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Campbell A, Hinton T, da Costa NC, O'Brian SE, Liang DR, Wheate NJ. Causes and outcomes of at-risk underperforming pharmacy students: implications for policy and practice. BMC Med Educ 2024; 24:421. [PMID: 38641772 PMCID: PMC11027423 DOI: 10.1186/s12909-024-05327-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This study aimed to understand the key determinants for poor academic performance of students completing a Bachelor of Pharmacy (BPharm), Bachelor of Pharmacy and Management (BPharmMgmt), or Master of Pharmacy (MPharm) degree. METHODS Data were collected on pharmacy students who had not met academic progression requirements between 2008 and 2018 at The University of Sydney, Australia. This included: age at the start of pharmacy degree; gender; whether they transferred from another university; whether they were a domestic or international student; Australian Tertiary Admissions Rank upon entry, previous studies in biology, chemistry, or mathematics; show cause triggers (units of study failed); number of show causes; students' written show cause responses; weighted average mark at last show cause or graduation; whether they graduated and were a registered pharmacist; and, the number of years they spent studying the degree. Descriptive studies were used to analyse student characteristics using SPSS software, and student self-reported reasons for poor performance were analysed reflexively using thematic analysis procedures using NVivo. RESULTS This study included 164 pharmacy students enrolled in a BPharm (79.3%, n = 130), BPharmMgmt (1.2%, n = 2), or MPharm (19.5%, n = 32). Of the students, 54% (n = 88) were men, 81% (n = 133) were domestic students, 15% (n = 24) transferred from another degree program, and 38% (n = 62) graduated from the course. Show cause students were less likely to graduate if they transferred from another degree program (P = 0.0002) or failed more than three units of study (UoS; P < 0.0001). The most commonly failed UoS were related to organic or pharmaceutical chemistry, and the top student self-reported reasons for poor performance was stress/anxiety, physical health, and depression. CONCLUSION Pharmacy schools should aim to address student foundational knowledge in chemistry, identify at-risk students early using pre-subject testing, and provide better services to address student mental health.
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Affiliation(s)
- Alice Campbell
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Tina Hinton
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
- Charles Perkin Centre, Faculty of Medicine and Health, The University of Sydney NSW, 2006, Sydney, NSW, Australia
| | - Narelle C da Costa
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Sian E O'Brian
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Danielle R Liang
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Nial J Wheate
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia.
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Green D, Bluhm K, Brinkmann M, Raes K, Lane T, Liber K, Janz DM, Hecker M. Cross-species apical microinjected selenomethionine toxicity in embryo-larval fishes. Sci Total Environ 2024; 912:169338. [PMID: 38104801 DOI: 10.1016/j.scitotenv.2023.169338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Selenium (Se) is an essential micronutrient that becomes toxic when exposures minimally exceed those that are physiologically required. Studies on Se contaminated aquatic environments have identified that embryo-larval fishes are at particular risk of Se toxicity, primarily due to maternal Se transfer to developing eggs during oogenesis. This study emulated these exposures in embryo-larval fathead minnow (FHM), rainbow trout (RBT), white sucker (WSu), and white sturgeon (WSt) using embryonic selenomethionine (SeMet) microinjections. Adverse Se-outcomes observed across these species included spinal and edematous deformities, total individuals deformed, and reduced survival. Spinal deformity was the most sensitive sublethal endpoint and developed at the lowest concentrations in WSt (10 % effects concentration (EC10) = 12.42 μg (total) Se/g dry weight (d.w.)) followed by WSu (EC10 = 14.49 μg Se/g d.w.) and FHM (EC10 = 18.10 μg Se/g d.w.). High mortality was observed in RBT, but SeMet influences were confounded by the species' innate sensitivity to the microinjections themselves. 5 % hazardous concentrations derived across exposure type data subsets were ∼49 % higher when derived from within-species maternal transfer exclusive data as opposed to all, or within-species microinjection exclusive, data. These results support the current exclusion of SeMet microinjections during regulatory guideline derivation and their inclusion when studying mechanistic Se toxicity across phylogenetically distant fishes.
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Affiliation(s)
- Derek Green
- Toxicology Graduate Program, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada
| | - Kerstin Bluhm
- Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada
| | - Markus Brinkmann
- Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; School of Environment and Sustainability, University of Saskatchewan, 117 Science Place, Saskatoon, SK S7N 5C8, Canada
| | - Katherine Raes
- Toxicology Graduate Program, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada
| | - Taylor Lane
- Toxicology Graduate Program, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada
| | - Karsten Liber
- Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; School of Environment and Sustainability, University of Saskatchewan, 117 Science Place, Saskatoon, SK S7N 5C8, Canada
| | - David M Janz
- Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada
| | - Markus Hecker
- Toxicology Centre, University of Saskatchewan, 44 Campus Drive, Saskatoon, SK S7N 5B3, Canada; School of Environment and Sustainability, University of Saskatchewan, 117 Science Place, Saskatoon, SK S7N 5C8, Canada.
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Pighini MJ, Guhn M, Zumbo BD. Over-reaching with causality language in neurodevelopmental infant research: A methodological literature review. Early Hum Dev 2023; 182:105781. [PMID: 37257252 DOI: 10.1016/j.earlhumdev.2023.105781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND A methodological review of 78 empirical articles focusing on the neurodevelopmental outcomes of at-risk infants was conducted. AIMS To examine ways language and terminology are used to describe methods, present results, and/or state conclusions in studies published during 1994-2005, a decade reflecting major advances in neurodevelopmental research and in medical intervention. More specifically, to investigate to what extent the design of the study and the language in the results section aligned in regard to causality. METHODS A process of search and selection of studies published in pediatric journals was conducted through Google Scholar. Criteria of inclusion and exclusion, following PRISMA, were used. Selected studies reported neurodevelopmental outcomes of infants and young children considered at-risk, and were further categorized accordingly to their study designs. Language use in regard to whether the presentation and interpretation of results may convey causal relationships between birth risk factors and neurodevelopmental outcomes was examined following two analytical steps. RESULTS Forty out of 78 studies, (51.28 %) used causality-implying language (e.g., effect, predict, influence) notwithstanding that the study design was non-causal. CONCLUSIONS Anticipating the next generation of neurodevelopmental-outcomes research, a framework that aims to raise awareness of the importance of language use and the impact of causality-related terms often used in longitudinal studies is proposed. The objective is to avoid ambiguities and misunderstandings around causal or non-causal connections between birth risk factors and developmental outcomes across diverse audiences, including early intervention practitioners working directly with infants and their families.
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Affiliation(s)
- Maria J Pighini
- Faculty of Education, The University of British Columbia, Canada.
