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van Munster M, Czabanowska K, Clemens T, Wieczorek E, Pedrosa D, Mestre TA, Stümpel J. Priorities in healthcare provision in Parkinson's disease from the perspective of Parkinson Nurses: A focus group study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100213. [PMID: 39161697 PMCID: PMC11332201 DOI: 10.1016/j.ijnsa.2024.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/18/2024] [Accepted: 06/04/2024] [Indexed: 08/21/2024] Open
Abstract
Background Through their expertise and diverse skills, Parkinson Nurses are key care providers for people with Parkinson's disease. They are seen as an important profession for person-centered and multidisciplinary care, considered priorities in Parkinson's care delivery. Currently, however, little is known about the priorities that this profession itself defines for the care of Parkinson's patients and how they perceive their own role in the care process. Objective To explore the perspective of Parkinson Nurses on care priorities in people with Parkinson's disease. Design Qualitative study. Settings The iCare-PD study served as the object of study by establishing an interdisciplinary, person-centered and nurse-led care model in several European countries and Canada. The nurses who participated in this model were part of the study. Participants Six Parkinson Nurses participated in the study. Methods We conducted a thematic focus group, adopting the paradigm of pragmatism to draft an interview guide. The focus group was based on the inspiration card method and followed recommendations for co-creation processes. Results Parkinson Nurses define care priorities for Parkinson's in areas of education, multi-professionalism, and need-orientation. They see themselves as mediators and coordinators of care delivery processes. Conclusions In line with international recommendations, Parkinson Nurses prioritize key aspects of multidisciplinary and person-centered care. At the same time, however, the nurses also name care priorities that go beyond the international recommendations. It is therefore crucial to integrate the perspective of this important profession into recommendations for the delivery of healthcare for people with Parkinson's.Tweetable abstract How do specialized nurses define priorities for person-centered Parkinson's care? Answers are sought in this qualitative study by @MarlenaMunster.
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Affiliation(s)
- Marlena van Munster
- Department of Neurology, Philipps University Marburg, 35043 Marburg, Germany
- Institute of General Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of International Health, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, Netherlands
| | - Katarzyna Czabanowska
- Department of International Health, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, Netherlands
- Department of Health Policy Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, 31-066 Krakow, Poland
| | - Timo Clemens
- Department of International Health, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, Netherlands
| | - Estera Wieczorek
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Krakow, Poland
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University, Maastricht, Netherlands
| | - David Pedrosa
- Department of Neurology, Philipps University Marburg, 35043 Marburg, Germany
| | - Tiago A. Mestre
- Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON K1Y 4E9, Canada
| | - Johanne Stümpel
- Department of Neurology, Philipps University Marburg, 35043 Marburg, Germany
- Center for Life Ethics, University of Bonn, 53113 Bonn, Germany
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Olesen J. From fragmentation to collaboration in European brain research: The early history of the European Brain Council (EBC), an organization that changed our perspective of advocacy. Eur J Neurol 2024; 31:e16130. [PMID: 37955553 PMCID: PMC11464389 DOI: 10.1111/ene.16130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/02/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The European Academy of Neurology (EAN) is a member of the European Brain Council (EBC), a coalition of neurologists, psychiatrists, neurosurgeons, neuroscientists, patient organizations and industry with an interest in the brain and its diseases. It was founded by the present author. Here, its formation, early history and the results of its advocacy are described. METHOD Eyewitness report and relevant literature were considered. RESULTS After a long and difficult inception, the European Brain Council (EBC) brought all major players with an interest in the brain and its diseases to work closely together. Important data on the cost of brain diseases, lack of funding and fantastic research possibilities were generated and effectively used in advocacy. During the early years of the collaborative effort, the funding of brain research increased from €85 million in framework program (FP) 5 to €260 million in FP6 and to more than €2000 million in FP7. CONCLUSION The EBC has been extremely successful. It is essential that advocacy in the European Union continues to be united so that those involved in brain research are able to speak with one voice to policy makers. An even bigger task, still insufficiently pursued, is for national brain councils to achieve prioritization of brain research in their national political agenda to bring about improved provision of care to those living with a brain disease.
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Affiliation(s)
- Jes Olesen
- Department of Neurology, Danish Headache CenterCopenhagen University HospitalGlostrupDenmark
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Chen T, Jin M, Chen L, Cai XX, Huang Y, Shen K, Li Y, Chen X, Chen L. Rapid detection of depression by volatile organic compounds from exhalation. J Breath Res 2024; 18:046013. [PMID: 39317233 DOI: 10.1088/1752-7163/ad7eef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/24/2024] [Indexed: 09/26/2024]
Abstract
Depression is a pervasive and often undetected mental health condition, which poses significant challenges for early diagnosis due to its silent and subtle nature. To evaluate exhaled volatile organic compounds (VOCs) as non-invasive biomarkers for the detection of depression using a virtual surface acoustic wave sensors array (VSAW-SA). A total of 245 participants were recruited from the Hangzhou Community Health Service Center, including 38 individuals diagnosed with depression and 207 control subjects. Breath samples were collected from all participants and subjected to analysis using VSAW-SA. Univariate and multivariate analyses were employed to assess the relationship between VOCs and depression. The findings revealed that the responses of virtual sensor ID 14, 44, 59, and 176, which corresponded respectively to ethanol, trichloroethylene or isoleucine, octanoic acid or lysine, and an unidentified compound, were sensitive to depression. Taking into account potential confounders, these sensor responses were utilized to calculate a depression detection indicator. It has a sensitivity of 81.6% and a specificity of 81.6%, with an area under the curve of 0.870 (95% CI = 0.816-0.923). Conclusions: exhaled VOCs as non-invasive biomarkers of depression could be detected by a VSAW-SA. Large-scale cohort studies should be conducted to confirm the potential ability of the VSAW-SA to diagnose depression.
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Affiliation(s)
- Tao Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
- Jianqiao Community Health Service Center, Shangcheng District, Hangzhou 310021, People's Republic of China
| | - Mengqi Jin
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Liqing Chen
- Jianqiao Community Health Service Center, Shangcheng District, Hangzhou 310021, People's Republic of China
| | - Xi Xuan Cai
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Yilin Huang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Keqing Shen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Yi Li
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of Ministry of Education of China, Zhejiang Provincial Key Laboratory of Cardio Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, Zhejiang 310027, People's Republic of China
- Hangzhou Zillion M&C Technology Co., Ltd, Hangzhou 310051, People's Republic of China
| | - Xing Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of Ministry of Education of China, Zhejiang Provincial Key Laboratory of Cardio Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, Zhejiang 310027, People's Republic of China
| | - Liying Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
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Moumen C, Rousselle M, Danel J, Vaiva G, Amad A, Horn M. [Which solution to functional somatic disorder: The ACSEPT program]. L'ENCEPHALE 2024:S0013-7006(24)00191-X. [PMID: 39366811 DOI: 10.1016/j.encep.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND Functional somatic disorder (FSD) is a prevalent disorder that can be severely disabling for the patient and is associated with major health costs. There are few formalized care programs for these disorders in the country, and their management encounters various difficulties, both in the diagnosis and its announcement and the treatment. Cognitive-behavioural and emotional therapy (CBT) is the standard on psychiatry care, and its efficacy has been demonstrated through several randomised controlled studies on the intensity of physical and psychological symptoms. INTERVENTION At Lille's University Hospital Center, we have established the "ACSEPT" care pathway for TSF management which consists of a psychiatric consultation followed by an individual referral, including a treatment using repeated transcranial magnetic stimulation (rTMS) or the integration of a CBT-based psychoeducation group. This group had the particularity of caring for all patients presenting FSD regardless of the associated physical symptoms. Educating medical professionals and conducting FSD research were other goals of ACSEPT. DISCUSSION/CONCLUSION ACSEPT allows an improvement in the care offered to these patients with a defined orientation and interdisciplinary, early, organized cares that are repeatable. Our goal is to study the effectiveness of these different interventions in subsequent studies, to continue the development of ACSEPT and to be able to distribute this intervention at the regional level to establish a clear care program allowing early management of these patients.
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Affiliation(s)
- Caroline Moumen
- Service de psychiatrie de l'adulte, hôpital Fontan, CHU de Lille, 59000 Lille, France; EPSM Lille-Métropole, 59280 Armentières, France; EPSM des Flandres, 59270 Bailleul, France.
| | - Margot Rousselle
- Service de psychiatrie de l'adulte, hôpital Fontan, CHU de Lille, 59000 Lille, France
| | - Jeanne Danel
- Service de psychiatrie de l'adulte, hôpital Fontan, CHU de Lille, 59000 Lille, France
| | - Guillaume Vaiva
- U1172 - LilNCog - Lille Neuroscience & Cognition, CHU de Lille, université de Lille, Inserm, 59000 Lille, France; Centre national de ressources et résilience pour les psychotraumas (Cn2r Lille Paris), 59000 Lille, France
| | - Ali Amad
- U1172 - LilNCog - Lille Neuroscience & Cognition, CHU de Lille, université de Lille, Inserm, 59000 Lille, France
| | - Mathilde Horn
- EPSM Lille-Métropole, 59280 Armentières, France; EPSM des Flandres, 59270 Bailleul, France; U1172 - LilNCog - Lille Neuroscience & Cognition, CHU de Lille, université de Lille, Inserm, 59000 Lille, France
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5
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van der Veen DJ, Siemonsma PC, van der Wees PJ, Swart BJMD, Satink T, Graff MJL. The regional development and implementation of home-based stroke rehabilitation using participatory action research. Disabil Rehabil 2024:1-15. [PMID: 39334550 DOI: 10.1080/09638288.2024.2404551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 09/10/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024]
Abstract
PURPOSE This study aims to overcome the challenges experienced in the regional development and implementation of home-based stroke rehabilitation (HBSR) and to understand the change process needed. MATERIALS AND METHODS Using participatory action research (PAR), participants and researchers collaboratively produced knowledge and took action to improve the offered HBSR. Different methods for data generation and analysis were used, depending on the aim of the PAR phase and the participants' stages of change. The Consolidated Framework for Implementation Research (CFIR) was used to select implementation strategies and to evaluate the implementation process. RESULTS Developing and implementing HBSR resulted in multiple products that promoted the implementation of a regional stroke network and affiliated work arrangements. Work arrangements were embodied in a stroke care pathway, follow-up tool, and expertise requirements. Evaluating the PAR process identified participants being able to take the lead, being facilitated by others, and making progress visible, as implementation facilitators. Collaborating within a primary care project can be challenging but is considered essential and has a positive impact on multiple levels. Also, the implementation of HBSR calls for multiple implementation strategies reflecting multiple CFIR constructs. CONCLUSION This study highlights the complexity and achievements of developing and implementing HBSR using PAR.
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Affiliation(s)
- Dinja J van der Veen
- IQ Health and Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Group Neurorehabilitation - Self-Regulation and Participation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Petra C Siemonsma
- Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Philip J van der Wees
- IQ Health and Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bert J M de Swart
- Research Group Neurorehabilitation - Self-Regulation and Participation, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ton Satink
- Research Group Neurorehabilitation - Self-Regulation and Participation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maud J L Graff
- Donders Institute for Brain, Cognition and Behavior, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
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Le M, Šarkić B, Anderson R. Prevalence of tinnitus following non-blast related traumatic brain injury: a systematic review of literature. Brain Inj 2024; 38:859-868. [PMID: 38775672 DOI: 10.1080/02699052.2024.2353798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES To establish the prevalence of tinnitus in adults who have sustained non-blast related traumatic brain injury (TBI), as well as the prevalence of tinnitus following TBI in the absence of hearing loss. METHODS A systematic search was carried out using MEDLINE, EMBASE, PsycINFO, CINAHL from January 1st 1990 to August 14th 2023. TBI, tinnitus and auditory findings were extracted from all eligible studies, and a descriptive synthesis performed. This systematic review was registered with PROSPERO (Registration number: CRD42022377637). RESULTS Based on the Oxford Centre of Evidence-Based Medicine (OCEBM) (2011) criteria, the highest quality evidence identified was at Level 2b, with the bulk of the included studies predominantly populating the lower evidence tiers. While there was a substantial variability in the methods used to establish and report the presence of tinnitus, its occurrence following TBI was evident in adults with and without hearing loss. CONCLUSION The need for prospective, longitudinal research into tinnitus following non-blast related TBI is evident. Such comprehensive studies hold the potential to inform and enhance the clinical diagnosis and management of this patient population.
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Affiliation(s)
- Michelle Le
- Audiology department, Barwon Health, Geelong, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Bojana Šarkić
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Richard Anderson
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Tundo A, Betrò S, de Filippis R, Felici R, Lucangeli C, Iommi M. Comparative Short- and Long-Term Effectiveness and Safety of Pramipexole and Aripiprazole Augmentation in Treatment-Resistant Unipolar Depression: An Observational Study. Biomedicines 2024; 12:2064. [PMID: 39335577 PMCID: PMC11428619 DOI: 10.3390/biomedicines12092064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This study compares the short- and long-term effectiveness and safety of pramipexole augmentation (PA) and aripiprazole augmentation (AA) for unipolar treatment-resistant depression (TRD). METHODS Patients were recruited in a private out-patients clinic specializing in mood disorders. At intake and at each visit, depressive and (hypo)manic symptoms, clinical status, and level of functioning were evaluated with appropriate scales. The trend of outcomes was analyzed using mixed-effect linear regression models. RESULTS The study includes 81 patients with unipolar TRD treated with PA and 51 with AA. After 12 and 24 weeks of treatment with PA, the predicted response (64.1% and 76.2%) and remission rates (49.7% and 72.7%) were significantly higher than the predicted response (32.2% and 38.0%) and remission rates (18.9% and 28.1%) for AA. The improvement in psychosocial functioning was significantly greater and faster in PA than in AA. PA showed significant superiority over AA as a maintenance strategy (time spent ill and psychosocial functioning) up to 12 months. No difference in safety was found at each time point. CONCLUSIONS PA could be an alternative option for the short- and long-term treatment of unipolar TRD, more effective than AA and similar in safety. These preliminary results need confirmation from randomized clinical trials.
