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Cheng YTD, Young KWD, Carlbring P, Ng YN, Hung SLS. A Pilot Randomized Controlled Trial Among People Recovering from Mental Illness: A Tailored Mindfulness-Based Intervention versus Relaxation Training. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:318-348. [PMID: 37982391 DOI: 10.1080/26408066.2023.2281418] [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: 11/21/2023]
Abstract
BACKGROUND This study assessed the potential effectiveness, acceptability and feasibility of a tailored mindfulness-based intervention (MBI, REMIND 2.0) for personal recovery among people with mental illness during the COVID-19 pandemic. METHODS In this pilot mixed methods randomized controlled trial, participants were assigned to either the MBI (n = 14) or the relaxation training (RT) (n = 14). Quantitative measures were used to assess primary outcomes, including personal recovery, mindfulness, self-compassion, resilience, and secondary outcomes, including depression, stress, anxiety, positive and negative moods, quality of life and general health at baseline (T0), post-intervention (T1) and one-month follow-up (T2). Quantitative interviews were conducted to explore the experiences and perceptions toward the MBI. RESULTS Results indicated significant group and time interactions for all outcomes except anxiety and stress. MBI participants showed significant improvements in all outcomes at T1, which were maintained at T2, except for positive mood. RT participants showed a significant decline in resilience but significant improvements in all secondary outcomes at T1, but all outcomes significantly declined at T2, except for anxiety and stress. MBI participants were receptive toward the programme in all aspects of personal recovery. CONCLUSIONS The tailored MBI is a potentially effective, feasible and acceptable approach to facilitate personal recovery among people with mental illness. Differences between MBI and RT are discussed.
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Affiliation(s)
- Yi Ting Daphne Cheng
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Kim Wan Daniel Young
- Department of Social Work, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Yat Nam Ng
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Biscoe N, New E, Murphy D. Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study. BMC Psychol 2024; 12:209. [PMID: 38622745 PMCID: PMC11020799 DOI: 10.1186/s40359-024-01713-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: 10/23/2023] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Less is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder. METHODS A total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition. RESULTS Each CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment. CONCLUSIONS This is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.
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Affiliation(s)
| | - Emma New
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Dominic Murphy
- Combat Stress, Leatherhead, Surrey, KT22 0BX, UK
- King's Centre for Military Health Research, King's College London, London, SE5 9PR, UK
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Kushwaha A, Basera DS, Kumari S, Sutar RF, Singh V, Das S, Agrawal A. Assessment of memory deficits in psychiatric disorders: A systematic literature review. J Neurosci Rural Pract 2024; 15:182-193. [PMID: 38746499 PMCID: PMC11090569 DOI: 10.25259/jnrp_456_2023] [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: 08/17/2023] [Accepted: 12/12/2023] [Indexed: 05/16/2024] Open
Abstract
Memory deficits are observed across psychiatric disorders ranging from the prodrome of psychosis to common mental disorders such as anxiety, depression, and dissociative disorders. Memory deficits among patients recovering from psychiatric disorders could be directly related to the primary illness or secondary to the adverse effect of a treatment such as Electroconvulsive Therapy (ECT). The trouble in the meaningful integration of working-memory and episodic memory is the most commonly affected domain that requires routine assessments. An update on the recent trends of methods of assessment of memory deficits is the first step towards understanding and correcting these deficits to target optimum recovery. A systematic literature search was conducted from October 2018 to October 2022 to review the recent methods of assessment of memory deficits in psychiatric disorders. The definition of 'Memory deficit' was operationalized as 'selective processes of memory, commonly required for activities of daily living, and affected among psychiatric disorders resulting in subjective distress and dysfunction'. We included 110 studies, most of them being conducted in western countries on patients with schizophrenia. Other disorders included dementia and mild cognitive impairment. Brief Assessment of Cognition in Schizophrenia, Cambridge Automated Neuropsychological Test Battery, California Verbal Learning Test, Trail Making Test Part A and B, Rey Auditory Verbal Learning Test, Wechsler Memory Scale, Wechsler Adults Intelligence Scale-IV were the most common neuropsychological assessments used. Mini-Mental State Examination and Montreal Cognitive Assessment were the most common bedside assessment tools used while Squire Subjective Memory Questionnaire was commonly used to measure ECT-related memory deficits. The review highlights the recent developments in the field of assessment of memory deficits in psychiatric disorders. Findings recommend and emphasize routine assessment of memory deficits among psychiatric disorders in developing countries especially severe mental illnesses. It remains interesting to see the role of standardized assessments in diagnostic systems given more than a decade of research on memory deficits in psychiatric disorders.
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Affiliation(s)
- Anuradha Kushwaha
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Devendra Singh Basera
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sangita Kumari
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Roshan Fakirchand Sutar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Saikat Das
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Moulaei K, Sharifi H, Bahaadinbeigy K, Dinari F. Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:116. [PMID: 38342912 PMCID: PMC10860230 DOI: 10.1186/s12888-024-05563-z] [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: 11/04/2023] [Accepted: 01/28/2024] [Indexed: 02/13/2024] Open
Abstract
INTRODUCTION Cognitive impairments present challenges for patients, impacting memory, attention, and problem-solving abilities. Virtual reality (VR) offers innovative ways to enhance cognitive function and well-being. This study explores the effects of VR-based training programs and games on improving cognitive disorders. METHODS PubMed, Scopus, and Web of Science were systematically searched until May 20, 2023. Two researchers selected and extracted data based on inclusion and exclusion criteria, resolving disagreements through consultation with two other authors. Inclusion criteria required studies of individuals with any cognitive disorder engaged in at least one VR-based training session, reporting cognitive impairment data via scales like the MMSE. Only English-published RCTs were considered, while exclusion criteria included materials not primarily focused on the intersection of VR and cognitive disorders. The risk of bias in the included studies was assessed using the MMAT tool. Publication bias was assessed using funnel plots and Egger's test. The collected data were utilized to calculate the standardized mean differences (Hedges's g) between the treatment and control groups. The heterogeneity variance was estimated using the Q test and I2 statistic. The analysis was conducted using Stata version 17.0. RESULTS Ten studies were included in the analysis out of a total of 3,157 retrieved articles. VR had a statistically significant improvement in cognitive impairments among patients (Hedges's g = 0.42, 95% CI: 0.15, 0.68; p_value = 0.05). games (Hedges's g = 0.61, 95% CI: 0.30, 0.39; p_value = 0.20) had a more significant impact on cognitive impairment improvement compared to cognitive training programs (Hedges's g = 0.29, 95% CI: -0.11, 0.69; p_value = 0.24). The type of VR intervention was a significant moderator of the heterogeneity between studies. CONCLUSION VR-based interventions have demonstrated promise in enhancing cognitive function and addressing cognitive impairment, highlighting their potential as valuable tools in improving care for individuals with cognitive disorders. The findings underscore the relevance of incorporating virtual reality into therapeutic approaches for cognitive disorders.
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Affiliation(s)
- Khadijeh Moulaei
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Dinari
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Hoffman L, Stewart BT, Courtwright KE, Callahan ML. Building Resilience and Improving Neurocognition (BRAIN): Feasibility and acceptability of a novel, multimodal telehealth cognitive rehabilitation intervention. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 38271323 DOI: 10.1080/23279095.2024.2302044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Cognitive deficits can impact daily functioning, general health, and psychological functioning. Multimodal group rehabilitation interventions designed for telehealth administration can optimally provide access and essential services for those who would otherwise not seek these services. We conducted a quality improvement project examining the feasibility and acceptability of Building Resilience and Improving Neurocognition (BRAIN), an eight-week multimodal telehealth cognitive rehabilitation group. METHOD Participants were veterans referred to a VA neuropsychology clinic for group cognitive rehabilitation. Self-report measures were used to collect information about general health, cognitive, and psychological concerns pre- and post-intervention. Twenty-two veterans with cognitive concerns pertaining to psychosocial factors or neurocognitive disorders completed pre- and post-intervention outcome measures. RESULTS Paired samples t-tests evaluated whether BRAIN improved self-reported emotional and functional status based on five self-report measures: MSNQ, WHODAS 2.0, PHQ-9, GAD-7, and PCL-5. Results showed clinically significant reductions on the MSNQ, PHQ-9 and PCL-5, with moderate effect sizes. On the MSNQ, participants endorsed decreased symptom severity on items associated with distractibility, slowed problem solving, requiring reminders, and difficulty multitasking. CONCLUSION The results indicate that BRAIN holds promise as a telehealth cognitive rehabilitation group intervention for reducing subjective cognitive concerns and symptoms of depression and PTSD.
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Affiliation(s)
- Liat Hoffman
- VA Portland Health Care System, Portland, OR, USA
| | - Brandon T Stewart
- VA Portland Health Care System, Portland, OR, USA
- St. Luke's Medical Center, Boise, ID, USA
| | - Kylie E Courtwright
- VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
- Pacific University, Forest Grove, OR, USA
| | - Megan L Callahan
- VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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Ekinci O. What Our Patients and Their Families Are Reading: Quality and Readability of Internet Information About Electroconvulsive Therapy. J ECT 2023; 39:242-247. [PMID: 37310071 DOI: 10.1097/yct.0000000000000933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The Internet is now more widely used than before by psychiatric patients and their families to search for medical conditions and treatments. To our knowledge, no study has addressed the quality and readability of online information about electroconvulsive therapy (ECT). We aimed to examine the quality and readability of English-language Internet information related to ECT. METHODS An advanced search of Internet Web sites containing information about ECT was conducted by using the search term "ECT or electroconvulsive therapy." The resulting Web sites were categorized into 1 of 3 categories (commercial, nonprofit, or professional organizations). Their quality was evaluated using Health on the Net code certification, the Journal of the American Medical Association (JAMA) benchmark criteria, and the DISCERN tool. The readability of the Web sites was assessed using the Flesch Reading Ease, Flesch-Kincaid Grade Level Formula, Simple Measure of Gobbledygook, and Gunning Fog indexes. RESULTS A total of 86 Web sites were included in the analysis. Of all these Web sites, 18 (20.9%) had a Health on the Net code certificate, and 16 (18.6%) were accepted as high quality (JAMA total score ≥3). The commercial Web sites had significantly lower DISCERN and JAMA benchmark scores compared with the other Web sites. A total of 30.23% of all the Web sites reached the recommended readability level (Flesch-Kincaid Grade Level Formula ≤ 8). Moreover, only 4 scored at the grade 5 to 6 reading level, which is considered ideal for patient educational materials. CONCLUSIONS Our study indicates that both the quality and readability of online information about ECT are not at the desired level. Physicians, patients, and their families should consider this failure in relation to online information about ECT. In addition, Web site creators and health authorities should be aware of their responsibilities for providing quality and readable health information to the public.