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Canada
| | - Bruno D Zumbo
- Faculty of Education, The University of British Columbia, Canada
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Petty A, Howes O, Eyles D. Animal Models of Relevance to the Schizophrenia Prodrome. Biol Psychiatry Glob Open Sci 2023; 3:22-32. [PMID: 36712558 PMCID: PMC9874082 DOI: 10.1016/j.bpsgos.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 02/01/2023] Open
Abstract
Patients with schizophrenia often undergo a prodromal phase prior to diagnosis. Given the absence of significant therapeutic improvements, attention has recently shifted to the possibility of intervention during this early stage to delay or diminish symptom severity or even prevent onset. Unfortunately, the 20 or so trials of intervention to date have not been successful in either preventing onset or improving long-term outcomes in subjects who are at risk of developing schizophrenia. One reason may be that the biological pathways an effective intervention must target are not static. The prodromal phase typically occurs during late adolescence, a period during which a number of brain circuits and structures are still maturing. We propose that developing a deeper understanding of which circuits/processes and brain structures are still maturing at this time and which processes drive the transition to schizophrenia will take us a step closer to developing better prophylactic interventions. Fortunately, such knowledge is now emerging from clinical studies, complemented by work in animal models. Our task here is to describe what would constitute an appropriate animal model to study and to potentially intervene in such processes. Such a model would allow invasive analysis of the cellular and molecular substrates of the progressive neurobiology that defines the schizophrenia prodrome and hopefully offer valuable insights into potential prophylactic targets.
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Affiliation(s)
- Alice Petty
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | | | - Darryl Eyles
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia.,Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
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Nevill AM, Leahy GD, Mayhew J, Sandercock GRH, Myers T, Duncan MJ. 'At risk' waist-to-height ratio cut-off points recently adopted by NICE and US Department of Defense will unfairly penalize shorter adults. What is the solution? Obes Res Clin Pract 2023; 17:1-8. [PMID: 36682982 DOI: 10.1016/j.orcp.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To a) demonstrate that adopting 'at risk' waist-to-height ratio (WHTR) cut-off points, recently approved by National Institute for Health and Care Excellence (NICE) and the United States Department of Defense (USDoD), will unfairly penalize shorter individuals and will be too lenient for taller individuals, b) to confirm that waist circumference (WC) of a sample of US service personnel, scales to approximately height0.5, supporting the notion that WC, to be independent of height (HT), should be normalized using WC.HT-0.5 (WHT•5R), and c) to identify the WHT•5R cut-off points that will reduce or eliminate this unwanted bias. SUBJECTS/METHODS We employed a three independent cross-sectional sample design. All n = 58,742 participants underwent anthropometric assessment of body mass, stature and waist circumference. RESULTS The allometric power-law model WC=a.HT^b for US service personnel identified the height exponent to be b= 0.418 (95 % CI 0.251-0.585), confirming that the simple body-shape index for WC to be independent of HT, should be WC.HT-0.5. Chi-square tests of independence and for linear trend confirmed that by adopting WHTR cut-off point, shorter individuals (both service personnel and non-service participants) will be over penalized (classified as being 'at risk'). New WC independent-of-height ratio cut-off points were found to resolve this problem. CONCLUSIONS Adopting WHTR cut-off thresholds (either 0.5 or 0.55) will lead to shorter adults being unfairly classified as being 'at risk' in terms of their central adiposity and general health status. Adopting new WHT•5R cut-off point thresholds were found to greatly reduce or eliminate this bias.
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Reardon T, Dodd H, Hill C, Jasper B, Lawrence PJ, Morgan F, Rapee RM, Ukoumunne OC, Violato M, Davey E, Halliday G, Jones B, Martineau L, McCall A, Niekamp N, Placzek A, Potts R, Weisser T, Creswell C. Minimising young children's anxiety through schools (MY-CATS): protocol for a cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of an online parent-led intervention compared with usual school practice for young children identified as at risk for anxiety disorders. Trials 2022; 23:149. [PMID: 35168635 PMCID: PMC8848959 DOI: 10.1186/s13063-022-06010-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying and supporting young children who are at risk of developing anxiety disorders would benefit children, families, and wider society. Elevated anxiety symptoms, inhibited temperament, and high parental anxiety are established risk factors for later anxiety disorders, but it remains unclear who is most likely to benefit from prevention and early intervention programmes. Delivering an online intervention through schools to parents of young children who have one or more of these risks could maximise reach. The primary aim of this trial is to evaluate the effectiveness and cost-effectiveness of delivering an online parent-led intervention, compared with usual school provision only, for children (aged 4-7) identified as at risk for anxiety disorders on the basis of at least one risk factor. We also aim to identify the characteristics of children who do and do not benefit from intervention and mechanisms of change from the intervention. METHODS The design will be a parallel group, superiority cluster randomised controlled trial, with schools (clusters) randomised to intervention or usual school practice arms in a 1:1 ratio stratified according to level of deprivation within the school. The study will recruit and randomise at least 60 primary/infant schools in England, and on the basis of recruiting 60 schools, we will recruit 1080 trial participants (540 per arm). Parents of all children (aged 4-7) in sampled Reception, Year 1, and Year 2 classes will be invited to complete screening questionnaires. Children who screen positive on the basis of anxiety symptoms, and/or behavioural inhibition, and/or parent anxiety symptoms will be eligible for the trial. Parents/carers of children in schools allocated to the intervention arm will be offered a brief online intervention; schools in both arms will continue to provide any usual support for children and parents throughout the trial. Assessments will be completed at screening, baseline (before randomisation), 6 weeks, 12 weeks, and 12 months post-randomisation. The primary outcome will be the absence/presence of an anxiety disorder diagnosis at 12 months. DISCUSSION The trial will determine if delivering an online intervention for parents of young children at risk of anxiety disorders identified through screening in schools is effective and cost-effective. TRIAL REGISTRATION ISRCTN 82398107 . Prospectively registered on Jan. 14, 2021.
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Affiliation(s)
- Tessa Reardon
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
| | - Helen Dodd
- College of Medicine and Health, University of Exeter, Exeter, UK.,School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Bec Jasper
- Parents and Carers Together, Suffolk, UK
| | - Peter J Lawrence
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, England
| | | | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Emily Davey
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Gemma Halliday
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Benjamin Jones
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Lindsey Martineau
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Amy McCall
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Natascha Niekamp
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Anna Placzek
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Ruth Potts
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Tamatha Weisser
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
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Law ML, Singh J, Mastroianni M, Santosh P. Parent-Mediated Interventions for Infants under 24 Months at Risk for Autism Spectrum Disorder: A Systematic Review of Randomized Controlled Trials. J Autism Dev Disord 2021; 52:2553-2574. [PMID: 34236590 PMCID: PMC9114042 DOI: 10.1007/s10803-021-05148-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
Prodromal symptoms of Autism Spectrum Disorder (ASD) have been detected within the first year of life. This review evaluated evidence from randomized controlled trials (RCTs) of parent-mediated interventions for infants under 24 months who are at risk for ASD. Electronic databases, including grey literature, were searched up till November 2019. Seven RCTs were identified. There was substantial heterogeneity in recruitment, outcome measures and effect size calculations. Interventions did not reduce the risk of later ASD diagnosis and post-intervention effects on infant outcomes were inconsistent, with five studies reporting significant improvements across both treatment and control groups. Moderate level of evidence of intervention effects on parental interaction skills and the small number of RCTs, and significant limitations restrict generalizability across studies.
