bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of the COVID-19 pandemic on symptom subtypes of obsessive-compulsive disorder: a cross-sectional study
Authors: Hassoulas Athanasios , Umla-Runge Katja , Adams Olivia , Scurlock-Green Madeline , Zahid Abeer , Hassoulas Antonia , Panayiotou Eliana 
Published: June 2021

AimsSince the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. The primary aim of this study was to investigate any significant changes to handwashing behaviour, as well as other related hygiene behaviours, across all symptom dimensions of OCD. The frequency of engaging with pandemic-related media coverage was also considered across all symptom subtypes.MethodA cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure.ResultFactor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). A significant correlation was revealed between the handwashing component and the OCI-R washing subscale (rs = 0.523, p = 0.0001), as well as between distress-avoidance and the OCI-R washing and ordering subscales (s = −0.227, p = 0.0001; rs = −0.159, p = 0.006). Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD.ConclusionThe pandemic has had a significant impact on individuals with contamination-related OCD symptoms, in relation to symptom severity and treatment disruption. Consideration should be given to targeted support tailored to patients with this subtype of OCD.
Does my patient have sex ? - Mental health professionals’ understanding of sexual health issues among their patients
Authors: Hettiarachchi Nalin , Kumar Praveen , balasundaram vikramraj 
Published: June 2021

AimsTo assess the level of understanding and difficulties encountered when obtaining sexual health details of their patients among mental health clinicians.BackgroundPeople with mental health problems, especially those treated with psychiatric medication experience greater rates of sexual difficulties than those in the general population. Mental health practitioners need to examine personal beliefs and attitudes about sexuality among people with mental health problems. Providing information about sexuality and sexual practice benefits and enhances the quality of life of people with mental health problems. Therefore taking a sexual history should be an integral part of psychiatric assessment.MethodAn online survey consisted of 17 questions to cover 3 areas of objectives mentioned above was created using Survey Monkey. A link to the survey was emailed to all the clinicians who perform psychiatric assessments. Response collection and data analysis was performed by the trust IT team.ResultTotal of 54 clinicians participated in the survey representing nurses, junior, middle grade doctors and consultants. Almost all stated that mental health patients have capacity to make appropriate decisions about their sexual behaviour patterns. 43% thought people with mental health problems don't have similar patterns of sexual behaviour compared to people without mental health problems. 11% stated that people with mental health problems do not experience greater rates of sexual difficulties than those in the general population. Nearly a third did not believe that telling patients about potential sexual side effects may lead to poor compliance. Nearly 70% stated taking a sexual history should be an integral part of psychiatric assessment. 44% reported lack of knowledge and skills when talking about sexual health and 33% avoided asking about sexual health due to lack of knowledge. Half of the clinicians avoided asking about sexual health due to the fear of embarrassing or causing distress to patients while 16% avoided asking about sexual health due to self-embarrassment. 65% talk about sexual health issues only if patients brought them up.During last 3 clinical encounters majority never asked about sexual difficulties, high risk behaviour and drug side-effects related to sexual difficulties. A significant proportion of clinicians never asked about contraception from their female clients.ConclusionSurvey revealed majority of mental health clinicians lack understanding and skills about sexual health issues highlighting the importance of raising awareness among clinicians about sexual health issues.
A survey of Irish psychiatric trainees attitudes to balint groups
Authors: Jain Sudha , Adams Emma , Lee Alyson 
Published: June 2021