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Affiliation(s)
- Okan Ekinci
- From the Psychiatry Department, Usak University Medical Faculty, Usak, Turkey
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Singh S, Gupta A, Singh GP. Decision making and its correlates in recurrent depressive disorder. Indian J Psychiatry 2023; 65:1158-1164. [PMID: 38249144 PMCID: PMC10795668 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_633_23] [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: 08/20/2023] [Revised: 10/07/2023] [Accepted: 10/26/2023] [Indexed: 01/23/2024] Open
Abstract
Objective Decision-making (DM) is simply choosing among alternatives or defining one's course of action. A depressed individual does not perceive himself as a decision-maker as ruminations reinforce dysfunctional metacognitive beliefs and poor executive functioning. The aim was to study and compare the relationship among DM, metacognition, and executive functioning in those with recurrent depressive disorder (RDD) and in healthy controls (HCs). Methods A cross-sectional comparative group study design was used with a sample size of 40, with 20 participants in each group. The tools used were Mini International Neuropsychiatric Interview, General Health Questionnaire, Melbourne Decision Making Questionnaire, Metacognitive Questionnaire, Wisconsin Card Sorting Test, and Controlled Oral Word Association Test. Results The RDD group had significantly higher scores on buck-passing (BP), procrastination (PR), hypervigilance, and dysfunctional metacognitive beliefs, and poor performance on executive functioning than HC. PR was inversely correlated with executive functioning and dysfunctional metacognitive beliefs in the RDD group, whereas in the HC group, BP was positively correlated with executive functioning and dysfunctional metacognitive beliefs. Conclusion DM has a significant relationship with executive functions and dysfunctional metacognitive beliefs; therefore, changes in any one variable contribute to changes in the other two. The altered attentional and executive control due to dysfunctional metacognitive beliefs leads to poor DM, resulting in psychosocial dysfunction. The underlying metacognitive beliefs and executive functioning play a crucial role in DM, the process determining psychosocial functioning.
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Affiliation(s)
- Sandeep Singh
- Department of Psychiatry, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
| | - Aarzoo Gupta
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Gurvinder Pal Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Santambrogio J, Bertelli MO, Terrevazzi S, De Carolis L, Francia E, Boldoni C, Calascibetta M, Cudazzo E, Lucca C, Viganò V, Danese M, Minazzi GA, Santarone A, Bianco A, Hassiotis A, Clerici M. Cognitive dysfunction and psychopathology: a cohort study of adults with intellectual developmental disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1029-1045. [PMID: 37690814 DOI: 10.1111/jir.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co-occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD. METHODS One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features. RESULTS Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS-IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles. CONCLUSIONS Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co-occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co-occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit.
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Affiliation(s)
- J Santambrogio
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - M O Bertelli
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - S Terrevazzi
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - L De Carolis
- Department of Economics, Management and Statistics, University of Milano-Bicocca, Milan, Italy
| | - E Francia
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - C Boldoni
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Calascibetta
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - E Cudazzo
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - C Lucca
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - V Viganò
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Danese
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - G A Minazzi
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Santarone
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - A Bianco
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - A Hassiotis
- Division of Psychiatry, University College of London, London, UK
| | - M Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Mental Health and Addiction Department, IRCCS Ospedale San Gerardo dei Tintori, Monza, Italy
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Maulik M, Looschen K, Smith C, Johnson K, Carman AF, Nagisetty C, Corriveau K, Salisbury C, Deschepper K, Michels M, Henderson-Redmond AN, Morgan DJ, Mitra S. Postpartum scarcity-adversity inflicts sex-specific cerebellar adaptations and reward behaviors in adolescence. Pharmacol Biochem Behav 2023; 231:173620. [PMID: 37625522 PMCID: PMC10565883 DOI: 10.1016/j.pbb.2023.173620] [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: 07/14/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023]
Abstract
Early life adversity in the form of poor postnatal care is a major developmental stressor impacting behavior later in life. Previous studies have shown the impact of early life stress on neurobehavioral abnormalities. Specifically, research has demonstrated how limited bedding and nesting (LBN) materials can cause behavioral deficits in adulthood. There is, however, a limited understanding of how LBN influences sex-specific neurobehavioral adaptation in adolescence, a developmental stage susceptible to psychiatric diseases including substance use disorder. LBN and stress-naive c57BL/6 adolescent male and female mouse offspring were tested for a battery of behaviors including open field, novel object recognition, elevated plus maze, social preference, and morphine-induced conditioned place preference. There was a significant sex-specific deficit in social preference in male mice exposed to LBN compared to stress-naïve counterparts and both LBN males and females had a higher preference towards the drug-paired chamber in the morphine-induced conditioned place preference test. These behavioral deficits were concomitant with sex-specific increases in the transcription factor, Klf9 in the deep cerebellar nuclei (DCN) of males. Further, mRNA levels of the circadian gene Bmal1, which is known to be transcriptionally regulated by Klf9, were decreased in the DCN. Since Bmal1 has recently been implicated in extracellular matrix modulation, we examined perineuronal nets (PNN) and observed depleted PNN in the DCN of males but not female LBN mice. Overall, we provide a novel understanding of how postpartum adversity impinges on the cerebellar extracellular matrix homeostasis, likely, through disruption of the circadian axis by Klf9 that might underlie sex-specific behavioral adaptations in adolescence.
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Affiliation(s)
- Malabika Maulik
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States; Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Kassandra Looschen
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Colton Smith
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Khyla Johnson
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Alaina F Carman
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Cherishma Nagisetty
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Katilyn Corriveau
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Colin Salisbury
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Kayla Deschepper
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Madison Michels
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Angela N Henderson-Redmond
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Daniel J Morgan
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Swarup Mitra
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States; Department of Pharmacology and Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
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Rivi V, Rigillo G, Toscano Y, Benatti C, Blom JMC. Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1217. [PMID: 37508714 PMCID: PMC10378710 DOI: 10.3390/children10071217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects.
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Affiliation(s)
- Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Giovanna Rigillo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Ylenia Toscano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Cristina Benatti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Johanna Maria Catharina Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Grover S, Avasthi A, Chakravarty R, Dan A, Chakraborty K, Neogi R, Desousa A, Nayak OP, Praharaj SK, Menon V, Deep R, Bathla M, Subramanyam AA, Nebhinani N, Ghosh P, Lakdawala B, Bhattacharya R. Insight in patients with bipolar disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study). Indian J Psychiatry 2023; 65:767-773. [PMID: 37645363 PMCID: PMC10461589 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_714_22] [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: 10/30/2022] [Revised: 04/17/2023] [Accepted: 06/28/2023] [Indexed: 08/31/2023] Open
Abstract
Background There are limited number of studies evaluating insight among patients with bipolar disorder (BD). Aim This study aimed to examine insight and its correlates in BD using the data from the multicenter BD course and outcome study from India (BiD-CoIN). The additional aim was to evaluate the insight in patients with BD using different scales and understand the correlates of insight. Materials and Methods 773 BD patients presently in clinical remission were evaluated on the Insight Scale for Affective Disorders (ISAD), insight items of the Hamilton Depression Rating Scale (HDRS), and the Young Mania Rating Scale (YMRS). Results The assessment scales influenced the prevalence of poor insight. Poorer insight irrespective of the assessment scale was consistently associated with higher residual depressive and manic symptoms, and a higher level of cognitive impairment and disability. Poor insight as assessed by ISAD was associated with a higher number of episodes in the lifetime, shorter duration of current remission, a higher number of depressive episodes, a higher amount of time spent in depressive episodes, higher depressive affective morbidity, a higher number of manic episodes, and higher residual depressive and manic symptoms. Conclusion Poor insight in BD is consistently associated with higher residual depressive and manic symptoms and a higher level of cognitive impairment and disability. However, in terms of course variables, the correlates vary depending on the assessment method.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Chakravarty
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amitava Dan
- Department of Psychiatry, Burdwan Medical College and Hospital, Burdwan, Bardhaman, West Bengal, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and JNM Hospital WBUHS, Kalyani, West Bengal, India
| | - Rajarshi Neogi
- Department of Psychiatry, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Avinash Desousa
- Department of Psychiatry, Lokmanya Tilak Municipal General Hospital (Sion Hospital), Mumbai, Maharashtra, India
| | - Omkar P. Nayak
- Department of Psychiatry, Lokmanya Tilak Municipal General Hospital (Sion Hospital), Mumbai, Maharashtra, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Raman Deep
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Manish Bathla
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
| | - Alka A. Subramanyam
- Department of Psychiatry, Topiwala National Medical College (Nair Hospital), Mumbai, Maharashtra, India
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prasonjit Ghosh
- Department of Psychiatry, Silchar Medical College, Silchar, Assam, India
| | - Bhaveshkumar Lakdawala
- Department of Psychiatry, Ahmedabad Municipal Corporation Medical Education Trust Medical College, Ahmedabad, Gujarat, India
| | - Ranjan Bhattacharya
- Department of Psychiatry, Murshidabad Medical College and Hospital, Murshidabad, West Bengal, India
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Kageyama M, Sakamoto T, Kobayashi A, Hirama A, Tamura H, Yokoyama K. Childhood Adversities and Psychological Health of Adult Children of Parents with Mental Illness in Japan. Healthcare (Basel) 2023; 11:healthcare11020214. [PMID: 36673582 PMCID: PMC9859196 DOI: 10.3390/healthcare11020214] [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: 12/15/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
In this study, we seek to clarify whether the present-day experience of psychological distress among adults whose parents suffered from mental illness is related to their childhood experiences of abuse and neglect and their provision of emotional care for their parents during their school-age years. To this end, a web-based cross-sectional study was conducted. A total of 120 participants over the age of 20 who attended a self-help group responded (50% response rate); of these, 94 had a parent diagnosed with a mental illness, and these participants were included for data analysis purposes. Of the 94 respondents, 65 (69.2%) were highly distressed, as measured by a Kessler (K) 6 measure of ≥5. A logistic regression analysis revealed that the experience of providing emotional care for parents during school-age childhood was significantly related to high levels of distress in adulthood (OR = 3.48; 95% CI 1.21-9.96). For children of parents with mental illnesses, the effects of providing emotional care for parents during childhood may include long-term psychological distress. For this reason, mentally ill parents raising children need visiting community nurses or other professionals to provide emotional care on behalf of their children.
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Affiliation(s)
- Masako Kageyama
- Institute of Advanced Co-Creation Studies, Osaka University, 1-7 Yamadaoka, Suita 565-0871, Osaka, Japan
- Correspondence: ; Tel./Fax: +81-6-6879-2553
| | - Taku Sakamoto
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Ayuna Kobayashi
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Akiko Hirama
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Hiroyuki Tamura
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Nursing, Yokohama Soei University, 1 Miho-cho, Yokohama 226-0015, Kanagawa, Japan
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Prediction of Cognitive Decline by Behavioral Symptoms in Neuropsychiatric Disorders. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-126596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Neuropsychiatric disorders are described by their neurological, behavioral, and cognitive symptoms. However, behavioral symptoms may often be overlooked due to the current approach in neurology. Objectives: This study investigated the relationship between behavioral symptoms and cognitive functioning in neurological disorders. The second aim was to predict neurocognitive patterns by behavioral symptoms as independent variables. Methods: Behavioral symptoms were collected based on semi-structured neuropsychiatric interviews with 211 patients admitted to the neuropsychiatry department of Ayatollah Kashani hospital in Isfahan by both a neuropsychiatry fellow and an attending neuropsychiatrist. A neuropsychiatry fellow assessed all patients using the neuropsychiatry unit cognitive (NUCog) assessment tool. We used a generalized linear model (GLM) to indicate the effect of behavioral symptoms on the risk of decline in cognitive domains. Due to the use of all available samples, this study had no age limit, and the patients were 15 to 92 years old. Results: The regression coefficient of NUCog subscale scores for behavioral symptoms using GLM revealed that education level had a positive relationship with the scores of attention (P < 0.001), visuoconstruction (P < 0.001), memory (P < 0.001), executive function (P < 0.001), language (P < 0.001), and the total score of NUCog (P < 0.001). Patients with apathy had lower scores on the memory subscale (P = 0.002) and total NUCog (P = 0.021). Similarly, patients with delusion had lower scores on memory (P = 0.006) and executive function (P = 0.026). There was a negative relationship between agitation and attention (P = 0.049), visuoconstruction (P = 0.015), memory (P = 0.018), executive function (P = 0.005), and total score of NUCog (P = 0.007). Sleep disturbances were accompanied by lower memory scores (P = 0.056) and lower mean NUCog scores (P = 0.052). Visual hallucination was associated with declined performance in attention (P = 0.057). Conclusions: Behavioral assessment can help predict cognitive patterns in patients with neurobehavioral syndromes.
