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Affiliation(s)
- Art Walaszek
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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Moreno-Lacalle RC, Bangsal MR, Bay-Ya MRT, Erese KAR, Gabol LAP, Geronimo MM, Legiralde SBB, Lomandas MMA, Menzi MMR, Real CDL, Solis JMBF, Ufina KU, Lacanaria MGC. Beliefs and Practices on Depression Among Selected Filipino Indigenous Peoples: A Focused Ethnography. J Transcult Nurs 2023; 34:321-329. [PMID: 37358240 DOI: 10.1177/10436596231183183] [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: 06/27/2023] Open
Abstract
INTRODUCTION Depression beliefs and practices among indigenous peoples are essential to creating responsive mental health services. The purpose of the study is to explore the cultural beliefs and practices on depression among the Ilocanos, Kankana-eys, and Maranaos indigenous peoples in the Philippines. METHOD The study employed a focused ethnography research design. The study involved 41 (N = 41) traditional healers and tribal leaders across Ilocano, Kankana-ey, and Maranao ethnic groups in the Philippine Islands. Interviews, reviews of records, and participant observation were used as data gathering tools. RESULTS Beliefs about depression include magico-spiritual influence, relational problems, economic pressure, and emotional domains. Practices were divided into three domains: preventive, curative, and rehabilitative interventions. DISCUSSION The depression beliefs and practices of Ilocano, Kankana-ey, and Maranao indigenous peoples are rooted in their tradition, culture, religion, and medical influences largely rooted in magico-spiritual approaches. These findings suggest the inclusion of culturally-based care to address depression.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Cici Donna L Real
- Jamaica Hospital and Medical Center, Richmond Hill, New York, NY, USA
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3
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Li C, Li X, Li Y, Niu X. The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population. Psychol Res Behav Manag 2023; 16:2103-2124. [PMID: 37325255 PMCID: PMC10263158 DOI: 10.2147/prbm.s411112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association. Materials and Methods A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity. Results Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI. Conclusion This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, Weihai, People’s Republic of China
| | - Xiang Li
- Business School, Shandong University, Weihai, People’s Republic of China
| | - Yuming Li
- Business School, Shandong University, Weihai, People’s Republic of China
| | - Xiaoru Niu
- School of Mechanical, Electrical & Information Engineering, Shandong University, Weihai, People’s Republic of China
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Simkin L, Yung P, Greig F, Perera G, Tsamakis K, Rizos E, Stewart R, Velayudhan L, Mueller C. The impact of the first UK COVID-19 lockdown on presentations with psychosis to mental health services for older adults: An electronic health records study in South London. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5834. [PMID: 36333839 PMCID: PMC9828419 DOI: 10.1002/gps.5834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Social distancing restrictions in the COVID-19 pandemic may have had adverse effects on older adults' mental health. Whereby the impact on mood is well-described, less is known about psychotic symptoms. The aim of this study was to compare characteristics associated with psychotic symptoms during the first UK lockdown and a pre-pandemic comparison period. METHODS In this retrospective observational study we analysed anonymised records from patients referred to mental health services for older adults in South London in the 16-week period of the UK lockdown starting in March 2020, and in the comparable pre-pandemic period in 2019. We used logistic regression models to compare the associations of different patient characteristics with increased odds of presenting with any psychotic symptom (defined as hallucinations and/or delusion), hallucinations, or delusions, during lockdown and the corresponding pre-pandemic period. RESULTS 1991 referrals were identified. There were fewer referrals during lockdown but a higher proportion of presentations with any psychotic symptom (48.7% vs. 42.8%, p = 0.018), particularly hallucinations (41.0% vs. 27.8%, p < 0.001). Patients of non-White ethnicity (adjusted odds ratio (OR): 1.83; 95% confidence interval (CI): 1.13-2.99) and patients with dementia (adjusted OR: 3.09; 95% CI: 1.91-4.99) were more likely to be referred with psychotic symptoms during lockdown. While a weaker association between dementia and psychotic symptoms was found in the pre-COVID period (adjusted OR: 1.55; 95% CI: 1.19-2.03), interaction terms indicated higher odds of patients of non-White ethnicity or dementia to present with psychosis during the lockdown period. CONCLUSIONS During lockdown, referrals to mental health services for adults decreased, but contained a higher proportion with psychotic symptoms. The stronger association with psychotic symptoms in non-White ethnic groups and patients with dementia during lockdown suggests that barriers in accessing care might have increased during the COVID-19 pandemic.