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Affiliation(s)
- Mei L Law
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, Addiction Sciences Building, 1-4 Windsor Walk, Denmark Hill, London, London, SE5 8BB, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jatinder Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, Addiction Sciences Building, 1-4 Windsor Walk, Denmark Hill, London, London, SE5 8BB, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Mathilde Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, Addiction Sciences Building, 1-4 Windsor Walk, Denmark Hill, London, London, SE5 8BB, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, Addiction Sciences Building, 1-4 Windsor Walk, Denmark Hill, London, London, SE5 8BB, UK.
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
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Jiménez JE, Gutiérrez N, de León SC. Analyzing the role of fidelity of RTI Tier 2 reading intervention in Spanish kindergarten and first grade students. Ann Dyslexia 2021; 71:28-49. [PMID: 33713278 DOI: 10.1007/s11881-021-00221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
This study examined the role of fidelity in the reading outcomes within a Tier 2 intervention implemented by Spanish kindergarten and first grade school teachers. For this purpose, differences in reading performance growth were analyzed among at-risk students who received a Tier 2 intervention with high fidelity, at-risk students who received the same intervention with medium fidelity, and an at-risk control group that did not receive a Tier 2 intervention. Implementation fidelity was analyzed using direct observations and self-reports. All students were assessed three times during the academic year. Hierarchical linear modeling analyses were conducted to explore differences in growth rate. The at-risk children in the intervention condition showed a higher growth compared to at-risk children in the control condition, and specifically when the intervention was delivered with a high degree of fidelity.
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Affiliation(s)
- Juan E Jiménez
- Department of Developmental and Educational Psychology, Faculty of Psychology and Speech Therapy, Universidad de La Laguna, Campus Guajara s/n, La Laguna, 38200, Tenerife, Canary Islands, Spain.
| | | | - Sara C de León
- Department of Developmental and Educational Psychology, Faculty of Psychology and Speech Therapy, Universidad de La Laguna, Campus Guajara s/n, La Laguna, 38200, Tenerife, Canary Islands, Spain
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Tanna NK, Alexander EC, Lee C, Lakhanpaul M, Popat RM, Almeida-Meza P, Tuck A, Manikam L, Blair M. Interventions to improve vitamin D status in at-risk ethnic groups during pregnancy and early childhood: a systematic review. Public Health Nutr 2021; 24:3498-519. [PMID: 33593453 DOI: 10.1017/S1368980021000756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups. DESIGN Review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour Model and Behaviour Change Wheel framework constructs used to underpin evaluation of interventions. Methodological quality evaluated using Cochrane Risk of Bias, Cochrane ROBINS-I and NHLBI tools. SETTING Databases Cochrane Library, MEDLINE, EMBASE, CINAHL with secondary search of Google Scholar. No country limits set. Papers between January 1990 and February 2018, published in English included. Anticipating study heterogeneity, outcome measures not pre-specified and identified from individual full papers. Updated literature search November 2020. PARTICIPANTS Patient or population including pregnant women, newborns and children aged under 18 years, from Asian or African ethnic groups. RESULTS Of 10 690 articles screened, 298 underwent full-text review, with 24 ultimately included for data extraction. All identified studies conducted a vitamin D pharmacological supplementation intervention, with two also incorporating a behavioural intervention strategy. No study explicitly defined a primary aim of evaluating a behavioural intervention, undertaken to study its effect on vitamin D supplement uptake. CONCLUSIONS There is a need to address the paucity of data in ethnic at-risk children on how behavioural interventions ideally developed and co-produced with the community under study, affect and help improve vitamin D uptake, within the antenatal and pregnancy phase as well as during childhood.
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Nasrallah HA. The pro- and con-debate about the at-risk state and early intervention: A commentary. Schizophr Res 2021; 227:18-19. [PMID: 32527678 DOI: 10.1016/j.schres.2020.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/28/2020] [Accepted: 05/03/2020] [Indexed: 12/13/2022]
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Wang YM, Xiao YH, Xie WL. Metabolite abnormalities in psychosis risk: A meta-analysis of proton magnetic resonance spectroscopy studies. Asian J Psychiatr 2020; 54:102220. [PMID: 32653847 DOI: 10.1016/j.ajp.2020.102220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/23/2020] [Accepted: 06/10/2020] [Indexed: 12/28/2022]
Abstract
Accumulating evidence implicates that individuals at high-risk of psychosis have already exhibited pathophysiological changes in brain metabolites including glutamate, gamma-Aminobutyric Acid (GABA), N-Acetylaspartate (NAA), creatine (Cr), myo-inositol (MI) and choline (Cho). These changes may contribute to the development of schizophrenia and associate with psychotic genes. However, specific metabolic changes of brain sub-regions in individuals at risk have still been controversial. Thus, the current study aimed to investigate the brain metabolic changes including glutamate, Glx, GABA, GABA/Glx, NAA, Cr, MI and Cho levels in individuals at risk by conducting a case-control meta-analysis and meta-regression of proton magnetic resonance spectroscopy studies. Primary outcomes revealed that individuals at risk exhibited increased Cr levels at the rostral medial prefrontal cortex (rmPFC), decreased NAA and Cr levels at the thalamus, and increased MI levels at the dorsolateral prefrontal cortex. Sub-group analyses further indicated that individuals with clinical high-risk (CHR) exhibited increased Cr levels at the medial prefrontal cortex (mPFC) and decreased Glx levels at the thalamus, while individuals with genetic risk (siblings of psychiatric patients) exhibited significant increased Glx and MI levels at the mPFC. However, GABA, GABA/Glx and Cho levels showed no significant result. These findings suggest that the dysfunctional metabolites at the mPFC and the thalamus may be an essential neurobiological basis at the early stage of psychosis.
