. A satisfaction survey instrument was developed with input from clients. A total of 120 clients were randomly assigned to be interviewed by either a staff member or a client. Clients from both facilities reported high levels of satisfaction regardless of the type of interviewer. Clients gave a significantly greater number of extremely negative responses when they were interviewed by client interviewers. No difference between the two groups was found in overall satisfaction with services received from case managers or physicians.
PubMed ID
10402622 View in PubMed
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Family physicians and the mental health system. Report from the Mental Health Supplement to the Ontario Health Survey.

https://arctichealth.org/en/permalink/ahliterature209443
Source
Can Fam Physician. 1997 Feb;43:251-6
Publication Type
Article
Date
Feb-1997
Author
A D Lesage
P. Goering
E. Lin
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto.
Source
Can Fam Physician. 1997 Feb;43:251-6
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adult
Family Practice - statistics & numerical data
Female
Health Services Research
Humans
Male
Mental Disorders - therapy
Mental Health Services - utilization
Ontario
Patient Acceptance of Health Care
Physician's Role
Questionnaires
Risk factors
Socioeconomic Factors
Abstract
To determine family physicians' role in the mental health care system.
The Mental Health Supplement to the Ontario Health Survey is an epidemiologic, retrospective, home-interview survey. Results reported here are based on responses of a weighted sample of patients aged 15 to 64.
Ontario, 1990 to 1991.
Random sample of 9953 household residents.
Standardized assessment of mental disorders, associated risk factors and disability, and patterns of use of mental health services.
More people seek mental health services from their family physicians (FPs) than from psychiatrists, social workers, or psychologists. Among patients who consulted for mental health purposes, more than 35.4% saw FPs only, 24.7% saw FPs and other mental health care providers (psychiatrists, psychologists, social workers, others), and 40% saw other mental health care providers only. There were few sociodemographic, diagnostic, or clinical severity differences between the FP-only group and the other two groups. Some evidence suggested FPs saw more recent onset cases, but they were also involved in joint care for more complex or disabled cases. More than 57% of those seeing FPs received medication; 43% received other forms of care. Those seeing FPs only made four visits per year; those who consulted other mental health professionals made 14 to 20.
Our study confirms FPs' important role in the current mental health care system.
Notes
Cites: Med Care. 1988 Jan;26(1):9-263336249
Cites: Arch Gen Psychiatry. 1985 Jan;42(1):89-943966857
Cites: Can J Psychiatry. 1990 Jun;35(5):397-4002372749
Cites: Can J Psychiatry. 1996 Nov;41(9):572-78946080
Cites: Can J Psychiatry. 1996 Nov;41(9):549-588946077
Cites: New Dir Ment Health Serv. 1994 Spring;(61):11-208208225
Cites: Arch Gen Psychiatry. 1993 Feb;50(2):95-1078381266
Cites: Arch Gen Psychiatry. 1993 Feb;50(2):85-948427558
Cites: J Psychiatr Res. 1994 Jan-Feb;28(1):57-848064641
PubMed ID
9040912 View in PubMed
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From hospital to community. Six-month and two-year outcomes for 505 patients.

https://arctichealth.org/en/permalink/ahliterature239964
Source
J Nerv Ment Dis. 1984 Nov;172(11):667-73
Publication Type
Article
Date
Nov-1984
Author
P. Goering
D. Wasylenki
W. Lancee
S J Freeman
Source
J Nerv Ment Dis. 1984 Nov;172(11):667-73
Date
Nov-1984
Language
English
Publication Type
Article
Keywords
Academies and Institutes
Adult
Aftercare - standards
Attitude to Health
Canada
Delivery of Health Care - standards
Employment
Female
Follow-Up Studies
Hospitals, General
Hospitals, State
Humans
Male
Mental Disorders - psychology - rehabilitation - therapy
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Discharge - standards
Patient Readmission
Psychiatric Status Rating Scales
Residence Characteristics
Social Adjustment
Abstract
The authors have completed a large descriptive study of the system of psychiatric aftercare in Metropolitan Toronto. This article describes the relevant 6-month and 2-year postdischarge outcome in each of five aftercare components for 505 subjects in a traditional system of service delivery. Provincial hospital, research institute, and general hospital subgroups are compared. For the total group, recidivism and employment rates are similar to those found in previous studies. Symptoms and distress levels are high. Considerable numbers of subjects live in inadequate and unsatisfactory housing. Social isolation, inadequate income, and difficulties with instrumental role functioning are persistent problems with little improvement between 6 months and 2 years postdischarge. Differences among the subgroups vary according to type of outcome and, for the most part, can be explained by differences in the characteristics of the patients served by the three types of inpatient treatment settings. These findings provide additional information about serious deficiencies in discharge planning and aftercare service delivery that is focused primarily upon the treatment of illness. The authors conclude that a more balanced system of aftercare requires a shift in resources to rehabilitation programs in the community.
PubMed ID
6092532 View in PubMed
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Gender differences among clients of a case management program for the homeless.

https://arctichealth.org/en/permalink/ahliterature224394
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Publication Type
Article
Date
Feb-1992
Author
P. Goering
D. Wasylenki
M S Onge
D. Paduchak
W. Lancee
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Date
Feb-1992
Language
English
Publication Type
Article
Keywords
Adult
Aged
Community Mental Health Services - utilization
Cross-Sectional Studies
Disability Evaluation
Female
Follow-Up Studies
Homeless Persons - psychology - statistics & numerical data
Humans
Incidence
Male
Managed Care Programs - utilization
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Ontario - epidemiology
Psychiatric Status Rating Scales
Psychotic Disorders - epidemiology - psychology - rehabilitation
Rehabilitation, Vocational - utilization
Sex Factors
Abstract
Differences between 24 female and 35 male clients were assessed at entry into an intensive case management program serving homeless shelter residents and again nine months later. Both men and women were socially isolated, with small social networks and severe deficits in social functioning. Histories of homelessness were similar for both genders, and there were no gender differences in psychopathology at baseline or follow-up. At entry into the program women had higher levels of social skills, larger and more supportive networks, and better housing conditions than men, but these differences disappeared after the subjects spent nine months in the program. Inadequate living conditions may have contributed to the more negative initial picture for men. Although there were more similarities than differences between the men and women in this sample, more research on gender differences is needed to design and evaluate programs for homeless mentally ill persons.
PubMed ID
1572613 View in PubMed
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Gender differences in legal involvement among homeless shelter users.

https://arctichealth.org/en/permalink/ahliterature191856
Source
Int J Law Psychiatry. 2001 Nov-Dec;24(6):583-93
Publication Type
Article
Author
G. Tolomiczenko
P. Goering
Author Affiliation
Department of Psychiatry, University of Toronto, Toronto, ON, Canada. George_Tolomiczenko@camh.net
Source
Int J Law Psychiatry. 2001 Nov-Dec;24(6):583-93
Language
English
Publication Type
Article
Keywords
Adult
Crime - statistics & numerical data
Demography
Female
Homeless Persons
Humans
Male
Multivariate Analysis
Ontario
Risk
Sex Distribution
Social Work
PubMed ID
11795222 View in PubMed
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38 records – page 1 of 4.