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Farran D, Feely O, Ashworth M, Gaughran F. Anticoagulation therapy and outcomes in patients with atrial fibrillation and serious mental illness: A systematic review and meta-analysis. J Psychiatr Res 2022; 156:737-753. [PMID: 36417811 DOI: 10.1016/j.jpsychires.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/06/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE A systematic review was conducted to investigate prevalence, management and outcomes of atrial fibrillation (AF) in people with Serious Mental Illnesses (SMI) versus the general population. DATA SOURCES MEDLINE, EMBASE, and PsycINFO were searched for primary research written in English and published between 2004 and 2022. STUDY SELECTION A total of 1459 studies were identified in the initial search of which 16 met the inclusion criteria. Studies (n = 4) reporting on ischaemic stroke and major bleeding events were included in the meta-analysis. DATA EXTRACTION Two independent reviewers extracted data and assessed risk of bias using the Newcastle-Ottawa Scale. Discrepancies were resolved by consulting a third reviewer. RESULTS Low rates of AF were reported among people with SMI suggesting under-recognition or recording gaps. People with SMI and AF were less likely to receive oral anticoagulation therapy compared to the general population. When receiving warfarin, those with bipolar disorder experienced poor anticoagulation control as measured by time in INR therapeutic range. Pooled analysis of risk estimates showed that in patients with identified AF, SMI was not significantly associated with an increased risk of stroke (HR: 1.09; 95%CI: 0.85 to 1.40; I2 = 60%, p = 0.04) or major bleeding (HR: 1.11; 95%CI: 0.95 to 1.28; I2 = 57%, p = 0.03) when adjusted for underlying stroke and bleeding risks using the CHA2DS2VASc and HASBLED scales respectively. CONCLUSION More research is needed to examine the prevalence, management and outcomes of AF in this population, and to evaluate the effect of the introduction of the novel anti-coagulants on these metrics over time.
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Affiliation(s)
- Dina Farran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Olwyn Feely
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mark Ashworth
- School of Life Course and Population Sciences, King's College London, London, UK
| | - Fiona Gaughran
- Department of Psychosis Studies, 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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15
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Canu D, Ioannou C, Müller K, Martin B, Fleischhaker C, Biscaldi M, Beauducel A, Smyrnis N, van Elst LT, Klein C. Evidence towards a continuum of impairment across neurodevelopmental disorders from basic ocular-motor tasks. Sci Rep 2022; 12:16521. [PMID: 36192503 PMCID: PMC9530118 DOI: 10.1038/s41598-022-19661-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/01/2022] [Indexed: 11/18/2022] Open
Abstract
Findings of genetic overlap between Schizophrenia, Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) contributed to a renewed conceptualization of these disorders as laying on a continuum based on aetiological, pathophysiological and neurodevelopmental features. Given that cognitive impairments are core to their pathophysiology, we compared patients with schizophrenia, ADHD, ASD, and controls on ocular-motor and manual-motor tasks, challenging crucial cognitive processes. Group comparisons revealed inhibition deficits common to all disorders, increased intra-subject variability in schizophrenia and, to a lesser extent, ADHD as well as slowed processing in schizophrenia. Patterns of deviancies from controls exhibited strong correlations, along with differences that posited schizophrenia as the most impaired group, followed by ASD and ADHD. While vector correlations point towards a common neurodevelopmental continuum of impairment, vector levels suggest differences in the severity of such impairment. These findings argue towards a dimensional approach to Neurodevelopmental Disorders’ pathophysiological mechanisms.
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Affiliation(s)
- Daniela Canu
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Chara Ioannou
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katarina Müller
- Psychotherapeutisches Wohnheim für Junge Menschen Leppermühle, Buseck, Germany
| | - Berthold Martin
- Psychotherapeutisches Wohnheim für Junge Menschen Leppermühle, Buseck, Germany
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monica Biscaldi
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Nikolaos Smyrnis
- 2nd Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece.,Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute «COSTAS STEFANIS», Athens, Greece
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. .,2nd Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece. .,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany.
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16
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Mitchell BL, Hansell NK, McAloney K, Martin NG, Wright MJ, Renteria ME, Grasby KL. Polygenic influences associated with adolescent cognitive skills. INTELLIGENCE 2022. [DOI: 10.1016/j.intell.2022.101680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Sachs G, Bannick G, Maihofer EIJ, Voracek M, Purdon SE, Erfurth A. Dimensionality analysis of the German version of the Screen for Cognitive Impairment in Psychiatry (SCIP-G). Schizophr Res Cogn 2022; 29:100259. [PMID: 35692619 PMCID: PMC9178470 DOI: 10.1016/j.scog.2022.100259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 01/09/2023]
Abstract
Background Psychiatric disorders, especially schizophrenia, are characterised by cognitive impairment. The rapid detection of cognitive dysfunction - also in the course of the disease - is of great importance. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed to provide screening of psychiatric patients in clinical practice and is available in several languages. Prior psychometric investigations into the dimensionality of the SCIP have produced two different models: a one-factor model assumes that the five subscales of the SCIP load together, whereas an alternative model suggests that the subscales load on two factors, namely verbal memory and processing speed. We carried out a confirmatory factor analysis of the German version of the SCIP (SCIP-G). Methods 323 patients with psychotic, bipolar affective, and depressive disorders were studied. Results The one-factor approach did not yield an acceptable model fit (chi-squared test: χ2 = 109.5, df = 5, p < 0.001, χ2/df = 21.9). A two-factor solution, with the subtests Verbal Learning Test-Immediate Recall, Delayed Recall Test of the VLT, and Working Memory Test loading on the first factor, whereas the subtests Verbal Fluency Test and Psychomotor Speed Test loading on the second factor, obtained a good model fit (χ2 = 6.7, df = 3, p = 0.08, χ2/df = 2.2). Conclusions These data show that a good model fit can be achieved with a two-factor solution for the SCIP. This study is the first to conduct a confirmatory factor analysis using the German SCIP version and to test its dimensional structure using a hypothesis-testing approach.
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Affiliation(s)
| | - Gloria Bannick
- 1 Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing, Vienna, Austria.,Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Eva I J Maihofer
- 1 Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing, Vienna, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Scot E Purdon
- Alberta Hospital Edmonton Neuropsychology, Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Andreas Erfurth
- Medical University of Vienna, Vienna, Austria.,1 Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing, Vienna, Austria
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18
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Dithurbide L, Boudreault V, Durand-Bush N, MacLeod L, Gauthier V. The impact of the COVID-19 pandemic on Canadian national team athletes’ mental performance and mental health: The perspectives of mental performance consultants and mental health practitioners. Front Psychol 2022; 13:937962. [PMID: 36059762 PMCID: PMC9435585 DOI: 10.3389/fpsyg.2022.937962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 global pandemic has led to significant disruptions in the lives of high-performance athletes, including the postponement of the Tokyo Olympic and Paralympic Games, the cancellation of many international and national competitions, and drastic changes in athletes’ daily training environment. The purpose of this research was to examine the interplay between the mental health and mental performance of Canadian national team athletes and the impact of the COVID-19 pandemic on these variables from the perspective of mental performance consultants and mental health practitioners. Twelve individuals working in these roles with national team athletes participated in focus groups and interviews during the second wave of the COVID-19 pandemic in Canada. Findings from the inductive reflexive thematic analysis revealed three main themes: (a) factors impacting athlete mental health (i.e., social and environmental, psychological, and public health restrictions), (b) consequences of COVID-19 for athletes (low mood symptoms, anxiety and stress symptoms, maladaptive behaviors, time for life outside of sport, rest, and recovery), and (c) impact of the pandemic on practitioners (roles, preparation and resources, gaps, and well-being). Interestingly, athletes with prior good mental performance skills were perceived to be more equipped to cope with challenges related to the pandemic, which concurrently seemed to facilitate good mental health throughout the pandemic. Furthermore, even though the pandemic had several debilitative consequences on athletes’ mental health, it imposed a break from training and competition that allowed them to rest and enjoy their life outside of sport. Finally, participants discussed the need for more mental health resources and better access to practitioners supporting mental performance and mental health in the Canadian sport system.
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Affiliation(s)
- Lori Dithurbide
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
- *Correspondence: Lori Dithurbide,
| | - Véronique Boudreault
- Faculté des Sciences de l’Activité Physique, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Lucy MacLeod
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Véronique Gauthier
- Département de psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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19
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van den Boogert F, Klein K, Spaan P, Sizoo B, Bouman YHA, Hoogendijk WJG, Roza SJ. Sensory processing difficulties in psychiatric disorders: A meta-analysis. J Psychiatr Res 2022; 151:173-180. [PMID: 35489177 DOI: 10.1016/j.jpsychires.2022.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/24/2022] [Accepted: 04/18/2022] [Indexed: 12/31/2022]
Abstract
In clinical practice, many individuals with psychiatric disorders report difficulties in sensory processing, including increased awareness or sensitivity to external stimuli. In this meta-analysis, we examined the sensory processing patterns of adolescent and adult individuals with a broad spectrum of different psychiatric conditions. A systematic search in various databases resulted in the inclusion of 33 studies (N=2008), all using the Adolescent/Adult Sensory Profile (AASP). By comparing diagnostic subgroups to the corresponding reference group of the AASP, we detected a general pattern of sensory processing, indicating elevated levels of low registration, sensory sensitivity and sensory avoiding and lowered sensory seeking behavior in patients with different types of psychiatric disorders. The majority of effect sizes were large to very large. In conclusion, sensory processing difficulties can be considered as a non-specific transdiagnostic phenotype associated with a broad spectrum of psychiatric conditions. Further research into the relevance and role of sensory processing difficulties in psychiatric disorders may improve long-term prognosis and treatment.