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Affiliation(s)
- Lauren Simkin
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Paul Yung
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Flora Greig
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Gayan Perera
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Konstantinos Tsamakis
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Second Department of PsychiatryNational and Kapodistrian University of Athens‘Attikon’ University General HospitalAthensGreece
| | - Emmanouil Rizos
- Second Department of PsychiatryNational and Kapodistrian University of Athens‘Attikon’ University General HospitalAthensGreece
| | - Robert Stewart
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Latha Velayudhan
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
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5
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James PB, Renzaho AMN, Mwanri L, Miller I, Wardle J, Gatwiri K, Lauche R. The prevalence of anxiety, depression, and post-traumatic stress disorder among African migrants: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114899. [PMID: 36252417 DOI: 10.1016/j.psychres.2022.114899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. METHODS We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I2 statistic was used to measure heterogeneity. RESULTS Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60%;95%CI (26.30-43.00), 33.20%;95%CI (27.70-38.37) and 37.9%;95%CI (23.5- 52.4) respectively. Significant heterogeneity (I2 >98%) existed in the prevalence estimates for anxiety, depression, and PTSD. Sub-group analyses indicate a significantly higher prevalence of anxiety and depression but PTSD for studies conducted in Africa than outside Africa. Similarly, higher prevalence rates for anxiety, depression, and PTSD were seen in studies that used a screening tool than in those that used a diagnostic tool, although a significant difference was observed for depression only. CONCLUSION Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lillian Mwanri
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia
| | - Ian Miller
- Sport and Exercise Science, Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Kathomi Gatwiri
- Centre for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
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6
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Fonseca de Freitas D, Agbedjro D, Kadra-Scalzo G, Francis E, Ridler I, Pritchard M, Shetty H, Segev A, Casetta C, Smart SE, Morris A, Downs J, Christensen SR, Bak N, Kinon BJ, Stahl D, Hayes RD, MacCabe JH. Clinical correlates of early onset antipsychotic treatment resistance. J Psychopharmacol 2022; 36:1226-1233. [PMID: 36268751 PMCID: PMC9643817 DOI: 10.1177/02698811221132537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is evidence of heterogeneity within treatment-resistant schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and others becoming treatment-resistant after an initial response period. These groups may have different aetiologies. AIM This study investigates sociodemographic and clinical correlates of early onset of TRS. METHOD Employing a retrospective cohort design, we do a secondary analysis of data from a cohort of people with TRS attending the South London and Maudsley. Regression analyses were conducted to identify the correlates of the length of treatment to TRS. Predictors included the following: gender, age, ethnicity, problems with positive symptoms, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics. RESULTS In a cohort of 164 people with TRS (60% were men), the median length of treatment to TRS was 3 years and 8 months. We observed no cut-off on the length of treatment until TRS presentation differentiating between early and late TRS (i.e. no bimodal distribution). Having mild to very severe problems with hallucinations and delusions at the treatment start was associated with earlier TRS (~19 months earlier). In sensitivity analyses, including only complete cases (subject to selection bias), treatment with a long-acting injectable antipsychotic was additionally associated with later TRS (~15 months later). CONCLUSION Our findings do not support a clear separation between early and late TRS but rather a continuum of the length of treatment before TRS onset. Having mild to very severe problems with positive symptoms at treatment start predicts earlier onset of TRS.