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12
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Wilson J, Rodrigues J. Classification accuracy and efficiency of writing screening using automated essay scoring. J Sch Psychol 2020; 82:123-40. [PMID: 32988459 DOI: 10.1016/j.jsp.2020.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/09/2020] [Accepted: 08/31/2020] [Indexed: 11/20/2022]
Abstract
The present study leveraged advances in automated essay scoring (AES) technology to explore a proof of concept for a writing screener using the Project Essay Grade (PEG) program. First, the study investigated the extent to which an AES-scored multi-prompt writing screener accurately classified students as at risk of failing a Common Core-aligned English language arts state test. Second, the study explored whether a similar level of classification accuracy could be achieved with a more efficient form of the AES-screener with fewer writing prompts. Third, the classification accuracy of the AES-scored screeners was compared to that of screeners scored for word count. Students in Grades 3-5 (n = 185, 167, and 187, respectively) composed six essays in response to multiple writing-prompt screeners on six different randomly assigned topics, consisting of two essays in each of three different genres (narrative, informative, and persuasive). Receiver operating characteristic (ROC) curve analysis was used to assess classification accuracy and to identify multiple cut scores with associated sensitivity and specificity values, and positive and negative posttest probabilities. Results indicated that the AES-scored multi-prompt screener and screeners with fewer prompts yield acceptable classification accuracy, are efficient, and are more accurate than screeners scored for word count. Overall, results illustrate the viability of writing screening using AES.
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Bala S, Pandve H, Manna R, Sreelal BS, Patel S, Saxena T, Joy SG. Impact of COVID-19 pandemic on mental health among Indians: A posttraumatic stress disorder. Ind Psychiatry J 2020; 29:251-256. [PMID: 34158709 PMCID: PMC8188926 DOI: 10.4103/ipj.ipj_121_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/23/2020] [Accepted: 11/26/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Post Traumatic stress disorder usually occurs after a traumatic event and nowadays we are all facing the pandemic - the COVID-19 which has effected our mental health to a great extent. So this study was taken up to assess the risk of Post traumatic stress disorder symptoms using impact of event scale-revised (IES-R), their main stressors and coping measurements. MATERIALS AND METHODS A telephonic interview schedule was adopted to fill the online questionnaire among general population of age group 20-55 years covering different states using snow ball technique. RESULTS depicted 8.2% at risk of post traumatic stress disorder symptoms and 32.5% at risk of suppressed immune system functioning which is presumed to have its effect for the next 10 years. The main stressors of Covid -19 with increased score were worry about economic influences, effect of social media on daily life, lack of social support and poor knowledge. Coping measurements with brief resilient coping scale found 40.5% as low resilient copers who had higher mean scores of IES-R. CONCLUSIONS This needs to be addressed earlier to bring up preventive strategies to ameliorate by including counselling services in the routine health care services of India.
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Affiliation(s)
- Sudha Bala
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Harshal Pandve
- Department of Community Medicine (PSM), PCMC's Yashwantrao Chavan Memorial Hospital and Postgraduate Medical Institute, Pimpri, Pune, Maharashtra, India
| | - Rinee Manna
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - B S Sreelal
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Sunil Patel
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Tanmay Saxena
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Sona G Joy
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
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14
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Al-Laith M, Jasenecova M, Abraham S, Bosworth A, Bruce IN, Buckley CD, Ciurtin C, D'Agostino MA, Emery P, Gaston H, Isaacs JD, Filer A, Fisher BA, Huizinga TWJ, Ho P, Jacklin C, Lempp H, McInnes IB, Pratt AG, Östor A, Raza K, Taylor PC, van Schaardenburg D, Shivapatham D, Wright AJ, Vasconcelos JC, Kelly J, Murphy C, Prevost AT, Cope AP. Arthritis prevention in the pre-clinical phase of RA with abatacept (the APIPPRA study): a multi-centre, randomised, double-blind, parallel-group, placebo-controlled clinical trial protocol. Trials 2019; 20:429. [PMID: 31307535 PMCID: PMC6633323 DOI: 10.1186/s13063-019-3403-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/06/2019] [Indexed: 01/01/2023] Open
Abstract
TRIAL DESIGN We present a study protocol for a multi-centre, randomised, double-blind, parallel-group, placebo-controlled trial that seeks to test the feasibility, acceptability and effectiveness of a 52-week period of treatment with the first-in-class co-stimulatory blocker abatacept for preventing or delaying the onset of inflammatory arthritis. METHODS The study aimed to recruit 206 male or female subjects from the secondary care hospital setting across the UK and the Netherlands. Participants who were at least 18 years old, who reported inflammatory sounding joint pain (clinically suspicious arthralgia) and who were found to be positive for serum autoantibodies associated with rheumatoid arthritis (RA) were eligible for enrolment. All study subjects were randomly assigned to receive weekly injections of investigational medicinal product, either abatacept or placebo treatment over the course of a 52-week period. Participants were followed up for a further 52 weeks. The primary endpoint was defined as the time to development of at least three swollen joints or to the fulfilment of the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for RA using swollen but not tender joints, whichever endpoint was met first. In either case, swollen joints were confirmed by ultrasonography. Participants, care givers, and those assessing the outcomes were all blinded to group assignment. Clinical assessors and ultrasonographers were also blinded to each other's assessments for the duration of the study. CONCLUSIONS There is limited experience of the design and implementation of trials for the prevention of inflammatory joint diseases. We discuss the rationale behind choice and duration of treatment and the challenges associated with defining the "at risk" state and offer pragmatic solutions in the protocol to enrolling subjects at risk of RA. TRIAL REGISTRATION Current Controlled Trials, ID: ISRCTN46017566 . Registered on 4 July 2014.
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Affiliation(s)
- Mariam Al-Laith
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK.