Aims1. To compare the experience of psychiatric trainees in Ireland of online Balint Groups (BG) in contrast to face to face groups.2. To assess the general attitudes of trainees to BG using the Psychological Medical Inventory (PMI) (Ireton and Sherman, 1988) scale.MethodAn online survey comprising two sections: 1. A questionnaire exploring participants experience, effectiveness and obstacles to attending the two formats of BG with a free text box response. 2. General attitude of trainees towards BG using PMI scale.An online cross-sectional survey using Survey Monkey. An invitation to participate in the survey was emailed to all trainees by the College of Psychiatrists in Ireland. All data were anonymised, and all data processing was conducted in line with GDPR. Statistical analysis was undertaken using Microsoft Excel. Thematic analysis was applied to the free-text box responses.Result16.49% (64/388) responded to the survey. Responses were uniform across all stages of training. 97% of respondents attended BG; 72% attended both formats, 25% attended only face-to-face and 3% online only. 65% of respondents preferred face to face compared to 18% online, whilst 11% stated no preference.On thematic analysis, trainees asserted a preference for face-to-face, describing better group cohesion, feeling safer to share, increased ease of interpreting non-verbal communication, and that conversation was more fluid. They described greater ease of engagement with the group/facilitator and preferred direct social interaction with peers.Conversely, most trainees acknowledged that online groups were convenient to attend, less time consuming & mitigated COVID risk associated with face-to-face meetings. Common themes against the use of online groups were: less psychotherapeutic in nature, technical issues, silences, unable to see participants faces and as though speaking “into the void”.Regarding trainees' attitudes to attending BG, most of the trainees found BG had been beneficial in developing more interest and confidence in dealing with the psychological aspects of patient care. Trainees agreed that skills improved in developing an excellent doctor-patient relationship, recognising patients under stress/ in distress, systemically obtaining psychological information and making treatment decisions based upon psychological needs and psychotherapeutic engagement. They agreed that they could better understand the influence of doctors' emotions on the doctor-patient relationship.ConclusionThis survey showed that most trainees find BG beneficial in developing better doctor-patient relationships, preferring face-to-face rather than online BG. However, they found online more convenient. A blended learning approach could provide trainees with the benefits of both formats of BG.
Mental disorder and PTSD in Syria during wartime: a nationwide crisis
Authors: Jomaa Sami , Kakaje Ameer , Al Zohbi Ragheed , Aldeen Osama Hosam , Makki Leen , Alyousbashi Ayham , Alhaffar Mhd Bahaa Aldin 
Published: June 2021

AimsSyria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees.MethodThis is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors.ResultOur study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores.ConclusionThe conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.
A retrospective observational study of vitamin D levels in patients within the Tameside and Glossop early intervention in psychosis team
Authors: Kaye Emily , Parker Pete , Fyall Thomas , Arrowsmith Katie , Hark Holly , Huda Samei Ahmed 
Published: June 2021

AimsGrowing evidence indicates that Vitamin D deficiency is associated with psychotic symptoms. Although evidence suggesting a causal relationship is limited, theories regarding neuro-inflammatory modulation are promising. Alternatively, deficiency may signify chronic illness or poor functioning. Nevertheless, Vitamin D levels below 50nmol/L increase the risk of osteoporosis, muscle weakness, falls and fractures, thus identification and treatment are important.The association between Vitamin D levels in patients within the Tameside Early Intervention in Psychosis Team (EIT) was studied, hypothesising a strong correlation.MethodThe records of all patients in the EIT as of 01/07/2020, over the age of 16 years old (n = 183), were studied. The first Vitamin D level taken while under the EIT and the CGI scores closest to the date of this level were recorded. Vitamin D levels of 25nmol/L and under were classified as deficient, levels of 25.1 - 50nmol/L were insufficient.Result45.90% (n = 84) of patients did not have their levels recorded. Of the 55% (n = 99) patients who had Vitamin D levels recorded, 49.50% (n = 49) were insufficient and 22.22% (n = 22) were deficient. Therefore, only 28.28% (n = 28) had either optimal or sufficient Vitamin D levels. The majority of Vitamin D levels were taken in Autumn (36.46% n = 36).75.76% (n = 75) of patients had both vitamin D levels and CGI scores recorded, with an average of 35.65 days between date level and score recorded. A weak negative correlation between overall CGI scores and vitamin D level was calculated, producing Spearman R Correlation Coefficient of -0.15.ConclusionAlmost 3/4 of the studied patients being assessed for psychotic symptoms had either insufficient or deficient levels of Vitamin D. The correlation between symptom severity and Vitamin D level was weak however. While we cannot comment on the causality of the relationship, it appears that there is an association between our studied patient group and Vitamin D insufficiency.The evidence to suggest that supplementation can reduce psychotic symptoms is limited however, supplementation can reduce the risk of osteoporosis and falls, therefore would improve patient care. Only 55% of the patients within the EIT had their Vitamin D levels tested. As a result of this study, the authors recommend that all patients in the EIT have their Vitamin D levels tested as part of their psychosis assessment.The study is limited due to low numbers of patients studied and the fact that recorded CGI scores were often recorded at a later date to Vitamin D levels.
The outcome of an attachment-based infant mental health therapeutic play programme on infant temperament, parent-infant relationship & maternal reflective functioning
Authors: Malinit Joy 
Published: June 2021