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Affiliation(s)
- Antonio Tundo
- Clinical Section, Institute of Psychopathology, 00196 Rome, Italy
| | - Sophia Betrò
- Clinical Section, Institute of Psychopathology, 00196 Rome, Italy
| | | | - Roberto Felici
- Clinical Section, Institute of Psychopathology, 00196 Rome, Italy
| | - Chiara Lucangeli
- Clinical Section, Institute of Psychopathology, 00196 Rome, Italy
| | - Marica Iommi
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
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8
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Tüzün M, Kallweit U, Seidel S, Endrich O, Trelle S, Leone MA, Bruni O, Dodel R, Konti M, Lolich M, Pupillo E, Ramankulov D, Vignatelli L, Meyer-Massetti C, Schmidt M, Bassetti CLA. The Burden of Sleep/Wake Disorders: Excessive Daytime Sleepiness and Insomnia Project. Methods Protoc 2024; 7:70. [PMID: 39311371 PMCID: PMC11417944 DOI: 10.3390/mps7050070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 08/21/2024] [Accepted: 08/29/2024] [Indexed: 09/26/2024] Open
Abstract
Excessive daytime sleepiness (EDS) and insomnia (IN) complaints represent the most common sleep/wake disorders. Currently, the specific needs of these patients and their relatives, as well as the overall socio-economic burden of IN and EDS remains widely unexplored. This pilot study to be carried out in Switzerland is a retro- and prospective, national, one-center cohort observational study for the systematic evaluation of the burden of EDS and IN and its evolution 12 months after the first assessment. Patient recruitment will be organized through 7-8 primary care providers (primary/general care practitioners and pharmacies). Primary outcomes are the prevalence of EDS/IN in the primary care setting and the association between EDS/IN with health-related quality of life (QOL) as assessed with the established instruments. Secondary outcomes are the association between EDS/IN with the presence of comorbidities, number of injuries/accidents, and number of sick/leave days for the subgroup of working subjects. Calculation of direct per-patient costs will be undertaken to analyze the economic implications of sleep/wake disorders, providing valuable insights into the financial burden experienced by affected individuals within the healthcare system. This research will provide information on the feasibility of such a study and inform on aspects of the QOL most associated with EDS/IN. Based on this pilot project, a European multicenter study on the burden of sleep/wake disorders will be conducted by the European Academy of Neurology.
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Affiliation(s)
- Marina Tüzün
- Interdisciplinary Sleep-Wake-Epilepsy-Center, Bern University Hospital (Inselspital), 3010 Bern, Switzerland; (M.T.)
| | - Ulf Kallweit
- Faculty of Medicine, University Witten/Herdecke, 58455 Witten, Germany
- Center for Biomedical Education and Research (ZBAF), 58455 Witten, Germany
| | - Stefan Seidel
- Rehabilitation Clinic Pirawarth, 2222 Bad Pirawarth, Austria
| | - Olga Endrich
- Medical faculty, Institute of Clinical Chemistry, 3010 Bern, Switzerland
- Department for BioMedical Research, University of Bern, 3008 Bern, Switzerland
| | - Sven Trelle
- Medical Directorate, Clinical Trials Unit, University of Bern, 3012 Bern, Switzerland
| | - Maurizio A. Leone
- Department of Neurosciences, Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy
| | - Richard Dodel
- Department of Geriatric Medicine, University Duisburg-Essen, 45141 Essen, Germany
| | - Maria Konti
- European Academy of Neurology, 1070 Vienna, Austria
| | - Maria Lolich
- European Academy of Neurology, 1070 Vienna, Austria
| | - Elisabetta Pupillo
- Department of Neurosciences, Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy
| | | | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Carla Meyer-Massetti
- Clinical Pharmacology & Toxicology, Department of General Internal Medicine, University Hospital Bern (Inselspital), 3010 Bern, Switzerland
| | - Markus Schmidt
- Interdisciplinary Sleep-Wake-Epilepsy-Center, Bern University Hospital (Inselspital), 3010 Bern, Switzerland; (M.T.)
| | - Claudio L. A. Bassetti
- Interdisciplinary Sleep-Wake-Epilepsy-Center, Bern University Hospital (Inselspital), 3010 Bern, Switzerland; (M.T.)
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, 3010 Bern, Switzerland
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Bohmeier B, Cybinski LM, Gromer D, Bellinger D, Deckert J, Erhardt-Lehmann A, Deserno L, Mühlberger A, Pauli P, Polak T, Herrmann MJ. Intermittent theta burst stimulation of the left dorsolateral prefrontal cortex has no additional effect on the efficacy of virtual reality exposure therapy for acrophobia. A randomized double-blind placebo-controlled study. Behav Brain Res 2024; 476:115232. [PMID: 39236930 DOI: 10.1016/j.bbr.2024.115232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/19/2024] [Accepted: 08/26/2024] [Indexed: 09/07/2024]
Abstract
Anxiety disorders are among the most common mental disorders. Treatment guidelines recommend pharmacotherapy and cognitive behavioral therapy as standard treatment. Although cognitive behavioral therapy is an effective therapeutic approach, not all patients benefit sufficiently from it. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation, have been investigated as promising adjuncts in the treatment of affective disorders. The aim of this study is to investigate whether a combination of intermittent theta burst stimulation (iTBS) and virtual reality exposure therapy leads to a significantly greater reduction in acrophobia than virtual reality exposure with sham stimulation. In this randomized double-blind placebo-controlled study, 43 participants with acrophobia received verum or sham iTBS over the left dorsolateral prefrontal cortex prior to two sessions of virtual reality exposure therapy. Stimulation of the left dorsolateral prefrontal cortex with iTBS was motivated by an experimental study showing a positive effect on extinction memory retention. Acrophobic symptoms were assessed using questionnaires and two behavioral approach tasks one week before, after treatment and six months after the second diagnostic session. The results showed that two sessions of virtual reality exposure therapy led to a significant reduction in acrophobic symptoms, with an overall remission rate of 79 %. However, there was no additional effect of iTBS of the left dorsolateral prefrontal cortex on the therapeutic effects. Further research is needed to determine how exactly a combination of transcranial magnetic stimulation and exposure therapy should be designed to enhance efficacy.
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Affiliation(s)
- Barbara Bohmeier
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Lisa M Cybinski
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Daniel Gromer
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany
| | - Daniel Bellinger
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Angelika Erhardt-Lehmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany; Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Lorenz Deserno
- Center of Mental Health, Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany
| | - Paul Pauli
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany
| | - Thomas Polak
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
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Marcigaglia S, De Plus R, Vandendriessche C, Schiltz E, Cuypers ML, Cools J, Hoffman LD, Vandenbroucke RE, Dewilde M, Haesler S. Microfluidic Interfaces for Chronic Bidirectional Access to the Brain. Adv Healthc Mater 2024; 13:e2400438. [PMID: 38885495 DOI: 10.1002/adhm.202400438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 06/11/2024] [Indexed: 06/20/2024]
Abstract
Two-photon polymerization (TPP) is an additive manufacturing technique with micron-scale resolution that is rapidly gaining ground for a range of biomedical applications. TPP is particularly attractive for the creation of microscopic three-dimensional structures in biocompatible and noncytotoxic resins. Here, TPP is used to develop microfluidic interfaces which provide chronic fluidic access to the brain of preclinical research models. These microcatheters can be used for either convection-enhanced delivery (CED) or for the repeated collection of liquid biopsies. In a brain phantom, infusions with the micronozzle result in more localized distribution clouds and lower backflow compared to a control catheter. In mice, the delivery interface enables faster, more precise, and physiologically less disruptive fluid injections. A second microcatheter design enables repeated, longitudinal sampling of cerebrospinal fluid (CSF) over time periods as long as 250 days. Moreover, further in vivo studies demonstrate that the blood-CSF barrier is intact after chronic implantation of the sampling interface and that samples are suitable for downstream molecular analysis for the identification of nucleic acid- or peptide-based biomarkers. Ultimately, the versatility of this fabrication technique implies a great translational potential for simultaneous drug delivery and biomarker tracking in a range of human neurological diseases.
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Affiliation(s)
- Simone Marcigaglia
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Department of Neurosciences, KU Leuven, Leuven, 3000, Belgium
| | - Robin De Plus
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Department of Neurosciences, KU Leuven, Leuven, 3000, Belgium
| | - Charysse Vandendriessche
- VIB Center for Inflammation Research, VIB, Ghent, 9052, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, 9052, Belgium
| | - Eleonore Schiltz
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Department of Neurosciences, KU Leuven, Leuven, 3000, Belgium
| | - Marie-Lynn Cuypers
- Laboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, 3000, Belgium
| | - Jordi Cools
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Current affiliation, Thermofisher Scientific (AIG/MSD), Dilbeek, 1702, Belgium
| | - Luis D Hoffman
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Current affiliation, SWave Photonics, Leuven, 3001, Belgium
| | - Roosmarijn E Vandenbroucke
- VIB Center for Inflammation Research, VIB, Ghent, 9052, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, 9052, Belgium
| | - Maarten Dewilde
- Laboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, 3000, Belgium
- PharmAbs-The KU Leuven Antibody Center, KU Leuven, Leuven, 3000, Belgium
| | - Sebastian Haesler
- Neuroelectronics Research Flanders (NERF), Leuven, 3000, Belgium
- Department of Neurosciences, KU Leuven, Leuven, 3000, Belgium
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11
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Liu GY, Yan MD, Mai YY, Fu FJ, Pan L, Zhu JM, Ji WJ, Hu J, Li WP, Xie W. Frontiers and hotspots in anxiety disorders: A bibliometric analysis from 2004 to 2024. Heliyon 2024; 10:e35701. [PMID: 39220967 PMCID: PMC11365340 DOI: 10.1016/j.heliyon.2024.e35701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/05/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This study aimed to analyze research on anxiety disorders using VOSviewer and CiteSpace to identify research hotspots and future directions. Methods We conduct ed a comprehensive search on the Web of Science Core Collection (WoSCC) for relevant studies about anxiety disorders published within the past two decades (from 2004 to 2024). VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas. Results A total of 22,267 publications related to anxiety disorders were retrieved. The number of publications about anxiety disorders has generally increased over time, with some fluctuations. The United States emerged as the most productive country, with Harvard University identified as the most prolific institution and Brenda W. J. H. Penninx as the most prolific author in the field. Conclusion This research identified the most influential publications, authors, journals, institutions, and countries in the field of anxiety research. Future research directions are involved advanced treatments based on pharmacotherapy, psychotherapy and digital interventions, mechanism exploration to anxiety disorders based on neurobiological and genetic basis, influence of social and environmental factors on the onset of anxiety disorders.
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Affiliation(s)
- Gui-Yu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Ming-De Yan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Yi-Yin Mai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Fan-Jia Fu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Lei Pan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Jun-Ming Zhu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Wen-Juan Ji
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Jiao Hu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Wei-Peng Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
- Department of Neurology, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Wei Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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12
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Dooley J, Hughes JG, Needham EJ, Palios KA, Liston A. The potential of gene delivery for the treatment of traumatic brain injury. J Neuroinflammation 2024; 21:183. [PMID: 39069631 DOI: 10.1186/s12974-024-03156-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/17/2024] [Indexed: 07/30/2024] Open
Abstract
Therapeutics for traumatic brains injuries constitute a global unmet medical need. Despite the advances in neurocritical care, which have dramatically improved the survival rate for the ~ 70 million patients annually, few treatments have been developed to counter the long-term neuroinflammatory processes and accompanying cognitive impairments, frequent among patients. This review looks at gene delivery as a potential therapeutic development avenue for traumatic brain injury. We discuss the capacity of gene delivery to function in traumatic brain injury, by producing beneficial biologics within the brain. Gene delivery modalities, promising vectors and key delivery routes are discussed, along with the pathways that biological cargos could target to improve long-term outcomes for patients. Coupling blood-brain barrier crossing with sustained local production, gene delivery has the potential to convert proteins with useful biological properties, but poor pharmacodynamics, into effective therapeutics. Finally, we review the limitations and health economics of traumatic brain injury, and whether future gene delivery approaches will be viable for patients and health care systems.
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Affiliation(s)
- James Dooley
- Department of Pathology, University of Cambridge, Cambridge, UK.
| | - Jasmine G Hughes
- Department of Pathology, University of Cambridge, Cambridge, UK
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Edward J Needham
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | | | - Adrian Liston
- Department of Pathology, University of Cambridge, Cambridge, UK
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13
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Steinl D, Holzerny P, Ruckdäschel S, Fäh D, Pataky Z, Peterli R, Schultes B, Landolt S, Pollak T. Cost of overweight, obesity, and related complications in Switzerland 2021. Front Public Health 2024; 12:1335115. [PMID: 39071145 PMCID: PMC11282501 DOI: 10.3389/fpubh.2024.1335115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/01/2024] [Indexed: 07/30/2024] Open
Abstract
Background The prevalence of obesity has increased significantly in recent decades. Today, it is estimated that more than one-third of the world's population has overweight or obesity, rendering it one of the most significant global health concerns. This article provides a current estimate of the direct costs associated with managing overweight and obesity, including treatment of related complications, among adolescents (≥15 years) and adults in Switzerland. Methods Prevalence of overweight and obesity based on the BMI reported in the 2017 Swiss Health Survey was extrapolated to 2021. Systematic literature searches were performed to identify treatment costs and epidemiological data of obesity-related complications and costs were extrapolated to 2021. Costing methodology was based on available source data for individual related complications. Treatment costs for complications attributable to overweight and obesity were estimated by applying their population attributable fraction (PAF). Results More than 3.1 million inhabitants of Switzerland aged ≥15 years met the criteria for overweight or obesity in 2021. The prevalence of overweight increase over the past decades from 30.4% in 1992 to 41.9% in 2017 while prevalence of obesity doubled from 5.4 to 11.3%. Overall, the total attributable costs of overweight and obesity caused by seven assessed obesity-related complications (asthma, coronary heart disease, depression, diabetes mellitus, hypertension, osteoarthritis, and stroke) are estimated at CHF 3657-5208 million with most of the costs (97-98%) caused by the assessed obesity-related complications. Only 2-3% of the total costs were attributable to the combined direct management of overweight and obesity by bariatric surgery (CHF 83 million), pharmacological therapy (CHF 26 million) and dietary counseling (CHF 18 million). Conclusion Overweight and obesity impose a significant cost impact on the Swiss healthcare system, accounting for 4.2-6.1% of total healthcare expenditures in 2021. Notably, direct treatment of overweight and obesity accounts for only 0.08-0.18% of the total healthcare expenditures. The analysis also revealed a significant lack of available health economic evidence, necessitating the use of assumptions and approximations in this estimation. This is noteworthy, as respective data would be available in healthcare systems but are either unpublished or inaccessible.