| | - Marianna Jasenecova
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Sonya Abraham
- Department of Rheumatology, National Institute for Health Research-Wellcome Clinical Research Facility, Hammersmith Hospital, Imperial College, London, W12 0HS, UK
| | - Aisla Bosworth
- National RA Society, The Switchback Office Park, Gardner Road, Maidenhead, SL6 7RJ, UK
| | - Ian N Bruce
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
- National Institute for Health Research Biomedical Research Centre and the Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Christopher D Buckley
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK
- Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, West Midlands, B71 4HJ, UK
| | - Coziana Ciurtin
- Department of Adolescent and Adult Rheumatology, University College London Hospitals NHS Trust, 3rd Floor Central, 250 Euston Road, London, NW1 2PG, UK
| | - Maria-Antonietta D'Agostino
- Rheumatology Department, Hôpital Ambroise Paré, 92100, Boulogne-Billancourt, France
- INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, 78180, Saint-Quentin en Yvelines, France
| | - Paul Emery
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, UK NIHR Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, LS4 7SA, UK
| | - Hill Gaston
- Department of Medicine, University of Cambridge and Addenbrookes Hospital NHS Trust, Cambridge, UK
| | - John D Isaacs
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, 3rd Floor William Leech Building, The Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - Andrew Filer
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK
- Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, West Midlands, B71 4HJ, UK
| | - Benjamin A Fisher
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK
- Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, West Midlands, B71 4HJ, UK
| | - Thomas W J Huizinga
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Pauline Ho
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
- National Institute for Health Research Biomedical Research Centre and the Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Clare Jacklin
- National RA Society, The Switchback Office Park, Gardner Road, Maidenhead, SL6 7RJ, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Iain B McInnes
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, 120 University Place, Glasgow, G12 8TA, UK
| | - Arthur G Pratt
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, 3rd Floor William Leech Building, The Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - Andrew Östor
- Department of Medicine, University of Cambridge and Addenbrookes Hospital NHS Trust, Cambridge, UK
| | - Karim Raza
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK
- Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, West Midlands, B71 4HJ, UK
| | - Peter C Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK
| | - Dirkjan van Schaardenburg
- Amsterdam Rheumatology and immunology Center, locations Reade and Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Dharshene Shivapatham
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Alison J Wright
- Clinical, Education & Health Psychology Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, London, WC1E 6BT, UK
| | - Joana C Vasconcelos
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Joanna Kelly
- King's Clinical Trials Unit, King's College London, Institute of Psychiatry, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Caroline Murphy
- King's Clinical Trials Unit, King's College London, Institute of Psychiatry, 16 De Crespigny Park, London, SE5 8AF, UK
| | - A Toby Prevost
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Andrew P Cope
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK.
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15
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Perich T, Mitchell PB. Psychological interventions for young people at risk for bipolar disorder: A systematic review. J Affect Disord 2019; 252:84-91. [PMID: 30981060 DOI: 10.1016/j.jad.2019.04.058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/08/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Several studies have recently been conducted that have explored the benefits of psychological interventions in reducing symptomatology or improving outcomes in young people at-risk of developing bipolar disorder. The aim of this review was to explore if such interventions reduce current psychiatric symptoms and prevent the development of new symptoms. METHODS A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Databases searched were MEDLINE, EMBASE, PsychInfo, CINAHL and SCOPUS from January 1990 until August 2018. The inclusion criteria were young people aged under 30 years with a family history of bipolar disorder and any empirical studies that contained a psychological or psychoeducation intervention. RESULTS A total of 7 articles (N = 138, 55 males) were included (mean age ranged from 12 to 15 years). Interventions conducted included Family Focussed Therapy, Interpersonal and Social Rhythm Therapy, and Mindfulness-based Cognitive Therapy for Children. Significant results were found in some studies, depending on the sample's initial symptoms, with reduced time to relapse and reduced symptoms of anxiety, depression and hypo/mania being found. LIMITATIONS No studies have explored if interventions may delay the time to onset of first hypo/manic episodes and only two randomised controlled trials were identified. CONCLUSIONS Some significant results were noted with lower symptoms of anxiety, depression and hypo/mania being found in some studies. It is currently unclear if psychological interventions may prevent the development of bipolar disorder or other psychiatric symptoms over time; further longitudinal studies are required.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797 Penrith, NSW 2751, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia
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16
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Reeve S, Nickless A, Sheaves B, Hodgekins J, Stewart SLK, Gumley A, Fowler D, Morrison A, Freeman D. Sleep duration and psychotic experiences in patients at risk of psychosis: A secondary analysis of the EDIE-2 trial. Schizophr Res 2019; 204:326-333. [PMID: 30121185 PMCID: PMC6406020 DOI: 10.1016/j.schres.2018.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 01/31/2023]
Abstract
Sleep disturbance is common among individuals at risk of psychosis, yet few studies have investigated the relationship between sleep disturbance and clinical trajectory. The Early Detection and Intervention Evaluation (EDIE-2) trial provides longitudinal data on sleep duration and individual psychotic experiences from a cohort of individuals at risk of psychosis, which this study utilises in an opportunistic secondary analysis. Shorter and more variable sleep was hypothesised to be associated with more severe psychotic experiences and lower psychological wellbeing. Mixed effect models were used to test sleep duration and range as predictors of individual psychotic experiences and psychological wellbeing over the 12-24 months (with assessments every 3 months) in 160 participants. Shorter sleep duration was associated with more severe delusional ideas and hallucinations cross-sectionally and longitudinally. The longitudinal relationships did not remain significant after conservative controls were added for the previous severity of psychotic experiences. No significant relationships were found between the sleep variables and other psychotic experiences (e.g. cognitive disorganisation), or psychological wellbeing. The results support a relationship between shorter sleep duration and delusional ideas and hallucinations. Future studies should focus on improving sleep disturbance measurement, and test whether treating sleep improves clinical trajectory in the at-risk group.
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Affiliation(s)
- S Reeve
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
| | - A Nickless
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - B Sheaves
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - J Hodgekins
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - S L K Stewart
- Department of Psychology, University of Chester, Parkgate Road, Chester, UK
| | - A Gumley
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - D Fowler
- School of Psychology, Pevensey Building, University of Sussex, Falmer, Brighton, UK
| | - A Morrison
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - D Freeman
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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17
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Collins JL, Jimenez R, Thomas LJ. Health out of foster care as young adults age out of foster care: A phenomenological exploration of seeking healthcare services after aging out of the US foster care system. Child Abuse Negl 2018; 81:322-331. [PMID: 29778990 DOI: 10.1016/j.chiabu.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
Some adolescents in the United States who have been abused and/or neglected by caregivers and placed in permanent custody of the state leave, or "age out" of foster care at 18 years of age. Poor health outcomes among individuals who age out are notable, yet few studies describe the phenomenon of seeking healthcare services after leaving foster care. The investigators specifically queried the phenomenon of seeking healthcare services after foster care drawing from the Phenomenology of Practice approach. We interviewed 13 young adults who aged out of care. Investigators extracted lived experience descriptions (LEDs) from interview transcripts and analyzed under phenomenological themes. Healthcare experiences were marked by avoiding self-disclosure, having no choice but to wait, missing family history, and relying on the kindness of strangers. Healthcare providers who integrate the findings into care delivery models will engage young adults with more understanding and sensitivities of ethical practice.
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Affiliation(s)
| | | | - Laura J Thomas
- Texas Tech University Health Sciences Center, United States.
