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General hospital psychiatry
Elsevier/North-Holland
General hospital psychiatry

Elsevier/North-Holland

0163-8343

General hospital psychiatry/Journal General hospital psychiatrySCIAHCISSCIISSHP
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    Anti-NMDA receptor encephalitis in older adults: A systematic review of case reports

    Serra-Mestres J.Martinez-Ramirez M.Boix-Quintana E.Davi-Loscos E....
    7页
    查看更多>>摘要：? 2021 Elsevier Inc.Objective: To ascertain the clinical characteristics of anti-NMDA receptor encephalitis (NMDARE) in older patients. Method: A systematic literature review using PubMed and Scopus of all published case reports of NMDARE was undertaken, from database inception to June 2020. From this, cases reporting on patients older than 65 years of age and whose diagnosis was confirmed by the presence of anti-NMDAR antibodies in CSF were selected. Results: 23 case reports fulfilling the study's criteria were found. Median age was 70.1 years (range 65–84), fourteen were female (60.9%), and mostly presented with acute behavioral and cognitive changes (95.7%). Atypical psychosis occurred in eleven patients (47.8%) with a sudden onset and fluctuating clinical pattern of delusions (39.1%), hallucinations (30.4%), and motility disturbances (34.8%) including catatonia (17.4%). Nine patients presented with seizures (39.1%). Pleocytosis in CSF (>5 WBC) was described in twelve cases (52.2%). Eleven cases (47.8%) had abnormal brain magnetic resonance imaging (MRI) scans with limbic inflammatory lesions. Thirteen patients had an abnormal EEG (56.5%). Conclusion: NMDARE should be included in the differential diagnosis of older patients who present with new psychiatric episodes, especially when characterized by sudden onset psychotic polymorphic symptomatology, fluctuating course with marked cognitive decline, and with catatonic features.
      原文链接:
    • NSTL
    • Elsevier

    Effect of peer support intervention on perinatal depression: A meta-analysis

    Fang Q.Lin L.Chen Q.Yuan Y....
    10页
    查看更多>>摘要：? 2021Background: To assess the effect of peer support on preventing or treating perinatal depression. Methods: Eight databases (Wanfang, VIP, CNKI, CBM, Pubmed, Embase, PsycINFO, and Cochrane) were systematically searched for eligible randomized controlled trials from inception to July 2021. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form. Results: A total of 16 studies (including 3154 participants, peer support group: 1568, control group: 1586) were included in this meta-analysis. The intervention group (peer support) had significantly better effect on preventing or treating perinatal depression than the control group [SMD = ?0.39, 95% CI (?0.54, ?0.24), P < 0.00001, I2 = 78%]. The results of subgroup analyses showed that peer support interventions provided in the perinatal period [SMD = ?0.51, 95% CI (?0.93, ?0.09), P = 0.02] or only in the postpartum period could improve the depression of mothers [SMD = ?0.44, 95% CI (?0.62, ?0.26), P < 0.00001]. Face-to-face interventions [SMD = ?0.28, 95% CI (?0.40, ?0.15), P < 0.0001] and telephone/internet-based interventions [SMD = ?0.73, 95% CI (?0.95, ?0.50), P < 0.00001] were both effective for perinatal depression. As for form of intervention, the combination of individual and group sessions had the best effect on improving perinatal depression [SMD = ?0.63, 95% CI (?1.04, ?0.23), P = 0.002]. Peer support with the frequency of at least once a week had a significant effect on perinatal depression [SMD = ?0.88, 95% CI (?1.32, ?0.44), P < 0.0001]. Interventions with a length of ≤3 months [SMD = ?2.20, 95% CI (?3.35, ?1.04), P = 0.0002] worked better than those lasting for 3–36 months [SMD = ?1.64, 95% CI (?2.38, ?0.90), P < 0.0001] in perinatal depression management. Peer support could improve perinatal depression both in low- and middle-income countries [SMD = ?0.70, 95% CI (?0.95, ?0.45), P < 0.00001] and high-income countries [SMD = ?0.15, 95% CI (?0.28, ?0.02), P = 0.03]. Conclusions: Providing peer support during the perinatal period or only postpartum period, using Internet or telephone approaches, a combination of group and individual, at least once a week can be regarded as an effective measure to manage perinatal depression.
      原文链接:
    • NSTL
    • Elsevier

