-
The American Journal of Geriatric... 2002The authors review epidemiological and survey research relevant to the relationships between religiousness/spirituality and mental health in people at the end of life,... (Review)
Review
The authors review epidemiological and survey research relevant to the relationships between religiousness/spirituality and mental health in people at the end of life, with the end of helping psychiatrists, psychologists, and other mental health professionals dealing with older Americans. They give special attention to well-being, religious coping, cognitive dysfunction, anxiety, depression, and suicide, and consider the extent to which hope is a mediator of the purported salutary effects of religiousness. Studies were selected from the comprehensive and systematic review of 20th-century scientific literature concerning religion and health. Authors also review current studies relevant to religion and end-of-life issues. Religious persons reported generally higher levels of well-being. The review also found fairly consistent inverse associations of religiousness with rates of depression and suicide. There was some negative association between religious participation and cognitive dysfunction, but the association with anxiety was inconsistent, with some studies showing a correlation between higher levels of religion and anxiety. Religion's effects on mental health are generally protective in direction but modest in strength.
Topics: Adaptation, Psychological; Aged; Aging; Health Status; Humans; Mental Health; Religion and Psychology
PubMed: 12095898
DOI: No ID Found -
BJPsych Open Jun 2023The classification of mental disorders used to be based only on people seen by hospital psychiatrists. In fact, most people with a mental disorder were, and are, not... (Review)
Review
BACKGROUND
The classification of mental disorders used to be based only on people seen by hospital psychiatrists. In fact, most people with a mental disorder were, and are, not seen by psychiatrists because of decisions made prior to psychiatric consultation. The first description of this 'pathway' to care and its levels and filters was published by Goldberg and Huxley in 1980.
AIMS
To conduct a review of papers relevant to the application of the Goldberg-Huxley model in the 21st century.
METHOD
Systematic review (PROSPERO registration CRD42021270603) of the pathway to psychiatric care in the 21st century. The review concentrates on community surveys and passage through the first filter (consultation in primary care or its equivalent). Ten databases were searched for papers meeting the defined inclusion criteria published between 2000 and 2019 and completed on 15 February 2020.
RESULTS
In total, 1824 papers were retrieved, 137 screened fully and 31 included in this review. The results are presented in a table comparing them with previous research. Despite major social, economic and health service changes since 1980, community prevalence and consultation rates remain remarkably consistent and in line with World Health Organization findings. Passage through the first filter is largely unchanged and there is evidence that the same factors operate internationally, especially gender and social parameters.
CONCLUSIONS
The Goldberg-Huxley model remains applicable internationally, but this may change owing to an increasingly mixed mental health economy and reduced access to primary care services.
PubMed: 37350326
DOI: 10.1192/bjo.2023.505 -
Revista Brasileira de Psiquiatria (Sao... Dec 2012This article aims to review the comorbidity of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) and bipolar disorder (BD), identify variables... (Review)
Review
OBJECTIVE
This article aims to review the comorbidity of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) and bipolar disorder (BD), identify variables requiring further investigation and to remind physicians that special care is required for diagnosis and therapy.
METHOD
A systematic review of articles published from 1987 to February 2012 was conducted in the Medline database with the following terms: (premenstrual syndrome OR premenstrual dysphoric disorder OR premenstrual) AND (bipolar OR mania OR manic). Seventeen articles were analyzed.
RESULTS
PMS and PMDD were most often comorbid among BD-II patients and vice versa. Moreover, patients with PMS or PMDD also have an increased risk of having BD-I. In addition, bipolar women susceptible to hormonal changes exhibit more severe symptoms, more frequent relapses and a worse therapeutic response.
CONCLUSION
Future investigations should attempt to stabilize hormonal levels through the continuous use of contraceptives to target a reduction in symptom severity. In addition, psychiatrists should note menstrual period dates and compare symptom intensity between the luteal and follicular phases. Finally, PMS and PMDD patients should be studied separately.
