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Zhu L, Xing Y, Jia H, Xu W, Wang X, Ding Y. Effects of telehealth interventions on the caregiver burden and mental health for caregivers of people with dementia: a systematic review and meta-analysis. Aging Ment Health 2024:1-13. [PMID: 38946249 DOI: 10.1080/13607863.2024.2371480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 06/16/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES To systematically evaluate the effects of telehealth interventions on the caregiver burden and mental health of caregivers for people with dementia (PWD). METHOD Relevant randomized controlled trials (RCTs) of telehealth interventions on caregivers were extracted from nine electronic databases (PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, SinoMed, CNKI, WanFang, and VIP). The retrieval time was from inception to 26 July 2023. RESULTS Twenty-two articles with 2132 subjects were included in the final analysis. The meta-analysis demonstrated that telehealth interventions exerted a significant effect in reducing caregiver burden (SMD: -0.14, 95 % CI: -0.25, -0.02, p = 0.02), depression (SMD = -0.17; 95%CI: -0.27, -0.07, p < 0.001) and stress (SMD = -0.20, 95%CI: -0.37, -0.04, p = 0.01). However, no statistically significant effect was observed on anxiety (SMD = -0.12, 95%CI: -0.27, 0.03, p = 0.12). Moreover, subgroup analysis showed that tailored interventions were associated with more evident reductions in depression (SMD = -0.26; 95%CI: -0.40, -0.13, p < 0.001) than standardized interventions (SMD = -0.08; 95%CI: -0.22, 0.06, p = 0.25). In addition, telehealth was effective in relieving depression in Internet-based (SMD = -0.17, 95%CI: -0.30, -0.03, p = 0.01) and Telephone-based group (SMD = -0.18, 95%CI: -0.34, -0.02, p = 0.03), while there was no significant difference in the Internet and Telephone-based group (SMD = -0.18, 95%CI: -0.54, 0.18, p = 0.32). CONCLUSION Telehealth could effectively reduce the burden and relieve the depression and stress of caregivers of PWD, while its effect on anxiety requires further research. Overall, telehealth has potential benefits in dementia care.
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Affiliation(s)
- Ling Zhu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yurong Xing
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Hongfei Jia
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Wenhui Xu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, Nanjing, China
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Zhou Y, Bai Z, Wan K, Qin T, He R, Xie C. Technology-based interventions on burden of older adults' informal caregivers: a systematic review and meta-analysis of randomized controlled trials. BMC Geriatr 2024; 24:398. [PMID: 38704539 PMCID: PMC11070124 DOI: 10.1186/s12877-024-05018-w] [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: 06/12/2023] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND An increasing number of technologies are provided to reduce the burden of older adults' informal caregivers. However, less is known about the effects and the mechanism of technology to work on burden. This review is to evaluate the effectiveness of technology-based interventions (TBI) in alleviating the burden of older adults' informal caregivers and to distinguish its effective mechanism via group disparities. METHODS A systematic review and meta-analysis of randomized controlled trials studies (RCTs) has been conducted. Web of Science, PubMed, EMBASE, Scopus, CINAHL, PsycINFO, WANFANG, CNKI, CQVIP databases, Cochrane Library Trials, and ClinicalTrials.gov were searched for trial studies and registry in both English and Chinese published from January 1990 to October 2022. Reviewers independently screened the articles and trials, conducted quality assessments, and extracted the data. All processes were guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias of the studies was evaluated by the Cochrane Systematic Review Handbook. The meta-analysis was conducted by RevMan 5.13. Subgroup analyses, sensitivity analyses, publication bias were also conducted. RESULTS A total of 11,095 RCTs were initially screened, and 14 trials representing 1010 informal caregivers were included finally. This review proved TBI effective in reducing caregiving burden older adults. Subgroup analysis showed effects of TBI differed by interventions on control group and medical conditions of care recipients. CONCLUSION TBI is an effective way to alleviate the burden on informal caregivers of aging people. Interventions for control groups and medical conditions of care-recipients are significant factors in effective interventions. Future researches could include more trials with high-quality or to explore more targeted aging groups, modalities of TBI, or caregiver outcomes. TRIAL REGISTRATION The review protocol was registered on PROSPERO [CRD42021277865].
