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Article ; Online: The connection between homelessness and dementia.

Panenka, William J / Thornton, Allen E / Stubbs, Jacob L

The Lancet. Public health

2024 Volume 9, Issue 4, Page(s) e212–e213

MeSH term(s)	Humans ; Ill-Housed Persons ; Dementia/epidemiology
Language	English
Publishing date	2024-01-13
Publishing country	England
Document type	Journal Article
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(24)00044-6
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Article ; Online: Antidepressants for depression after concussion and traumatic brain injury are still best practice.

Silverberg, Noah D / Panenka, William J

BMC psychiatry

2019 Volume 19, Issue 1, Page(s) 100

Abstract: Background: Depression is a common complication of traumatic brain injury (TBI). New evidence suggests that antidepressant medication may be no more effective than placebo in this population.: Main body: Selective serotonin reuptake inhibitors are ... ...

Abstract	Background: Depression is a common complication of traumatic brain injury (TBI). New evidence suggests that antidepressant medication may be no more effective than placebo in this population. Main body: Selective serotonin reuptake inhibitors are recommended as first-line treatment for depression in contemporary expert consensus clinical practice guidelines for management of TBI. This recommendation is based on multiple prior meta-analyses of clinical trials in depression after TBI as well as depression in the general population. The evidence is mixed. A recent clinical trial and new meta-analysis including that trial found no benefit of antidepressants for depression following TBI. We argue that this finding should not change practice, i.e., patients who present with depression after TBI should still be considered for antidepressant treatment, because they may (1) benefit from robust placebo effects, (2) benefit from an alternative or adjunctive medication if the agent prescribed first does not achieve a depression remission, and (3) make improvements that are not captured well by traditional depression outcome measures, which are confounded by TBI sequelae. Patients with mild TBI are especially appropriate for antidepressant therapy because they, on average, more closely resemble patients with no known TBI history enrolled in typical primary Major Depressive Disorder clinical trials than patients enrolled in TBI trials in placebo-controlled trials published to date. Conclusion: TBI, and especially mild TBI, is not a contraindication for antidepressant therapy. Health providers should routinely screen and initiate treatment for depression after TBI.
MeSH term(s)	Antidepressive Agents/therapeutic use ; Antidepressive Agents, Second-Generation/therapeutic use ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/drug therapy ; Clinical Trials as Topic ; Depression/drug therapy ; Depression/etiology ; Depressive Disorder, Major/drug therapy ; Depressive Disorder, Major/etiology ; Humans ; Randomized Controlled Trials as Topic ; Serotonin Uptake Inhibitors/therapeutic use
Chemical Substances	Antidepressive Agents ; Antidepressive Agents, Second-Generation ; Serotonin Uptake Inhibitors
Language	English
Publishing date	2019-03-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ISSN	1471-244X
ISSN (online)	1471-244X
DOI	10.1186/s12888-019-2076-9
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Article ; Online: Catastrophizing is associated with excess cognitive symptom reporting after mild traumatic brain injury.

Shi, Shuyuan / Picon, Edwina L / Rioux, Mathilde / Panenka, William J / Silverberg, Noah D

Neuropsychology

2023 Volume 38, Issue 2, Page(s) 126–133

Abstract: Objective: Persistent cognitive symptoms after mild traumatic brain injury (mTBI) often do not correlate with objective neuropsychological performance. Catastrophizing (i.e., excessively negative interpretations of symptoms) may help explain this ... ...

Abstract	Objective: Persistent cognitive symptoms after mild traumatic brain injury (mTBI) often do not correlate with objective neuropsychological performance. Catastrophizing (i.e., excessively negative interpretations of symptoms) may help explain this discrepancy. We hypothesize that symptom catastrophizing will be associated with greater cognitive symptom reporting relative to neuropsychological test performance in people seeking treatment for mTBI. Method: Secondary analysis of baseline data from a randomized controlled trial. Adults with mTBI ( Results: Symptom catastrophizing was associated with more severe cognitive symptoms when controlling for neuropsychological performance (β = 0.44, 95% CI [0.23, 0.65]). Symptom catastrophizing was also associated with higher subjective-objective cognition residuals (β = 0.43, 95% CI [0.22, 0.64]). Catastrophizing remained a significant predictor after affective distress was introduced as a covariate. Conclusions: Catastrophizing is associated with misperceptions of cognitive functioning following mTBI, specifically overreporting cognitive symptoms relative to neuropsychological performance. Symptom catastrophizing may be an important determinant of cognitive symptom reporting months after mTBI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
MeSH term(s)	Adult ; Female ; Humans ; Male ; Brain Concussion/complications ; Brain Concussion/psychology ; Brain Injuries, Traumatic/psychology ; Cognition ; Linear Models ; Neuropsychological Tests ; Surveys and Questionnaires ; Middle Aged ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1042412-x
ISSN	1931-1559 ; 0894-4105
ISSN (online)	1931-1559
ISSN	0894-4105
DOI	10.1037/neu0000930
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Article ; Online: Litigation, Performance Validity Testing, and Treatment Outcomes in Adults With Mild Traumatic Brain Injury.