    Mental health conditions and adherence to direct oral anticoagulants in patients with incident atrial fibrillation: A nationwide cohort study

    Teppo K.Jaakkola J.Airaksinen K.E.J.Biancari F....
    6页
    查看更多>>摘要：? 2022 The Author(s)Objective: Medication adherence is essential for effective stroke prevention in patients with atrial fibrillation (AF). We aimed to assess whether adherence to direct oral anticoagulants (DOACs) in AF patients is affected by the presence of mental health conditions (MHCs). Methods: The nationwide FinACAF cohort covered 74,222 AF patients from all levels of care receiving DOACs during 2011–2018 in Finland. Medication possession ratio (MPR) was used to quantify adherence. Patients with MPR ≥0.90 were defined adherent. MHCs of interest were depression, bipolar disorder, anxiety disorder and schizophrenia. Results: The patients' (mean age 75.4 ± 9.5 years, 50.8% female) mean MPR was 0.84 (SD 0.22), and 59.5% had MPR ≥0.90. Compared to patients without MHC, the adjusted ORs (95% CI) for adherent DOAC use emerged slightly lower in patients with depression (0.92 (0.84–0.99)) and bipolar disorder (0.77 (0.61–0.97)) and unsignificant in patients with anxiety disorder (1.08 (0.96–1.21)) and schizophrenia (1.13 (0.90–1.43)). However, when only persistent DOAC therapy was analyzed, no MHC was associated with poor adherence, and instead anxiety disorder was associated with adherent DOAC use (1.18 (1.04–1.34)). Conclusion: Adherence to DOACs in AF patients in Finland was relatively high, and no meaningful differences between patients with and without MHCs were observed.
      原文链接:
    • NSTL
    • Elsevier

    Redesign of a brief PTSD treatment in safety net integrated primary care: Supporting implementation in the context of the COVID-19 pandemic

    Valentine S.E.Fuchs C.Godfrey L.Elwy A.R....
    8页
    查看更多>>摘要：? 2021 Elsevier Inc.Objective: We conducted a formative evaluation to understand the impact of the COVID-19 pandemic on the safety net integrated primary care setting and to identify (and respond to) new implementation barriers prior to a hybrid type I effectiveness-implementation trial of a posttraumatic stress disorder (PTSD) treatment. Method: We used surveys and qualitative interviews with employee stakeholders (N = 27) to (1) understand pandemic-related factors that may influence implementation, including changes in patient needs, provider experiences, and the practice, and (2) assess the need for augmentation to study design, implementation plan, or intervention. Results: Conventional content analysis and survey findings suggest that patient acuity and volume increased provider burden, leading to high burnout. Although the shift to telehealth improved behavioral health access, issues with technology access and literacy were common. Changes to the study design and implementation plan, based on findings, included the provision of multi-modality treatments (in person, telehealth, web-administered), technology and administrative support, and other strategies for reducing provider burnout. Conclusions: This study describes how an ongoing research study adapted to major changes to the implementation setting during the pandemic. Changes to study design and implementation plan were responsive to the shift to telehealth and therapist burden (and burnout) concerns.
      原文链接:
    • NSTL
    • Elsevier

    Validity of the Hospital Anxiety and Depression Scale (HADS) in primary care patients in Colombia

    Cassiani-Miranda C.A.Scoppetta O.Cabanzo-Arenas D.F.
    8页
    查看更多>>摘要：? 2021 Elsevier Inc.Objective: To assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. Methods: A criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. Results: Cronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. Conclusion: The HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.
      原文链接:
    • NSTL
    • Elsevier

    Zinc in depression: From development to treatment: A comparative/ dose response meta-analysis of observational studies and randomized controlled trials