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Affiliation(s)
| | | | | | - David Fäh
- School of Health Professions, Bern University of Applied Sciences (BFH), Bern, Switzerland
- Department of Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Zoltan Pataky
- Unit of Therapeutic Patient Education, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, World Health Organization Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Ralph Peterli
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd., St. Gallen, Switzerland
| | | | - Timo Pollak
- Novo Nordisk Denmark A/S, Copenhagen, Denmark
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14
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Kassa MA, Anbesaw T, Nakie G, Melkam M, Azmeraw M, Semagn EG, Abate BB. Investigating war trauma, its effects, and associated risk factors on anxiety among high school students in Woldia town, northeast Ethiopia, 2022. Front Psychiatry 2024; 15:1368285. [PMID: 39056017 PMCID: PMC11270624 DOI: 10.3389/fpsyt.2024.1368285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia. Objective We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia. Methods A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety. Results A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety. Conclusions and recommendations The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Azmeraw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, College of Veterinary Medicine, Wollo University, Dessie, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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15
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Simei JLQ, de Souza JDR, Lisboa JR, Guimarães FS, Crippa JADS. Cannabidiol in anxiety disorders: Current and future perspectives. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 177:205-234. [PMID: 39029985 DOI: 10.1016/bs.irn.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Anxiety disorders are highly prevalent psychiatric disorders, characterized by a chronic course and often accompanied by comorbid symptoms that impair functionality and decrease quality of life. Despite advances in basic and clinical research in our understanding of these disorders, currently available pharmacological options are associated with limited clinical benefits and side effects that frequently lead to treatment discontinuation. Importantly, a significant number of patients do not achieve remission and live with lifelong residual symptoms that limit daily functioning. Since the 1970s, basic and clinical research on cannabidiol (CBD), a non-psychotomimetic compound found in the Cannabis sativa plant, has indicated relevant anxiolytic effects, garnering attention for its therapeutic potential as an option in anxiety disorder treatment. This chapter aims to review the history of these studies on the anxiolytic effects of CBD within the current understanding of anxiety disorders. It highlights the most compelling current evidence supporting its anxiolytic effects and explores future perspectives for its clinical use in anxiety disorders.
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Affiliation(s)
- João Luís Queiroz Simei
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - José Diogo Ribeiro de Souza
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil.
| | - João Roberto Lisboa
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Francisco Silveira Guimarães
- National Institute for Science and Technology, Translational Medicine, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - José Alexandre de Souza Crippa
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Institute for Science and Technology, Translational Medicine, Brazil
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16
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Islamoska S, Forman CR, Panicker JN, Flachenecker P, Phé V, Brichetto G, Blok B, Barken KB. The impact of bladder problems on well-being in multiple sclerosis - A cross-sectional study. Mult Scler Relat Disord 2024; 87:105661. [PMID: 38728957 DOI: 10.1016/j.msard.2024.105661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/12/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Persons with multiple sclerosis (pwMS) frequently suffer from bladder problems that are not identified and managed optimally, reducing quality of life and increasing risk of health consequences. OBJECTIVE This study aimed to investigate associations between bladder problems and well-being of pwMS. METHODS The study included 1872 pwMS from France, Germany, Italy, and the UK self-reporting on demographics, MS status, bladder problems and management, and well-being. Logistic regression analyses were performed to investigate associations with self-reported well-being. RESULTS Population mean age was 51 years and 79 % were women. Among pwMS, 55 % reported bladder problems indicating overactive bladder (OAB), and 40 % reported self-experienced urinary retention. Self-management of bladder problems was reported by 32 %, 33 % were yet to have problem resolution, and 45 % reported a wish to receive bladder management help. Additionally, 35 % of pwMS reported that bladder problem onset preceded awareness of a link to MS. OAB, problem self-management, and urinary complications were significantly associated with lower well-being. CONCLUSION Bladder problems affect pwMS across disease subtypes and many attempt self-management. Consequently, pwMS with bladder problems are more likely to experience lower well-being, suggesting an unmet need. Raising awareness of the link between bladder problems and well-being could benefit pwMS living with bladder problems.
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Affiliation(s)
| | | | - Jalesh N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, UK; UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | | | - Véronique Phé
- Sorbonne University, Tenon Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Bertil Blok
- Department of Urology, Section of Neuro-Urology, Erasmus Medical Center, Rotterdam, the Netherlands
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17
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Mulfinger N, Angerer P, Erim Y, Hander N, Hansmann M, Herold R, Kilian R, Kröger C, Rothermund E, Weber J, Waldmann T. [Mental health problems among employees: service use and costs to the German healthcare system]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:760-771. [PMID: 38862729 PMCID: PMC11230946 DOI: 10.1007/s00103-024-03901-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/16/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Service use among employees with mental health problems and the associated costs for the health and social system have not yet been systematically analysed in studies or have only been recorded indirectly. The aim of this article is to report the service use in this target group, to estimate the costs for the health and social system and to identify possible influencing factors on the cost variance. METHODS As part of a multicentre study, use and costs of health and social services were examined for a sample of 550 employees with mental health problems. Service use was recorded using the German version of the Client Sociodemographic Service Receipt Inventory (CSSRI). Costs were calculated for six months. A generalized linear regression model was used to examine influencing cost factors. RESULTS At the start of the study, the average total costs for the past six months in the sample were € 5227.12 per person (standard deviation € 7704.21). The regression model indicates significant associations between increasing costs with increasing age and for people with depression, behavioural syndromes with physiological symptoms, and other diagnoses. DISCUSSION The calculated costs were similar in comparison to clinical samples. It should be further examined in longitudinal studies whether this result changes through specific interventions.
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Affiliation(s)
- Nadine Mulfinger
- Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg, Lindenallee 2, 89312, Günzburg, Deutschland.
| | - Peter Angerer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Yesim Erim
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Nicole Hander
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Marieke Hansmann
- Institut für Psychologie, Abteilung Klinische Psychologie und Psychotherapie, Universität Hildesheim, Hildesheim, Deutschland
| | - Regina Herold
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Reinhold Kilian
- Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg, Lindenallee 2, 89312, Günzburg, Deutschland
| | - Christoph Kröger
- Institut für Psychologie, Abteilung Klinische Psychologie und Psychotherapie, Universität Hildesheim, Hildesheim, Deutschland
| | - Eva Rothermund
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Jeannette Weber
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Tamara Waldmann
- Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg, Lindenallee 2, 89312, Günzburg, Deutschland
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18
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Burke C, Crossan C, Tyas E, Hemstock M, Lee D, Bowditch S. A Cost-Utility Analysis of Add-On Cannabidiol Versus Usual Care Alone for the Treatment of Seizures Associated with Tuberous Sclerosis Complex in England and Wales. PHARMACOECONOMICS - OPEN 2024; 8:611-626. [PMID: 38441854 PMCID: PMC11252107 DOI: 10.1007/s41669-024-00474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the cost effectiveness of plant-derived highly purified cannabidiol (Epidyolex® in the UK; 100 mg/mL oral solution) as an add-on treatment to usual care for the management of treatment-refractory seizures associated with tuberous sclerosis complex (TSC) in patients aged ≥ 2 years. METHODS A cohort-based model was developed using a National Health Service perspective and lifetime horizon. Health states were based on weekly seizure frequency and seizure-free days, utilizing patient-level data from the GWPCARE6 trial (ClinicalTrials.gov identifier: NCT02544763). Two independent regression models were applied to individual patient-level data to predict seizure-free days and seizure frequency. Healthcare resource utilization data were sourced from a Delphi panel, and patient and caregiver health-related quality of life values were elicited using vignettes valued by the general public. Outcomes relating to TSC-associated neuropsychiatric disorders were modeled with costs and quality-adjusted life-years sourced from published literature. RESULTS In the base case, compared with usual care alone, 12 mg/kg/day cannabidiol was associated with an incremental cost-effectiveness ratio (ICER) of £23,797. The National Institute for Health and Care Excellence disease severity modifier reduced the ICER to £19,831. Probabilities of cost effectiveness at willingness-to-pay thresholds of £20,000 and £30,000 were 30% and 52%, respectively, for the base case and 39% and 66%, respectively, for the disease severity modifier. Results were robust to sensitivity and scenario analyses. CONCLUSIONS At 12 mg/kg/day and an ICER threshold of £20,000-£30,000, we provide evidence for the cost effectiveness of add-on cannabidiol treatment for patients with TSC-associated seizures aged ≥ 2 years who are refractory to current treatment.
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Affiliation(s)
- Colin Burke
- Lumanity, Inc., Great Suffolk Yard, 121-131 Great Suffolk Street, London, SE1 1PP, UK.
| | - Catriona Crossan
- Lumanity, Inc., Great Suffolk Yard, 121-131 Great Suffolk Street, London, SE1 1PP, UK
| | - Emma Tyas
- Lumanity, Inc., Great Suffolk Yard, 121-131 Great Suffolk Street, London, SE1 1PP, UK
| | - Matthew Hemstock
- Lumanity, Inc., Great Suffolk Yard, 121-131 Great Suffolk Street, London, SE1 1PP, UK
| | - Dawn Lee
- Lumanity, Inc., Great Suffolk Yard, 121-131 Great Suffolk Street, London, SE1 1PP, UK
| | - Sally Bowditch
- Jazz Pharmaceuticals, Inc., 1 Cavendish Place, Marylebone, London, W1G 0QF, UK
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Eckart C, Reif A. The research landscape of bipolar disorder in Germany: productive, but underfunded. Int J Bipolar Disord 2024; 12:22. [PMID: 38878206 PMCID: PMC11180073 DOI: 10.1186/s40345-024-00344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The recurrent mental illness bipolar disorder is a major burden on the healthcare system, which underlines the importance of research into this disease. Germany is one of the most productive countries in this research activity. This bibliometric analysis aims to outline the social and conceptual structure of the German research landscape on bipolar disorder over the last decade. Furthermore, we provide a short overview over current public funding. RESULTS Concerning the social structure, most of the German publications were collaboration projects, both with a national but also international orientation, in the latter case predominantly with countries of the global North. Analysis of the conceptual structure of German research activity identified psychiatric genetics, early recognition of bipolar disorder, neuroimaging, and pharmacological interventions as important topics within the field. In the context of a survey, only few publicly funded research projects were reported, many of which did not exclusively investigate bipolar disorder but followed a transdiagnostic approach. CONCLUSIONS Our bibliometric analysis revealed internationally well-networked German research activities on bipolar disorder. In stark contrast to its high prevalence and correspondingly high financial burden to the healthcare system, current grant support for research on this illness is strikingly low, particularly concerning the development of novel treatments.
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Affiliation(s)
- Cindy Eckart
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany
- German Society for Bipolar Disorders (DGBS e.V.), Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany.
- German Society for Bipolar Disorders (DGBS e.V.), Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
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20
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Bassetti CLA, Accorroni A, Arnesen A, Basri HB, Berger T, Berlit P, Boon P, Charway‐Felli A, Kruja J, Lewis S, Markowski M, Medina MT, McCombe P, Moro E, Ozturk S, Smith P, Vuletic V. General neurology: Current challenges and future implications. Eur J Neurol 2024; 31:e16237. [PMID: 38545838 PMCID: PMC11236055 DOI: 10.1111/ene.16237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND AND PURPOSE In the coming decades, the world will face an increasing burden of neurological disorders (ND) and an urgent need to promote brain health. These challenges contrast with an insufficient neurological workforce in most countries, as well as decreasing numbers of general neurologists and neurologists attracted to work in general neurology (GN). This white paper aims to review the current situation of GN and reflect on its future. METHODS The European Academy of Neurology (EAN) task force (TF) met nine times between November 2021 and June 2023. During the 2023 EAN annual meeting, attendees were asked to answer five questions concerning the future of GN. The document was sent for suggestions and eventually approval to the board and the presidents of the 47 national societies of the EAN. RESULTS The TF first identified four relevant current and future challenges related to GN: (i) definition, (ii) practice, (iii) education, and (iv) research. The TF then identified seven initiatives to further develop GN at both the academic and community level. Finally, the TF formulated 16 recommendations to promote GN in the future. CONCLUSIONS GN will remain essential in the coming decades to provide rapid, accessible, and comprehensive management of patients with ND that is affordable and cost-effective. There is also a need for research, education, and other initiatives aiming to facilitate improved working conditions, recognition, and prestige for those pursuing a career in GN.
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Affiliation(s)
| | - Alice Accorroni
- Neurology DepartmentGeneva University HospitalGenevaSwitzerland
| | - Astri Arnesen
- European Federation of Neurological AssociationsBrusselsBelgium
| | - Hamidon Bin Basri
- Department of Neurology, Faculty of Medicine and Health SciencesUniversiti Putra MalaysiaSerdangMalaysia
| | - Thomas Berger
- Department of NeurologyMedical University of ViennaViennaAustria
| | | | - Paul Boon
- Department of NeurologyGhent University HospitalGhentBelgium
- Eindhoven University of TechnologyEindhoventhe Netherlands
| | | | - Jera Kruja
- Department of NeurologyUniversity Medical Center Mother Teresa, University of MedicineTiranaAlbania
| | - Steven Lewis
- Lehigh Valley Fleming Neuroscience InstituteAllentownPennsylvaniaUSA
| | | | - Marco Tulio Medina
- Facultad de Ciencias MedicasNational Autonomous University of HondurasTegucigalpaHonduras
| | - Pamela McCombe
- Faculty of Medicine, UQ Centre for Clinical ResearchUniversity of QueenslandHerston, QueenslandAustralia
| | - Elena Moro
- Department of Psychiatry, Neurology, and Neurological RehabilitationGrenoble Alpes University HospitalGrenobleFrance
| | - Serefnur Ozturk
- Department of NeurologySelcuk UniversitySelçuklu/KonyaTurkey
| | - Phil Smith
- Department of NeurologyUniversity Hospital of Wales Heath ParkCardiffUK
| | - Vladimira Vuletic
- Department of NeurologyMedical Faculty, University of RijekaRijekaCroatia
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21
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Abbak N, Nemutlu E, Reçber T, Gul ASD, Akkoyun HT, Akkoyun MB, Yilmaz G, Ekin S, Bakir A, Arihan O. Behavior, antioxidant, and metabolomics effects of Allium tuncelianum. Food Sci Nutr 2024; 12:3538-3551. [PMID: 38726412 PMCID: PMC11077190 DOI: 10.1002/fsn3.4022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 05/12/2024] Open
Abstract
Allium species are consumed extensively as folkloric medicine and dietary elements, but limited studies have been conducted on them. In this study, the effects of an ethanol-water extract obtained from the underground bulb of Allium tuncelianum (Kollmann) Özhatay, B. Mathew & Şiraneci (AT) on the behavioral, antioxidant, and metabolite parameters in rats were evaluated. AT was administered orally once a day at doses of 100 and 400 mg/kg to male Wistar albino rats for 10 consecutive days. The elevated plus maze, rotarod, and hotplate tests were used to examine anxiety-like behaviors, locomotor activities, and pain perception in the rats, respectively. Additionally, untargeted metabolomic analyses were performed on plasma samples and AT extracts using two orthogonal analytical platforms. The phenolic components, mainly fumaric acid, malic acid, vanillic acid, quercetin-3-arabinoside, hydrocinnamic acid, and gallocatechin, were determined in the extract. In addition, arbutin, salicylic acid, trehalose, and nicotinic acid were analyzed in the extract for the first time. The AT extract did not decrease the catalase, glutathione peroxidase, or superoxide dismutase levels; however, diazepam decreased some of those parameters significantly in the brain, liver, and kidney. Although both the AT and diazepam treatments resulted in an increase in anxiolytic-like effects compared to the control group, no significant differences were observed (p > .05). In the metabolomic analysis, significant changes were observed in the rats treated with AT and diazepam, and they caused significant changes in some metabolic pathways, including amino acid and fatty acid metabolism, compared to the control.