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Affiliation(s)
- Frank van den Boogert
- Department of Psychiatry, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands; Department of Research, Transfore, 7416 SB, Deventer, the Netherlands
| | - Katharina Klein
- Department of Research, Transfore, 7416 SB, Deventer, the Netherlands
| | - Pascalle Spaan
- Department of Psychiatry, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands; Department of Research, Transfore, 7416 SB, Deventer, the Netherlands
| | - Bram Sizoo
- Center for Developmental Disorders, Dimence Institute for Mental Health, 7416 SB, Deventer, the Netherlands
| | - Yvonne H A Bouman
- Department of Research, Transfore, 7416 SB, Deventer, the Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands
| | - Sabine J Roza
- Department of Psychiatry, Erasmus University Medical Center, 3015 GD, Rotterdam, the Netherlands; Netherlands Institute for Forensic Psychiatry and Psychology, 3511 EW, Utrecht, the Netherlands.
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20
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Saffi F, Rocca CCA, Toschi-Dias E, Durães RSS, Serafim AP. Cognitive Processes and Legal Capacity in Patients With Bipolar Disorder: A Brief Research Report. Front Psychol 2022; 13:867750. [PMID: 35846610 PMCID: PMC9280414 DOI: 10.3389/fpsyg.2022.867750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022] Open
Abstract
The current study verified the association between cognitive process such as attention, executive functioning, and legal capacity in patients with bipolar disorder (BD). The sample consisted of 72 participants, assorted to episodic patients (n = 21), euthymic patients (n = 22), and healthy controls (HCs) (n = 29). We used the following neuropsychological measures: subtests of the Wechsler Abbreviated Intelligence Scale (WASI): vocabulary and matrix reasoning; Continuous Performance Test (CPT); Five Digit Test (FDT); and Rey–Osterrieth Complex Figure (ROCF). Euthymic patients expressed slower processing speed (FDT) compared to HC. They tended to make more errors with slightly worse discrimination, suggesting more impulsiveness (CPT, p < 0.01). On the contrary, episodic patients showed worse discrimination, committed more omissions, were more inconsistent with regard to response speed (CPT-3, p < 0.01), showed more difficulties in organizing their actions (ROCF: copy, p = 0.03), and were more rigid (FDT: flexibility, p = 0.03). The results suggest that bipolar patients in episode express more cognitive impairments that can compromise the quality of legal capacity. These results highlight the need for more protective support for episodic BD patients regarding legal capacity.
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21
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R. R, Uthaiah CA, C. M. R, Madhunapantula SV, Salimath PV, K. P, M. SK, M. R. K. Comparative assessment of cognitive impairment and oxidative stress markers among vitamin D insufficient elderly patients with and without type 2 diabetes mellitus (T2DM). PLoS One 2022; 17:e0269394. [PMID: 35709193 PMCID: PMC9202850 DOI: 10.1371/journal.pone.0269394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disorders of mental health are known to affect cognitive functions, hence called as cognitive disorders. Impaired glucose metabolism, insulin resistance, vitamin-D deficiency and oxidative stress are some of the key early events reported to be involved in the pathogenesis of most common cognitive disorders, which include Alzheimer's disease. Type-2 diabetes mellitus (T2DM) is one of the known contributing factors of cognitive impairment and dementia. METHODS A cross sectional study was carried out in 145 subjects, who were assessed for cognitive function by modified mini mental status examination (3MS). In addition, measurement of fasting blood sugar (FBS), fasting insulin, HbA1c, lipid profile, vitamin D and oxidative markers was performed. Participants were divided into different groups based on (a) vitamin D insufficiency and sufficiency; (b) diabetic and non-diabetic with and without cognitive impairment. RESULTS The study included a total of 145 subjects; 51 males and 94 females and the mean age was 68.24±9.70 years. Among diabetics with vitamin D insufficiency, 35 subjects (71.43%) had cognitive impairment, but, among non-diabetics with vitamin D insufficiency, 27 subjects (62.79%) had cognitive impairment. Chi square test showed no significant association between diabetes, vitamin D insufficiency and cognitive impairment. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels were non-significantly lower in cognition-impaired subjects, when compared to cognition normal subjects in diabetics with vitamin D insufficiency. CONCLUSION Our study showed that cognitive impairment is more predominant in individuals with diabetes. However, our study did not find any significant relationship between T2DM, vitamin D deficiency, cognitive impairment, and oxidative stress. A significant association was found only with GPx and 3MSE score in vitamin D insufficient non-diabetics.
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Affiliation(s)
- Rajalakshmi R.
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Chinnappa A. Uthaiah
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Ramya C. M.
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Paramahans V. Salimath
- JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Praveen K.
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Srinath K. M.
- Department of Medicine, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Kishor M. R.
- Department of Psychiatry, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
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Hamaideh SH, Khait AA, Al-Modallal H, Abujilban S, Alhamdan A, Masa'deh R. Patients Hospitalized for Psychiatric Problems and Their Knowledge, Attitudes, and Practices Toward COVID-19. J Psychosoc Nurs Ment Health Serv 2022; 60:37-45. [PMID: 35316119 DOI: 10.3928/02793695-20220315-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The current study aimed to assess knowledge, attitudes, and practices (KAP) toward coronavirus disease 2019 (COVID-19) of persons hospitalized for psychiatric problems and the correlation between knowledge and demographics. A correlational, cross-sectional study was used to collect data through structured interviews from a convenience sample of 200 patients with psychiatric disorders seeking treatment at a psychiatric hospital using the Knowledge, Attitudes, and Practices questionnaire. Participants had poor knowledge (51.5%), moderate attitudes (75%), and low to moderate practices (61%) toward COVID-19. Knowledge was different across most demographic and illness-related variables. Global assessment of functioning and educational level predicted knowledge and accounted for 37.5% of the variance. Due to disability and poor self-care, persons hospitalized for psychiatric problems are more vulnerable to infectious diseases than the general population. Mental health nurses need to raise KAP toward COVID-19. Current results are informative to health care policymakers and mental health authorities in helping identify target populations for prevention and education about COVID-19. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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Pollak J. Neurocognitive Impairment as a Specifier for the
Diagnostic and Statistical Manual of Mental Disorders. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220124-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Fortuna KL, Marceau SR, Kadakia A, Pratt SI, Varney J, Walker R, Myers AL, Thompson S, Carter K, Greene K, Pringle W. Peer Support Specialists’ Perspectives of a Standard Online Research Ethics Training: Qualitative Study. JMIR Form Res 2022; 6:e29073. [PMID: 35103606 PMCID: PMC8848236 DOI: 10.2196/29073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/09/2021] [Accepted: 09/13/2021] [Indexed: 01/17/2023] Open
Abstract
Background
Certified peer support specialists (CPS) have a mental health condition and are trained and certified by their respective state to offer Medicaid reimbursable peer support services. CPS are increasingly involved as partners in research studies. However, most research ethics training in the protection of human subjects is designed for people who, unlike CPS, have had exposure to prior formal research training.
Objective
The aim of this study is to explore the perspectives of CPS in completing the Collaborative Institutional Training Initiative Social and Behavioral Responsible Conduct of Research online training.
Methods
A total of 5 CPS were recruited using a convenience sample framework through the parent study, a patient-centered outcomes research study that examined the comparative effectiveness of two chronic health disease management programs for people with serious mental illness. Participants independently completed the Collaborative Institutional Training Initiative Social and Behavioral Responsible Conduct of Research online training. All participants completed 15 online modules in approximately 7-9 hours and also filled out a self-report measure of executive functioning (the Adult Executive Functioning Inventory [ADEXI]). Qualitative data were collected from a 1-hour focus group and qualitative analysis was informed by the grounded theory approach. The codebook consisted of codes inductively derived from the data. Codes were independently assigned to text, grouped, and checked for themes. Thematic analysis was used to organize themes.
Results
Passing scores for each module ranged from 81%-89%, with an average of 85.4% and a median of 86%. The two themes that emerged from the focus group were the following: comprehension (barrier) and opportunity (facilitator). Participants had a mean score of 27.4 on the ADEXI.
Conclusions
The CPS perceived the research ethics online training as an opportunity to share their lived experience expertise to enhance current research efforts by nonpeer scientists. Although the CPS completed the online research ethics training, the findings indicate CPS experienced difficulty with comprehension of the research ethics online training materials. Adaptations may be needed to facilitate uptake of research ethics online training by CPS and create a workforce of CPS to offer their lived experience expertise alongside peer and nonpeer researchers.
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Affiliation(s)
- Karen L Fortuna
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Skyla R Marceau
- Geisel School of Medicine, Dartmouth College, Concord, NH, United States
| | | | - Sarah I Pratt
- Geisel School of Medicine, Dartmouth College, Concord, NH, United States
| | - Joy Varney
- Centerstone Kentucky, Louisville, KY, United States
| | - Robert Walker
- Office of Recovery and Empowerment, Massachusetts Department of Mental Health, Boston, MA, United States
| | - Amanda L Myers
- Institute for Behavioral Health, Heller School, Brandeis University, Waltham, MA, United States
| | | | | | - Kaycie Greene
- Centerstone Tennessee, Clarksville, TN, United States
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Dombi ZB, Szendi I, Burnet PWJ. Brain Derived Neurotrophic Factor and Cognitive Dysfunction in the Schizophrenia-Bipolar Spectrum: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:827322. [PMID: 35686181 PMCID: PMC9170985 DOI: 10.3389/fpsyt.2022.827322] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/27/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Cognitive impairment is a core feature of disorders on the schizophrenia-bipolar spectrum, i.e., schizophrenia, bipolar disorder, and schizoaffective disorder. Brain-derived neurotrophic factor (BDNF) has been proposed to be a biomarker of cognitive impairment in these disorders as it plays a critical role in neuroplasticity and proposed to mediate some of the psychotropic effects of medication. However, despite numerous studies investigating the association between circulating BDNF and these disorders, no solid conclusions have been drawn regarding its involvement in cognitive impairment. OBJECTIVES The current systematic review and meta-analysis aims to examine blood BDNF levels and cognitive dysfunction in patients on the schizophrenia-bipolar spectrum as well as to evaluate whether circulating BDNF measurements can act as a biomarker for cognitive dysfunction. METHODS Studies were identified by searching Embase and Medline databases for English language articles published in peer-reviewed journals between 2000 January and 2021 June according to the PRISMA guidelines. A total of 815 articles were identified of which 32 met the inclusion criteria for the systematic review - reporting on comparisons between blood BDNF levels and cognitive functions of schizophrenia or bipolar disorder patients versus healthy controls (no studies involving schizoaffective patients were specifically obtained for the time being). Twenty-four of these studies (19 with schizophrenia and 5 with bipolar disorder patients) were eligible to be included in the meta-analysis. RESULTS Our findings indicated that circulating BDNF levels were significantly reduced in patients experiencing an acute episode of schizophrenia or bipolar disorder compared to healthy controls. Cognitive function was also found to be significantly worse in patients, however, correlations between BDNF levels and cognitive impairment were not always detected. Interventions, especially pharmacotherapy seemed to improve certain aspects of cognition and increase circulating BDNF levels. CONCLUSION Circulating BDNF alone does not seem to be a valid biomarker of cognitive dysfunction in patients with disorders on the schizophrenia-bipolar spectrum, owing to several confounding factors. Changes of the circulating levels of BDNF should be evaluated in a wider context of other stress-, immune-, and inflammatory-related factors.