Topics: Bipolar Disorder; Comorbidity; Diagnosis, Dual (Psychiatry); Female; Humans; Premenstrual Syndrome; Progesterone; Socioeconomic Factors
PubMed: 23429819
DOI: 10.1016/j.rbp.2012.04.010 -
BMC Psychiatry Dec 2020The use of atypical antipsychotics which currently form the primary choice pharmacotherapy for several mental health conditions have been linked to cardiovascular and...
BACKGROUND
The use of atypical antipsychotics which currently form the primary choice pharmacotherapy for several mental health conditions have been linked to cardiovascular and metabolic side effects. This systematic review aimed to investigate the barriers to monitoring and management of cardiovascular co-morbidities in patients prescribed antipsychotic medicines.
METHODS
A protocol-led (CRD-42018106002) systematic literature review was conducted by searching Medline, Embase, and PsycINFO databases 2003 until October 2019. Cochrane, Centre for Review and Dissemination (CRD) and PRISMA guidelines were followed. Studies investigating barriers to monitoring and management of cardiovascular co-morbidities in patients prescribed antipsychotic medicines were included.
RESULTS
A total of 23 records were included. Key barriers included a) health-care system-related factors such as lack of knowledge and expertise amongst care providers, available resources, confusion around remit and roles, fragmentation of care such as across general practitioners and psychiatrists, and time constraints and b) patient-related factors such as disability resulting from mental health conditions, knowledge and skills of the patients.
CONCLUSION
Barriers to monitoring and management of cardiovascular and metabolic health of patients taking antipsychotic medicines are multidimensional. Apart from educational interventions directed to both patients and health-care professionals, the results suggest a need for the improvement of wider system-related factors to improve physical health of patients prescribed antipsychotic medicines. Clearer guidelines, clarity of remit and roles amongst service providers are necessary in addition to educational interventions directed at patients and health-care professionals in improving physical health monitoring, counselling and management of patients prescribed antipsychotic medicines.
TRIAL REGISTRATION
A protocol was developed and registered with PROSPERO as per PRISMA-P guidelines ( CRD 42018106002 ).
Topics: Antipsychotic Agents; Comorbidity; Delivery of Health Care; Health Personnel; Humans
PubMed: 33276762
DOI: 10.1186/s12888-020-02990-6 -
The British Journal of Psychiatry : the... Oct 2016People with a history of self-harm are at a far greater risk of suicide than the general population. However, the relationship between self-harm and suicide is complex. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
People with a history of self-harm are at a far greater risk of suicide than the general population. However, the relationship between self-harm and suicide is complex.
AIMS
To undertake the first systematic review and meta-analysis of prospective studies of risk factors and risk assessment scales to predict suicide following self-harm.
METHOD
We conducted a search for prospective cohort studies of populations who had self-harmed. For the review of risk scales we also included studies examining the risk of suicide in people under specialist mental healthcare, in order to broaden the scope of the review and increase the number of studies considered. Differences in predictive accuracy between populations were examined where applicable.
RESULTS
Twelve studies on risk factors and 7 studies on risk scales were included. Four risk factors emerged from the meta-analysis, with robust effect sizes that showed little change when adjusted for important potential confounders. These included: previous episodes of self-harm (hazard ratio (HR) = 1.68, 95% CI 1.38-2.05, K = 4), suicidal intent (HR = 2.7, 95% CI 1.91-3.81, K = 3), physical health problems (HR = 1.99, 95% CI 1.16-3.43, K = 3) and male gender (HR = 2.05, 95% CI 1.70-2.46, K = 5). The included studies evaluated only three risk scales (Beck Hopelessness Scale (BHS), Suicide Intent Scale (SIS) and Scale for Suicide Ideation). Where meta-analyses were possible (BHS, SIS), the analysis was based on sparse data and a high heterogeneity was observed. The positive predictive values ranged from 1.3 to 16.7%.
CONCLUSIONS
The four risk factors that emerged, although of interest, are unlikely to be of much practical use because they are comparatively common in clinical populations. No scales have sufficient evidence to support their use. The use of these scales, or an over-reliance on the identification of risk factors in clinical practice, may provide false reassurance and is, therefore, potentially dangerous. Comprehensive psychosocial assessments of the risks and needs that are specific to the individual should be central to the management of people who have self-harmed.