Mikolic, Ana / Panenka, William J / Iverson, Grant L / Cotton, Erica / Burke, Matthew J / Silverberg, Noah D

The Journal of head trauma rehabilitation

2023 Volume 39, Issue 3, Page(s) E153–E161

Abstract: Objective: To investigate whether involvement in litigation and performance validity test (PVT) failure predict adherence to treatment and treatment outcomes in adults with persistent symptoms after mild traumatic brain injury (mTBI).: Setting: ... ...

Abstract	Objective: To investigate whether involvement in litigation and performance validity test (PVT) failure predict adherence to treatment and treatment outcomes in adults with persistent symptoms after mild traumatic brain injury (mTBI). Setting: Outpatient concussion clinics in British Columbia, Canada. Participants were assessed at intake (average 12.9 weeks postinjury) and again following 3 to 4 months of rehabilitation. Participants: Adults who met the World Health Organization Neurotrauma Task Force definition of mTBI. Litigation status was known for 69 participants ( n = 21 reported litigation), and 62 participants completed a PVT ( n = 13 failed the Test of Memory Malingering) at clinic intake. Design: Secondary analysis of a clinical trial (ClinicalTrials.gov #NCT03972579). Main measures: Outcomes included number of completed sessions, homework adherence, symptoms (Rivermead Post Concussion Symptoms Questionnaire), disability ratings (World Health Organization Disability Assessment Schedule 2.0), and patient-rated global impression of change. Results: We did not observe substantial differences in session and homework adherence associated with litigation or PVT failure. Disability and postconcussion symptoms generally improved with treatment. Involvement in litigation was associated with a smaller improvement in outcomes, particularly disability ( B = 2.57, 95% confidence interval [CI] [0.25-4.89], P = .03) and patient-reported global impression of change (odds ratio [OR] = 4.19, 95% CI [1.40-12.57], P = .01). PVT failure was not associated with considerable differences in treatment outcomes. However, participants who failed the PVT had a higher rate of missing outcomes (31% vs 8%) and perceived somewhat less global improvement (OR = 3.47, 95% CI [0.86-14.04]; P = .08). Conclusion: Adults with mTBI who are in litigation or who failed PVTs tend to adhere to and improve following treatment. However, involvement in litigation may be associated with attenuated improvements, and pretreatment PVT failure may predict lower engagement in the treatment process.
MeSH term(s)	Humans ; Male ; Female ; Adult ; Brain Concussion/rehabilitation ; Brain Concussion/therapy ; Middle Aged ; Treatment Outcome ; Disability Evaluation ; British Columbia ; Neuropsychological Tests ; Post-Concussion Syndrome/rehabilitation ; Post-Concussion Syndrome/diagnosis ; Young Adult ; Jurisprudence ; Malingering/diagnosis
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639221-0
ISSN	1550-509X ; 0885-9701
ISSN (online)	1550-509X
ISSN	0885-9701
DOI	10.1097/HTR.0000000000000903
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Zs.A 2278: Show issues

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Article: Chronic Treatment With Psilocybin Decreases Changes in Body Weight in a Rodent Model of Obesity.

Huang, Joyce / Pham, Michelle / Panenka, William J / Honer, William G / Barr, Alasdair M

Frontiers in psychiatry

2022 Volume 13, Page(s) 891512

Abstract: Background: There are currently relatively few effective pharmacological treatments for obesity, and existing ones may be associated with limiting side-effects. In the search for novel anti-obesity agents, drugs that modify central serotonergic systems ... ...