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Affiliation(s)
- Nigar Abbak
- Department of Physiology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of PharmacyHacettepe UniversityAnkaraTurkey
| | - Tuba Reçber
- Department of Analytical Chemistry, Faculty of PharmacyHacettepe UniversityAnkaraTurkey
| | - Asli San Dagli Gul
- Department of Physiology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - H. Turan Akkoyun
- Department of Physiology, Veterinary FacultySiirt UniversitySiirtTurkey
| | | | - Gulderen Yilmaz
- Department of Pharmaceutical Botany, Faculty of PharmacyAnkara UniversityAnkaraTurkey
| | - Suat Ekin
- Department of Biochemistry, Faculty of ScienceVan Yuzuncu Yil UniversityVanTurkey
| | - Ahmet Bakir
- Department of Biochemistry, Faculty of ScienceVan Yuzuncu Yil UniversityVanTurkey
| | - Okan Arihan
- Department of Physiology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
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22
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García-Estela A, Angarita-Osorio N, Holzhausen MC, Mora-Salgueiro J, Pérez V, Duarte E, Faulkner G, Colom F. Evaluating the effect of exercise-based interventions on functioning in people with transdiagnostic depressive symptoms: A systematic review of randomised controlled trials. J Affect Disord 2024; 351:231-242. [PMID: 38278328 DOI: 10.1016/j.jad.2024.01.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Depressive symptoms are associated with various conditions and can exacerbate the outcome of somatic diseases. Transdiagnostic symptom-based approaches provide treatment flexibility, and exercise has demonstrated benefits beyond clinical symptoms. This work aimed to synthesise and establish the effects of exercise-based interventions on global functioning and quality of life in adults with transdiagnostic depressive symptoms, as well as their impact on clinical symptoms. METHODS A systematic review was conducted following PRISMA guidelines. PubMed, Scopus and PsycINFO databases were searched from inception to April 2023. Eligibility criteria included randomised controlled trials involving adults with transdiagnostic depressive symptoms who received exercise-based interventions and provided details of the interventions. Comparators included treatment as usual or other active control groups. The Cochrane quality assessment tool was used for quality assessment. RESULTS Fifteen articles involving 2064 participants were included. Data on study design, sample, intervention characteristics, and outcomes were extracted. Several trials demonstrated the expected positive effects of exercise on functioning (7/15). Most results supported the benefits of adjunctive exercise interventions on illness outcomes. LIMITATIONS The studies had methodological limitations, including small sample sizes and an underrepresentation of somatic diseases. CONCLUSIONS The functional consequences of exercise-based interventions targeting depressive symptoms are often understudied. Incorporating exercise routinely as an add-on treatment for transdiagnostic depressive symptoms could improve overall functioning, quality of life, and symptom severity. There is a need to expand the focus of exercise-based interventions to incorporate functional outcomes. Future research should address the methodological limitations and include a wider range of participants, including those with somatic diseases.
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Affiliation(s)
- Aitana García-Estela
- Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Biomedical Research in Mental Health Network (CIBERSAM), Madrid, Spain
| | - Natalia Angarita-Osorio
- Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Biomedical Research in Mental Health Network (CIBERSAM), Madrid, Spain
| | - Marlene Charlotte Holzhausen
- Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Javier Mora-Salgueiro
- Consumer and Psychology Unit, Faculty of Psychology, University of Santiago de Compostela, Spain
| | - Víctor Pérez
- Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Biomedical Research in Mental Health Network (CIBERSAM), Madrid, Spain; Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
| | - Esther Duarte
- Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Physical Medicine and Rehabilitation Department, Hospital del Mar, Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Francesc Colom
- Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Biomedical Research in Mental Health Network (CIBERSAM), Madrid, Spain; Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain; Department of Basic, Evolutive and Education Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain.
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23
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Slot MIE, van Hell HH, Rossum IWV, Dazzan P, Maat A, de Haan L, Crespo-Facorro B, Glenthøj B, Lawrie SM, McDonald C, Gruber O, van Amelsvoort T, Arango C, Kircher T, Nelson B, Galderisi S, Weiser M, Sachs G, Maatz A, Bressan RA, Kwon JS, Mizrahi R, McGuire P, Kahn RS. A naturalistic cohort study of first-episode schizophrenia spectrum disorder: A description of the early phase of illness in the PSYSCAN cohort. Schizophr Res 2024; 266:237-248. [PMID: 38431986 DOI: 10.1016/j.schres.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/18/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND We examined the course of illness over a 12-month period in a large, international multi-center cohort of people with a first-episode schizophrenia spectrum disorder (FES) in a naturalistic, prospective study (PSYSCAN). METHOD Patients with a first episode of schizophrenia, schizoaffective disorder (depressive type) or schizophreniform disorder were recruited at 16 institutions in Europe, Israel and Australia. Participants (N = 304) received clinical treatment as usual throughout the study. RESULTS The mean age of the cohort was 24.3 years (SD = 5.6), and 67 % were male. At baseline, participants presented with a range of intensities of psychotic symptoms, 80 % were taking antipsychotic medication, 68 % were receiving psychological treatment, with 46.5 % in symptomatic remission. The mean duration of untreated psychosis was 6.2 months (SD = 17.0). After one year, 67 % were in symptomatic remission and 61 % were in functional remission, but 31 % had been readmitted to hospital at some time after baseline. In the cohort as a whole, depressive symptoms remained stable over the follow-up period. In patients with a current depressive episode at baseline, depressive symptoms slightly improved. Alcohol, tobacco and cannabis were the most commonly used substances, with daily users of cannabis ranging between 9 and 11 % throughout the follow-up period. CONCLUSIONS This study provides valuable insight into the early course of a broad range of clinical and functional aspects of illness in FES patients in routine clinical practice.
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Affiliation(s)
- Margot I E Slot
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Hendrika H van Hell
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Inge Winter-van Rossum
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America.
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark 458 Hill, London SE5 8AF, United Kingdom.
| | - Arija Maat
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Lieuwe de Haan
- Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychiatry, University of Sevilla. Hospital Universitario Virgen del Rocio, IBiS-CSIC, Sevilla, Spain.
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Dept. of Clinical Medicine, Copenhagen, Denmark.
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland.
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Centre, Maastricht, the Netherlands.
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Centro de Investigación Biomédica en Red del área de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany.
| | - Barnaby Nelson
- Orygen, 35 Poplar Road, Parkville, Victoria, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Silvana Galderisi
- University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| | - Anke Maatz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Rodrigo A Bressan
- Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, 101 Dahakno, Jongno-gu, Seoul, Republic of Korea.
| | - Romina Mizrahi
- Department of Psychiatry, McGill University, Montreal, Canada.
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
| | - René S Kahn
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America.
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24
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Vita A, Barlati S, Porcellana M, Sala E, Lisoni J, Brogonzoli L, Percudani ME, Iardino R. The patient journey project in Italian mental health services: results from a co-designed survey on clinical interventions and current barriers to improve the care of people living with schizophrenia. Front Psychiatry 2024; 15:1382326. [PMID: 38606407 PMCID: PMC11007707 DOI: 10.3389/fpsyt.2024.1382326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction The Patient Journey Project aimed to analyze the scenario among Italian Mental Health Services (MHS) to understand the clinical interventions that are properly implemented and the ones deserving further implementation to design an effective treatment plan for patients living with schizophrenia (PLWS). Methods The 60-items survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the Patient Journey and focused on three phases of schizophrenia course: early detection and management, acute phase management, long-term management/continuity of care. Respondents were Heads of the Mental Health Departments and Addiction Services (MHDAS) or facilities directors throughout Italian MHS. For each statement, respondents expressed the consensus on the importance and the degree of implementation in clinical practice. Results Considering the importance of the statement, strong consensus was reached for most of the statements. Good levels of implementation were found on 2/17 statements of early detection and management, on 3/16 statements for acute phase management and on 1/27 statements of long-term management/continuity of care. Poor levels of implementation were found on 1/17 statements of early detection and management, none of acute phase management, and 4/27 statements for long-term management/continuity of care. Moderate levels of implementation were found on 14/17 statements for early detection and management, on 13/16 statements of acute phase management, and on 22/27 statements of long-term management/continuity of care. Thus, among Italian MHDAS, most interventions for PLWS were moderately implemented in clinical practice. Discussion Italian MHS have to provide new strategies and structural actions to overcome these current limitations and barriers to effectively improve the journey of PLWS. The areas that deserve most implementation include interventions during the early stage (especially the continuity of care between Child and Adolescent Mental Health Services and Adult Mental Health Services), the evidence-based psychosocial interventions during the chronic stages of the disorder, and the continuity of care after acute hospitalization.
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Affiliation(s)
- Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Elisa Sala
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
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25
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Mayer SF, Corcoran C, Kennedy L, Leucht S, Bighelli I. Cognitive behavioural therapy added to standard care for first-episode and recent-onset psychosis. Cochrane Database Syst Rev 2024; 3:CD015331. [PMID: 38470162 PMCID: PMC10929366 DOI: 10.1002/14651858.cd015331.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) can be effective in the general population of people with schizophrenia. It is still unclear whether CBT can be effectively used in the population of people with a first-episode or recent-onset psychosis. OBJECTIVES To assess the effects of adding cognitive behavioural therapy to standard care for people with a first-episode or recent-onset psychosis. SEARCH METHODS We conducted a systematic search on 6 March 2022 in the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ClinicalTrials.gov, ISRCTN, and WHO ICTRP. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing CBT added to standard care vs standard care in first-episode or recent-onset psychosis, in patients of any age. DATA COLLECTION AND ANALYSIS Two review authors (amongst SFM, CC, LK and IB) independently screened references for inclusion, extracted data from eligible studies and assessed the risk of bias using RoB2. Study authors were contacted for missing data and additional information. Our primary outcome was general mental state measured on a validated rating scale. Secondary outcomes included other specific measures of mental state, global state, relapse, admission to hospital, functioning, leaving the study early, cognition, quality of life, satisfaction with care, self-injurious or aggressive behaviour, adverse events, and mortality. MAIN RESULTS We included 28 studies, of which 26 provided data on 2407 participants (average age 24 years). The mean sample size in the included studies was 92 participants (ranging from 19 to 444) and duration ranged between 26 and 52 weeks. When looking at the results at combined time points (mainly up to one year after start of the intervention), CBT added to standard care was associated with a greater reduction in overall symptoms of schizophrenia (standardised mean difference (SMD) -0.27, 95% confidence interval (CI) -0.47 to -0.08, 20 RCTs, n = 1508, I2 = 68%, substantial heterogeneity, low certainty of the evidence), and also with a greater reduction in positive (SMD -0.22, 95% CI -0.38 to -0.06, 22 RCTs, n = 1565, I² = 52%, moderate heterogeneity), negative (SMD -0.20, 95% CI -0.30 to -0.11, 22 RCTs, n = 1651, I² = 0%) and depressive symptoms (SMD -0.13, 95% CI -0.24 to -0.01, 18 RCTs, n = 1182, I² = 0%) than control. CBT added to standard care was also associated with a greater improvement in the global state (SMD -0.34, 95% CI -0.67 to -0.01, 4 RCTs, n = 329, I² = 47%, moderate heterogeneity) and in functioning (SMD -0.23, 95% CI -0.42 to -0.05, 18 RCTs, n = 1241, I² = 53%, moderate heterogeneity, moderate certainty of the evidence) than control. We did not find a difference between CBT added to standard care and control in terms of number of participants with relapse (relative risk (RR) 0.82, 95% CI 0.57 to 1.18, 7 RCTs, n = 693, I² = 48%, low certainty of the evidence), leaving the study early for any reason (RR 0.87, 95% CI 0.72 to 1.05, 25 RCTs, n = 2242, I² = 12%, moderate certainty of the evidence), adverse events (RR 1.29, 95% CI 0.85 to 1.97, 1 RCT, n = 43, very low certainty of the evidence) and the other investigated outcomes. AUTHORS' CONCLUSIONS This review synthesised the latest evidence on CBT added to standard care for people with a first-episode or recent-onset psychosis. The evidence identified by this review suggests that people with a first-episode or recent-onset psychosis may benefit from CBT additionally to standard care for multiple outcomes (overall, positive, negative and depressive symptoms of schizophrenia, global state and functioning). Future studies should better define this population, for which often heterogeneous definitions are used.