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Affiliation(s)
- Daniela Fonseca de Freitas
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- Department of Psychiatry, University of
Oxford, Oxford, UK
| | - Deborah Agbedjro
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
| | | | - Emma Francis
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- Division of Psychology and Language
Sciences, University College London, London, UK
| | - Isobel Ridler
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
| | - Megan Pritchard
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS
Foundation Trust, London, UK
- Norwich Medical School, University of
East Anglia, Norwich, UK
| | - Hitesh Shetty
- South London and Maudsley NHS
Foundation Trust, London, UK
| | - Aviv Segev
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv, Israel
- Shalvata Mental Health Center, Hod
Hasharon, Israel
| | - Cecilia Casetta
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- Department of Health Sciences,
Università degli Studi di Milano, Milan, Italy
| | - Sophie E. Smart
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- MRC Centre for Neuropsychiatric
Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Anna Morris
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
| | - Johnny Downs
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS
Foundation Trust, London, UK
| | | | | | - Bruce J. Kinon
- Lundbeck Pharmaceuticals LLC,
Deerfield, IL, USA
- Cyclerion Therapeutics, Cambridge,
MA, USA
| | - Daniel Stahl
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
| | - Richard D. Hayes
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
| | - James H. MacCabe
- Institute of Psychiatry, Psychology and
Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS
Foundation Trust, London, UK
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Hasannezhad Reskati M, Kheradmand M, Moosazadeh M, Assadi T, Shafizad M, Hedayatizadeh‐Omran A, Hosseini S, Elyasi F. Comparing mental health status and COVID-19 event impact between survivors and the general population during the second wave of the pandemic in Iran. Nurs Open 2022; 10:738-753. [PMID: 36017940 PMCID: PMC9538826 DOI: 10.1002/nop2.1341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/28/2022] [Accepted: 08/07/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND AIM The coronavirus disease 2019 (COVID-19) pandemic has to date overwhelmed the survivors and the general population. The present study aimed to compare the mental health status and the COVID-19 event impact between the survivors and the general population in Mazandaran Province, Northern Iran. DESIGN A web-based cross-sectional survey was used. METHODS This study was performed using convenience sampling. RESULTS In total, 1,766 participants were included in this study. The findings revealed that the posttraumatic stress disorder (PTSD) severity in both outpatient and hospitalized groups was significantly higher than that in the general population. Besides, the levels of anxiety and depression in the group receiving inpatient care and treatment had significantly elevated than those in the general population. CONCLUSION Given the high prevalence rate of mental disorders, healthcare professionals are recommended to plan for various interventions and support services to boost community mental health status.
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Affiliation(s)
| | - Motahareh Kheradmand
- Health Sciences Research center, Addiction InstituteMazandaran University of Medical SciencesSariIran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non‐communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Touraj Assadi
- Department of Emergency Medicine, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Misagh Shafizad
- Department of Neurosurgery, Orthopedic Research CenterMazandaran University of Medical SciencesSariIran
| | | | - Seyed Hamzeh Hosseini
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research Center, Addiction InstituteMazandaran University of Medical SciencesSariIran,Department of Psychiatry, Faculty of MedicineMazandaran University of Medical SciencesSariIran
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A Systematic Review of Inequalities in the Mental Health Experiences of Black African, Black Caribbean and Black-mixed UK Populations: Implications for Action. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01352-0. [PMID: 35767218 DOI: 10.1007/s40615-022-01352-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Measurable differences in the experience and treatment of mental health conditions have been found to exist between different racial categories of community groups. The objective of this research was to review the reported mental health of Black African-Caribbean communities in the UK, determinants of mental health, and interventions to enhance their experiences of mental health services. METHOD The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was applied. To be included, papers must be published in a peer reviewed journal; report on adult populations (over 18) from any of Black African, Black Caribbean or Black mixed people in the UK; and assess (quantitative), or discuss (qualitative) mental health experiences, determinants of mental health, or interventions intended to enhance experiences of mental health services among the target population. The aims, inclusion criteria, data extraction, and data quality evaluation were specified in advance. Searches were conducted using EBSCO (PsychInfo; MEDLINE; CINAHL Plus; psychology and behavioural sciences collection). The search strategy included search terms relating to the aim. Risk of bias was assessed using a standard tool, records were organised using Endnote, and data were extracted and synthesised using Microsoft Excel. RESULTS Thirty-six studies were included, of which 26 were quantitative and six reported exclusively on Black participants. Black populations were less likely to access mental health support via traditional pathways due to stigma and mistrust of mental health services. Black Africans especially, sought alternative help from community leaders, which increased the likelihood of accessing treatment at the point of crisis or breakdown, which in turn increased risk of being detained under the Mental Health Act and via the criminal justice system. DISCUSSION Findings suggest a cycle of poor mental health, coercive treatment, stigma, and mistrust of services as experienced by Black communities. Evidence was limited by poorly defined ethnic categories, especially where Black populations were subsumed into one category. It is recommended that mental health services work collaboratively with cultural and faith communities in supporting Black people to cope with mental illness, navigate mental health pathways, and provide culturally appropriate advice. Protocol Registration Number PROSPERO CRD42021261510.