Abstract	Background: There are currently relatively few effective pharmacological treatments for obesity, and existing ones may be associated with limiting side-effects. In the search for novel anti-obesity agents, drugs that modify central serotonergic systems have historically proven to be effective in promoting weight loss. Psilocin, which is rapidly metabolized from psilocybin, is an agonist at multiple serotonin receptors. In the present study we assessed the effects of psilocybin and a positive control (metformin) on changes in body weight in a rat model of obesity. Methods: Five groups of adult male rats were pre-conditioned with a cafeteria diet until obese (>600 g) and then treated with either psilocybin (0.1, 1, or 5 mg/kg, i.p.), metformin (300 mg/kg, p.o.) or vehicle control. Treatments were for 27 consecutive weekdays, and body weights and high calorie food intake were recorded daily. Fasting glucose levels were recorded after 11 days of treatment. At the end of treatment rats completed a glucose tolerance test, and multiple fat pads were dissected out to assess adiposity. Results: The medium dose psilocybin group had to be terminated from the study prematurely. Both the low and high dose psilocybin groups caused a significant decrease in changes in body weight compared to controls. The metformin group produced a greater decrease in change in body weight than either psilocybin groups or controls. Both high dose psilocybin and metformin decreased consumption of the high calorie diet, and exhibited decreased central adiposity. Conclusion: Psilocybin demonstrated modest but significant effects on weight gain. Further study is recommended.
Language	English
Publishing date	2022-05-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2022.891512
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Article ; Online: Headache Trigger Sensitivity and Avoidance after Mild Traumatic Brain Injury.

Silverberg, Noah D / Martin, Paul / Panenka, William J

Journal of neurotrauma

2019 Volume 36, Issue 10, Page(s) 1544–1550

Abstract: Most patients with primary headache disorders identify environmental stimuli (e.g., visual glare), situational factors (e.g., stress), physiological states (e.g., hormones), or activities (e.g., exercise) as triggers that elicit or worsen headache ... ...

Abstract	Most patients with primary headache disorders identify environmental stimuli (e.g., visual glare), situational factors (e.g., stress), physiological states (e.g., hormones), or activities (e.g., exercise) as triggers that elicit or worsen headache episodes. Headache triggers have not been previously studied in post-traumatic headache (PTH). The present study explored the frequency of headache triggers and their avoidance in PTH. Participants with mild traumatic brain injury (TBI) were recruited from outpatient specialty clinics and completed questionnaires at or soon after their initial clinic visit. The research assessment included a list of 12 possible headache triggers where participants were asked to rate sensitivity (how often they get a headache when exposed to the trigger) and avoidance (how often they try to avoid the trigger). Enrolled participants were 40.6 years old (standard deviation [SD] = 11.8 years) on average, predominantly female (69.8%) and Caucasian (69.8%), and injured in a motor vehicle crash (47.2%) or fall (20.8%). They were assessed at 9.4 weeks (SD = 6.8) post-injury. Most patients with mild TBI in this consecutive series (82.7%) reported ongoing headaches. Mental exertion, stress, and lack of sleep were rated as the most potent headache triggers and among the most frequently avoided. Odors or foods, hunger, and weather conditions were rated as the least potent triggers. Headache trigger sensitivity and avoidance were moderately correlated (r = 0.736,
MeSH term(s)	Adult ; Avoidance Learning ; Brain Concussion/complications ; Female ; Humans ; Male ; Post-Traumatic Headache/etiology
Language	English
Publishing date	2019-01-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645092-1
ISSN	1557-9042 ; 0897-7151
ISSN (online)	1557-9042
ISSN	0897-7151
DOI	10.1089/neu.2018.6025
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Zs.A 2016: Show issues

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Article ; Online: Work Productivity Loss After Mild Traumatic Brain Injury.

Silverberg, Noah D / Panenka, William J / Iverson, Grant L

Archives of physical medicine and rehabilitation

2018 Volume 99, Issue 2, Page(s) 250–256

Abstract: Objectives: To examine the completeness of return to work (RTW) and the degree of productivity loss in individuals who do achieve a complete RTW after mild traumatic brain injury (MTBI).: Design: Multisite prospective cohort.: Setting: Outpatient ... ...