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Affiliation(s)
- Zsófia B Dombi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Medical Division, Gedeon Richter Plc., Budapest, Hungary
| | - István Szendi
- Department of Psychiatry, Kiskunhalas Semmelweis Hospital, Kiskunhalas, Hungary.,Department of Software Engineering, University of Szeged, Szeged, Hungary
| | - Philip W J Burnet
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Identification of Molecular Markers of Clozapine Action in Ketamine-Induced Cognitive Impairment: A GPCR Signaling PathwayFinder Study. Int J Mol Sci 2021; 22:ijms222212203. [PMID: 34830086 PMCID: PMC8621432 DOI: 10.3390/ijms222212203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Cognitive disorders associated with schizophrenia are closely linked to prefrontal cortex (PFC) dysfunction. Administration of the non-competitive NMDA receptor antagonist ketamine (KET) induces cognitive impairment in animals, producing effects similar to those observed in schizophrenic patients. In a previous study, we showed that KET (20 mg/kg) induces cognitive deficits in mice and that administration of clozapine (CLZ) reverses this effect. To identify biochemical mechanisms related to CLZ actions in the context of KET-induced impairment, we performed a biochemical analysis using the same experimental paradigm—acute and sub-chronic administration of these drugs (0.3 and 1 mg/kg). Methods: Since the effect of CLZ mainly depends on G-protein-related receptors, we used the Signaling PathwayFinder Kit to identify 84 genes involved in GPCR-related signal transduction and then verified the genes that were statistically significantly different on a larger group of mice using RT-PCR and Western blot analyses after the administration of acute and sub-chronic drugs. Results: Of the 84 genes involved in GPCR-related signal transduction, the expression of six, βarrestin1, βarrestin2, galanin receptor 2 (GalR2), dopamine receptor 2 (DRD2), metabotropic glutamate receptor 1 (mGluR1), and metabotropic glutamate receptor 5 (mGluR5), was significantly altered. Since these genes affect the levels of other signaling proteins, e.g., extracellular signal-regulated kinase 1/2 (ERK1/2), G protein-coupled receptor kinase 2 (Grk2), and G protein-gated inwardly rectifying potassium 3 (Girk3), we determined their levels in PFC using Western blot. Most of the observed changes occurred after acute treatment with 0.3 mg/kg CLZ. We showed that acute treatment with CLZ at a lower dose significantly increased βarrestin1 and ERK1/2. KET treatment induced the upregulation of βarrestin1. Joint administration of these drugs had no effect on the βarrestin1 level. Conclusion: The screening kit we used to study the expression of GPCR-related signal transduction allowed us to select several important genes affected by CLZ. However, the obtained data do not explain the mechanism of action of CLZ that is responsible for reversing KET-induced cognitive impairment.
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Early life Adversity, functional connectivity and cognitive performance in Schizophrenia: The mediating role of IL-6. Brain Behav Immun 2021; 98:388-396. [PMID: 34242739 DOI: 10.1016/j.bbi.2021.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Exposure to childhood trauma (CT) is associated with cognitive impairment in schizophrenia, and deficits in social cognition in particular. Here, we sought to test whether IL-6 mediated the association between CT and social cognition both directly, and sequentially via altered default mode network (DMN) connectivity. METHODS Three-hundred-and-eleven participants (104 patients and 207 healthy participants) were included, with MRI data acquired in a subset of n = 147. CT was measured using the childhood trauma questionnaire (CTQ). IL-6 was measured in both plasma and in toll like receptor (TLR) stimulated whole blood. The CANTAB emotion recognition task (ERT) was administered to assess social cognition, and cortical connectivity was assessed based on resting DMN connectivity. RESULTS Higher IL-6 levels, measured both in plasma and in toll-like receptor (TLR-2) stimulated blood, were significantly correlated with higher CTQ scores and lower cognitive and social cognitive function. Plasma IL-6 was further observed to partly mediate the association between higher CT scores and lower emotion recognition performance (CTQ total: βindirect -0.0234, 95% CI: -0.0573 to -0.0074; CTQ physical neglect: βindirect = -0.0316, 95% CI: -0.0741 to -0.0049). Finally, sequential mediation was observed between plasma IL-6 levels and DMN connectivity in mediating the effects of higher CTQ on lower social cognitive function (βindirect = -0.0618, 95% CI: -0.1523 to -0.285). CONCLUSION This work suggests that previous associations between CT and social cognition may be partly mediated via an increased inflammatory response. IL-6's association with changes in DMN activity further suggest at least one cortical network via which CT related effects on cognition may be transmitted.
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Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021. [PMID: 33686200 DOI: 10.1038/s41562-021-01053-4.genetic] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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Marees AT, Smit DJ, Abdellaoui A, Nivard MG, van den Brink W, Denys D, Galama TJ, Verweij KJ, Derks EM. Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021; 5:1065-1073. [PMID: 33686200 PMCID: PMC8376746 DOI: 10.1038/s41562-021-01053-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/13/2021] [Indexed: 01/31/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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Affiliation(s)
- Andries T. Marees
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands,QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,Correspondence: Andries T. Marees () Eske M. Derks ()
| | - Dirk J.A. Smit
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michel G. Nivard
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Titus J. Galama
- Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,University of Southern California, Dornsife Center for Economic and Social Research (CESR), Los Angeles, CA, USA,Erasmus School of Economics, Erasmus University, Rotterdam, The Netherlands
| | - Karin J.H. Verweij
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eske M. Derks
- QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Correspondence: Andries T. Marees () Eske M. Derks ()
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Identification of pleiotropy at the gene level between psychiatric disorders and related traits. Transl Psychiatry 2021; 11:410. [PMID: 34326310 PMCID: PMC8322263 DOI: 10.1038/s41398-021-01530-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/08/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
Major mental disorders are highly prevalent and make a substantial contribution to the global disease burden. It is known that mental disorders share clinical characteristics, and genome-wide association studies (GWASs) have recently provided evidence for shared genetic factors as well. Genetic overlaps are usually identified at the single-marker level. Here, we aimed to identify genetic overlaps at the gene level between 7 mental disorders (schizophrenia, autism spectrum disorder, major depressive disorder, anorexia nervosa, ADHD, bipolar disorder and anxiety), 8 brain morphometric traits, 2 cognitive traits (educational attainment and general cognitive function) and 9 personality traits (subjective well-being, depressive symptoms, neuroticism, extraversion, openness to experience, agreeableness and conscientiousness, children's aggressive behaviour, loneliness) based on publicly available GWASs. We performed systematic conditional regression analyses to identify independent signals and select loci associated with more than one trait. We identified 48 genes containing independent markers associated with several traits (pleiotropy at the gene level). We also report 9 genes with different markers that show independent associations with single traits (allelic heterogeneity). This study demonstrates that mental disorders and related traits do show pleiotropy at the gene level as well as the single-marker level. The identification of these genes might be important for prioritizing further deep genotyping, functional studies, or drug targeting.
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Janković M, Masthoff E, Spreen M, de Looff P, Bogaerts S. A Latent Class Analysis of Forensic Psychiatric Patients in Relation to Risk and Protective Factors. Front Psychol 2021; 12:695354. [PMID: 34354640 PMCID: PMC8329083 DOI: 10.3389/fpsyg.2021.695354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/29/2021] [Indexed: 01/06/2023] Open
Abstract
Forensic psychiatric patients form a very heterogeneous population regarding psychopathology, criminal history, and risk factors for reoffending. Therefore, the present study aimed to investigate whether there are more homogeneous classes of forensic patients based on DSM-IV-TR Axis I and II diagnoses and previously committed offenses, by means of explorative latent class analysis (LCA). It was also investigated which risk and protective factors are significantly more prevalent in one class compared to other classes. The study sample contained 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from high-security forensic clinics. Data were retrospectively derived from electronic patient files. Five distinctive patient classes emerged: class with only Axis II diagnosis, class with multiple problems, antisocial class, psychotic class, and intellectually disabled class. These classes differed significantly in risk and protective factors. This study contributes to the understanding of patient classes and provides directions for future, class-tailored interventions.
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Affiliation(s)
- Marija Janković
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Fivoor Science and Treatment Innovation, Rotterdam, Netherlands
| | - Erik Masthoff
- Fivoor Science and Treatment Innovation, Rotterdam, Netherlands
| | - Marinus Spreen
- Department of Social Work, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | - Peter de Looff
- Fivoor Science and Treatment Innovation, Rotterdam, Netherlands
| | - Stefan Bogaerts
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Fivoor Science and Treatment Innovation, Rotterdam, Netherlands
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Going "Up" to Move Forward: S-1 Bifactor Models and the Study of Neurocognitive Abilities in Psychopathology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7413. [PMID: 34299862 PMCID: PMC8307957 DOI: 10.3390/ijerph18147413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Recently, structural models of psychopathology, that address the diagnostic stability and comorbidity issues of the traditional nosological approach, have dominated much of the psychopathology literature. Structural approaches have given rise to the p-factor, which is claimed to reflect an individual's propensity toward all common psychopathological symptoms. Neurocognitive abilities are argued to be important to the development and maintenance of a wide range of disorders, and have been suggested as an important driver of the p-factor. However, recent evidence argues against p being an interpretable substantive construct, limiting conclusions that can be drawn from associations between p, the specific factors of a psychopathology model, and neurocognitive abilities. Here, we argue for the use of the S-1 bifactor approach, where the general factor is defined by neurocognitive abilities, to explore the association between neurocognitive performance and a wide range of psychopathological symptoms. We use simulation techniques to give examples of how S-1 bifactor models can be used to examine this relationship, and how the results can be interpreted.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
- WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Perth 6845, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Perth 6845, Australia;
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Bhat PS, Raj J, Chatterjee K, Srivastava K. Cognitive dysfunction in first-episode schizophrenia and its correlation with negative symptoms and insight. Ind Psychiatry J 2021; 30:310-315. [PMID: 35017817 PMCID: PMC8709515 DOI: 10.4103/ipj.ipj_107_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cognitive dysfunction in schizophrenia is a well-known feature and can adversely affect the patient participation in treatment and rehabilitation. Studies have shown its relationship to the severity of negative symptoms and level of insight also. Not many Indian studies are available on this in first-episode schizophrenia, and hence, this study was undertaken. MATERIALS AND METHODS Eight-five cases of first-episode schizophrenia fulfilling inclusion criteria were included in the study after ethical clearance, informed consent, and stabilization of acute symptoms. All were assessed using psychosocial pro forma, Addenbrooke's Cognitive Examination-III Scale, positive and negative syndrome scale, and schedule for the assessment of insight. Data analysis was done using Statistical Package for Social Sciences Version 20:0. RESULTS Cognitive dysfunction was seen in 40% of patients. Maximum dysfunction was in the memory domain followed by fluency domain and language domain was relatively well preserved. A significant negative correlation was observed between cognitive function and negative symptoms, but a significant positive correlation was seen with insight. CONCLUSION Cognitive dysfunction is present in a significant proportion of schizophrenia in the first episode itself. Early assessment will facilitate appropriate interventions directed at insight and cognitive rehabilitation.