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Affiliation(s)
- Susanna Franziska Mayer
- Section for Evidence-Based Medicine in Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, München, Germany
| | | | - Liam Kennedy
- Department of Old Age Psychiatry, Carew House, St Vincent's Hospital, Dublin, Ireland
| | - Stefan Leucht
- Section for Evidence-Based Medicine in Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, München, Germany
- German Center for Mental Health (DZPG), Munich, Germany
| | - Irene Bighelli
- Section for Evidence-Based Medicine in Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, München, Germany
- German Center for Mental Health (DZPG), Munich, Germany
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26
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Leehr EJ, Seeger FR, Böhnlein J, Gathmann B, Straube T, Roesmann K, Junghöfer M, Schwarzmeier H, Siminski N, Herrmann MJ, Langhammer T, Goltermann J, Grotegerd D, Meinert S, Winter NR, Dannlowski U, Lueken U. Association between resting-state connectivity patterns in the defensive system network and treatment response in spider phobia-a replication approach. Transl Psychiatry 2024; 14:137. [PMID: 38453896 PMCID: PMC10920691 DOI: 10.1038/s41398-024-02799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 03/09/2024] Open
Abstract
Although highly effective on average, exposure-based treatments do not work equally well for all patients with anxiety disorders. The identification of pre-treatment response-predicting patient characteristics may enable patient stratification. Preliminary research highlights the relevance of inhibitory fronto-limbic networks as such. We aimed to identify pre-treatment neural signatures differing between exposure treatment responders and non-responders in spider phobia and to validate results through rigorous replication. Data of a bi-centric intervention study comprised clinical phenotyping and pre-treatment resting-state functional connectivity (rsFC) data of n = 79 patients with spider phobia (discovery sample) and n = 69 patients (replication sample). RsFC data analyses were accomplished using the Matlab-based CONN-toolbox with harmonized analyses protocols at both sites. Treatment response was defined by a reduction of >30% symptom severity from pre- to post-treatment (Spider Phobia Questionnaire Score, primary outcome). Secondary outcome was defined by a reduction of >50% in a Behavioral Avoidance Test (BAT). Mean within-session fear reduction functioned as a process measure for exposure. Compared to non-responders and pre-treatment, results in the discovery sample seemed to indicate that responders exhibited stronger negative connectivity between frontal and limbic structures and were characterized by heightened connectivity between the amygdala and ventral visual pathway regions. Patients exhibiting high within-session fear reduction showed stronger excitatory connectivity within the prefrontal cortex than patients with low within-session fear reduction. Whereas these results could be replicated by another team using the same data (cross-team replication), cross-site replication of the discovery sample findings in the independent replication sample was unsuccessful. Results seem to support negative fronto-limbic connectivity as promising ingredient to enhance response rates in specific phobia but lack sufficient replication. Further research is needed to obtain a valid basis for clinical decision-making and the development of individually tailored treatment options. Notably, future studies should regularly include replication approaches in their protocols.
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Affiliation(s)
- Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
| | - Fabian R Seeger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
- Otto-Creutzfeld Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Kati Roesmann
- Otto-Creutzfeld Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
- Institute for Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
- Institute of Psychology, Unit of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrück, Osnabrück, Germany
| | - Markus Junghöfer
- Otto-Creutzfeld Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Hanna Schwarzmeier
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Niklas Siminski
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Till Langhammer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ulrike Lueken
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Berlin, Germany
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Waliszewska-Prosół M, Montisano DA, Antolak M, Bighiani F, Cammarota F, Cetta I, Corrado M, Ihara K, Kartamysheva R, Petrušić I, Pocora MM, Takizawa T, Vaghi G, Martelletti P, Corso B, Raggi A. The impact of primary headaches on disability outcomes: a literature review and meta-analysis to inform future iterations of the Global Burden of Disease study. J Headache Pain 2024; 25:27. [PMID: 38433202 PMCID: PMC10910736 DOI: 10.1186/s10194-024-01735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The burden and disability associated with headaches are conceptualized and measured differently at patients' and populations' levels. At the patients' level, through patient-reported outcome measures (PROMs); at population level, through disability weights (DW) and years lived with a disability (YLDs) developed by the Global Burden of Disease Study (GBD). DW are 0-1 coefficients that address health loss and have been defined through lay descriptions. With this literature review, we aimed to provide a comprehensive analysis of disability in headache disorders, and to present a coefficient referring to patients' disability which might inform future GBD definitions of DW for headache disorders. METHODS We searched SCOPUS and PubMed for papers published between 2015 and 2023 addressing disability in headache disorders. The selected manuscript included a reference to headache frequency and at least one PROM. A meta-analytic approach was carried out to address relevant differences for the most commonly used PROMs (by headache type, tertiles of medication intake, tertiles of females' percentage in the sample, and age). We developed a 0-1 coefficient based on the MIDAS, on the HIT-6, and on MIDAS + HIT-6 which was intended to promote future DW iterations by the GBD consortium. RESULTS A total of 366 studies, 596 sub-samples, and more than 133,000 single patients were available, mostly referred to cases with migraine. Almost all PROMs showed the ability to differentiate disability severity across conditions and tertiles of medication intake. The indexes we developed can be used to inform future iterations of DW, in particular considering their ability to differentiate across age and tertiles of medication intake. CONCLUSIONS Our review provides reference values for the most commonly used PROMS and a data-driven coefficient whose main added value is its ability to differentiate across tertiles of age and medication intake which underlie on one side the increased burden due to aging (it is likely connected to the increased impact of common comorbidities), and by the other side the increased burden due to medication consumption, which can be considered as a proxy for headache severity. Both elements should be considered when describing disability of headache disorders at population levels.
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Affiliation(s)
| | - Danilo Antonio Montisano
- Dipartimento Di Neuroalgologia, Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Mariola Antolak
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Federico Bighiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Francescantonio Cammarota
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Ilaria Cetta
- Neuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Michele Corrado
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Keiko Ihara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Japanese Red Cross, Ashikaga Hospital, Tochigi, Japan
| | - Regina Kartamysheva
- Department of Neurology, University Clinic of Kazan Federal University, Kazan, Russian Federation
| | - Igor Petrušić
- Faculty of Physical Chemistry, Laboratory for Advanced Analysis of Neuroimages, University of Belgrade, Belgrade, Serbia
| | - Maria Magdalena Pocora
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Gloria Vaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Barbara Corso
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Alberto Raggi
- SC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Mayntz SK, Peronard CRF, Søgaard J, Chang AY. The economic burden of diseases in the Nordic countries: A systematic review. Scand J Public Health 2024; 52:234-246. [PMID: 36782401 DOI: 10.1177/14034948231153025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Economic burden studies can provide insights into the drivers leading to increasing healthcare costs. It can also provide a more holistic view of how diseases impact the welfare of patients and their families. Having concrete estimates of the economic burden across multiple diseases can help policymakers determine which diseases are economically more burdensome. This study aimed to review and summarise comprehensively economic burden studies across multiple diseases in the Nordic countries between 2000 and 2020. METHODS According to the 2020 PRISMA statement, a systematic literature review was conducted in PubMed, CINAHL, Academic Search Premier and Global Health databases using key terms related to the economic burden of any disease in Denmark, Finland, Greenland, Iceland, Norway and Sweden. Grey literature was also reviewed. RESULTS A total of 10,050 potential titles and abstracts were identified and screened, and 254 full-text papers that met the inclusion criteria were evaluated by two independent reviewers. Of these, 119 articles were included in a qualitative synthesis. Twenty-nine had clearly defined comparison groups, thus able to attribute the costs to the disease. Large variations concerning methodology and cost components were noted. Across diseases, the economic burden ranged from EUR 1668 per patient annually for chronic obstructive pulmonary disease to EUR 93,041 for multiple sclerosis. However, estimates varied widely, even within each disease. CONCLUSIONS Our review highlights the need for more comparable economic burden studies. Future studies should focus on applying robust methodology and homogeneous cost-reporting methods to inform policymakers about which diseases are economically more burdensome.
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Affiliation(s)
| | | | - Jes Søgaard
- The Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Denmark
| | - Angela Y Chang
- Department of Clinical Research, University of Southern Denmark, Denmark
- The Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Denmark
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark
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Kruse C, Lipinski A, Verheyen M, Balzer-Geldsetzer M, Wittenberg M, Lorenzl S, Richinger C, Schmotz C, Tönges L, Woitalla D, Klebe S, Bloem BR, Hommel A, Meissner WG, Laurens B, Boraud T, Foubert-Samier A, Vergnet S, Tison F, Costa N, Odin P, Rosqvist K, Norlin JM, Hjalte F, Schrag A, Dodel R. Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries. Mov Disord 2024; 39:571-584. [PMID: 38425158 DOI: 10.1002/mds.29718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disease that leads to progressive disability. Cost studies have mainly explored the early stages of the disease, whereas late-stage patients are underrepresented. OBJECTIVE The aim is to evaluate the resource utilization and costs of PD management in people with late-stage disease. METHODS The Care of Late-Stage Parkinsonism (CLaSP) study collected economic data from patients with late-stage PD and their caregivers in five European countries (France, Germany, the Netherlands, UK, Sweden) in a range of different settings. Patients were eligible to be included if they were in Hoehn and Yahr stage >3 in the on state or Schwab and England stage at 50% or less. In total, 592 patients met the inclusion criteria and provided information on their resource utilization. Costs were calculated from a societal perspective for a 3-month period. A least absolute shrinkage and selection operator approach was utilized to identify the most influential independent variables for explaining and predicting costs. RESULTS During the 3-month period, the costs were €20,573 (France), €19,959 (Germany), €18,319 (the Netherlands), €25,649 (Sweden), and €12,156 (UK). The main contributors across sites were formal care, hospitalization, and informal care. Gender, age, duration of the disease, Unified Parkinson's Disease Rating Scale 2, the EQ-5D-3L, and the Schwab and England Scale were identified as predictors of costs. CONCLUSION Costs in this cohort of individuals with late-stage PD were substantially higher compared to previously published data on individuals living in earlier stages of the disease. Resource utilization in the individual sites differed in part considerably among these three parameters mentioned. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Christopher Kruse
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Anna Lipinski
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Malte Verheyen
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Monika Balzer-Geldsetzer
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Michael Wittenberg
- Coordination Center for Clinical Trials of the Philipps-University Marburg, Marburg, Germany
| | - Stefan Lorenzl
- Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria
| | - Carmen Richinger
- Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmotz
- Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria
| | - Lars Tönges
- Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany
- Neurodegeneration Research, Centre for Protein Diagnostics (ProDi), Ruhr-University, Bochum, Germany
| | - Dirk Woitalla
- Department of Neurology, St. Josef-Krankenhaus Kupferdreh, Essen, Germany
| | - Stephan Klebe
- Department of Neurology, Essen University Hospital, Essen, Germany
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Adrianus Hommel
- Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Wassilios G Meissner
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - Brice Laurens
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - Thomas Boraud
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - Alexandra Foubert-Samier
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - Sylvain Vergnet
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - François Tison
- Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France
| | - Nadège Costa
- Health Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kristina Rosqvist
- Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jenny M Norlin
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Frida Hjalte
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Anette Schrag
- Department of Clinical Neurosciences, UCL Institute of Neurology, University College London, London, UK
| | - Richard Dodel
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
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Boon P, Lescrauwaet E, Aleksovska K, Konti M, Berger T, Leonardi M, Marson T, Kallweit U, Moro E, Toscano A, Rektorova I, Crean M, Sander A, Joyce R, Bassetti C. A strategic neurological research agenda for Europe: Towards clinically relevant and patient-centred neurological research priorities. Eur J Neurol 2024; 31:e16171. [PMID: 38085270 PMCID: PMC11235625 DOI: 10.1111/ene.16171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND AND PURPOSE Neurological disorders constitute a significant portion of the global disease burden, affecting >30% of the world's population. This prevalence poses a substantial threat to global health in the foreseeable future. A lack of awareness regarding this high burden of neurological diseases has led to their underrecognition, underappreciation, and insufficient funding. Establishing a strategic and comprehensive research agenda for brain-related studies is a crucial step towards aligning research objectives among all pertinent stakeholders and fostering greater societal awareness. METHODS A scoping literature review was undertaken by a working group from the European Academy of Neurology (EAN) to identify any existing research agendas relevant to neurology. Additionally, a specialized survey was conducted among all EAN scientific panels, including neurologists and patients, inquiring about their perspectives on the current research priorities and gaps in neurology. RESULTS The review revealed the absence of a unified, overarching brain research agenda. Existing research agendas predominantly focus on specialized topics within neurology, resulting in an imbalance in the number of agendas across subspecialties. The survey indicated a prioritization of neurological disorders and research gaps. CONCLUSIONS Building upon the findings from the review and survey, key components for a strategic and comprehensive neurological research agenda in Europe were delineated. This research agenda serves as a valuable prioritization tool for neuroscientific researchers, as well as for clinicians, donors, and funding agencies in the field of neurology. It offers essential guidance for creating a roadmap for research and clinical advancement, ultimately leading to heightened awareness and reduced burden of neurological disorders.
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Affiliation(s)
- Paul Boon
- Department of Neurology and 4BrainGhent University HospitalGhentBelgium
- Eindhoven University of TechnologyEindhoventhe Netherlands
- European Academy of NeurologyViennaAustria
| | - Emma Lescrauwaet
- Department of Neurology and 4BrainGhent University HospitalGhentBelgium
- Eindhoven University of TechnologyEindhoventhe Netherlands
| | | | | | - Thomas Berger
- Department of Neurology and Comprehensive Centre of Clinical Neurosciences and Mental HealthMedical University of ViennaViennaAustria
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit and Coma Research CentreFondazione IRCCS Instituto Neurologico C. BestaMilanItaly
| | - Tony Marson
- Department of Pharmacology and TherapeuticsUniversity of LiverpoolLiverpoolUK
| | - Ulf Kallweit
- Centre for Narcolepsy and Hypersomnolence Disorders, Professorship for Narcolepsy and Hypersomnolence Research, Department of MedicineWitten/Herdecke UniversityWittenGermany
- Centre for Biomedical Education and ResearchWitten/Herdecke UniversityWittenGermany
| | - Elena Moro
- Department of PsychiatryNeurology and Neurological Rehabilitation of CHUGrenobleFrance
| | - Antonio Toscano
- ERN‐NMD Centre for Neuromuscular Disorders of Messina, Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Irena Rektorova
- Brain and Mind ResearchCentral European Institute of Technology, Masaryk UniversityBrnoCzechia
- First Department of NeurologySt. Anne's University Hospital and Faculty of Medicine, Masaryk UniversityBrnoCzechia
| | | | | | - Robert Joyce
- Discipline of Occupational Therapy, School of Health SciencesNational University of IrelandGalwayIreland
| | - Claudio Bassetti
- Department of Neurology, InselspitalUniversity of BernBernSwitzerland
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Murphy M, Erridge S, Holvey C, Coomber R, Rucker JJ, Sodergren MH. A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance. Neuropsychopharmacol Rep 2024; 44:129-142. [PMID: 38155535 PMCID: PMC10932782 DOI: 10.1002/npr2.12407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Research on cannabis-based medicinal products (CBMPs) in anxiety remains inconclusive due to a paucity of high-quality evidence. Studies indicate a bidirectional relationship between generalized anxiety disorder (GAD) and sleep disruption, but it is unclear how this affects CBMP treatment outcomes. This study aims to compare the patient-reported outcome measures (PROMs) of patients prescribed CBMPs for GAD, with and without impaired sleep. METHODS Changes in PROMs were recorded from baseline to 1, 3, 6, and 12 months between those with impaired or unimpaired sleep. Multivariate logistic regression was applied to compare factors associated with a clinically significant improvement in GAD-7 at 12 months. Secondary outcomes included adverse event incidence and frequency. RESULTS Of the 302 patients that fit the inclusion criteria, mean GAD-7, single-item sleep quality, and EQ-5D-5L index values improved at all time points (p < 0.001). A relationship between sleep impairment and clinically significant changes in GAD-7 at 1 and 3 months was identified (p ≤ 0.01). On multivariate regression, only baseline GAD severity was associated with an increased likelihood of observing a clinically significant improvement in anxiety (p < 0.001). Seven hundred and seven (234%) adverse events were reported by 55 (18.21%) participants. CONCLUSIONS This study observed an association between CBMP treatment and improvements in anxiety in patients with GAD. While patients with comorbid sleep disruption had greater improvements in anxiety, the differences were not maintained in a multivariate analysis. Baseline anxiety severity may be a predictor for CBMP treatment outcomes.
