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Biomedical subjects

J Bisson

Publications and source records attributed to J Bisson.

At least 19 recordsLinked to original sources
PubMed2005

Psychological treatment of post-traumatic stress disorder (PTSD).

BACKGROUND: Psychological interventions are widely used in the treatment of post-traumatic stress disorder (PTSD). OBJECTIVES: To perform a systematic review of randomised controlled trials of all psychological treatments except eye movement desensitisation and reprocessing following the guidelines of the Cochrane Collaboration. SEARCH STRATEGY: Systematic searches of computerised databases, hand search of the Journal of Traumatic Stress, searches of reference lists, known websites and discussion fora, and personal communication with key workers. SELECTION CRITERIA: Types of studies - Any randomised controlled trial of a psychological treatment. Types of participants - Adults suffering from traumatic stress symptoms for three months or more. Types of interventions - Trauma-focused cognitive behavioural therapy/exposure therapy (TFCBT); stress management (SM); other therapies (supportive therapy, non-directive counselling, psychodynamic therapy and hypnotherapy); group cognitive behavioural therapy (group CBT). Types of outcomes - Severity of clinician rated traumatic stress symptoms. Secondary measures included self-reported traumatic stress symptoms, depressive symptoms, anxiety symptoms, adverse effects and dropouts. DATA COLLECTION AND ANALYSIS: Data was entered using the Review Management software. Quality assessments were performed. The data were analysed for summary effects using the RevMan 4.2 programme. MAIN RESULTS: Twenty-nine studies were included in the review. With regards to reduction of clinician assessed PTSD symptoms TFCBT did significantly better than waitlist/usual care (standardised mean difference (SMD) = -1.36; 95% CI, -1.88 to -0.84; 13 studies; n = 609). There was no significant difference between TFCBT and SM (SMD = -0.27; 95% CI, -0.71 to 0.16; 6 studies; n = 239). TFCBT did significantly better than other therapies (SMD = -0.81; 95% CI, -1.19 to -0.42; 3 studies; n = 120). Stress management did significantly better than waitlist/usual care (SMD = -1.14; 95% CI, -1.62 to -0.67; 3 studies; n = 86) and than other therapies (SMD = -1.22; 95% CI, -2.09 to -0.35; 1 study; n = 25). There was no significant difference between other therapies and waitlist/usual care control (SMD = -0.43; 95% CI, -0.90 to 0.04; 2 studies; n = 72). Group TFCBT was significantly better than waitlist/usual care (SMD = -0.72; 95% CI, -1.14 to -0.31). AUTHORS' CONCLUSIONS: There was evidence that individual TFCBT, stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There was some evidence that individual TFCBT is superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT was also more effective than other therapies. There was insufficient evidence to determine whether psychological treatment is harmful. There was some evidence of greater drop-out in active treatment groups.

Adult↗
PubMed2000

Brief psychological interventions ("debriefing") for trauma-related symptoms and the prevention of post traumatic stress disorder.

OBJECTIVES: To assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder. SEARCH STRATEGY: Electronic searching of MEDLINE, EMBASE, PsychLit, PILOTS, Biosis, Pascal, Occ.Safety and Health, CDSR and the Trials Register of the Depression, Anxiety and Neurosis group. Hand search of Journal of Traumatic Stress. Contact with leading researchers. SELECTION CRITERIA: The inclusion criteria for all randomized studies was that they should focus on persons recently (one month or less) exposed to a traumatic event, should consist of a single session only, and that the intervention involve some form of emotional processing/ventilation by encouraging recollection/reworking of the traumatic event accompanied by normalisation of emotional reaction to the event. DATA COLLECTION AND ANALYSIS: 8 trials fulfilled the inclusion criteria. Quality was generally poor. Data from two trials could not be synthesised. MAIN RESULTS: Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD). Those who received the intervention showed no significant short term (3-5 months) in the risk of PTSD (pooled odds ratio 1.0, 95% ci 0.6-1.8). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.9, 95% ci 1.1-7.5). The pooled odds ratio for the two trials with follow ups just included unity (odds ratio 2.0, 95% ci 0.9-4.5). There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety. REVIEWER'S CONCLUSIONS: There is no current evidence that psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.

Crisis Intervention↗
PubMed1999

Longitudinal effects of an early family intervention programme on the adaptation of parents of children with a disability.