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Affiliation(s)
| | - Jitin Raj
- Department of Psychiatry, INHS Sanjivani, Kochi, Kerala, India
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Developmental stress has sex-specific effects on contextual and cued fear conditioning in adulthood. Physiol Behav 2021; 231:113314. [PMID: 33417904 DOI: 10.1016/j.physbeh.2021.113314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 11/22/2022]
Abstract
Stress-induced deviations in central nervous system development has long-term effects on adult mental health. Previous research in humans demonstrates that prenatal or adolescent stress increases the risk for psychiatric disorders. Animal models investigating the effects of stress during prenatal or adolescent development produces behavioral outcomes analogous to those observed in humans. However, whether adolescent stress exposure potentiates the effects of prenatal stress is currently unknown. Thus, the current study tested whether adolescent stress increases the impact of prenatal stress on contextual and cued fear memory in adulthood. Male and female Sprague Dawley rats were exposed to a chronic variable stress schedule during the last week of gestation, during adolescence, or during both developmental periods before undergoing fear conditioning training in adulthood. Our hypothesis predicted that the combined effects of prenatal and adolescent stress on contextual and cued fear memory would be greater than the effects of stress during either time period alone. In contrast to our hypothesis, however, we found independent effects of prenatal and adolescent stress on contextual and cued fear memory in both sexes, with no additional combined impact of stress exposure during both developmental phases. In males, developmental stress increased freezing behavior during contextual and cued testing regardless of whether stress exposure was prenatal, adolescent, or combined prenatal and adolescent stress exposure. In contrast, the effects of developmental stress in females were both test- and ovarian hormone status-dependent. During cued testing, nonstressed female freezing behavior depended on estrous cycle phase, whereas freezing behavior in stressed females did not, suggesting that developmental stress interferes with hormone-dependent cued fear memory. No effects of developmental stress or estrous cycle phase were observed for contextual fear memory in females. The results of the current study suggest that the effects of prenatal and adolescent stress on contextual and cued fear memory are not cumulative, but the effects of developmental stress on associative memory differ between males and females.
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Littlefield AK, Lane SP, Gette JA, Watts AL, Sher KJ. The "Big Everything": Integrating and investigating dimensional models of psychopathology, personality, personality pathology, and cognitive functioning. Personal Disord 2021; 12:103-114. [PMID: 32915005 PMCID: PMC8318803 DOI: 10.1037/per0000457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Common factors are increasingly used to model the structure of psychopathology ("p"), personality (General Factor of Personality [GFP]), pathological personality (General Factor of Pathological Personality [GFPP]), and intelligence ("g"). Using 4 waves spanning ages 18-29 in a cohort of college students (baseline n = 489), this study used indicators of psychopathology, personality, pathological personality, and cognitive functioning to compare models that included Cognitive Functioning, p, GFP, GFPP, and a "Big Everything" factor (which included cross-domain measures as indicators). GFP, GFPP, and p exhibited substantial overlap, and the Big Everything factor accounted for considerable variance in psychopathology, personality, and pathological personality indicators. Only a self-report measure of cognitive functioning loaded significantly onto the Big Everything. This study highlights concerns in the pursuit of identifying and reifying common factors based on the modeling of residual variances and limitations of using factor modeling to determine the structure of psychologically relevant phenomena. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Grover S, Avasthi A, Chakravarty R, Dan A, Chakraborty K, Neogi R, Desouza A, Nayak O, Praharaj SK, Menon V, Deep R, Bathla M, Subramanyam AA, Nebhinani N, Ghosh P, Lakdawala B, Bhattacharya R, Gania A. Prescription patterns in clinically stable patients with bipolar disorder: Findings from the Bipolar Disorder Course and Outcome from India (BiD-CoIN) study. Asian J Psychiatr 2021; 57:102549. [PMID: 33484992 DOI: 10.1016/j.ajp.2021.102549] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/20/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
AIM To evaluate the prescription pattern of patients with BD, currently in clinical remission. Additional aim of the study was tocompare the prescription pattern across different study centres. METHODOLOGY Prescription of 773 patients, currently in clinical remission, recruited from the outpatient setting of 14 General Hospital Tertiary Care Units of tertiary care centres in the country were evaluated. RESULTS Almost all (98.1 %) participants were on medications at the time of assessment. In terms of conventional mood stabilizers, those receiving valproate (44.2 %), out-numbered those receiving lithium (38.9 %). A small proportion (7.4 %) was receiving a combination of both valproate and lithium. About two-third (62.5 %) were receiving at least one antipsychotic medication, with olanzapine (31.7 %) being the most commonly prescribed antipsychotic, followed by quetiapine (11.1 %), and risperidone (9.6 %). About one-third (34.4 %) of the participants were receiving antidepressants, with sertraline (22.6 %) forming bulk of the prescription. Less than half (43.9 %) of the participants were also receiving a benzodiazepine medication at the time of assessment, with chlordiazepoxide (18 %) being the most common agent, followed by clonazepam (14.5 %). There was variation in the prescription patterns across different centres, in terms of monotherapy, polypharmacy, use of preferred conventional mood stabilizers, use of various antipsychotics and antidepressants. CONCLUSION Besides conventional mood stabilizers, about two-third of patients with bipolar disorder received concomitant antipsychotics, one-third received concomitant antidepressants and less than half received benzodiazepines.
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Affiliation(s)
- Sandeep Grover
- Post Graduate Institute of Medical Education & Research, Chandigarh, India.
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Rahul Chakravarty
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amitava Dan
- Burdwan Medical College & Hospital, Burdwan, India
| | | | | | - Avinash Desouza
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Omkar Nayak
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Samir Kumar Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Raman Deep
- All India Institute of Medical Sciences, New Delhi, India
| | - Manish Bathla
- Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, India
| | | | | | | | - Bhavesh Lakdawala
- Ahmedabad Municipal Corporation Medical Education Trust Medical College, Ahmedabad, India
| | | | - AbMajid Gania
- Sher-I-Kashmir Institute Of Medical Sciences, Srinagar, India
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Marcus F, Nel Y. An assessment of voting knowledge and related decisions amongst hospitalised mental healthcare users in South Africa. S Afr J Psychiatr 2021; 27:1529. [PMID: 33604072 PMCID: PMC7876961 DOI: 10.4102/sajpsychiatry.v27i0.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/18/2020] [Indexed: 11/04/2022] Open
Abstract
Background The South African Constitution protects the right to vote for every citizen. The Electoral Act (No. 73 of 1998) limits registration on the voter’s roll on the basis of being declared of ‘unsound mind’ or ‘mentally disordered’ by the high court or detention under the Mental Health Care Act (No. 17 of 2002). There is limited information regarding voting knowledge and subsequent voting-related decisions amongst South African involuntary mental healthcare users (MHCUs). Aim To compare voting knowledge and related decisions between hospitalised MHCUs and non-psychiatric hospitalised patients (controls). Setting Participants were recruited from Sterkfontein Psychiatric Hospital (MHCUs) and Chris Hani Baragawanth Academic Hospital orthopaedic wards (controls) in Gauteng, South Africa. Method A cross-sectional survey was conducted using a modified Cognitive Assessment Tool for Voting (MCAT-V) questionnaire. Scores on the MCAT-V were compared between the MHCU and control groups, along with socio-demographic variables and clinical variables. Results There was a significant association between group (MHCU vs. control) and HLOE (p = 0.016). Although the median overall score for the controls (11; interquartile range [IQR] 10–12) was significantly higher than that for the MHCUs (10; IQR 8–12) (p = 0.043), when controlling for education level, there was no significant association between group (MHCU/control) and MCAT-V scores (p = 0.011). The MCAT-V scores of the ‘Doe questions’ between the MHCUs and controls were not significantly different (p = 0.063). There was a difference in ‘reasoning scores’ between MHCUs and controls (p = 0.0082) and this was associated with level of educational attainment (p = 0.013). Conclusion The limitations regarding voter registration legislated in the South African Electoral Act, are not supported by the findings of this study. The MCAT-V demonstrates a possible educational bias and therefore is not recommended as a screening tool for assessing voting competency.
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Affiliation(s)
- Felicity Marcus
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yvette Nel
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Loi SM, Eratne D, Goh AMY, Wibawa P, Farrand S, Kelso W, Evans A, Watson R, Walterfang M, Velakoulis D. A 10 year retrospective cohort study of inpatients with younger-onset dementia. Int J Geriatr Psychiatry 2021; 36:294-301. [PMID: 32892399 DOI: 10.1002/gps.5424] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/03/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Younger-onset dementia (YOD) refers to a dementia where symptom onset occurs when the patient is less than 65 years of age. YOD is far less common than late-onset dementia (occurring when patients are over 65 years old) and more challenging to diagnose due to its heterogeneous presentation. There have been relatively few studies describing demographic and diagnostic characteristics of patients with YOD in the community, particularly with follow-up information. METHODS A retrospective cohort study was performed of inpatients admitted to a tertiary neuropsychiatry service, located in metropolitan Victoria, Australia, from 2009 to 2019. Inpatients with a YOD diagnosis were identified and data regarding diagnosis, demographics and investigations were obtained. RESULTS There were 849 individual inpatients who were admitted to the service in the 10-year period and received comprehensive assessment. There were 306 individuals who received a YOD diagnosis, using contemporaneous diagnostic criteria (frequency 36%). The most common diagnoses were Alzheimer's disease (24.2%), frontotemporal dementia (23.1%), Huntington's disease (16.7%) and vascular dementia (7.8%). More than half of these inpatients were followed up and 6.5% had a diagnostic change when reviewed. CONCLUSIONS This study reports on the largest cohort of YOD to date, with diagnostic breakdown similar to previous retrospective file reviews. The neuropsychiatry service is funded to follow-up its patients, thus allowing re-assessment and continuity of care. While there are limitations in this study such as the lack of neuropathological outcomes, the findings emphasise the strengths of follow-up and appropriate service provision for these patients.
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Affiliation(s)
- Samantha M Loi
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - Anita M Y Goh
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia.,National Ageing Research Institute, Parkville, Australia
| | - Pierre Wibawa
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia
| | - Sarah Farrand
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia
| | - Wendy Kelso
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychology, Monash University, Clayton, Australia
| | - Andrew Evans
- Department of Medicine, Royal Melbourne Hospital, Parkville, Australia
| | - Rosie Watson
- Department of Medicine, Royal Melbourne Hospital, Parkville, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Mark Walterfang
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia
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Karayanidis F, McKewen M. More than “just a test”—Task-switching paradigms offer an early warning system for cognitive decline. PSYCHOLOGY OF LEARNING AND MOTIVATION 2021. [DOI: 10.1016/bs.plm.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Diet, Exercise, Lifestyle, and Mental Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study. Nutrients 2020; 13:nu13010024. [PMID: 33374693 PMCID: PMC7822407 DOI: 10.3390/nu13010024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18–29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year period (2014–2019) to collect data from different populations at different time-points and seasons. A backward stepwise regression analysis was used on 2628 records. Mental distress in young women was associated with high consumption of caffeine and fast-food, and it was negatively correlated with moderate-high levels of exercise as well as frequent breakfast consumption. Mature women shared several common factors with young women; however, high fruit consumption was negatively associated with mental distress. For young men, high exercise, moderate consumption of dairy, and moderate-high intake of meat were negatively associated with mental distress. In addition, high fast-food and caffeine consumption were positively associated with mental distress in young men. For mature men, strong negative associations between higher education, moderate intake of nuts and mental distress surfaced. Our results support the need to customize dietary and lifestyle recommendations to improve mental wellbeing.