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Affiliation(s)
- Matthew Murphy
- Medical Cannabis Research GroupDepartment of Surgery and CancerImperial College LondonLondonUK
| | - Simon Erridge
- Medical Cannabis Research GroupDepartment of Surgery and CancerImperial College LondonLondonUK
- Sapphire Medical ClinicsLondonUK
| | | | - Ross Coomber
- Sapphire Medical ClinicsLondonUK
- St. George's Hospital NHS TrustLondonUK
| | - James J. Rucker
- Department of Psychological MedicineKings College LondonLondonUK
- South London & Maudsley NHS Foundation TrustLondonUK
| | - Mikael H. Sodergren
- Medical Cannabis Research GroupDepartment of Surgery and CancerImperial College LondonLondonUK
- Sapphire Medical ClinicsLondonUK
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Durand M, Castelli C, Roux-Marson C, Kinowski JM, Leguelinel-Blache G. Evaluating the costs of adverse drug events in hospitalized patients: a systematic review. HEALTH ECONOMICS REVIEW 2024; 14:11. [PMID: 38329561 PMCID: PMC10851489 DOI: 10.1186/s13561-024-00481-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Adverse drug events (ADEs) are not only a safety and quality of care issue for patients, but also an economic issue with significant costs. Because they often occur during hospital stays, it is necessary to accurately quantify the costs of ADEs. This review aimed to investigate the methods to calculate these costs, and to characterize their nature. METHODS A systematic literature review was conducted to identify methods used to assess the cost of ADEs on Medline, Web of Science and Google Scholar. Original articles published from 2017 to 2022 in English and French were included. Economic evaluations were included if they concerned inpatients. RESULTS From 127 studies screened, 20 studies were analyzed. There was a high heterogeneity in nature of costs, methods used, values obtained, and time horizon chosen. A small number of studies considered non-medical (10%), indirect (20%) and opportunity costs (5%). Ten different methods for assessing the cost of ADEs have been reported and nine studies did not explain how they obtained their values. CONCLUSIONS There is no consensus in the literature on how to assess the costs of ADEs, due to the heterogeneity of contexts and the choice of different economic perspectives. Our study adds a well-deserved overview of the existing literature that can be a solid lead for future studies and method implementation. TRIAL REGISTRATION PROSPERO registration CRD42023413071.
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Affiliation(s)
- Maxime Durand
- Department of Pharmacy, Nîmes University Hospital, Univ Montpellier, Nîmes, France.
| | - Christel Castelli
- Department of Law and Health Economics, Faculty of Pharmacy, Univ Montpellier, Montpellier, France
- Department of Innovation, Communication and Market, Univ Montpellier, Montpellier, France
- Department of Clinical Research, AESIO SANTE Méditerranée Beau Soleil Clinic, Montpellier, France
| | - Clarisse Roux-Marson
- Department of Pharmacy, Nîmes University Hospital, Univ Montpellier, Nîmes, France
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
| | - Jean-Marie Kinowski
- Department of Pharmacy, Nîmes University Hospital, Univ Montpellier, Nîmes, France
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
| | - Géraldine Leguelinel-Blache
- Department of Pharmacy, Nîmes University Hospital, Univ Montpellier, Nîmes, France
- Department of Law and Health Economics, Faculty of Pharmacy, Univ Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
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Zhao Y, Lu F, Wang X, Luo Y, Zhang R, He P, Zheng X. The economic burden of autism spectrum disorder with and without intellectual disability in China: A nationwide cost-of-illness study. Asian J Psychiatr 2024; 92:103877. [PMID: 38176313 DOI: 10.1016/j.ajp.2023.103877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE The economic burden of autism spectrum disorder (ASD) on individuals, their families and society as a whole is poorly understood. Accurate figures are crucial for economic estimates and service planning. METHODS The total lifetime individual costs and annual societal costs of ASD in China were estimated with a prevalence-based, gross cost of illness approach and data from multiple sources. The direct medical costs in outpatient and inpatient settings from the electronic health records (EHRs) of hospitals, and direct nonmedical costs from a national survey were included. The indirect costs were from both the national survey and the estimation using human capital methods. Age-specific lifetime incremental societal costs were measured. Comorbidity-related and unrelated costs were analyzed separately. RESULTS The discounted lifetime cost for an individual with ASD in China was $2.65 million (at 2020 prices, $) for those without intellectual disability (ID) and $4.61 million (at 2020 prices, $) for those with ID. The total cost of ASD amounted to $41.8 billion in 2020. Productivity loss were major cost drivers for ASD individuals without ID. Direct nonmedical costs (rehabilitation or adult care costs etc.) were major drivers for ASD individuals with ID. In a lifetime course, the total annual costs for middle aged and elderly (>42 years) were highest, followed by transitional adults (18-29 years) and preschoolers, both for individuals with or without ID. The distribution of costs over the lifespan varied by the cost category. CONCLUSIONS ASD imposes a substantial economic burden on families and health care systems. Sectors and services coordination should be given policy considerations.
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Affiliation(s)
- Yanan Zhao
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China
| | - Xiangyu Wang
- China Center for Food and Drug International Exchange, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing, China; Neuroscience Research Institute, Peking University, Beijing, China; Key laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, China; Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China.
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
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Shon WJ, Seong H, Song JW, Shin DM. Taste receptor type 1 member 3 is required for the fertility of male mice. Heliyon 2024; 10:e24577. [PMID: 38312691 PMCID: PMC10835302 DOI: 10.1016/j.heliyon.2024.e24577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Male infertility is a global health concern. However, its underlying pathophysiology remains unclear. Taste receptor type 1 member 3 (TAS1R3) is highly expressed in the testes, indicating its potential involvement in male fertility. Using wild-type and Tas1r3 knockout (KO) mice, we investigated whether TAS1R3 modulates male reproductive function. Tas1r3 KO mice exhibited reduced male fertility compared to WT mice, with fewer live pups per litter and a delayed first litter. Testicular transcriptome analysis indicated suppressed PKA/CREB/StAR signaling-mediated testosterone synthesis in Tas1r3 KO mice. In silico single-cell RNA sequencing revealed considerably higher Tas1r3 expression in Leydig cells than in other testicular cell subtypes. An in vitro study validated that Tas1r3 knockdown downregulated the expression of Creb1 and steroidogenic genes in Leydig cells. Our results suggest that testicular TAS1R3 is intricately involved in male reproduction via the PKA/CREB/StAR signaling pathway, highlighting its potential as a promising target for addressing male infertility.
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Affiliation(s)
- Woo-Jeong Shon
- Research Institute of Human Ecology, Seoul National University, Gwanak-gu, Seoul 08826, Republic of Korea
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Hobin Seong
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae Won Song
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Dong-Mi Shin
- Research Institute of Human Ecology, Seoul National University, Gwanak-gu, Seoul 08826, Republic of Korea
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
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Cao H, Wu Y, Yin H, Sun Y, Yuan H, Tao M. Global Trends in the Incidence of Anxiety Disorders From 1990 to 2019: Joinpoint and Age-Period-Cohort Analysis Study. JMIR Public Health Surveill 2024; 10:e49609. [PMID: 38285497 PMCID: PMC10862248 DOI: 10.2196/49609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/25/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Anxiety disorders (ADs) are the most common mental illness with high prevalence, chronicity, and comorbidity. Despite rapid economic and cultural development, the global incidence of ADs continues to increase, with predominance in male individuals. OBJECTIVE To address the above issues, we analyzed the dynamic trends of the global incidence and disease burden of ADs from 1990 to 2019 and their different effects on age, period, and birth cohort and predicted the future trend of AD incidence. METHODS The data were obtained from the Global Burden of Disease study in 2019. A joinpoint regression model was used to calculate the annual percent change in AD incidence, and age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort. Nordpred age-period-cohort analysis was used to predict the incidence of ADs from 2020 to 2044. RESULTS The age-standardized incidence rate of ADs increased by 1.06% for both sexes, and the age-standardized disability-adjusted life-year (DALY) rate (ASDR) decreased by 0.12%. Joinpoint regression indicated that increments in average annual percent changes in the age-standardized incidence rate (0.068 vs 0.012) and ASDR (0.035 vs -0.015) for ADs globally were higher among male individuals than female individuals. The age-period-cohort analyses revealed that the relative risk (RR) of the incidence and DALYs of ADs among people of different sexes increased with age in adolescence and middle age and then decreased. For the period effect, the RR of incidence decreased, whereas the RR of DALYs increased in both sexes. Moreover, the RR of the incidence gradually increased and DALYs slowly decreased with birth year for both male and female individuals. New cases of ADs in male individuals are predicted to increase in the coming 25 years. CONCLUSIONS This study provided the changing trend of the global incidence and disease burden of ADs in the past 3 decades, indicating that early prevention and effective control cannot be ignored. We analyzed the age-period-cohort effect of potential trends in ADs and predicted future incidence trends. The results suggest that we should take active intervention measures, focusing on high-risk groups and developing effective management and control policies to reduce the global burden of disease.
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Affiliation(s)
- Huiru Cao
- Department of Gastroenterology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yang Wu
- Department of Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Hui Yin
- Department of Hospital Infection, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yanqi Sun
- Department of Prevention and Health Care, People's Hospital of Rizhao, Rizhao, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Mengjun Tao
- Department of Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Ulrich S, Gantenbein AR, Zuber V, Von Wyl A, Kowatsch T, Künzli H. Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial. J Med Internet Res 2024; 26:e50132. [PMID: 38265863 PMCID: PMC10851123 DOI: 10.2196/50132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/20/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Primary headaches, including migraine and tension-type headaches, are widespread and have a social, physical, mental, and economic impact. Among the key components of treatment are behavior interventions such as lifestyle modification. Scalable conversational agents (CAs) have the potential to deliver behavior interventions at a low threshold. To our knowledge, there is no evidence of behavioral interventions delivered by CAs for the treatment of headaches. OBJECTIVE This study has 2 aims. The first aim was to develop and test a smartphone-based coaching intervention (BalanceUP) for people experiencing frequent headaches, delivered by a CA and designed to improve mental well-being using various behavior change techniques. The second aim was to evaluate the effectiveness of BalanceUP by comparing the intervention and waitlist control groups and assess the engagement and acceptance of participants using BalanceUP. METHODS In an unblinded randomized controlled trial, adults with frequent headaches were recruited on the web and in collaboration with experts and allocated to either a CA intervention (BalanceUP) or a control condition. The effects of the treatment on changes in the primary outcome of the study, that is, mental well-being (as measured by the Patient Health Questionnaire Anxiety and Depression Scale), and secondary outcomes (eg, psychosomatic symptoms, stress, headache-related self-efficacy, intention to change behavior, presenteeism and absenteeism, and pain coping) were analyzed using linear mixed models and Cohen d. Primary and secondary outcomes were self-assessed before and after the intervention, and acceptance was assessed after the intervention. Engagement was measured during the intervention using self-reports and usage data. RESULTS A total of 198 participants (mean age 38.7, SD 12.14 y; n=172, 86.9% women) participated in the study (intervention group: n=110; waitlist control group: n=88). After the intervention, the intention-to-treat analysis revealed evidence for improved well-being (treatment: β estimate=-3.28, 95% CI -5.07 to -1.48) with moderate between-group effects (Cohen d=-0.66, 95% CI -0.99 to -0.33) in favor of the intervention group. We also found evidence of reduced somatic symptoms, perceived stress, and absenteeism and presenteeism, as well as improved headache management self-efficacy, application of behavior change techniques, and pain coping skills, with effects ranging from medium to large (Cohen d=0.43-1.05). Overall, 64.8% (118/182) of the participants used coaching as intended by engaging throughout the coaching and completing the outro. CONCLUSIONS BalanceUP was well accepted, and the results suggest that coaching delivered by a CA can be effective in reducing the burden of people who experience headaches by improving their well-being. TRIAL REGISTRATION German Clinical Trials Register DRKS00017422; https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00017422.
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Affiliation(s)
- Sandra Ulrich
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Andreas R Gantenbein
- Pain and Research Unit, ZURZACH Care, Bad Zurzach, Switzerland
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Viktor Zuber
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Agnes Von Wyl
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Hansjörg Künzli
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
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Chalet FX, Albanese E, Egea Santaolalla C, Ellis JG, Ferini-Strambi L, Heidbreder A, Léger D, Modi K, Morin CM, Olopoenia A. Epidemiology and burden of chronic insomnia disorder in Europe: an analysis of the 2020 National Health and Wellness Survey. J Med Econ 2024; 27:1308-1319. [PMID: 39318277 DOI: 10.1080/13696998.2024.2407631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 09/26/2024]
Abstract
INTRODUCTION Chronic insomnia disorder (CID) is considered a significant worldwide public health concern; however, its exact burden is unknown. We estimate its prevalence across France, Germany, Italy, Spain, and the United Kingdom, and assess the economic and humanistic burden for a broader insomnia population. METHODS This retrospective, cross-sectional, observational study used 2020 National Health and Wellness Survey (NHWS) data. Patients reporting insomnia were characterized to define CID. Health-related quality of life (HRQoL), work productivity, and healthcare resource use (HCRU) outcomes were assessed in four cohorts according to insomnia diagnosis and treatment status and examined using multivariable analyses according to Insomnia Severity Index categories. RESULTS Among 62,319 respondents, 9,035 (21.2%) reported experiencing insomnia over the previous 12 months. CID prevalence rates were 5.5% to 6.7% across the five countries and 6.0% overall. HRQoL outcomes were persistently poorer in cohorts of patients diagnosed with insomnia than those with undiagnosed insomnia. Undiagnosed and treated insomnia patients reported the highest work presenteeism and total work productivity impairment and the highest number of emergency room and hospitalization visits than patients with insomnia (either treated or untreated). After adjusting for covariates, patients with severe insomnia reported significantly worse EQ-5D-5L utility scores, higher absenteeism and presenteeism rates, and more healthcare provider visits over the past 6 months than patients without insomnia (all p < 0.01). CONCLUSIONS Our prevalence rates for CID align with published literature. A diagnosis of insomnia, use of sleep medications, and severity of insomnia are associated with poor quality of life, loss of work productivity, and higher HCRU, confirming the high unmet need and substantial humanistic and economic burden of CID.