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Fernandez-Rodrigues V, Sanchez-Carro Y, Lagunas LN, Rico-Uribe LA, Pemau A, Diaz-Carracedo P, Diaz-Marsa M, Hervas G, de la Torre-Luque A. Risk factors for suicidal behaviour in late-life depression: A systematic review. World J Psychiatry 2022; 12:187-203. [PMID: 35111588 PMCID: PMC8783161 DOI: 10.5498/wjp.v12.i1.187] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/17/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.
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Affiliation(s)
| | - Yolanda Sanchez-Carro
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid 28046, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
| | - Luisa Natalia Lagunas
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
| | - Laura Alejandra Rico-Uribe
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Psychology, La Rioja International University, Logrono 26006, Spain
| | - Andres Pemau
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | | | - Marina Diaz-Marsa
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
- Institute of Psychiatry and Mental Health, San Carlos Clinical Hospital, Madrid 28040, Spain
| | - Gonzalo Hervas
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
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10
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Ford E, Curlewis K, Squires E, Griffiths LJ, Stewart R, Jones KH. The Potential of Research Drawing on Clinical Free Text to Bring Benefits to Patients in the United Kingdom: A Systematic Review of the Literature. Front Digit Health 2021; 3:606599. [PMID: 34713089 PMCID: PMC8521813 DOI: 10.3389/fdgth.2021.606599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The analysis of clinical free text from patient records for research has potential to contribute to the medical evidence base but access to clinical free text is frequently denied by data custodians who perceive that the privacy risks of data-sharing are too high. Engagement activities with patients and regulators, where views on the sharing of clinical free text data for research have been discussed, have identified that stakeholders would like to understand the potential clinical benefits that could be achieved if access to free text for clinical research were improved. We aimed to systematically review all UK research studies which used clinical free text and report direct or potential benefits to patients, synthesizing possible benefits into an easy to communicate taxonomy for public engagement and policy discussions. Methods: We conducted a systematic search for articles which reported primary research using clinical free text, drawn from UK health record databases, which reported a benefit or potential benefit for patients, actionable in a clinical environment or health service, and not solely methods development or data quality improvement. We screened eligible papers and thematically analyzed information about clinical benefits reported in the paper to create a taxonomy of benefits. Results: We identified 43 papers and derived five themes of benefits: health-care quality or services improvement, observational risk factor-outcome research, drug prescribing safety, case-finding for clinical trials, and development of clinical decision support. Five papers compared study quality with and without free text and found an improvement of accuracy when free text was included in analytical models. Conclusions: Findings will help stakeholders weigh the potential benefits of free text research against perceived risks to patient privacy. The taxonomy can be used to aid public and policy discussions, and identified studies could form a public-facing repository which will help the health-care text analysis research community better communicate the impact of their work.
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Affiliation(s)
- Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Keegan Curlewis
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Emma Squires
- Swansea Medical School, University of Swansea, Swansea, United Kingdom
| | - Lucy J. Griffiths
- Swansea Medical School, University of Swansea, Swansea, United Kingdom
| | - Robert Stewart
- King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kerina H. Jones
- Swansea Medical School, University of Swansea, Swansea, United Kingdom
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11
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Tsamakis K, Tsiptsios D, Ouranidis A, Mueller C, Schizas D, Terniotis C, Nikolakakis N, Tyros G, Kympouropoulos S, Lazaris A, Spandidos DA, Smyrnis N, Rizos E. COVID-19 and its consequences on mental health (Review). Exp Ther Med 2021; 21:244. [PMID: 33603852 PMCID: PMC7851613 DOI: 10.3892/etm.2021.9675] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
As one year is approaching since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, it is important to acknowledge the detrimental effect that it is having on mental health at the individual, societal and public health levels. The current review presents the direct and indirect psychological impact of COVID-19 on the general public, as well as on vulnerable groups, including the elderly, the young, healthcare professionals, people with pre-existing mental health issues, those infected by COVID-19, homeless people and refugees. Important findings are discussed in the present review, including the social stigma in older people associated with portraying COVID-19 as the disease of the elderly, and the limited psychological impact of COVID-19 in the severely mentally ill, alongside the response of the mental healthcare systems globally to this unparalleled public health crisis. The important lessons to be learnt so far can help formulate individual mental health recommendations, as well as improved intervention and prevention public health strategies.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Dimitrios Tsiptsios