Abstract	Objectives: To examine the completeness of return to work (RTW) and the degree of productivity loss in individuals who do achieve a complete RTW after mild traumatic brain injury (MTBI). Design: Multisite prospective cohort. Setting: Outpatient concussion clinics. Participants: Patients (N=79; mean age, 41.5y; 55.7% women) who sustained an MTBI and were employed at the time of the injury. Participants were enrolled at their first clinic visit and assessed by telephone 6 to 8 months postinjury. Interventions: Not applicable. Main outcome measures: Structured interview of RTW status, British Columbia Postconcussion Symptom Inventory (BC-PSI), Lam Employment Absence and Productivity Scale (LEAPS), Mini International Neuropsychiatric Interview, and brief pain questionnaire. Participants who endorsed symptoms from ≥3 categories with at least moderate severity on the BC-PSI were considered to meet International Classification of Diseases, 10th Revision criteria for postconcussional syndrome. RTW status was classified as complete if participants returned to their preinjury job with the same hours and responsibilities or to a new job that was at least as demanding. Results: Of the 46 patients (58.2%) who achieved an RTW, 33 (71.7%) had a complete RTW. Participants with complete RTW had high rates of postconcussional syndrome (44.5%) and comorbid depression (18.2%), anxiety disorder (24.2%), and bodily pain (30.3%). They also reported productivity loss on the LEAPS, such as "getting less work done" (60.6%) and "making more mistakes" (42.4%). In a regression model, productivity loss was predicted by the presence of postconcussional syndrome and a comorbid psychiatric condition, but not bodily pain. Conclusions: Even in patients who RTW after MTBI, detailed assessment revealed underemployment and productivity loss associated with residual symptoms and psychiatric complications.
MeSH term(s)	Adult ; Brain Concussion/rehabilitation ; Efficiency ; Female ; Humans ; Male ; Post-Concussion Syndrome/rehabilitation ; Prospective Studies ; Return to Work ; Surveys and Questionnaires
Language	English
Publishing date	2018
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2017.07.006
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Article ; Online: Fear Avoidance and Clinical Outcomes from Mild Traumatic Brain Injury.

Silverberg, Noah D / Panenka, William J / Iverson, Grant L

Journal of neurotrauma

2018 Volume 35, Issue 16, Page(s) 1864–1873

Abstract: Characterizing psychological factors that contribute to persistent symptoms after mild traumatic brain injury (MTBI) can inform early intervention. To determine whether fear avoidance, a known risk factor for chronic disability after musculoskeletal ... ...

Abstract	Characterizing psychological factors that contribute to persistent symptoms after mild traumatic brain injury (MTBI) can inform early intervention. To determine whether fear avoidance, a known risk factor for chronic disability after musculoskeletal injury, is associated with worse clinical outcomes from MTBI, adults were recruited from four outpatient MTBI clinics and assessed at their first clinic visit (mean = 2.7, standard deviation = 1.5 weeks post-injury) and again four to five months later. Of 273 patients screened, 102 completed the initial assessment, and 87 returned for the outcome assessment. The initial assessment included a battery of questionnaires that measure activity avoidance and associated fears. Endurance, an opposite behavior pattern, was measured with the Behavioral Response to Illness Questionnaire. The multi-dimensional outcome assessment included measures of post-concussion symptoms (British Columbia Postconcussion Symptom Inventory), functional disability (World Health Organization Disability Assessment Schedule-12 2.0), return to work status, and psychiatric complications (MINI Neuropsychiatric Interview). A single component was retained from principal components analysis of the six avoidance subscales. In generalized linear modeling, the avoidance composite score predicted symptom severity (95% confidence interval [CI] for B = 1.22-6.33) and disability (95% CI for B = 2.16-5.48), but not return to work (95% CI for B = -0.68-0.24). The avoidance composite was also associated with an increased risk for depression (odds ratio [OR] = 1.76, 95% CI = 1.02-3.02) and anxiety disorders (OR = 1.89, 95% CI = 1.16-3.19). Endurance behavior predicted the same outcomes, except for depression. In summary, avoidance and endurance behavior were associated with a range of adverse clinical outcomes from MTBI. These may represent early intervention targets.
MeSH term(s)	Adult ; Avoidance Learning ; Brain Concussion/complications ; Brain Concussion/psychology ; Female ; Humans ; Male ; Middle Aged ; Post-Concussion Syndrome/etiology ; Post-Concussion Syndrome/psychology ; Psychological Tests ; Recovery of Function ; Surveys and Questionnaires
Language	English
Publishing date	2018-04-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645092-1
ISSN	1557-9042 ; 0897-7151
ISSN (online)	1557-9042
ISSN	0897-7151
DOI	10.1089/neu.2018.5662
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Zs.A 2016: Show issues

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Article ; Online: Relationship between drug-induced movement disorders and psychosis in adults living in precarious housing or homelessness.

