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A description is presented on a course providing instruction in evidence-based mental health practice in a postgraduate setting. Concepts covered include statistical testing, use of blinding and control groups, randomization, the hypothesis testing/falsificationist research model and justification of conclusions.

Research was conducted to establish the practical psychometric features of the Shape- and Weight-Based Self-Esteem (SAWBS) inventory in women with eating disorders. The self-report instrument was tested in 48 women with ages ranging between 17 and 45 who were diagnosed as having eating disorders including bulimia nervosa and anorexia nervosa. SAWBS scores indicate that the effect of shape and weight on self-esteem was not related to actual shape and weight but to perceptions of being overweight.

Skinfold calipers are a better method than bioelectrical impedance analysis (BIA) for determining changes in the body composition due to anorexia nervosa. BIA is unable to record changes due to hydration differences, and to determine the water distribution in the intracellular and extracellular compartments. BIA uses regression analysis, and the body composition values are adjusted toward the group mean position. Values varying from the mean give wrong estimates of body fatness. Modifications incorporated in BIA, to make it more sensitive to hydration, fail to give satisfactory results.

A study was conducted on bulimic and anorexic patients to determine the possible seasonality of symptoms. The study used a modified Seasonal Pattern Assessment Questionnaire to identify seasonality patterns. Results showed the bulimic patients had higher global seasonality scores than anorexic and normal patients. It suggests that seasonality of symptoms are more specific to bulimic patients than to anorexic ones.

A double-blind, placebo-controlled, randomized clinical study of 35 female anorexia nervosa patients reveals that zinc supplementation increases their weight gain. The subjects were given 100 mg of placebo or zinc gluconate everyday until their body mass index (BMI) increased by 10%. The rate of increase in BMI of the placebo group was half that of the zinc supplemented group.

Hypophosphatemia plays a role in the occurrence of refeeding syndrome in individuals with anorexia nervosa. Anorexic patients on a refeeding schedule should be given oral phosphate at the beginning of the schedule. The case study of a patient with hypophosphatemia shows that regular monitoring of serum electrodes, particularly during the first refeeding week, can guard against refeeding complications. In severe hypophosphatemia, both intravenous and oral phosphate supplementation, and reduction or termination of feeding are important.

An analysis of a case of a 24-year-old anorectic woman with polyglandular autoimmune syndrome (PAS) shows that pernicious anemia, an autoimmune disease often associated with PAS, can be excluded through a Schilling test. A patient suffering from PAS or vitiligo, an autoimmune disease, often demonstrates pernicious anemia. It can be identified by the low vitamin B12 levels.

The standard mortality ratio in the anorexia nervosa (AN) patient population is determined. The result suggests that AN has the highest mortality rate of any psychiatric disorder in young females.

Problematic substance use (PSU) among nurses has wide‐ranging adverse implications. A critical integrative literature review was conducted with an emphasis on building knowledge regarding the influence of structural factors within nurses' professional environments on nurses with PSU. Five thematic categories emerged: (i) access, (ii) stress, and (iii) attitudes as contributory factors, (iv) treatment policies for nurses with PSU, and (v) the culture of the nursing profession. Conclusions were that an overemphasis on individual culpability and failing predominates in the literature and that crucial knowledge gaps exist regarding the influence of structural factors on driving and shaping nurses' substance use. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the association between time to diagnosis and sociodemographic and clinical characteristics as well as time to diagnosis and physical and mental health status, among Canadian adults with a self-reported mood and/or anxiety disorder diagnosis. Methods: We used data from the 2014 Survey on Living with Chronic Diseases in Canada--Mood and Anxiety Disorders Component. The study sample (n=3212) was divided into three time to diagnosis subgroups: long (> 5 years), moderate (1-5 years) and short (< 1 year). We performed descriptive and multinomial multivariate logistic regression analyses. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results: The majority (61.6%) of Canadians with a mood and/or anxiety disorder diagnosis reported having received their diagnosis more than one year after symptom onset (30.0% reported a moderate delay and 31.6% a long delay). Upon controlling for individual characteristics, we found significant associations between a moderate delay and having no or few physical comorbidities; a long delay and older age; and both moderate and long delays and early age of symptom onset. In addition, a long delay was significantly associated with "poor" or "fair" perceived mental health and the greatest number of activity limitations. Conclusion: These findings affirm that a long delay in diagnosis is associated with negative health outcomes among Canadian adults with mood and/or anxiety disorders. Time to diagnosis is particularly suboptimal among older adults and people with early symptom onset. Tailored strategies to facilitate an early diagnosis for those at greatest risk of a delayed diagnosis, especially for those with early symptom onset, are needed. [ABSTRACT FROM AUTHOR]