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Affiliation(s)
- Yang Zhou
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China.
- The Evidence-Based Research Center of Social Science & Health, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China.
| | - Zhenggang Bai
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
- The Evidence-Based Research Center of Social Science & Health, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
| | - Keyan Wan
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
| | - Tianyi Qin
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
| | - Rui He
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
| | - Chengdan Xie
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, No. 200, Xiaolingwei District, Nanjing, 210094, Jiangsu Province, China
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Cui X, Wang J, Wu B, Zhao Q, Tang X, Wang J. Interventions for Persons with Young-Onset Dementia and Their Families: A Scoping Review. J Alzheimers Dis 2024; 97:1519-1531. [PMID: 38277297 DOI: 10.3233/jad-231006] [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: 01/28/2024]
Abstract
Background Dementia occurring before age 65 is known as young-onset dementia (YOD), with Alzheimer's disease being the most common type. YOD poses unique challenges for persons and families, impacting their working-age years and family responsibilities. Person-centered interventions and services are essential to improve their quality of life and social engagement. Objective This study aims to synthesize non-pharmacological interventions for persons with YOD and their families to inform future targeted interventions. Methods We conducted a systematic literature search across four databases: PubMed, PsycINFO, Scopus, and CINAHL. The included articles were carefully screened, categorized, and synthesized by following Arksey and O'Malley's five stages framework. Results We included 20 studies reported in 24 papers, with 11 studies (14 papers) on persons with YOD and nine studies (10 papers) on families. Quantitative intervention results vary, but qualitative interviews show positive feedback. Stakeholders provided positive evaluations, stating these interventions provided a sense of normalcy, facilitated communication among families, enhanced the independence of persons with YOD, and improved the families' caregiving self-efficacy, thereby reducing care burden and psychological distress. The heterogeneity among the studies posed integration challenges. Conclusions Interventions for YOD can improve the quality of life for both persons with YOD and their families. More extensive intervention studies are urgently needed, especially in developing countries, with a focus on family-centered and life course perspectives. In future intervention research design, a more extensive incorporation of stakeholder involvement is essential for successful implementation. Moreover, the integration of new technologies shows promise as a potential avenue for intervention advancement.
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Affiliation(s)
- Xiaoyan Cui
- Fudan University School of Nursing, Shanghai, China
| | - Junqiao Wang
- Fudan University School of Nursing, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xueting Tang
- Fudan University School of Nursing, Shanghai, China
| | - Jing Wang
- University of New Hampshire, NH, USA
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Wrede N, Töpfer NF, Wilz G. Effects of general change mechanisms on outcome in telephone-based cognitive-behavioral therapy for distressed family caregivers. J Clin Psychol 2023; 79:2207-2224. [PMID: 37192433 DOI: 10.1002/jclp.23535] [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: 12/20/2022] [Revised: 03/29/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The study investigated the influence of general change mechanisms (GCMs) on outcome in telephone-based cognitive-behavioral therapy (CBT) for family caregivers. METHODS In a stepped-care intervention approach, highly distressed family caregivers received telephone-based CBT after completing a care counseling intervention. Sixty-six therapist-caregiver dyads rated emotional bond, agreement on collaboration, problem actuation, resource activation, clarification of meaning, and mastery after each of 12 therapy sessions. Outcomes were caregiver burden (SCQ-AV) and depression (CES-D) after therapy. Associations of GCMs with outcome were examined in multilevel regression models. RESULTS Caregiver burden was significantly predicted by caregiver-rated emotional bond (β = -0.18) as well as therapist-rated resource activation (β = -0.26), problem actuation (β = -0.22), clarification of meaning (β = -0.18), and mastery (β = -0.18). None of the GCMs predicted depression from any perspective. CONCLUSION The findings suggest that GCMs are relevant for reducing caregiver burden in CBT for family caregivers and should be fostered in treatment manuals, in particular therapist-rated GCMs. Since therapist and caregiver perspectives differed in predicting caregiver burden, future research should investigate perspective congruence and its effect on therapy outcome.