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Esan O, Oladele O, Adediran KI, Abiona TO. Neurocognitive Impairments (NCI) in bipolar disorder: Comparison with schizophrenia and healthy controls. J Affect Disord 2020; 277:175-181. [PMID: 32829193 DOI: 10.1016/j.jad.2020.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/28/2020] [Accepted: 08/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Neurocognitive impairments (NCI) are common in patients with bipolar I disorder. However, reports about the affected domains, outcomes and magnitude have been inconsistent. The aim of this study was to compare the magnitude (severity) and specificity (domains), of (NCI) in euthymic Bipolar I Disorder (BD) patients with a demographically and educationally matched sample of patients with schizophrenia in remission (SC) and healthy controls (HC). METHODS The Screen for Cognitive Impairment in Psychiatry (SCIP) was applied in this cross-sectional study, to all consecutive and consenting euthymic outpatients with bipolar I disorder (BD) (n = 76), remitted patients with schizophrenia (n = 130) and age and gender-matched healthy controls (HC) (n = 100). The cognitive tests done included Verbal List Learning-Immediate (VLT-I), Working Memory Test (WMT), Verbal Fluency Test (VFT), Verbal Learning Test-Delayed (VLT-D) and Processing Speed Test (PST). Within the bipolar group, the association between NCI and functioning was assessed. RESULTS There was a significant difference in the proportions of participants that had cognitive impairment from the 3 groups (37% (HC) vs. 71.1% (BD) vs. 91.5%(SC) (p=<0.001). The BD group in comparison to the HCs did worse on all domains of the SCIP except WMT and PST. The BD group was not significantly different from the SC group in all neuropsychological domains of the SCIP except WMT. BD group significantly functions better than the SC group. The severity of depressive symptomatology and VLT-I were independent predictors of functioning in the BD group. CONCLUSION Cognitive impairment affects almost all the neurocognitive domains of the BD group. The difference in NCI between euthymic BD patients and SC in remission are quantitative rather than qualitative.
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Affiliation(s)
- Oluyomi Esan
- Department of Psychiatry, University of Ibadan, University College Hospital, PMB 5116 Ibadan, Nigeria.
| | - Oluremi Oladele
- Department of Psychiatry, University College Hospital, PMB 5116 Ibadan, Nigeria
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Xie Z, Ossip DJ, Rahman I, O’Connor RJ, Li D. Electronic cigarette use and subjective cognitive complaints in adults. PLoS One 2020; 15:e0241599. [PMID: 33137145 PMCID: PMC7605645 DOI: 10.1371/journal.pone.0241599] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/17/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Electronic cigarette use (vaping) has become popular in recent years. The number of Americans with a variety of cognitive deficits has been increasing dramatically. This study aimed to examine the potential association of vaping with subjective cognitive complaints in US adults. METHODS A combined 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) national survey dataset yielded 886,603 adults who indicated their smoking and vaping status, as well as whether they had subjective cognitive complaints. With this dataset, the cross-sectional association of electronic cigarette use with subjective cognitive complaints was examined using multivariable weighted logistic regression models. RESULTS Both dual users (adjusted Odds Ratio [aOR] = 2.07; 95% Confidence Interval [CI] = 1.66 to 2.60) and current vapers who were either ex-smokers (aOR = 1.94; 95% CI = 1.40 to 2.71) or never smoked (aOR = 1.96; 95% CI = 1.16 to 3.30) showed a significantly higher association with subjective cognitive complaints than never users. Current smokers (aOR = 1.49; 95% CI = 1.32 to 1.69) and ex-smokers (aOR = 1.25; 95% CI = 1.11 to 1.41) had a significantly higher association with subjective cognitive complaints compared to never users. Compared to current smokers, the ex-smokers showed a lower association with subjective cognitive complaints (aOR = 0.84; 95% CI = 0.73 to 0.96). Finally, the association of vaping with subjective cognitive complaints was not statistically significant in individual age group. CONCLUSION Similar to smoking, vaping is associated with subjective cognitive complaints in US adults. These results provide preliminary evidence for a cross-sectional association of vaping with potential cognitive health effects in adults.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, United States of America
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Madden DR, Lam CN, Redline B, Dzubur E, Rhoades H, Intille SS, Dunton GF, Henwood B. Real-Time Data Collection to Examine Relations Between Physical Activity and Affect in Adults With Mental Illness. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2020; 42:386-393. [PMID: 33022657 PMCID: PMC8761482 DOI: 10.1123/jsep.2019-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
Adults with serious mental illness engage in limited physical activity, which contributes to significant health disparities. This study explored the use of both ecological momentary assessments (EMAs) and activity trackers in adults with serious mental illness to examine the bidirectional relationship between activity and affect with multilevel modeling. Affective states were assessed up to seven times per day using EMA across 4 days. The participants (n = 20) were equipped with a waist-worn accelerometer to measure moderate to vigorous physical activity. The participants had a mean EMA compliance rate of 88.3%, and over 90% of completed EMAs were matched with 30-min windows of accelerometer wear. The participants who reported more positive affect than others had a higher probability of engaging in moderate to vigorous physical activity. Engaging in more moderate to vigorous physical activity than one's usual was associated with more negative affect. This study begins to address the effect of momentary mood on physical activity in a population of adults that is typically difficult to reach.
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Affiliation(s)
- Danielle R. Madden
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Chun Nok Lam
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Brian Redline
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Eldin Dzubur
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Harmony Rhoades
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Stephen S. Intille
- College of Computer and Information Science and Bouvé College of Health Sciences, Northeastern University
| | - Genevieve F. Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Benjamin Henwood
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
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Haddar M, Azuma K, Izuo N, Kyosuke U, Asano T, Muramatsu SI, Nitta A. Impairment of cognitive function induced by Shati/Nat8l overexpression in the prefrontal cortex of mice. Behav Brain Res 2020; 397:112938. [PMID: 32998043 DOI: 10.1016/j.bbr.2020.112938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
A novel N-acetyltransferase, Shati/Nat8l, was identified in the brains of mice exposed to methamphetamine. Shati/Nat8l overexpression in the medial prefrontal cortex (mPFC) was found to attenuate methamphetamine-induced dependence. The mPFC is a brain region that plays an important role in cognitive function. However, the effect of Shati/Nat8l on cognition and memory has not yet been clarified. To understand the role of Shati/Nat8l in memory, we generated C57BL/6J mice with overexpressed Shati/Nat8l in the mPFC and performed memory-related experiments, including novel object-location and object-in-context tests. Furthermore, we used quantitative immunohistochemistry to assess the presynaptic and postsynaptic proteins, synaptophysin and postsynaptic density protein (PSD)-95, respectively. Shati/Nat8l overexpression in the mPFC impaired both novel object-location and object-in-context memory. Moreover, Shati/Nat8l overexpression in the mPFC reduced PSD-95 levels, but not synaptophysin levels in the mPFC. These results demonstrated that Shati/Nat8l overexpression in the mPFC is involved in location and contextual memory, and can affect the excitatory postsynaptic protein, PSD-95.
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Affiliation(s)
- Meriem Haddar
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Katsunori Azuma
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Naotaka Izuo
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Uno Kyosuke
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Laboratory of Molecular Pharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata-shi, Osaka, Japan
| | - Takashi Asano
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shin-Ichi Muramatsu
- Division of Neurological Gene Therapy, Open Innovation Center, Jichi Medical University, Shimotsuke, Japan; Center for Gene & Cell Therapy, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Atsumi Nitta
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
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Ronaldson A, Elton L, Jayakumar S, Jieman A, Halvorsrud K, Bhui K. Severe mental illness and health service utilisation for nonpsychiatric medical disorders: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003284. [PMID: 32925912 PMCID: PMC7489517 DOI: 10.1371/journal.pmed.1003284] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Psychiatric comorbidity is known to impact upon use of nonpsychiatric health services. The aim of this systematic review and meta-analysis was to assess the specific impact of severe mental illness (SMI) on the use of inpatient, emergency, and primary care services for nonpsychiatric medical disorders. METHODS AND FINDINGS PubMed, Web of Science, PsychINFO, EMBASE, and The Cochrane Library were searched for relevant studies up to October 2018. An updated search was carried out up to the end of February 2020. Studies were included if they assessed the impact of SMI on nonpsychiatric inpatient, emergency, and primary care service use in adults. Study designs eligible for review included observational cohort and case-control studies and randomised controlled trials. Random-effects meta-analyses of the effect of SMI on inpatient admissions, length of hospital stay, 30-day hospital readmission rates, and emergency department use were performed. This review protocol is registered in PROSPERO (CRD42019119516). Seventy-four studies were eligible for review. All were observational cohort or case-control studies carried out in high-income countries. Sample sizes ranged from 27 to 10,777,210. Study quality was assessed using the Newcastle-Ottawa Scale for observational studies. The majority of studies (n = 45) were deemed to be of good quality. Narrative analysis showed that SMI led to increases in use of inpatient, emergency, and primary care services. Meta-analyses revealed that patients with SMI were more likely to be admitted as nonpsychiatric inpatients (pooled odds ratio [OR] = 1.84, 95% confidence interval [CI] 1.21-2.80, p = 0.005, I2 = 100%), had hospital stays that were increased by 0.59 days (pooled standardised mean difference = 0.59 days, 95% CI 0.36-0.83, p < 0.001, I2 = 100%), were more likely to be readmitted to hospital within 30 days (pooled OR = 1.37, 95% CI 1.28-1.47, p < 0.001, I2 = 83%), and were more likely to attend the emergency department (pooled OR = 1.97, 95% CI 1.41-2.76, p < 0.001, I2 = 99%) compared to patients without SMI. Study limitations include considerable heterogeneity across studies, meaning that results of meta-analyses should be interpreted with caution, and the fact that it was not always possible to determine whether service use outcomes definitively excluded mental health treatment. CONCLUSIONS In this study, we found that SMI impacts significantly upon the use of nonpsychiatric health services. Illustrating and quantifying this helps to build a case for and guide the delivery of system-wide integration of mental and physical health services.