This study assesses the longitudinal effects of an original early intervention programme on the adaptation of parents of children with a disability (Down syndrome and cleft lip/palate, i.e. DS and CLP). Variations in the effects of the programme according to the time of measurement, the type of disability and parent's gender are also examined. Globally, the results show a better adaptation among parents who participated in the intervention programme compared to those who did not participated in the programme. These parents had lower levels of parental stress, they had more positive perceptions and attitudes concerning their child's disability and their parental situation, they were more confident in their own resources and the help they could receive from others, they had lower levels of emotional distress, anxiety and depression and they perceived more emotional support from their spouse. In general, these gains were maintained throughout the year when the children were between six and 18 months of age, they were relatively similar for parents of children with DS and parents of children with CLP, as well as for mothers and fathers.

Adaptation, Psychological↗
PubMed1999

The validity of the CAGE scale to screen for heavy drinking and drinking problems in a general population survey.

BACKGROUND: The CAGE scale is a short test developed in the 1970s to screen for alcoholism or covert drinking problems. The reliability and validity of the scale has been demonstrated in the majority of studies conducted in clinical settings, but the validity of the scale in general population surveys has not yet been shown conclusively. AIMS: The goal of this study was to assess the criterion validity of the CAGE scale in a general population survey. METHOD: Data from a large general health survey conducted in 1992 in the province of Quebec (Canada) (N = 23,564) were used to define various measures of heavy drinking and drinking problems and to calculate, for male and female drinkers separately, standard measures of sensitivity, specificity and positive predictive value at different cutoff scores on the CAGE. FINDINGS: With respect to both male and female drinkers, with all operational definitions of heavy drinking and useful cutoff scores on the CAGE, the scale was shown to be unable to discriminate between heavy drinkers and non-heavy drinkers. Prevalence of drinking problems among CAGE positive drinkers was also very low. CONCLUSION: These results do not support the use of the CAGE as a screening tool for heavy drinking and drinking problems in a general population survey or as a tool to estimate the prevalence of drinking problems in the population.

Adolescent↗
PubMed1999

Adaptation of parents in relation to their 6-month-old infant's type of disability.

The adaptation of parents to a disabled infant was studied in relation to the type of disability presented by the baby. Participants were divided according to three types of disability and one control group: patents of infants with (1) Down's syndrome (DS), (2) congenital heart disease (CHD), (3) a cleft lip and/or palate (CLP), and (4) no disability (ND). The data were collected using a self-administered questionnaire given to each parent 6 months after the birth of their baby. The measures included parenting stress, stress appraisal, and psychological distress. Overall, the results indicate that parents of infants with DS and parents of infants with CHD report greater levels of parenting stress and psychological distress than parents of babies with CLP or non-disabled infants. Mothers were found to report greater levels of stress and distress overall, but differences across diagnostic groups were similar for mothers and fathers. The implications of the findings for theory and clinical intervention are discussed.

Adaptation, Psychological↗
PubMed1999

Wives' convergence with their husbands' alcohol use: social conditions as mediators.

OBJECTIVE: This study examines, in a general population, how the association of wives' alcohol use with their husbands' is mediated by social conditions such as working and child-rearing roles, age, marital happiness and socioeconomic levels. METHOD: Data come from the Québec Health and Social Survey 1992-93. The sample comprised 6,582 couples; 3,872 couples after weighting. Regression analyses assessed the contribution of husbands' drinking to wives' drinking, independently, as well as in interaction with social conditions. Frequency of drinking in general and frequency of five or more drinks per occasion (5+) were analyzed. RESULTS: Wives' drinking is positively related to their husbands' drinking, both in terms of frequency of drinking and, to a lesser degree, of frequency of 5+. The drinking frequency association is not modified by working or child-rearing roles, nor by age, but is more marked for couples of higher socioeconomic levels and for wives happy with marital life. The frequency of 5+ association is not modified by marital happiness or by wives' working roles, but is more marked for couples of higher socioeconomic levels, for couples with a child at home and for younger women. CONCLUSIONS: This study highlights the contribution of social factors to the association of wives' drinking with their husbands' and suggests that these social factors operate through structuring marital drinking interactions. Further research is needed to clarify the complex social processes that mediate the spousal drinking association.

Adolescent↗
PubMed1998

Brief early psychological interventions following trauma: a systematic review of the literature.

A systematic literature search/review was undertaken of brief early psychological interventions following trauma. Only six randomized controlled trials were found, and none of these included group interventions. Of the six trials, two studies associated the intervention with a positive outcome, two demonstrated no difference on outcome between intervention and non-intervention groups, and two showed some negative outcomes in the intervention group. This review suggests that early optimism for brief early psychological interventions including debriefing was misplaced and that there is an urgent need for randomized controlled trials of group debriefing and other early interventions.

Humans↗
PubMed1998

[Systematic family nursing intervention applied to the birth of a disabled child: effects on the parents' adaptation].