Topics: Risk Assessment; Risk Factors; Suicide
PubMed: 27340111
DOI: 10.1192/bjp.bp.115.170050 -
Current Cardiology Reviews 2020In the last two decades, a new phenotype termed Sarcopenic Obesity (SO), in which sarcopenia and obesity coexist, has emerged. (Meta-Analysis)
Meta-Analysis
BACKGROUND
In the last two decades, a new phenotype termed Sarcopenic Obesity (SO), in which sarcopenia and obesity coexist, has emerged.
OBJECTIVE
The aim of this systematic review and meta-analysis was first to assess the prevalence of Metabolic syndrome (Mets) among individuals with and without SO, and second, to determine if SO may increase the relative risk of Mets.
METHODS
This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the data were collated by means of metaanalysis and narrative synthesis.
RESULTS
Twelve studies including a total of 11,308 adults with overweight or obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, a similar overall prevalence of Mets in individuals with SO (61.49%; 95% CI: 52.19-70.40) when compared to those without SO (56.74%; 95% CI: 47.32-65.93) was identified. Second, the presence of SO appears not to increase the risk of Mets with respect to those without SO (RR = 1.08, 95% CI: 0.99- 1.17, p = 0.07).
CONCLUSION
No higher prevalence of Mets among individuals with SO when compared to those with obesity only, nor a significant association between SO and a higher risk of Mets was found.
Topics: Aged; Female; Humans; Male; Metabolic Syndrome; Obesity; Prevalence; Risk Factors; Sarcopenia
PubMed: 32056530
DOI: 10.2174/1573403X16666200214104122 -
Seizure Dec 2021This article systematically reviews the literature on the effectiveness of psychological interventions for non-epileptic seizures (NES) in children and adolescents. (Review)
Review
BACKGROUND
This article systematically reviews the literature on the effectiveness of psychological interventions for non-epileptic seizures (NES) in children and adolescents.
METHODS
Embase, Medline and PsycINFO were searched to December 2020, for articles published in English, which used an objective measure to evaluate the outcome of a psychological intervention for NES. Further studies were identified from reference lists and experts in the field were contacted for unpublished studies.
RESULTS
Twelve studies met inclusion criteria. Of these, four were set up with the primary aim of evaluating an intervention of which two used a control group, two were prospective outcome studies and eight looked at retrospective clinical data. Two studies evaluated a single treatment modality, the others multiple treatment components. Overall, psychoeducation, and top-down psychotherapy, such as cognitive therapies, were the most frequent interventions, with recent studies describing body-oriented (bottom-up) approaches. Analysis across all studies identified a range of additional intervention components which included assessment and/or treatment for co-morbidities, liaison with school and support for parents, highlighting the importance of individualised treatment packages.
CONCLUSIONS
There is a paucity of studies specifically evaluating interventions for NES. Though a range of approaches have been described in managing this patient group, with generally positive outcomes, it is not possible to conclude from the available literature that one treatment approach is superior to another, though the information may be helpful in developing management guidelines.
Topics: Adolescent; Child; Humans; Prospective Studies; Psychosocial Intervention; Psychotherapy; Retrospective Studies; Seizures
PubMed: 34656015
DOI: 10.1016/j.seizure.2021.09.006 -
Journal of Eating Disorders Aug 2023Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. (Review)
Review
OBJECTIVE
Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures.
METHODS
An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment.
RESULTS
The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged.
CONCLUSION
The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.
PubMed: 37537604
DOI: 10.1186/s40337-023-00849-1 -
World Journal of Psychiatry May 2023Several genetic testing techniques have been recommended as a first-tier diagnostic tool in clinical practice for diagnosing autism spectrum disorder (ASD). However, the...