Kim, David D / Procyshyn, Ric M / Jones, Andrea A / Gicas, Kristina M / Jones, Paul W / Petersson, Anna M / Lee, Lik Hang N / McLellan-Carich, Rachel / Cho, Lianne L / Panenka, William J / Leonova, Olga / Lang, Donna J / Thornton, Allen E / Honer, William G / Barr, Alasdair M

Journal of psychiatric research

2024 Volume 170, Page(s) 290–296

Abstract: Background: Studies have reported positive associations between drug-induced movement disorders (DIMDs) and symptoms of psychosis in patients with schizophrenia. However, it is not clear which subtypes of symptoms are related to each other, and whether ... ...

Abstract	Background: Studies have reported positive associations between drug-induced movement disorders (DIMDs) and symptoms of psychosis in patients with schizophrenia. However, it is not clear which subtypes of symptoms are related to each other, and whether one symptom precedes another. The current report assessed both concurrent and temporal associations between DIMDs and symptoms of psychosis in a community-based sample of homeless individuals. Methods: Participants were recruited in Vancouver, Canada. Severity of DIMDs and psychosis was rated annually, allowing for the analysis of concurrent associations between DIMDs and Positive and Negative Syndrome Scale (PANSS) five factors. A brief version of the PANSS was rated monthly using five psychotic symptoms, allowing for the analysis of their temporal associations with DIMDs. Mixed-effects linear and logistic regression models were used to assess the associations. Results: 401 participants were included, mean age of 40.7 years (SD = 11.2) and 77.4% male. DIMDs and symptoms of psychosis were differentially associated with each other, in which the presence of parkinsonism was associated with greater negative symptoms, dyskinesia with disorganized symptoms, and akathisia with excited symptoms. The presence of DIMDs of any type was not associated with depressive symptoms. Regarding temporal associations, preceding delusions and unusual thought content were associated with parkinsonism, whereas dyskinesia was associated with subsequent conceptual disorganization. Conclusions: The current study found significant associations between DIMDs and symptoms of psychosis in individuals living in precarious housing or homelessness. Moreover, there were temporal associations between parkinsonism and psychotic symptoms (delusions or unusual thought content), and the presence of dyskinesia was temporally associated with higher odds of clinically relevant conceptual disorganization.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Housing ; Psychotic Disorders/epidemiology ; Dyskinesias ; Ill-Housed Persons ; Parkinsonian Disorders
Language	English
Publishing date	2024-01-03
Publishing country	England
Document type	Journal Article
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2024.01.003
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Article ; Online: Differential sensitivity of intraindividual variability dispersion and global cognition in the prediction of functional outcomes and mortality in precariously housed and homeless adults.

Blumberg, Michelle J / Petersson, Anna M / Jones, Paul W / Jones, Andrea A / Panenka, William J / Leonova, Olga / Vila-Rodriguez, Fidel / Lang, Donna J / Barr, Alasdair M / MacEwan, G William / Buchanan, Tari / Honer, William G / Gicas, Kristina M

The Clinical neuropsychologist

2024 , Page(s) 1–24

Abstract: Objective: To examine cognitive intraindividual variability (IIV) dispersion as a predictor of everyday functioning and mortality in persons who are homeless or precariously housed.: Method: Participants were 407 community-dwelling adults, followed ... ...

Abstract	Objective: To examine cognitive intraindividual variability (IIV) dispersion as a predictor of everyday functioning and mortality in persons who are homeless or precariously housed. Method: Participants were 407 community-dwelling adults, followed for up to 13 years. Neurocognition was assessed at baseline and IIV dispersion was derived using a battery of standardized tests. Functional outcomes (social, physical) were obtained at baseline and last follow-up. Mortality was confirmed with Coroner's reports and hospital records ( Results: Higher IIV dispersion predicted poorer current physical functioning ( Conclusions: Our findings suggest that indices of neurocognitive functioning (i.e. IIV dispersion and global cognition) may be differentially related to discrete dimensions of functional outcomes in an at-risk population. IIV dispersion may be a complimentary marker of emergent physical health dysfunction in precariously housed adults and may be best used in conjunction with traditional neuropsychological indices.
Language	English
Publishing date	2024-03-05
Publishing country	England
Document type	Journal Article
ZDB-ID	639080-8
ISSN	1744-4144 ; 0920-1637 ; 1385-4046
ISSN (online)	1744-4144
ISSN	0920-1637 ; 1385-4046
DOI	10.1080/13854046.2024.2325167
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