This quasi-experimental study evaluated the effectiveness of a new systemic family nursing intervention to facilitate the adaptation of parents with a handicapped child, as well as variations in effectiveness according to the gender of the parent, family income, and type of handicap. Conducted over a 6-month period, the intervention began immediately after birth and included the participation of 198 mothers and fathers of 6-month-old babies with Down syndrome or a cleft lip and/or palate. Half of the group received the intervention, while the other half, constituting the control group, received regular services. Emotional distress was measured, as were various aspects of parental stress. The results confirm the program's effectiveness. Almost all parental stress indicators showed less stress among parents who received the intervention. For some indicators, the effect of the intervention varied with the parent's gender. No significant correlation was found to exist between the program's effectiveness and family income or type of handicap. These results are discussed in light of the goals of the intervention, various aspects of parental adaptation, and a number of factors that may be linked to the effectiveness of the intervention.

Adaptation, Psychological↗
PubMed1997

[Neuroleptic medication and the risk of tardive dyskinesia: a survey of psychiatrists and general practitioners in Quebec].

UNLABELLED: The incidence of tardive dyskinesia (TD) during the first five years of neuroleptic treatment of adult schizophrenic patients, may rise to 35%. Yet, the prevention of this iatrogenic effect remains a secondary objective for clinicians. This study explored how medication decisions might vary depending on patient characteristics and medical specialty, and to identify correlates of prescribing aimed at the prevention of TD. METHOD: Simulated medication decisions were elicited from 352 psychiatrists and 279 general practitioners in response to 12 brief written descriptions of a male schizophrenic outpatient treated for 5 years with 20 mg/day of haloperidol. Patient age, psychotic symptoms, signs of dyskinesia, and effectiveness of past treatment varied systematically in the descriptions. RESULTS: Every variable except patient age affected decisions. Most physicians reduced doses for stable patients. In cases of active psychosis, decisions were affected by presence of dyskinesia and treatment effectiveness. Psychiatrists were more likely to increase or reduce doses, general practitioners to change medication. Very few physicians opted to cease medication. Younger psychiatrists made the most prudent decisions. CONCLUSIONS: From a tardive dyskinesia prevention perspective, similar prescriptions to older and younger patients are worrying. We need to understand why physicians might believe that older patients require just as aggressive medication regimen as younger patients. Respondents within and between specialties tend make similar simulated decisions, but these do not necessarily reflect recommendations from controlled research on chronic neuroleptic treatment.

Adult↗
PubMed1996

When anthropology meets epidemiology: using social representations to predict drinking patterns.

Based on a sample of 2,015 adult drinkers from the Montreal metropolitan area (Quebec, Canada), this study investigates the relationship between eight social representations of drinking (i.e., compensatory, convivial, relaxing, disinhibitory, harmful, sexually enhancing, conventional, socially enabling) and drinking measures (QF Index, drinking frequency, and maximum number of drinks on one occasion) according to age and sex. The representations explain up to 34% of the variance in drinking measures. Representations differed in the strength of their relation to drinking measures and in population prevalence. Strength of relation to drinking and prevalence rates were relatively independent. Representations were generally more strongly endorsed by men than women, although they were related in the same way to drinking behaviors. Representations were also more strongly endorsed by younger than by older respondents, and they related differently to drinking in each age group. The implications of these results for prevention are discussed.

Adolescent↗
PubMed1993

Is selective abortion for a genetic disease an issue for the medical profession? A comparative study of Quebec and France.

This article discusses the results of a study of the stand and attitudes of physicians from the Picardie, Nord-Pas-de-Calais region in France and the province of Quebec (Canada) regarding abortion following the diagnosis of a fetal anomaly by ultrasound, amniocentesis, or chorionic villus sampling. The study examined the degree of acceptability of abortion for several specific conditions as well as the physicians' perceptions of their role in the women's decision to abort. The study shows a consensus (over 75 per cent of the physicians surveyed) for aborting a fetus with trisomy 21. There is a similar consensus, except among Francophones in Quebec, for muscular dystrophy, cystic fibrosis, and Huntington disease. Conversely, there is no consensus (below 60 per cent) for several anomalies. In these cases, Quebec Anglophone physicians find abortion more acceptable than Quebec Francophone or French physicians. Concerning the role of the practitioners in the decision to abort, physicians in France tend to be much more directive than their overseas colleagues. Several hypotheses are suggested to explain the difference between the three groups surveyed.

Abortion, Therapeutic↗
PubMed1979

Urolithiasis from stapler anastomosis.

The simplicity of operation and versatility and speed of automatic stapling devices in the creation of ileal loops have been amply documented. Three cases of stone formation in the ileal loop, secondary to encrustation about the staples, are reported herein, and the modification to the surgical technic which would obviate this problem is presented.

Adult↗