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Affiliation(s)
- Nicolas Wrede
- Department of Counseling and Clinical Intervention, Institute of Psychology, Friedrich-Schiller-University Jena, Jena, Germany
| | - Nils F Töpfer
- Department of Counseling and Clinical Intervention, Institute of Psychology, Friedrich-Schiller-University Jena, Jena, Germany
| | - Gabriele Wilz
- Department of Counseling and Clinical Intervention, Institute of Psychology, Friedrich-Schiller-University Jena, Jena, Germany
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Cao C, Li S, Zhou G, Xu C, Chen X, Qiu H, Li X, Liu Y, Cao H, Bi C. Global trends in COVID-19 Alzheimer's related research: a bibliometric analysis. Front Neurol 2023; 14:1193768. [PMID: 37342784 PMCID: PMC10278887 DOI: 10.3389/fneur.2023.1193768] [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: 03/31/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Background The COVID-19 pandemic has significantly impacted public health, putting people with Alzheimer's disease at significant risk. This study used bibliometric analysis method to conduct in-depth research on the relationship between COVID-19 and Alzheimer's disease, as well as to predict its development trends. Methods The Web of Science Core Collection was searched for relevant literature on Alzheimer's and Coronavirus-19 during 2019-2023. We used a search query string in our advanced search. Using Microsoft Excel 2021 and VOSviewer software, a statistical analysis of primary high-yield authors, research institutions, countries, and journals was performed. Knowledge networks, collaboration maps, hotspots, and regional trends were analyzed using VOSviewer and CiteSpace. Results During 2020-2023, 866 academic studies were published in international journals. United States, Italy, and the United Kingdom rank top three in the survey; in terms of productivity, the top three schools were Harvard Medical School, the University of Padua, and the University of Oxford; Bonanni, Laura, from Gabriele d'Annunzio University (Italy), Tedeschi, Gioacchino from the University of Campania Luigi Vanvitelli (Italy), Vanacore, Nicola from Natl Ctr Dis Prevent and Health Promot (Italy), Reddy, P. Hemachandra from Texas Tech University (USA), and El Haj, Mohamad from University of Nantes (France) were the authors who published the most articles; The Journal of Alzheimer's Disease is the journals with the most published articles; "COVID-19," "Alzheimer's disease," "neurodegenerative diseases," "cognitive impairment," "neuroinflammation," "quality of life," and "neurological complications" have been the focus of attention in the last 3 years. Conclusion The disease caused by the COVID-19 virus infection related to Alzheimer's disease has attracted significant attention worldwide. The major hot topics in 2020 were: "Alzheimer' disease," COVID-19," risk factors," care," and "Parkinson's disease." During the 2 years 2021 and 2022, researchers were also interested in "neurodegenerative diseases," "cognitive impairment," and "quality of life," which require further investigation.
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Affiliation(s)
- Chenjun Cao
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Sixin Li
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Gaoya Zhou
- Department of Neurology, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Neurology, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Caijuan Xu
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Xi Chen
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Huiwen Qiu
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Xinyu Li
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Ying Liu
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Hui Cao
- Department of Psychiatry, School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Changlong Bi
- Department of Neurosurgery, Xiangya Hospital, Center South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Biancuzzi H, Dal Mas F, Bidoli C, Pegoraro V, Zantedeschi M, Negro PA, Campostrini S, Cobianchi L. Economic and Performance Evaluation of E-Health before and after the Pandemic Era: A Literature Review and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4038. [PMID: 36901048 PMCID: PMC10002225 DOI: 10.3390/ijerph20054038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
E-Health represents one of the pillars of the modern healthcare system and a strategy involving the use of digital and telemedicine tools to provide assistance to an increasing number of patients, reducing, at the same time, healthcare costs. Measuring and understanding the economic value and performance of e-Health tools is, therefore, essential to understanding the outcome and best uses of such technologies. The aim of this paper is to determine the most frequently used methods for measuring the economic value and the performance of services in the framework of e-Health, considering different pathologies. An in-depth analysis of 20 recent articles, rigorously selected from more than 5000 contributions, underlines a great interest from the clinical community in economic and performance-related topics. Several diseases are the object of detailed clinical trials and protocols, leading to various economic outcomes, especially in the COVID-19 post-pandemic era. Many e-Health tools are mentioned in the studies, especially those that appear more frequently in people's lives outside of the clinical setting, such as apps and web portals, which allow for clinicians to keep in contact with their patients. While such e-Health tools and programs are increasingly studied from practical perspectives, such as in the case of Virtual Hospital frameworks, there is a lack of consensus regarding the recommended models to map and report their economic outcomes and performance. More investigations and guidelines by scientific societies are advised to understand the potential and path of such an evolving and promising phenomenon.