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18
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Suaya JA, Jiang Q, Scott DA, Gruber WC, Webber C, Schmoele-Thoma B, Hall-Murray CK, Jodar L, Isturiz RE. Post hoc analysis of the efficacy of the 13-valent pneumococcal conjugate vaccine against vaccine-type community-acquired pneumonia in at-risk older adults. Vaccine 2018; 36:1477-1483. [PMID: 29429807 DOI: 10.1016/j.vaccine.2018.01.049] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Individuals with certain chronic medical conditions are at higher risk of developing pneumonia and pneumococcal disease than those without. Using data from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), this post hoc analysis assessed the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ≥65 years with at-risk conditions. METHODS The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) was a double-blind, parallel-group, randomized, placebo-controlled study in the Netherlands in which adults aged ≥65 years received either PCV13 or placebo. Outcomes of interest were identified using prespecified clinical criteria, radiographic confirmation, routine microbiologic testing, and a serotype-specific urinary antigen detection assay. In this post hoc analysis, participants were classified by at-risk status based on self-reporting of any of the following chronic medical conditions: heart disease, lung disease, asthma, diabetes, liver disease, and smoking. The objective of this analysis was to assess PCV13 vaccine efficacy (VE) against a first episode of vaccine-serotype community-acquired pneumonia (VT-CAP) in at-risk participants. RESULTS Of the 84,496 adults enrolled in the study, 41,385 (49.2%) were considered at risk owing to chronic medical conditions. Of the 139 VT-CAP cases, 115 (82.7%) occurred in these participants. VE of PCV13 against a first episode of VT-CAP among participants with at-risk conditions was 40.3% (95.2% CI: 11.4%, 60.2%). Average duration of follow-up since vaccination was 3.95 years for at-risk participants; protection did not wane over the study period. CONCLUSIONS This post hoc analysis of the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) showed significant and persistent efficacy of PCV13 against VT-CAP in at-risk older adults. ClinicalTrials.gov identifier: NCT00744263.
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Affiliation(s)
- José A Suaya
- Pfizer Vaccines Medicines Development & Scientific and Clinical Affairs, New York, NY, USA.
| | - Qin Jiang
- Pfizer Vaccines Medicines Development & Scientific and Clinical Affairs, Collegeville, PA, USA.
| | - Daniel A Scott
- Pfizer Vaccines Clinical Research and Development, Pearl River, NY, USA.
| | - William C Gruber
- Pfizer Vaccines Clinical Research and Development, Pearl River, NY, USA.
| | - Chris Webber
- Pfizer Vaccines Clinical Research and Development, Pearl River, NY, USA.
| | | | - Cassandra K Hall-Murray
- Pfizer Vaccines Medicines Development & Scientific and Clinical Affairs, Collegeville, PA, USA.
| | - Luis Jodar
- Pfizer Vaccines Medicines Development & Scientific and Clinical Affairs, Collegeville, PA, USA.
| | - Raul E Isturiz
- Pfizer Vaccines Medicines Development & Scientific and Clinical Affairs, Collegeville, PA, USA.
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19
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Ouboussad L, Hunt L, Hensor EMA, Nam JL, Barnes NA, Emery P, McDermott MF, Buch MH. Profiling microRNAs in individuals at risk of progression to rheumatoid arthritis. Arthritis Res Ther 2017; 19:288. [PMID: 29273071 PMCID: PMC5741901 DOI: 10.1186/s13075-017-1492-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/01/2017] [Indexed: 12/30/2022] Open
Abstract
Background Individuals at risk of rheumatoid arthritis (RA) demonstrate systemic autoimmunity in the form of anti-citrullinated peptide antibodies (ACPA). MicroRNAs (miRNAs) are implicated in established RA. This study aimed to (1) compare miRNA expression between healthy individuals and those at risk of and those that develop RA, (2) evaluate the change in expression of miRNA from “at-risk” to early RA and (3) explore whether these miRNAs could inform a signature predictive of progression from “at-risk” to RA. Methods We performed global profiling of 754 miRNAs per patient on a matched serum sample cohort of 12 anti-cyclic citrullinated peptide (CCP) + “at-risk” individuals that progressed to RA. Each individual had a serum sample from baseline and at time of detection of synovitis, forming the matched element. Healthy controls were also studied. miRNAs with a fold difference/fold change of four in expression level met our primary criterion for selection as candidate miRNAs. Validation of the miRNAs of interest was conducted using custom miRNA array cards on matched samples (baseline and follow up) in 24 CCP+ individuals; 12 RA progressors and 12 RA non-progressors. Results We report on the first study to use matched serum samples and a comprehensive miRNA array approach to identify in particular, three miRNAs (miR-22, miR-486-3p, and miR-382) associated with progression from systemic autoimmunity to RA inflammation. MiR-22 demonstrated significant fold difference between progressors and non-progressors indicating a potential biomarker role for at-risk individuals. Conclusions This first study using a cohort with matched serum samples provides important mechanistic insights in the transition from systemic autoimmunity to inflammatory disease for future investigation, and with further evaluation, might also serve as a predictive biomarker. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1492-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Ouboussad
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - L Hunt
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - E M A Hensor
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J L Nam
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - N A Barnes
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Present Address: Faculty of Life Sciences, University of Manchester, Manchester, UK
| | - P Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M F McDermott
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M H Buch
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK. .,National Institute for Health Research - Leeds Biomedical Research Centre (NIHR-LBRC), Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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20
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Okado Y, Ewing E, Rowley C, Jones DE. Trajectories of Mental Health-Related Service Use Among Adolescents With Histories of Early Externalizing Problems. J Adolesc Health 2017; 61:198-204. [PMID: 28438524 PMCID: PMC5529137 DOI: 10.1016/j.jadohealth.2017.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To inform efforts to reduce costly service utilization, the present study examined longitudinal trajectories of mental health-related outpatient and residential service use among at-risk youth with a history of early externalizing problems. METHODS A cohort of 809 children in the Fast Track Project, a multisite longitudinal study of children at risk for conduct disorder, were followed prospectively from kindergarten through 12th grade. They resided in high-risk areas with high rates of poverty, crime, and violence. Their outpatient and residential service use was assessed annually between sixth and 12th grades through parent report. Growth mixture modeling was applied to model individual differences in trajectories of service use during this period. Teacher, parent, and observer-reported childhood predictors of those trajectories were also examined. RESULTS Most youths had minimal service use during preadolescence into adolescence. However, approximately 31% had moderate probability of using outpatient counseling services, and approximately 8% had elevated probability of seeing a family doctor for mental health needs. For residential services, approximately 6% had moderate to high probability of service use that peaked during transition to high school, whereas close to 5% had service use that dramatically increased during high school. Childhood predictors of these trajectories included earlier externalizing, internalizing, and emotion regulation problems. CONCLUSIONS This study is the first to use person-centered analytic methods to examine longitudinal trajectories in mental health-related service use among at-risk adolescents. Timely treatment for severe externalizing problems, comorbid internalizing problems, and emotion dysregulation during childhood may be crucial for preventing chronic service use.