- Department of Clinical Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, United Kingdom
| | - Andreas Ouranidis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Christos Terniotis
- Department of Child and Adolescent Psychiatry, General Hospital of Agrinio, Agrinio 30100, Greece
| | - Nikolaos Nikolakakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Georgios Tyros
- Department of Dermatology, Syggros Hospital, Athens 16121, Greece
| | - Stylianos Kympouropoulos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Andreas Lazaris
- Department of Vascular Surgery, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Nikolaos Smyrnis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
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12
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Vorvolakos T, Leontidou E, Tsiptsios D, Mueller C, Serdari A, Terzoudi A, Nena E, Tsamakis K, Constantinidis TC, Tripsianis G. The association between sleep pathology and depression: A cross-sectional study among adults in Greece. Psychiatry Res 2020; 294:113502. [PMID: 33068911 DOI: 10.1016/j.psychres.2020.113502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/03/2020] [Indexed: 12/28/2022]
Abstract
A cross-sectional population based study was conducted in order to evaluate the potential association of sleep characteristics with depression using self-reported questionnaires and taking into account several socio-demographic, lifestyle and health related characteristics. 957 participants aged between 19 and 86 years old were enrolled in our study. Depression symptoms were assessed using the Beck Depression Inventory. Participants self-reported their daily sleep habits and filled in the Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index and Berlin Questionnaire. Overall prevalence of depression was 28.4%. Depression symptoms were more prominent among minority groups. Subjects with depression reported shorter sleep duration and had reduced sleep efficiency. In patients with depression mean sleep duration was reduced by 23 min and mean sleep efficiency by 4%. Patients with depression were at higher risk of insomnia, poor sleep quality and obstructive sleep apnea, but not of excessive daytime sleepiness. Concerning insomnia subtypes, depression was associated with difficulties maintaining sleep and early morning awakening, but not problems initiating sleep. Sleep disturbances are highly prevalent in depression and our findings support early pharmacological or cognitive behavioral interventions in order to address this key depression-associated symptom. Only addressing problems initiating sleep might not be sufficient in depression.
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Affiliation(s)
- Theofanis Vorvolakos
- Department of Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Eleni Leontidou
- Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitrios Tsiptsios
- Neurophysiology Department, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, United Kingdom.
| | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Aspasia Serdari
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Aikaterini Terzoudi
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Theodoros C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Gregory Tripsianis
- Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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13
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Bittar A, Velupillai S, Downs J, Sedgwick R, Dutta R. Reviewing a Decade of Research Into Suicide and Related Behaviour Using the South London and Maudsley NHS Foundation Trust Clinical Record Interactive Search (CRIS) System. Front Psychiatry 2020; 11:553463. [PMID: 33329090 PMCID: PMC7729078 DOI: 10.3389/fpsyt.2020.553463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022] Open
Abstract
Suicide is a serious public health issue worldwide, yet current clinical methods for assessing a person's risk of taking their own life remain unreliable and new methods for assessing suicide risk are being explored. The widespread adoption of electronic health records (EHRs) has opened up new possibilities for epidemiological studies of suicide and related behaviour amongst those receiving healthcare. These types of records capture valuable information entered by healthcare practitioners at the point of care. However, much recent work has relied heavily on the structured data of EHRs, whilst much of the important information about a patient's care pathway is recorded in the unstructured text of clinical notes. Accessing and structuring text data for use in clinical research, and particularly for suicide and self-harm research, is a significant challenge that is increasingly being addressed using methods from the fields of natural language processing (NLP) and machine learning (ML). In this review, we provide an overview of the range of suicide-related studies that have been carried out using the Clinical Records Interactive Search (CRIS): a database for epidemiological and clinical research that contains de-identified EHRs from the South London and Maudsley NHS Foundation Trust. We highlight the variety of clinical research questions, cohorts and techniques that have been explored for suicide and related behaviour research using CRIS, including the development of NLP and ML approaches. We demonstrate how EHR data provides comprehensive material to study prevalence of suicide and self-harm in clinical populations. Structured data alone is insufficient and NLP methods are needed to more accurately identify relevant information from EHR data. We also show how the text in clinical notes provide signals for ML approaches to suicide risk assessment. We envision increased progress in the decades to come, particularly in externally validating findings across multiple sites and countries, both in terms of clinical evidence and in terms of NLP and machine learning method transferability.