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Affiliation(s)
- Helena Biancuzzi
- Department of Economics, Ca’ Foscari University of Venice, 30123 Venice, Italy
| | - Francesca Dal Mas
- Department of Management, Ca’ Foscari University of Venice, 30123 Venice, Italy
| | - Chiara Bidoli
- Department of Economics, Ca’ Foscari University of Venice, 30123 Venice, Italy
| | - Veronica Pegoraro
- Department of Economics, Ca’ Foscari University of Venice, 30123 Venice, Italy
| | | | | | - Stefano Campostrini
- Department of Economics, Ca’ Foscari University of Venice, 30123 Venice, Italy
| | - Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- General Surgery Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- ITIR—Institute for Transformative Innovation Research, 27100 Pavia, Italy
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SARS-CoV-2, COVID-19 and Neurodegeneration. Brain Sci 2022; 12:brainsci12070897. [PMID: 35884704 PMCID: PMC9312886 DOI: 10.3390/brainsci12070897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic continues to affect many areas of our daily life. In addition to the immense societal and economic changes, medical care of patients has now been modified both in the outpatient and inpatient clinical settings [...]
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Kang M, Farrand S, Walterfang M, Velakoulis D, Loi SM, Evans A. Carer burden and psychological distress in young-onset dementia: An Australian perspective. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5765. [PMID: 35708197 PMCID: PMC9328388 DOI: 10.1002/gps.5765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Carer burden in dementia is associated with poor outcomes, including early nursing home placement for people with dementia and psychological distress for their carers. Carers of people with young-onset dementia (YOD) are particularly vulnerable to carer burden. Yet they are often overlooked by clinicians as dementia services are generally designed for older people. We sought to estimate the rate of burden and psychological distress in carers of YOD at a state-wide tertiary service based in Australia. METHODS We conducted a cross-sectional study examining 71 dyads from a Neuropsychiatry service. We collected patient demographic and clinical data including the Neuropsychiatry Unit Cognitive Assessment tool (NUCOG) and Mini-Mental State Examination (MMSE). Carer data, such as demographics and psychological distress, were obtained using Depression Anxiety Stress Scale 21 (DASS-21). Carer burden was rated using the Zarit Burden Inventory-short version (ZBI). RESULTS Higher carer burden, measured using ZBI, was associated with longer duration of dementia and greater severity of overall cognitive impairment. Carers who felt burdened reported higher levels of stress, depression, and anxiety measured using DASS-21. Multiple linear regression analysis found carer burden was independently predicted by duration of dementia, total cognition score and carers experiencing psychological stress. DISCUSSION We found that patient variables of dementia duration and cognitive impairment and carer variable of carer stress to be associated with carer burden. Poor executive function was associated with carer stress. Early identification and management of carer burden and psychological distress is important for outcomes. Ideally, this should be provided by a specialist YOD service.
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Affiliation(s)
- Matthew Kang
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Sarah Farrand
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Mark Walterfang
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Dennis Velakoulis
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Samantha M. Loi
- NeuropsychiatryRoyal Melbourne HospitalParkvilleVICAustralia
- Melbourne Neuropsychiatry Centre & Department of PsychiatryUniversity of MelbourneParkvilleVICAustralia
| | - Andrew Evans
- Department of NeurologyRoyal Melbourne HospitalMelbourneVICAustralia
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