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Affiliation(s)
| | - Emiliano Albanese
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | | | - Jason G Ellis
- Department of Psychology, Northumbria University, Newcastle, UK
| | | | - Anna Heidbreder
- Department of Neurology, Johannes Kepler University Linz, Linz, Austria
| | - Damien Léger
- Centre du Sommeil et de la Vigilance, Université Paris Cité, Paris, France
| | - Kushal Modi
- Oracle Life Sciences, Real World Evidence, Austin, Texas, USA
| | - Charles M Morin
- School of Psychology and Centre de recherche CERVO/Brain Research Center, Université Laval, Québec City, Canada
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Bertl M, Bignoumba N, Ross P, Yahia SB, Draheim D. Evaluation of deep learning-based depression detection using medical claims data. Artif Intell Med 2024; 147:102745. [PMID: 38184352 DOI: 10.1016/j.artmed.2023.102745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/08/2024]
Abstract
Human accuracy in diagnosing psychiatric disorders is still low. Even though digitizing health care leads to more and more data, the successful adoption of AI-based digital decision support (DDSS) is rare. One reason is that AI algorithms are often not evaluated based on large, real-world data. This research shows the potential of using deep learning on the medical claims data of 812,853 people between 2018 and 2022, with 26,973,943 ICD-10-coded diseases, to predict depression (F32 and F33 ICD-10 codes). The dataset used represents almost the entire adult population of Estonia. Based on these data, to show the critical importance of the underlying temporal properties of the data for the detection of depression, we evaluate the performance of non-sequential models (LR, FNN), sequential models (LSTM, CNN-LSTM) and the sequential model with a decay factor (GRU-Δt, GRU-decay). Furthermore, since explainability is necessary for the medical domain, we combine a self-attention model with the GRU decay and evaluate its performance. We named this combination Att-GRU-decay. After extensive empirical experimentation, our model (Att-GRU-decay), with an AUC score of 0.990, an AUPRC score of 0.974, a specificity of 0.999 and a sensitivity of 0.944, proved to be the most accurate. The results of our novel Att-GRU-decay model outperform the current state of the art, demonstrating the potential usefulness of deep learning algorithms for DDSS development. We further expand this by describing a possible application scenario of the proposed algorithm for depression screening in a general practitioner (GP) setting-not only to decrease healthcare costs, but also to improve the quality of care and ultimately decrease people's suffering.
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Affiliation(s)
- Markus Bertl
- Department of Health Technologies, Tallinn University of Technology, Akadeemia Tee 15A, Tallinn, 12618, Estonia.
| | - Nzamba Bignoumba
- Department of Software Science, Tallinn University of Technology, Akadeemia Tee 15A, Tallinn, 12618, Estonia
| | - Peeter Ross
- Department of Health Technologies, Tallinn University of Technology, Akadeemia Tee 15A, Tallinn, 12618, Estonia; Department of Research, East-Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Sadok Ben Yahia
- Department of Software Science, Tallinn University of Technology, Akadeemia Tee 15A, Tallinn, 12618, Estonia; University of Southern Denmark, Alsion 2, Sønderborg, 6400, Denmark
| | - Dirk Draheim
- Information Systems Group, Tallinn University of Technology, Akadeemia Tee 15A, Tallinn, 12618, Estonia
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Majuri M, Wallius MA. Promoting mental health through collaboration between workplaces and occupational health services - Preliminary findings from a survey and workshop in Finland. Prev Med Rep 2024; 37:102534. [PMID: 38162117 PMCID: PMC10755463 DOI: 10.1016/j.pmedr.2023.102534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 10/31/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024] Open
Abstract
Disability due to mental health problems places a significant burden on both society and the individual. Occupational health professionals play a key role in promoting mental health in collaboration with workplaces. Our study focused on the joint preventive mental health practices of workplaces and occupational health services (OHS). We used a multiple method approach. We gathered data in parallel from September to October 2021 through an online survey and a workshop of 102 participants. The survey was sent to 25 workplaces and their OHS (N = 25), and assessed employee perceptions of collaboration in mental health practices. We set no exclusion criteria and included all responses. We used Fisher's Exact Test in the statistical analysis. We studied 140 comments on the means of the mental health support obtained in the workshop, using content analysis. The survey response rate was 78 % (N = 39). The OHS providers (N = 15) claimed that mental health support was being provided through collaboration, and 74 % (N = 24) of the workplaces agreed. Content analysis streamlined collaboration methods into six upper categories: by (1) Planning measures together, (2) Strengthening employees' resources, (3) Discussing work ability, (4) Providing supervisors/managers with support, (5) Discussing and collaborating, and (6) Clarifying responsibilities and roles in the support of mental health. We found 55 different practices for streamlining collaboration between workplaces and OHS. We conclude that the practices to promote mental health through collaboration between workplaces and OHS require joint planning.
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Affiliation(s)
- Minna Majuri
- Finnish Institute of Occupational Health, Finland
- University of Helsinki, Faculty of Medicine, Clinicum, Department of Public Health, Finland
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Jalali R, Godlewska I, Fadrowska-Szleper M, Pypkowska A, Kern A, Bil J, Manta J, Romaszko J. Significance of S100B Protein as a Rapid Diagnostic Tool in Emergency Departments for Traumatic Brain Injury Patients. J Pers Med 2023; 13:1724. [PMID: 38138951 PMCID: PMC10744632 DOI: 10.3390/jpm13121724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Traumatic brain injuries (TBIs) are not only the leading cause of death among people below 44 years of age, but also one of the biggest diagnostic challenges in the emergency set up. We believe that the use of serum biomarkers in diagnosis can help to improve patient care in TBI. One of them is the S100B protein, which is currently proposed as a promising diagnostic tool for TBI and its consequences. In our study, we analyzed serum biomarker S100B in 136 patients admitted to the Emergency Department of the Regional Specialist Hospital in Olsztyn. Participants were divided into three groups: patients with head trauma and alcohol intoxication, patients with head trauma with no alcohol intoxication and a control group of patients with no trauma or with injury in locations other than the head. In our study, as compared to the control group, patients with TBI had a significantly higher S100B level (both with and without intoxication). Moreover, in both groups, the mean S100B protein level was significantly higher in patients with pathological changes in CT. According to our study results, the S100B protein is a promising diagnostic tool, and we propose including its evaluation in routine regimens in patients with TBI.
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Affiliation(s)
- Rakesh Jalali
- Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland; (I.G.); (M.F.-S.); (A.P.)
- Clinical Emergency Department, Regional Specialist Hospital, 10-561 Olsztyn, Poland
| | - Izabela Godlewska
- Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland; (I.G.); (M.F.-S.); (A.P.)
| | - Magdalena Fadrowska-Szleper
- Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland; (I.G.); (M.F.-S.); (A.P.)
| | - Agata Pypkowska
- Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland; (I.G.); (M.F.-S.); (A.P.)
| | - Adam Kern
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland;
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Joanna Manta
- Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland; (I.G.); (M.F.-S.); (A.P.)
- Clinical Emergency Department, Regional Specialist Hospital, 10-561 Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland;
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Papst L, Zickwolf C, Käfer M, Beierlein V, Köllner V. Responsivity and relation to depressive symptoms of occupational behavior and experience patterns. Front Public Health 2023; 11:1271486. [PMID: 38170056 PMCID: PMC10758614 DOI: 10.3389/fpubh.2023.1271486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Work stress is a frequent factor in the development of depression. However, not only workplace environment, but also personal attitudes may affect stress experience. The aim of this study was to investigate the change sensitivity of occupational attitudes in psychosomatic inpatients and assess the relationship of changes to depressive symptom reduction. Methods The data set encompassed N = 1708 inpatients from two German psychosomatic rehabilitation clinics at admission and discharge. Responsivity of AVEM measures was evaluated by Bonferroni-corrected t-tests and Cohen's dz effect sizes for paired samples. The relation of occupational behavior and experience patterns and depressive symptoms as assessed by the BDI-II questionnaire was calculated by Pearson correlation analysis of pre-post differential values. Results Changes in work attitudes were found on eight out of eleven AVEM subscales (Padj ≤ 0.001, Cohen's dz = -0.45 to 0.43) and all AVEM coping styles. Most patients (57.4%) were classified to have a Burnout occupational coping style at admission. Changes following rehabilitation were most frequently observed from Burnout to Sparing coping styles (8.3%). Small to moderate associations between changes in occupational attitudes and depressive symptom reduction were found for all subscales (r = -0.39 to 0.25) except work ambition, and for occupational coping styles Burnout (r = 0.19), Sparing (r = -0.18) and Healthy (r = -0.10), but not Ambitious. Discussion The data support responsivity of occupational behavior and experience patterns within a psychosomatic rehabilitation setting. Correlations with depressive symptom reduction suggest that occupational attitudes are related but separate treatment targets.
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Affiliation(s)
- Lilia Papst
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – University Medicine Berlin, Berlin, Germany
| | - Christian Zickwolf
- Mediclin Bliestal Clinics, Clinic for Psychosomatic Medicine, Blieskastel, Germany
| | - Michael Käfer
- Mediclin Bliestal Clinics, Clinic for Psychosomatic Medicine, Blieskastel, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – University Medicine Berlin, Berlin, Germany
- Department of Psychosomatics and Behavioural Psychotherapy, Rehabilitation Centre Seehof, Teltow, Germany
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Tumurbaatar E, Bat-Erdene E, Amartuvshin T, Dashtseren M, Tumur-Ochir G, Boldbaatar D, Jadamba T, Hiramoto T, Oka T, Lkhagvasuren B. Heart rate variability and tension-type headache: A population-based cross-sectional study. IBRO Neurosci Rep 2023; 15:194-202. [PMID: 38204569 PMCID: PMC10776315 DOI: 10.1016/j.ibneur.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/11/2023] [Accepted: 09/09/2023] [Indexed: 01/12/2024] Open
Abstract
Background The relationship between tension-type headache (TTH) and autonomic functions is poorly understood, although TTH is one of the most prevalent disorders in the general population. The aim of this study was to investigate the direct and indirect effects of TTH on the autonomic functions measured by heart rate variability (HRV). Methods This population-based cross-sectional study was carried out in the general population of Ulaanbaatar between July and September in 2020. After physical examination, trained researchers applied structured interviews to examine the remote history of TTH and mental distress, followed by a recording of HRV to detect autonomic activity. Psychological factors and the quality of life were measured using Hospital Anxiety Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). Binary logistic regression and GLM mediation model analysis were used to examine the effects of risk factors on the associations between TTH and autonomic functions. Results Among participants (n = 217, mean age=41.8 ± 11.5 years), a total of 117 (53.9%) participants had a remote history of TTH. The age and sex-adjusted prevalence was 43%. Groups did not differ statistically in the HRV indices. LF/HF (ratio of low-frequency to high frequency), the index of sympathovagal balance, was correlated with the HADS anxiety. TTH was associated with mental distress. Binary logistic regression analysis confirms the relationship suggesting that TTH was associated with increased likelihood of mental distress, and decreasing RMSSD (root mean square of the sum of the squares of differences between adjacent NN intervals) and pNN50 (NN50 divided by the total number of NN intervals) were the independent predictors of TTH. GLM mediation model indicated that the relationship between TTH and RMSSD was mediated by mental distress. Conclusions The present study suggests that mental distress is a critical factor in the association between TTH and autonomic dysfunction. Additionally, our findings demonstrate the influence of age and gender on TTH. These results highlight the need to understand the mechanisms underlying pathophysiology to facilitate targeted and efficacious prevention and management approaches for TTH.
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Affiliation(s)
- Enkhnaran Tumurbaatar
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar 16066, Mongolia
- Brain Science Institute, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Enkhjin Bat-Erdene
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar 16066, Mongolia
- Child Health Institute of New Jersey, Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
| | - Tsolmontuya Amartuvshin
- Department of Surveillance and Statistics, National Center for Mental Health, Ulaanbaatar 13280, Mongolia
| | - Myagmartseren Dashtseren
- Department of Surveillance and Statistics, National Center for Mental Health, Ulaanbaatar 13280, Mongolia
| | - Gantsetseg Tumur-Ochir
- Department of Surveillance and Statistics, National Center for Mental Health, Ulaanbaatar 13280, Mongolia
| | - Damdindorj Boldbaatar
- Brain Science Institute, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Tsolmon Jadamba
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar 16066, Mongolia
| | - Tetsuya Hiramoto
- Department of Psychosomatic Medicine, Fukuoka National Hospital, National Hospital Organization, Fukuoka, Fukuoka 811-1394, Japan
| | - Takakazu Oka
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba 286-8520, Japan
| | - Battuvshin Lkhagvasuren
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar 16066, Mongolia
- Brain Science Institute, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba 286-8520, Japan
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Henning A, Linden M, Muschalla B. Self- and observer ratings of capacity limitations in patients with neurological conditions. BRAIN IMPAIR 2023; 24:586-600. [PMID: 38167355 DOI: 10.1017/brimp.2022.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships. METHOD The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S). RESULTS Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings. CONCLUSIONS The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.
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Affiliation(s)
- Anne Henning
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
- Brandenburgklinik Berlin-Brandenburg, Bernau bei Berlin, Germany
| | - Michael Linden
- Research Group Psychosomatic Rehabilitation, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Beate Muschalla
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
- Brandenburgklinik Berlin-Brandenburg, Bernau bei Berlin, Germany
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Yip PK, Liu ZH, Hasan S, Pepys MB, Uff CEG. Serum amyloid P component accumulates and persists in neurones following traumatic brain injury. Open Biol 2023; 13:230253. [PMID: 38052249 DOI: 10.1098/rsob.230253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/19/2023] [Indexed: 12/07/2023] Open
Abstract
The mechanisms underlying neurodegenerative sequelae of traumatic brain injury (TBI) are poorly understood. The normal plasma protein, serum amyloid P component (SAP), which is normally rigorously excluded from the brain, is directly neurocytotoxic for cerebral neurones and also binds to Aβ amyloid fibrils and neurofibrillary tangles, promoting formation and persistence of Aβ fibrils. Increased brain exposure to SAP is common to many risk factors for dementia, including TBI, and dementia at death in the elderly is significantly associated with neocortical SAP content. Here, in 18 of 30 severe TBI cases, we report immunohistochemical staining for SAP in contused brain tissue with blood-brain barrier disruption. The SAP was localized to neurofilaments in a subset of neurones and their processes, particularly damaged axons and cell bodies, and was present regardless of the time after injury. No SAP was detected on astrocytes, microglia, cerebral capillaries or serotoninergic neurones and was absent from undamaged brain. C-reactive protein, the control plasma protein most closely similar to SAP, was only detected within capillary lumina. The appearance of neurocytotoxic SAP in the brain after TBI, and its persistent, selective deposition in cerebral neurones, are consistent with a potential contribution to subsequent neurodegeneration.