    Ashourpour M.Keshani P.Soltani S.Yosaee S....
    8页
    查看更多>>摘要：? 2020 Elsevier Inc.Background: A previous meta-analysis suggested that zinc status may be linked to depression status. However, it remains unclear whether zinc status can predict the risk of depression development, or whether the monotherapy of zinc is superior to the combination of zinc supplementation and antidepressant medications in the treatment of depression. Therefore, this meta-analysis aimed to clarify the impact of zinc status and supplementation on depression development and status across all available evidence. Methods: PubMed, EMBASE, Scopus, and ISI web of science were searched, up to 14 May 2020, for relevant publications. Pooled relative risks (RRs) with 95% confidence intervals (CI) in observational studies, and mean and standard deviation (SD) for the change in depression score in RCTs were calculated using a random-effects model. Results: The meta-analysis of RCTs indicated that zinc supplementation significantly lowered depressive symptom scores of depressed patients [weighted mean difference (WMD = ?4.15 point; 95% CI: ?6.56, ?1.75 point; P < 0.01)], and the improvement in depression status occurred only when zinc supplementation was prescribed as a monotherapy. The cohort studies showed that the highest level of zinc intake was associated with a 28% reduced risk of depression (RR: 0.66; 95% CI: 0.50, 0.82; I2 = 13.90). Dose-response analyses revealed a significant non-linear effect of baseline mood status on depression score. Conclusion: Current evidence from observational studies and RCT's supports the potential benefits zinc to reduce the risk of, and alleviate, depression. However, further trials are needed to confirm the beneficial effect of zinc as a monotherapy versus adjunctive therapies.
      原文链接:
    • NSTL
    • Elsevier

    Effects of standard treatments on depressive/anxiety symptoms in patients with inflammatory bowel disease: A systematic review and meta-analysis

    Shi Y.Zhu L.Zhao E.Yu Q....
    8页
    查看更多>>摘要：? 2020 Elsevier Inc.Objective: A combination of inflammatory bowel disease (IBD) and psychological comorbidities can influence the natural course of IBD. A systematic review and meta-analysis was performed to examine whether a standard IBD medical therapy without any antipsychotic intervention has beneficial effects on depression/anxiety in IBD patients. Methods: PubMed and Web of Science databases were systematically searched for related literature from their inception to March 2020. The random-effects model was used to calculate the standardized mean difference (SMD). A total of 16 eligible studies were included in the present meta-analysis. Results: Compared with baseline assessments, IBD patients with standard IBD medication had significantly reduced depression assessment scores (pooled SMD = 0.500; 95% confidence interval: 0.207, 0.793; P = 0.001). These results were obtained without any psychological interventions. Additionally, no significant differences in anxiety-related scores were detected between the baseline assessments and the end of therapy assessments (pooled SMD = 0.083; 95% confidence interval: ?0.120, 0.285; P = 0.425). The meta-regression and subgroup analyses revealed that differences in assessment tools and medications might be the main source of heterogeneity. Conclusion: Standard IBD treatments can significantly alleviate the depressive symptoms in IBD patients. However, more studies are needed to analyze this association.
      原文链接:
    • NSTL
    • Elsevier

    The crossroads of digital phenotyping

    Davidson B.I.
    7页
    查看更多>>摘要：? 2020The term ‘Digital Phenotyping’ has started to appear with increasing regularity in medical research, especially within psychiatry. This aims to bring together digital traces (e.g., from smartphones), medical data (e.g., electronic health records), and lived experiences (e.g., daily activity, location, social contact), to better monitor, intervene, and diagnose various psychiatric conditions. However, is this notion any different from digital traces or the quantified self? While digital phenotyping has the potential to transform and revolutionize medicine as we know it; there are a number of challenges that must be addressed if research is to blossom. At present, these issues include; (1) methodological issues, for example, the lack of clear theoretical links between digital markers (e.g., battery life, interactions with smartphones) and condition relapses, (2) the current tools being employed, where they typically have a number of security or privacy issues, and are invasive by nature, (3) analytical methods and approaches, where I question whether research should start in larger-scale epidemiological scale or in smaller (and potentially highly vulnerable) patient populations as is the current norm, (4) the current lack of security and privacy regulation adherence of apps used, and finally, (5) how do such technologies become integrated into various healthcare systems? This aims to provide deep insight into how the Digital Phenotyping could provide huge promise if we critically reflect now and gather clinical insights with a number of other disciplines such as epidemiology, computer- and the social sciences to move forward.
      原文链接:
    • NSTL
    • Elsevier

    PASS: A checklist for assessing the quality of systematic reviews of prevalence studies

    Walker J.Hobbs H.Magill N.van Niekerk M....
    2页
      原文链接:
    • NSTL
    • Elsevier

    Depressive symptoms in cystic fibrosis patients and their caretakers are best predicted by their respective sense of belonging

    Hornig I.Forster A.Katscher-Peitz A.Hewig J....
    2页
      原文链接:
    • NSTL
    • Elsevier