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Affiliation(s)
- Yuko Okado
- Department of Psychology, California State University, Fullerton, Fullerton, California.
| | - Emily Ewing
- Department of Psychology, California State University, Fullerton, P.O. Box 6846, Fullerton, CA 92834-6846
| | - Christina Rowley
- Department of Psychology, California State University, Fullerton, P.O. Box 6846, Fullerton, CA 92834-6846
| | - Damon E. Jones
- Bennett Pierce Prevention Research Center, Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802
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21
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K DP, Srinath DS, Seshadri DS, Girimaji DS, Kommu DJ. Lost time-Need for more awareness in early intervention of autism spectrum disorder. Asian J Psychiatr 2017; 25:13-5. [PMID: 28262133 DOI: 10.1016/j.ajp.2016.07.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/20/2016] [Accepted: 07/10/2016] [Indexed: 11/23/2022]
Abstract
Delay in the diagnosis and early intervention for Autism spectrum disorders has been observed across cultures and within the same cultural context. With the current evidence base for early intervention there is a need for greater awareness for early recognition, evaluation and intervention. This brief report discusses the average age at recognition to initiation of intervention and possible ways to address delay. Since early intervention programs for ASD results in favourable outcome, it would be good practice to routinely screen children at first consultation and initiate intervention in any child suspected to be 'At Risk' for ASD.
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Yang LH, Link BG, Ben-David S, Gill KE, Girgis RR, Brucato G, Wonpat-Borja AJ, Corcoran CM. Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis. Schizophr Res 2015; 168:9-15. [PMID: 26314731 PMCID: PMC4751087 DOI: 10.1016/j.schres.2015.08.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 08/02/2015] [Accepted: 08/04/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Despite advances that the psychosis "clinical high-risk" (CHR) identification offers, risk of stigma exists. Awareness of and agreement with stereotypes has not yet been evaluated in CHR individuals. Furthermore, the relative stigma associated with symptoms, as opposed to the label of risk, is not known, which is critical because CHR identification may reduce symptom-related stigma. METHODS Thirty-eight CHR subjects were ascertained using standard measures from the Center of Prevention and Evaluation/New York State Psychiatric Institute/ Columbia University. Labeling-related measures adapted to the CHR group included "stereotype awareness and self-stigma" ("Stereotype awareness", "Stereotype Agreement", "Negative emotions [shame]"), and a parallel measure of "Negative emotions (shame)" for symptoms. These measures were examined in relation to symptoms of anxiety and depression, adjusting for core CHR symptoms (e.g. attenuated psychotic symptoms). RESULTS CHR participants endorsed awareness of mental illness stereotypes, but largely did not themselves agree with these stereotypes. Furthermore, CHR participants described more stigma associated with symptoms than they did with the risk-label itself. Shame related to symptoms was associated with depression, while shame related to the risk-label was associated with anxiety. CONCLUSION Both stigma of the risk-label and of symptoms contribute to the experience of CHR individuals. Stereotype awareness was relatively high and labeling-related shame was associated with increased anxiety. Yet limited agreement with stereotypes indicated that labeling-related stigma had not fully permeated self-conceptions. Furthermore, symptom-related stigma appeared more salient overall and was linked with increased depression, suggesting that alleviating symptom-related shame via treating symptoms might provide major benefit.
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Affiliation(s)
- Lawrence H Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Bruce G Link
- University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA.
| | - Shelly Ben-David
- New York University Silver School of Social Work, 1 Washington Square North, New York, NY 10003, USA.
| | - Kelly E Gill
- The Catholic University of America, 620 Michigan Ave. NE, Washington, DC 20064, USA.
| | - Ragy R Girgis
- New York State Psychiatric Institute at Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Gary Brucato
- New York State Psychiatric Institute at Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Ahtoy J Wonpat-Borja
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Cheryl M Corcoran
- New York State Psychiatric Institute at Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
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Abstract
This study evaluated a program to identify and support students at risk for failure in nursing courses or NCLEX-RN. A case management model (CMM) was implemented to provide assessment of and support for 183 bachelor of science in nursing students; 83 were identified as at risk by the CMM criteria. The CMM involved student self-evaluation and grade assessment of prerequisite and nursing courses. Science course grades were all found to be significantly higher for those students who passed NCLEX-RN on the first attempt than those who did not. Admission GPA was significant (t=2.443, P=.018). Using a Motivated Strategies for Learning Questionnaire for self-evaluation, at-risk students rated their performance in nursing courses higher in every area than the non-at-risk student group, significantly higher for self-efficacy (t = 2.829, P=.005) and metacognition (t =2.426, P=.016). Neither task value nor critical thinking scores were significant. Graduation rate was 100% with 158 students passing NCLEX-RN on the first attempt (64 of 83 at risk and 94 of 100 non-at risk). The CMM was effective in identification and support of at-risk students.
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Affiliation(s)
- Betty L Elder
- Associate Professor, Wichita State University, Wichita, KS.
| | - Phyllis Jacobs
- Associate Professor, Wichita State University, Wichita, KS
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Perich T, Lau P, Hadzi-Pavlovic D, Roberts G, Frankland A, Wright A, Green M, Breakspear M, Corry J, Radlinska B, McCormack C, Joslyn C, Levy F, Lenroot R, Nurnberger Jnr JI, Mitchell PB. What clinical features precede the onset of bipolar disorder? J Psychiatr Res 2015; 62:71-7. [PMID: 25700556 DOI: 10.1016/j.jpsychires.2015.01.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/26/2015] [Accepted: 01/31/2015] [Indexed: 01/08/2023]
Abstract
Despite a growing number of reports, there is still limited knowledge of the clinical features that precede the onset of bipolar disorder (BD). To explore this, we investigated baseline data from a prospectively evaluated longitudinal cohort of subjects aged 12-30 years to compare: first, lifetime rates of clinical features between a) subjects at increased genetic risk for developing BD ('AR'), b) participants from families without mental illness ('controls'), and c) those with established BD; and, second, prior clinical features that predict the later onset of affective disorders in these same three groups. This is the first study to report such comparisons between these three groups (though certainly not the first to compare AR and control samples). 118 AR participants with a parent or sibling with BD (including 102 with a BD parent), 110 controls, and 44 BD subjects were assessed using semi-structured interviews. AR subjects had significantly increased lifetime risks for depressive, anxiety and behavioural disorders compared to controls. Unlike prior reports, preceding anxiety and behavioural disorders were not found to increase risk for later onset of affective disorders in the AR sample, perhaps due to limited sample size. However, preceding behavioural disorders did predict later onset of affective disorders in the BD sample. The findings that i) AR subjects had higher rates of depressive, anxiety and behavioural disorders compared to controls, and ii) prior behavioural disorders increased the risk to later development of affective disorders in the BD group, suggest the possibility of therapeutic targeting for these disorders in those at high genetic risk for BD.