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Affiliation(s)
- Ping K Yip
- Centre for Neuroscience, Surgery & Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Zhou-Hao Liu
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shumaila Hasan
- Department of Neurosurgery, Royal London Hospital, Whitechapel, London E1 1FR, UK
| | - Mark B Pepys
- Wolfson Drug Discovery Unit, University College London, London NW3 2PG, UK
| | - Christopher E G Uff
- Centre for Neuroscience, Surgery & Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
- Department of Neurosurgery, Royal London Hospital, Whitechapel, London E1 1FR, UK
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Ell J, Schmid SR, Benz F, Spille L. Complementary and alternative treatments for insomnia disorder: a systematic umbrella review. J Sleep Res 2023; 32:e13979. [PMID: 37527850 DOI: 10.1111/jsr.13979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 08/03/2023]
Abstract
Insomnia is a common disorder and cognitive behavioural therapy for insomnia (CBT-I) is recommended as first-line treatment. However, CBT-I is not widely distributed and infrequently available while medication is not indicated for long-term use. To close this evident gap in supply, alternative treatments could be utilised. High-quality research on this topic is scarce, and there is currently no comprehensive publication on the effectiveness of alternative treatments. To address this pressing question, we systematically summarised the existing research on alternative treatments for insomnia. A comprehensive search of systematic reviews and (network) meta-analyses of randomised controlled trials investigating the efficacy of alternative treatments compared to waiting-list control or placebo in adults with insomnia disorder with or without comorbidities was conducted in PubMed, MEDLINE, PsycInfo, and PsycArticles on December 6, 2022, yielding 391 records. Finally, 15 eligible studies were included. Evidence on acupuncture, exogenous melatonin, mind-body interventions and exercise, repetitive transcranial magnetic stimulation (rTMS), valerian, and light exposure was found. Acupuncture, rTMS and mind-body exercises significantly improved sleep quality and insomnia severity but effects on objectively assessed outcomes were inconclusive. Melatonin led to a reduction in both self-reported and objectively assessed sleep onset latency. Light exposure and valerian did not significantly improve sleep outcomes. Overall, the quality of studies was rated as low. Results indicate that alternative treatments are effective mostly on subjective outcomes. However, evidence on the efficacy of some intervention types is sparse and there is a need for high-quality original studies. Future research could investigate whether combining different alternative treatment aspects with CBT-I improves individual treatment.
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Affiliation(s)
- Johanna Ell
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Sarah R Schmid
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Lukas Spille
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre - University of Freiburg, University of Freiburg, Freiburg, Germany
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Falkai P, Rossner MJ, Raabe FJ, Wagner E, Keeser D, Maurus I, Roell L, Chang E, Seitz-Holland J, Schulze TG, Schmitt A. Disturbed Oligodendroglial Maturation Causes Cognitive Dysfunction in Schizophrenia: A New Hypothesis. Schizophr Bull 2023; 49:1614-1624. [PMID: 37163675 PMCID: PMC10686333 DOI: 10.1093/schbul/sbad065] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND HYPOTHESIS Cognitive impairment is a hallmark of schizophrenia, but no effective treatment is available to date. The underlying pathophysiology includes disconnectivity between hippocampal and prefrontal brain regions. Supporting evidence comes from diffusion-weighted imaging studies that suggest abnormal organization of frontotemporal white matter pathways in schizophrenia. STUDY DESIGN Here, we hypothesize that in schizophrenia, deficient maturation of oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes substantially contributes to abnormal frontotemporal macro- and micro-connectivity and subsequent cognitive deficits. STUDY RESULTS Our postmortem studies indicate a reduced oligodendrocyte number in the cornu ammonis 4 (CA4) subregion of the hippocampus, and others have reported the same histopathological finding in the dorsolateral prefrontal cortex. Our series of studies on aerobic exercise training showed a volume increase in the hippocampus, specifically in the CA4 region, and improved cognition in individuals with schizophrenia. The cognitive effects were subsequently confirmed by meta-analyses. Cell-specific schizophrenia polygenic risk scores showed that exercise-induced CA4 volume increase significantly correlates with OPCs. From animal models, it is evident that early life stress and oligodendrocyte-related gene variants lead to schizophrenia-related behavior, cognitive deficits, impaired oligodendrocyte maturation, and reduced myelin thickness. CONCLUSIONS Based on these findings, we propose that pro-myelinating drugs (e.g., the histamine blocker clemastine) combined with aerobic exercise training may foster the regeneration of myelin plasticity as a basis for restoring frontotemporal connectivity and cognition in schizophrenia.
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Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Moritz J Rossner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Florian J Raabe
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Lukas Roell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Emily Chang
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Thomas G Schulze
- Institute for Psychiatric Phenomic and Genomic (IPPG), Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo (USP), São Paulo-SP, Brazil
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Toubasi A, Al-Sayegh TN. Short-term Exposure to Air Pollution and Ischemic Stroke: A Systematic Review and Meta-analysis. Neurology 2023; 101:e1922-e1932. [PMID: 37758483 PMCID: PMC10662999 DOI: 10.1212/wnl.0000000000207856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/28/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has established a connection between extended exposure to air pollutants and ischemic stroke. However, the link between short-term exposure to air pollutants and stroke remains less definitive. METHODS A comprehensive search was conducted on MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences databases up until February 2023, without any language restrictions. The inclusion criteria encompassed observational or interventional studies that examined the correlation between short-term exposure to air pollutants (carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2], ozone [O3]) and particulate matter with diameters of less than 1 µm, less than 2.5 µm, or less than 10 µm (PM1, PM2.5, and PM10), with the incidence and mortality of ischemic stroke. Short-term exposure was defined as exposure occurring within 5 days of the onset of stroke. RESULTS A total of 18,035,408 cases of ischemic stroke were included in the analysis, derived from 110 observational studies. Asia accounted for most included studies, representing 58.8% of the total. By contrast, Europe and the Americas contributed 24.6% and 16.7% of the studies, respectively. Notably, none of the included studies were conducted in Africa. Stroke incidence was significantly associated with an increase in the concentration of NO2 (RR = 1.28; 95% CI 1.21-1.36), O3 (RR = 1.05; 95% CI 1.03-1.07), CO (RR = 1.26; 95% CI 1.21-1.32), SO2 (RR = 1.15; 95% CI 1.11-1.19), PM1 (RR = 1.09; 95% CI 1.06-1.12), PM2.5 (RR = 1.15; 95% CI 1.13-1.17), and PM10 (RR = 1.14; 95% CI 1.12-1.16). Moreover, an increase in the concentration of NO2 (RR = 1.33; 95% CI 1.07-1.65), SO2 (RR = 1.60; 95% CI 1.05-2.44), PM2.5 (RR = 1.09; 95% CI 1.04-1.15), and PM10 (RR = 1.02; 95% CI 1.00-1.04) was associated with an increase in stroke mortality. DISCUSSION There is a strong and significant correlation between gaseous and particulate air pollutants and the occurrence and mortality rates of stroke. This close temporal association underscores the importance of implementing global initiatives to develop policies aimed at reducing air pollution. By doing so, alleviate the burden of ischemic stroke and its consequences.
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Affiliation(s)
- Ahmad Toubasi
- From the Faculty of Medicine, the University of Jordan, Amman.
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Chmiel J, Gladka A, Leszek J. The Effect of Transcranial Direct Current Stimulation (tDCS) on Anorexia Nervosa: A Narrative Review. Nutrients 2023; 15:4455. [PMID: 37892530 PMCID: PMC10610104 DOI: 10.3390/nu15204455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Introduction: Anorexia nervosa (AN) is a severe, debilitating disease with high incidence and high mortality. The methods of treatment used so far are moderately effective. Evidence from neuroimaging studies helps to design modern methods of therapy. One of them is transcranial direct current stimulation (tDCS), a non-invasive brain neuromodulation technique. (2) Methods: The purpose of this narrative review is to bring together all studies investigating the use of tDCS in the treatment of AN and to evaluate its effect and efficiency. Searches were conducted in the Pubmed/Medline, Research Gate, and Cochrane databases. (3) Results: The literature search resulted in five articles. These studies provide preliminary evidence that tDCS has the potential to alter eating behaviour, body weight, and food intake. Additionally, tDCS reduced symptoms of depression. Throughout all trials, stimulation targeted the left dorsolateral prefrontal cortex (DLPFC). Although the number of studies included is limited, attempts were made to elucidate the potential mechanisms underlying tDCS action in individuals with AN. Recommendations for future tDCS research in AN were issued. (4) Conclusions: The included studies have shown that tDCS stimulation of the left DLPFC has a positive effect on AN clinical symptoms and may improve them, as measured by various assessment measures. It is important to conduct more in-depth research on the potential benefits of using tDCS for treating AN. This should entail well-designed studies incorporating advanced neuroimaging techniques, such as fMRI. The aim is to gain a better understanding of how tDCS works in AN.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Anna Gladka
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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Rinaldi G, Osman N, Kaess M, Schimmelmann BG, Kindler J, Schultze-Lutter F, Michel C. Exploring the complex relationships between coping strategies, locus of control and self-esteem with psychopathology: structural equation modeling with a special focus on clinical high-risk of psychosis. Eur Psychiatry 2023; 66:e88. [PMID: 37848406 PMCID: PMC10755569 DOI: 10.1192/j.eurpsy.2023.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Coping strategies, competence, and locus of control (LOC) beliefs are important predictors of mental health (MH). However, research into their complex interactions has produced mixed results. Our study investigated them further in the previously unexplored context of clinical high-risk (CHR) of psychosis. METHODS We tested six alternative structural equation models in a community sample (N = 523), hypothesizing a mediating role of coping and treating CHR symptoms as (i) an additional mediator or (ii) a specific outcome. Our measurement model included two latent factors of MH: (1) psychopathology (PP), consisting of presence of mental disorders, global and psychosocial functioning, and (2) self-rated health (SRH) status. RESULTS In the model with the best Akaike Information Criterion and the latent factors as outcome variables, maladaptive coping completely mediated the impact of maladaptive LOC on PP and SRH. Additionally, CHR symptoms partially mediated the effect of maladaptive coping on PP and SRH in the community sample, as long as sex was not entered into the model. In the clinical sample (N = 371), the model did not support a mediation by CHR symptoms, despite significant pathways with both coping and MH outcomes; further, competence beliefs directly impacted SRH. CONCLUSIONS Coping strategies are an important intervention target for MH promotion, especially in the community. In clinical populations, interventions focusing on coping strategies may improve CHR symptoms, thus potentially supporting better MH, especially SRH. Additionally, due to their mostly cascading effects on MH, improving competence and LOC beliefs may also promote psychological well-being.
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Affiliation(s)
- Giulia Rinaldi
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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50
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Hickie IB, Iorfino F, Rohleder C, Song YJC, Nichles A, Zmicerevska N, Capon W, Guastella AJ, Leweke FM, Scott J, McGorry P, Mihalopoulos C, Killackey E, Chong MK, McKenna S, Aji M, Gorban C, Crouse JJ, Koethe D, Battisti R, Hamilton B, Lo A, Hackett ML, Hermens DF, Scott EM. EMPOWERED trial: protocol for a randomised control trial of digitally supported, highly personalised and measurement-based care to improve functional outcomes in young people with mood disorders. BMJ Open 2023; 13:e072082. [PMID: 37821139 PMCID: PMC10583041 DOI: 10.1136/bmjopen-2023-072082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/08/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES Many adolescents and young adults with emerging mood disorders do not achieve substantial improvements in education, employment, or social function after receiving standard youth mental health care. We have developed a new model of care referred to as 'highly personalised and measurement-based care' (HP&MBC). HP&MBC involves repeated assessment of multidimensional domains of morbidity to enable continuous and personalised clinical decision-making. Although measurement-based care is common in medical disease management, it is not a standard practice in mental health. This clinical effectiveness trial tests whether HP&MBC, supported by continuous digital feedback, delivers better functional improvements than standard care and digital support. METHOD AND ANALYSIS This controlled implementation trial is a PROBE study (Prospective, Randomised, Open, Blinded End-point) that comprises a multisite 24-month, assessor-blinded, follow-up study of 1500 individuals aged 15-25 years who present for mental health treatment. Eligible participants will be individually randomised (1:1) to 12 months of HP&MBC or standardised clinical care. The primary outcome measure is social and occupational functioning 12 months after trial entry, assessed by the Social and Occupational Functioning Assessment Scale. Clinical and social outcomes for all participants will be monitored for a further 12 months after cessation of active care. ETHICS AND DISSEMINATION This clinical trial has been reviewed and approved by the Human Research Ethics Committee of the Sydney Local Health District (HREC Approval Number: X22-0042 & 2022/ETH00725, Protocol ID: BMC-YMH-003-2018, protocol version: V.3, 03/08/2022). Research findings will be disseminated through peer-reviewed journals, presentations at scientific conferences, and to user and advocacy groups. Participant data will be deidentified. TRIAL REGISTRATION NUMBER ACTRN12622000882729.
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Affiliation(s)
- Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Cathrin Rohleder
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alissa Nichles
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Natalia Zmicerevska
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - William Capon
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Adam J Guastella
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - F Markus Leweke
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Medicine Mannheim, Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Jan Scott
- Newcastle University, Newcastle upon Tyne, UK
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne Australia, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne Australia, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Min K Chong
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sarah McKenna
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Melissa Aji
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Carla Gorban
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jacob J Crouse
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Blake Hamilton
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
- headspace Camperdown, Camperdown, New South Wales, Australia
| | - Alice Lo
- Mind Plasticity, Sydney, New South Wales, Australia
| | - Maree L Hackett
- George Institute for Global Health, Newtown, New South Wales, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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