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Affiliation(s)
- André Bittar
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sumithra Velupillai
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Johnny Downs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Rosemary Sedgwick
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Rina Dutta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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14
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Tsamakis K, Gadelrab R, Wilson M, Bonnici-Mallia AM, Hussain L, Perera G, Rizos E, Das-Munshi J, Stewart R, Mueller C. Dementia in People from Ethnic Minority Backgrounds: Disability, Functioning, and Pharmacotherapy at the Time of Diagnosis. J Am Med Dir Assoc 2020; 22:446-452. [PMID: 32758391 DOI: 10.1016/j.jamda.2020.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Increasingly, older populations in the United Kingdom and other well-resourced settings are ethnically diverse. Despite a concern that the prevalence of dementia is expected to rise, very little is known about the association of ethnicity and dementia among aging older adults. The current study aimed to compare ethnic group differences in symptom profile, functioning and pharmacotherapy at dementia diagnosis. DESIGN Cross-sectional study of patient characteristics at the point of dementia diagnosis. SETTING AND PARTICIPANTS In total, 12,154 patients aged 65 years or older diagnosed with dementia in Southeast London between 2007 and 2015. METHODS Data were extracted from the Clinical Record Interactive Search system, which provides anonymized access to the electronic health records of a large mental healthcare provider in Southeast London. Patients from ethnic minority backgrounds were compared with white British individuals on mental and physical well-being, functional scales and medications prescribed at dementia diagnosis, as well as subtype of dementia documented anywhere in the record. RESULTS Compared with white British patients, Black African and Black Caribbean patients were more likely to present with psychotic symptoms and were less likely to have an antidepressant prescribed; white Irish patients had higher rates of substance/alcohol use and depressive symptoms were more prevalent in South Asian patients; all ethnic minority groups had higher odds of polypharmacy; and vascular dementia diagnoses were more common in Black and Irish ethnic minority groups. CONCLUSIONS AND IMPLICATIONS At dementia diagnosis, there are substantial differences in noncognitive mental health symptoms and pharmacotherapy across ethnic minority groups and compared with the white British majority population. Some of these differences might reflect access/treatment inequalities or implicit unconscious bias related to ethnicity, influencing both. They need to be taken into consideration to optimize pathways into care and personalize assessment and management.
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Affiliation(s)
- Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; Second Department of Psychiatry, University General Hospital ATTIKON, School of Medicine, Athens, Greece
| | - Romayne Gadelrab
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Mimi Wilson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | | | - Labib Hussain
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Gayan Perera
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Emmanouil Rizos
- Second Department of Psychiatry, University General Hospital ATTIKON, School of Medicine, Athens, Greece
| | - Jayati Das-Munshi
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Robert Stewart
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.
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15
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Tsamakis K, Triantafyllis AS, Tsiptsios D, Spartalis E, Mueller C, Tsamakis C, Chaidou S, Spandidos DA, Fotis L, Economou M, Rizos E. COVID-19 related stress exacerbates common physical and mental pathologies and affects treatment (Review). Exp Ther Med 2020; 20:159-162. [PMID: 32509006 PMCID: PMC7271730 DOI: 10.3892/etm.2020.8671] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
COVID-19 pandemic has caused a global public health emergency resulting in unprecedented individual and societal fear and anxiety. The stress surrounding this biothreat appears to have clinical implications in all aspects of medicine, both in mental and physical health spheres. The impact of COVID-19 related anxiety in Cardiology, Paediatrics, Oncology, Dermatology, Neurology and Mental Health and how it affects treatments is discussed. Moreover, the need for introducing novel communication and therapeutic approaches is highlighted in the new landscape of the COVID-19 era.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
| | | | - Dimitrios Tsiptsios
- Department of Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR47TP, UK
| | - Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Charalampos Tsamakis
- Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | - Sofia Chaidou
- 1st Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Lampros Fotis
- Department of Paediatrics, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
| | - Marina Economou
- Byron-Kessariani Community Mental Health Centre, First Department of Psychiatry, University of Athens, ‘EGINITION’ Hospital, 11528 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
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