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Affiliation(s)
- Tania Perich
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Phoebe Lau
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Adam Wright
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Melissa Green
- School of Psychiatry, University of New South Wales, Australia
| | - Michael Breakspear
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia; Division of Mental Health Research, Queensland Institute of Medical Research, Australia; Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Justine Corry
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Basia Radlinska
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Clare McCormack
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Cassandra Joslyn
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia
| | - Florence Levy
- School of Psychiatry, University of New South Wales, Australia; Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Rhoshel Lenroot
- School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - John I Nurnberger Jnr
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Australia; Black Dog Institute, Prince of Wales Hospital, Australia; Prince of Wales Hospital, Randwick, New South Wales, Australia.
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25
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Arat HE, Chouinard VA, Cohen BM, Lewandowski KE, Öngür D. Diffusion tensor imaging in first degree relatives of schizophrenia and bipolar disorder patients. Schizophr Res 2015; 161:329-39. [PMID: 25542860 PMCID: PMC4308443 DOI: 10.1016/j.schres.2014.12.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES White matter (WM) abnormalities are one of the most widely and consistently reported findings in schizophrenia (SZ) and bipolar disorder (BD). If these abnormalities are inherited determinants of illness, suitable to be classified as an endophenotype, relatives of patients must also have them at higher rate compared to the general population. In this review, we evaluate published diffusion tensor imaging (DTI) studies comparing first degree relatives of SZ and BD patients and healthy control subjects. METHODS We searched PubMed, Embase and PsychInfo for DTI studies which included an unaffected relative and a healthy comparison group. RESULTS 22 studies fulfilled the inclusion criteria. WM abnormalities were found in many diverse regions in relatives of SZ patients. Although the findings were not completely consistent across studies, the most implicated areas were the frontal and temporal WM regions and the corpus callosum. Studies in relatives of BD patients were fewer in number with less consistent findings reported across studies. CONCLUSIONS Our review supports the concept of WM abnormalities as an endophenotype in SZ, with somewhat weaker evidence in BD, but larger and higher quality studies are needed to make a definitive comment.
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Affiliation(s)
- Hidayet E. Arat
- Dokuz Eylul University, Faculty of Medicine Department of Psychiatry, Izmir, Turkey,McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA
| | - Virginie-Anne Chouinard
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Bruce M. Cohen
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Kathryn E. Lewandowski
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Dost Öngür
- McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02114, USA.
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Tseng WL, Bones BL, Kayser RR, Olsavsky AK, Fromm SJ, Pine DS, Leibenluft E, Brotman MA. An fMRI study of emotional face encoding in youth at risk for bipolar disorder. Eur Psychiatry 2015; 30:94-8. [PMID: 25172156 PMCID: PMC10656053 DOI: 10.1016/j.eurpsy.2014.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/09/2014] [Accepted: 05/20/2014] [Indexed: 11/30/2022] Open
Abstract
Face memory deficits may be a bipolar disorder (BD) endophenotype. BD (n=27) and unaffected youth at risk (n=13) exhibited middle frontal gyrus hypoactivation during successful vs. unsuccessful encoding. Parahippocampal gyrus dysfunction was found in BD and at-risk youth (vs. low-risk, n=37). Middle occipital gyrus hypoactivation was only present in BD.
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Affiliation(s)
- W-L Tseng
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - B L Bones
- Georgetown University School of Medicine, Washington, DC, USA
| | - R R Kayser
- Georgetown University School of Medicine, Washington, DC, USA
| | - A K Olsavsky
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - S J Fromm
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - D S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - E Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - M A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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27
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Abstract
BACKGROUND Major depression is associated with abnormalities in reward processing at neural and behavioural levels. Neural abnormalities in reward have been described in young people at familial risk of depression but behavioural changes in reward-based decision making have been less studied in this group. METHOD We studied 63 young people (mean age 18.9 years) with a parent with a diagnosis of major depression but who had never been depressed themselves, that is with a positive family history of depression (the FH+ group). Participants performed the Cambridge Gambling Task (CGT), which provides several measures of decision making including deliberation time, quality of decision making, risk taking, risk adjustment and delay aversion. A control group of 49 age- and gender-matched young people with no history of mood disorder in a first-degree relative undertook the same task. RESULTS Both FH+ participants and controls had low and equivalent scores on anxiety and depression self-rating scales. Compared to controls, the FH+ participants showed overall lower risk taking, although like controls they made more risky choices as the odds of a favourable outcome increased. No other measures of decision making differed between the two groups. CONCLUSIONS Young people at increased familial risk of depression have altered risk taking that is not accounted for by current affective symptomatology. Lowered risk taking might represent an impairment in reward seeking, which is one of several changes in reward-based behaviours seen in acutely depressed patients; however, our findings suggest that decreased reward seeking could be part of a risk endophenotype for depression.
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Affiliation(s)
- Z. N. Mannie
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - C. Williams
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - M. Browning
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - P. J. Cowen
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
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28
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Simon AE, Borgwardt S, Riecher-Rössler A, Velthorst E, de Haan L, Fusar-Poli P. Moving beyond transition outcomes: meta-analysis of remission rates in individuals at high clinical risk for psychosis. Psychiatry Res 2013; 209:266-72. [PMID: 23871169 DOI: 10.1016/j.psychres.2013.03.004] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 02/24/2013] [Accepted: 03/03/2013] [Indexed: 01/28/2023]
Abstract
Recent evidence suggests that transition risks from initial clinical high risk (CHR) status to psychosis are decreasing. The role played by remission in this context is mostly unknown. The present study addresses this issue by means of a meta-analysis including eight relevant studies published up to January 2012 that reported remission rates from an initial CHR status. The primary effect size measure was the longitudinal proportion of remissions compared to non-remission in subjects with a baseline CHR state. Random effect models were employed to address the high heterogeneity across studies included. To assess the robustness of the results, we performed sensitivity analyses by sequentially removing each study and rerunning the analysis. Of 773 subjects who met initial CHR criteria, 73% did not convert to psychosis along a 2-year follow. Of these, about 46% fully remitted from the baseline attenuated psychotic symptoms, as evaluated on the psychometric measures usually employed by prodromal services. The corresponding clinical remission was estimated as high as 35% of the baseline CHR sample. The CHR state is associated with a significant proportion of remitting subjects that can be accounted by the effective treatments received, a lead time bias, a dilution effect, a comorbid effect of other psychiatric diagnoses.
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Affiliation(s)
- Andor E Simon
- University Psychiatry Clinics, University of Basel, 4031 Basel, Switzerland; Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, 4101 Bruderholz, Switzerland; University Hospital of Psychiatry, University of Bern, 3010 Bern, Switzerland
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