BACKGROUND
Several genetic testing techniques have been recommended as a first-tier diagnostic tool in clinical practice for diagnosing autism spectrum disorder (ASD). However, the actual usage rate varies dramatically. This is due to various reasons, including knowledge and attitudes of caregivers, patients, and health providers toward genetic testing. Several studies have therefore been conducted worldwide to investigate the knowledge, experiences, and attitudes toward genetic testing among caregivers of children with ASD, adolescent and adult ASD patients, and health providers who provide medical services for them. However, no systematic review has been done.
AIM
To systematically review research on knowledge, experiences, and attitudes towards genetic testing among caregivers of children with ASD, adolescent and adult ASD patients, and health providers.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and searched the literature in three English language databases (PubMed, Web of Science, and PsychInfo) and two Chinese databases (CNKI and Wanfang). Searched literature was screened independently by two reviewers and discussed when inconsistency existed. Information on characteristics of the study, characteristics of participants, and main findings regarding knowledge, experience, and attitudes of caregivers of children with ASD, adolescent and adult ASD patients, and health providers concerning ASD genetic testing were extracted from included papers into a charting form for analysis.
RESULTS
We included 30 studies published between 2012 and 2022 and conducted in 9 countries. Most of the studies ( = 29) investigated caregivers of children with ASD, one study also included adolescent and adult patients, and two covered health providers. Most (51.0%-100%) of the caregivers/patients knew there was a genetic cause for ASD and 17.0% to 78.1% were aware of ASD genetic testing. However, they lacked full understanding of genetic testing. They acquired relevant and necessary information from physicians, the internet, ASD organizations, and other caregivers. Between 9.1% to 72.7% of caregivers in different studies were referred for genetic testing, and between 17.4% to 61.7% actually obtained genetic testing. Most caregivers agreed there are potential benefits following genetic testing, including benefits for children, families, and others. However, two studies compared perceived pre-test and post-test benefits with conflicting findings. Caregivers concerns included high costs, unhelpful results, negative influences (, causing family conflicts, causing stress/risk/pain to children ) prevented some caregivers from using genetic testing. Nevertheless, 46.7% to 95.0% caregivers without previous genetic testing experience intended to obtain it in the future, and 50.5% to 59.6% of parents previously obtaining genetic testing would recommend it to other parents. In a single study of child and adolescent psychiatrists, 54.9% of respondents had ordered ASD genetic testing for their patients in the prior 12 mo, which was associated with greater knowledge of genetic testing.
CONCLUSION
Most caregivers are willing to learn about and use genetic testing. However, the review showed their current knowledge is limited and usage rates varied widely in different studies.
PubMed: 37303934
DOI: 10.5498/wjp.v13.i5.247 -
Therapeutic Advances in... Apr 2014The burden of depressive disorders and the frequent inadequacy of their current pharmacological treatments are well established. The anaesthetic and hallucinogenic drug... (Review)
Review
The burden of depressive disorders and the frequent inadequacy of their current pharmacological treatments are well established. The anaesthetic and hallucinogenic drug ketamine has provoked much interest over the past decade or so as an extremely rapidly acting antidepressant that does not modify 'classical' monoaminergic receptors. Current evidence has shown several ways through which it might exert therapeutic antidepressant actions: blockade of glutamatergic NMDA receptors and relative upregulation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) subtypes may alter cortical connectivity patterns; through intracellular changes in protein expression, including the proteins mammalian target of rapamycin (mTOR) and brain-derived neurotrophic factor (BDNF); and alteration of intracellular signalling cascades. The clinical evidence demonstrates rapid improvements in mood and suicidal thinking in most participants, although study numbers have generally been small and many trials are unblinded and methodologically weak. There is a small body of work to suggest ketamine might also augment electroconvulsive therapy and potentially have a role as a surgical anaesthetic in depressed patients. A major problem is that the effects of ketamine appear temporary, disappearing after days to weeks (although longer benefits have been sustained in some), and attempts to circumvent this through pharmacological augmentation have been disappointing thus far. These exciting data are providing new insights into neurobiological models of depression, and potentially opening up a new class of antidepressants, but there are significant practical and ethical issues about any future mainstream clinical role it might have.
PubMed: 24688759
DOI: 10.1177/2045125313507739