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Affiliation(s)
- Amy Ronaldson
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Lotte Elton
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Simone Jayakumar
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Anna Jieman
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Kristoffer Halvorsrud
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Effects of different types of sensory signals on reaching performance in persons with chronic schizophrenia. PLoS One 2020; 15:e0234976. [PMID: 32579579 PMCID: PMC7314021 DOI: 10.1371/journal.pone.0234976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 06/06/2020] [Indexed: 11/19/2022] Open
Abstract
Previous studies have reported movement abnormalities in persons with schizophrenia. This study aimed to examine the differences between persons with chronic schizophrenia and healthy control participants in reaching movement and the effects of sensory signals on reaching performance in persons with chronic schizophrenia. A counter-balanced repeated-measures design was employed. Twenty persons with schizophrenia and 20 age- and gender-matched control participants were recruited in this study. Reaching performance was measured in three types of sensory signal conditions (visual, auditory, and no signal), i.e., two externally triggered and one self-initiated movement were assessed in reaction time/inter-response interval, movement time, peak velocity, percentage of time in which peak velocity occurred, and movement units. The results revealed significant main effects of group in reaction time/inter-response interval (p = 0.003), movement time (p < 0.001), peak velocity (p < 0.001), and movement units (p < 0.001). The persons with chronic schizophrenia demonstrated slower response to signals and in self-initiated movement, increased movement time, and less forceful and less smooth movement compared to healthy control participants when performing the reaching task. The interaction effect between group and signal in reaction time/inter-response interval was also significant (p < 0.001). The inter-response interval for self-initiated reaching was the shortest in healthy controls. Conversely, the inter-response interval for self-initiated reaching was the longest in persons with schizophrenia. The main effect of the signal on movement time was significant (p < 0.001). The movement time of reaching was longer in response to the auditory signal than in response to visual or self-initiated. The differences in percentages of time in which peak velocity occurred between persons with schizophrenia and healthy controls (p > 0.01) and across the three conditions (p > 0.01) were non-significant. Neither duration of illness nor antipsychotic dosage was significantly associated with reaching performance (all p > 0.01). In conclusion, these findings indicate that reaching movement in persons with chronic schizophrenia is slower, less forceful, and less coordinated compared to healthy control participants. In addition, persons with chronic schizophrenia also had shorter inter-response interval for self-initiated movement and shorter movement time in auditory signal condition, independent of duration of illness and antipsychotic dosage.
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Delagneau G, Bowden SC, Bryce S, van-der-El K, Hamilton M, Adams S, Burgat L, Killackey E, Rickwood D, Allott K. Thematic analysis of youth mental health providers' perceptions of neuropsychological assessment services. Early Interv Psychiatry 2020; 14:220-227. [PMID: 31512388 DOI: 10.1111/eip.12876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/09/2019] [Accepted: 08/25/2019] [Indexed: 01/18/2023]
Abstract
AIM A growing number of quantitative studies have investigated the utility of neuropsychological assessment in mental health settings. However, to the best of our knowledge, no previous study has qualitatively explored youth mental health providers' perceptions of neuropsychological assessment services. A more in-depth understanding of the perceived advantages and barriers associated with neuropsychological assessment in youth mental health settings is critical to better inform policy, practice and service uptake. Thus, the aim of this study was to qualitatively explore clinicians' views about neuropsychological assessments for youth with mental health concerns. METHODS A single open-ended qualitative question, included as part of an anonymous cross-sectional online survey, was completed by clinicians (N = 206) treating or assessing adolescents and young adults within Australian primary care mental health centres (headspace). Responses were analysed using an inductive approach to thematic analysis. RESULTS Five main themes were identified. Clinicians (a) identified barriers to accessing neuropsychological assessments (53%), (b) indicated a range of mixed outcomes following neuropsychological assessment (39%), (c) highlighted a need for neuropsychological assessments (22%), (d) reported a lack of awareness about this resource (10%) and (e) described practice issues associated with neuropsychological services (4%). CONCLUSION This study uncovered perceived factors contributing to reduced access to neuropsychological assessment in Australian youth mental health settings. Given potential adverse outcomes resulting from this clinical service gap, efforts should be made to address factors contributing to poorer access, thereby mitigating the impact of poor access on the management of mental illness in youth. Several strategies, including funding neuropsychological assessments, are discussed.
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Affiliation(s)
- Garance Delagneau
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Shayden Bryce
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Kristi van-der-El
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Matthew Hamilton
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Sophie Adams
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen Youth Health, Parkville, Victoria, Australia
| | - Liz Burgat
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia & headspace The National Youth Mental Health Foundation, Melbourne, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
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Gopal S, Gogate J, Pungor K, Kim E, Singh A, Mathews M. Improvement of Negative Symptoms in Schizophrenia with Paliperidone Palmitate 1-Month and 3-Month Long-Acting Injectables: Results from a Phase 3 Non-Inferiority Study. Neuropsychiatr Dis Treat 2020; 16:681-690. [PMID: 32184607 PMCID: PMC7064291 DOI: 10.2147/ndt.s226296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/04/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Negative symptoms in schizophrenia are associated with impairments in social and cognitive functioning leading to substantial long-term disability. Available antipsychotic treatments have demonstrated only modest benefit in the improvement of negative symptoms. OBJECTIVE To compare improvements in negative symptoms among patients treated with paliperidone palmitate 3-month (PP3M) or paliperidone palmitate 1-month (PP1M) long-acting injectable (LAI) formulations. METHODS Data from a randomized double-blind (DB), phase-3, non-inferiority study in patients with schizophrenia were analyzed. Following screening, patients entered a 17-week open-label (OL) phase to receive flexibly dosed PP1M followed by a 48-week DB phase where patients were randomized (1:1) to receive either PP1M or PP3M. Positive and Negative Syndrome Scale (PANSS) total scores with emphasis on 7-item negative subscale scores for PP1M vs PP3M were assessed. RESULTS Of 1429 patients enrolled, 1016 were randomized to receive PP3M (n=504) or PP1M (n=512). At baseline, mean (SD) PANSS negative subscale was 23.2 (4.60) and negative symptom factor score was 22.3 (4.87), indicating moderate-to-severe negative symptoms. Negative subscale and symptoms factor scores showed continuous improvements throughout OL (15.9 [4.99]) and DB (14.9 [4.81]) phases. Mean (SD) changes from DB baseline in the PANSS negative subscale score were comparable between PP1M (-1.4 [3.67]) and PP3M (-1.4 [3.63]) treatment groups. CONCLUSION Treatment with PP3M or PP1M demonstrated comparable improvement in negative symptoms in patients with moderate-to-severe negative symptoms and in patients with prominent negative symptoms. Long-term treatment with PP3M demonstrated benefit, suggesting that continuous antipsychotic medication treatment for >1 year is needed to achieve greater benefit for negative symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01515423.
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Affiliation(s)
- Srihari Gopal
- Janssen Research and Development, LLC, Titusville, NJ, USA
| | | | | | - Edward Kim
- Janssen Scientific Affairs, Janssen Pharmaceuticals, Titusville, NJ, USA
| | - Arun Singh
- Janssen Research and Development, LLC, Titusville, NJ, USA
| | - Maju Mathews
- Janssen Research and Development, LLC, Titusville, NJ, USA
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49
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Soni H, Grando A, Murcko A, Diaz S, Mukundan M, Idouraine N, Karway G, Todd M, Chern D, Dye C, Whitfield MJ. State of the art and a mixed-method personalized approach to assess patient perceptions on medical record sharing and sensitivity. J Biomed Inform 2020; 101:103338. [PMID: 31726102 PMCID: PMC6952579 DOI: 10.1016/j.jbi.2019.103338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 11/07/2019] [Accepted: 11/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Sensitive health information possesses risks, such as stigma and discrimination, when disclosed. Few studies have used a patient's own electronic health records (EHRs) to explore what types of information are considered sensitive andhow such perceptions affect data sharing preferences. After a systematic literature review, we designed and piloted a mixed-method approach that employs an individual's own records to assess content sensitivity and preferences for granular data sharing for care and research. METHODS A systematic literature review of methodologies employed to assess data sharing willingness and perceptions on data sensitivity was conducted. A methodology was designed to organize and categorize sensitive health information from EHRs. Patients were asked permission to access their EHRs, including those available through the state's health information exchange. A semi-structured interview script with closed card sorting was designed and personalized to each participant's own EHRs using 30 items from each patient record. This mixed method combines the quantitative outcomes from the card sorting exercises with themes captured from interview audio recording analysis. RESULTS Eight publications on patients' perspectives on data sharing and sensitivity were found. Based on our systematic review, the proposed method meets a need to use EHRs to systematize the study of data privacy issues. Twenty-five patients with behavioral health conditions, English and Spanish-speaking, were recruited. On average, participants recognized 82.7% of the 30 items from their own EHRs. Participants considered mental health (76.0%), sexual and reproductive health (75.0%) and alcohol use and alcoholism (50.0%) sensitive information. Participants were willing to share information related to other addictions (100.0%), genetic data (95.8%) and general physical health information (90.5%). CONCLUSION The findings indicate diversity in patient views on EHR sensitivity and data sharing preferences and the need for more granular and patient-centered electronic consent mechanisms to accommodate patient needs. More research is needed to validate the generalizability of the proposed methodology.
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Affiliation(s)
- Hiral Soni
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States
| | - Adela Grando
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States.
| | - Anita Murcko
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States
| | - Sabrina Diaz
- Kinesiology, College of Health Solutions, Arizona State University, Phoenix, United States
| | - Madhumita Mukundan
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States
| | - Nassim Idouraine
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States
| | - George Karway
- Biomedical Informatics, College of Health Solutions, Arizona State University, Scottsdale, United States
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, Phoenix, United States
| | | | - Christy Dye
- Partners in Recovery, Phoenix, United States
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50
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Coelho JCF, Ribeiro ARM, Sampaio FMC, Sequeira CADC, Lleixà Fortuño MDM, Roldán Merino J. Cultural Adaptation and Psychometric Properties Assessment of the NOC Outcome "Cognition" in a Sample of Portuguese Adults With Mental Illness. Int J Nurs Knowl 2019; 31:180-187. [PMID: 31833220 DOI: 10.1111/2047-3095.12268] [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: 09/26/2019] [Revised: 11/15/2019] [Accepted: 12/01/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Cultural adaptation and psychometric properties assessment of the Nursing Outcomes Classification (NOC) outcome "Cognition" in a sample of Portuguese adults with mental illness. METHODS Methodological study. FINDINGS The final European Portuguese version of the NOC outcome "Cognition", consisting of 13 items, showed good psychometric properties. An exploratory factor analysis was performed from which only one factor was established. CONCLUSIONS The European Portuguese version of the NOC outcome "Cognition" seems to gather very satisfactory psychometric properties for assessing cognition in the Portuguese population. IMPLICATIONS FOR NURSING PRACTICE This study contributed to advance the nursing body of knowledge and to better assess cognition in a clinical context.
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Affiliation(s)
- Joana Catarina Ferreira Coelho
- University Rovira i Virgili, Spain, registered mental health nurse at the Psychiatry Department, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal, invited assistant at Nursing School of Porto, Portugal, and collaborator researcher at the NursID Research Group, CINTESIS, Portugal
| | - Ana Rita Martins Ribeiro
- Nursing School of Porto, Portugal and registered nurse at the Psychiatry Department, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal
| | - Francisco Miguel Correia Sampaio
- Faculty of Health Sciences, University Fernando Pessoa, Portugal, doctorate integrated researcher at the NursID Research Group, CINTESIS, Portugal, and postdoctoral researcher at the Faculty of Medicine, University of Porto, Portugal
| | | | | | - Juan Roldán Merino
- Nursing School of Barcelona, Campus Docent Sant Joan de Déu-Private Foundation, University of Barcelona, Spain and researcher at the GEIMAC Research Group (Group Consolidat 2017-1681: Group of Studies of Invariance of the Instruments of Measurement and Analysis of the Change in the Social and Health Areas), Barcelona, Spain
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