AimsIn the Philippines, there is a need for preventive, early intervention programs for perinatal and infant mental health. This is the first local study that investigated an attachment-based, therapeutic play programme (Baby Bonding) on infant temperament, parent-infant relationship and maternal reflecting functioning.BackgroundThis study was an effort towards bridging the “10/90 gap in infant mental health research” wherein 90% of the world's infants are born in low- middle-income countries (Population Reference Bureau, 2013b) and “only 10% of the worldwide spending on health research is directed towards the problems that primarily affect the poorest 90% of the world's population (Tomlinson et al., 2014).MethodPhase I involved local validation of the Parent-Rated Outcome Measures (PROM)- Infant Characteristics Questionnaire (ICQ), Mother Object Relations Scale (MORS) and Parental Reflective Functioning Questionnaire (PRFQ).Healthy mother-baby dyads, from the low socio-economic stratum, were screened using Parent Evaluation of Developmental Status (PEDS) and Hospital and Anxiety Depression Scale (HADS).Phase II carried out randomized controlled design wherein mother-baby dyads were enrolled either in the usual care group or the 6-weekly Baby Bonding intervention.Result102 mothers answered the PROM. Their responses constituted the training set of the study tools. Baseline responses of the mothers from the usual care (N = 51) and intervention (N = 53) groups formed the evaluation set for the Filipino- translated instruments. In both the training and evaluation sets, if certain identified questions were to be removed from the PROM, better and acceptable Cronbach values were consistently generated.There were no statistical differences on parent-infant relationship and reflective functioning between the usual care and intervention group. There was movement of the intervention group from high-challenging onto intermediate to low-levels of challenging temperament in the dull-dimension of the ICQ after 6 sessions. In comparison, infants in the control group remained in the high-challenging temperament after 6 weeks of usual care.ConclusionLinguistically validated study instruments (ICQ and MORS) provided accurate assessments of infant temperament and parent-child relationship. The Filipino-translated PRFQ has limited validity in evaluating parental reflective functioning (RF). “On-line” measures that video mother-baby interactions could have better captured changes in RF. As measured by the dull dimension of the ICQ, the Baby Bonding programme improved sociability of the infants (7 months or younger).
Maternal immune activation generates anxiety in offspring: A translational meta-analysis
Authors: Matos Ursula , Quagliato Laiana Azevedo , Nardi Antonio Egidio 
Published: June 2021

AimsMaternal immune activation (MIA) during pregnancy is recognized as an etiological risk factor for various psychiatric disorders, such as schizophrenia, major depressive disorder, and autism. Prenatal immune challenge may serve as a “disease primer” into an altered trajectory of fetal brain development that, in combination with other genetic and environmental factors, may ultimately result in the emergence of different psychiatric conditions. However, the association between MIA and the offspring's chances of developing anxiety disorders is less clear. To examine the effect of MIA on offspring anxiety, a systematic review and meta-analysis of the preclinical literature was conducted.MethodA systematic search of the PubMed, Web of Science, PsycINFO, and Cochrane Library electronic databases was performed using the PRISMA and WHO methodologies for systematic reviews. Studies that investigated if MIA during rodent's pregnancy could cause anxiety symptoms in offspring were included.ResultOverall, the meta-analysis showed that MIA induced anxiety behavior in offspring. The studies provide strong evidence that prenatal immune activation impacts specific molecular targets, synapse formation and function, and a disbalance in neurotransmission that could be related to the generation of offspring anxiety. Future research should further explore the role of MIA in anxiety endophenotypes.ConclusionAccording to this meta-analysis, MIA plays an important role in the pathophysiological mechanisms of anxiety disorders and provides a promising therapeutic target.
Mindfulness based cognitive therapy for recurrent depressive disorder
Authors: McLoughlin James , Martin Paula , McCarthy Geraldine , Piong Chee Lin 
Published: June 2021

AimsMindfulness-based therapies have been demonstrated to be effective in reducing anxiety, stress and depressive symptoms in adults. Depression is a chronic relapsing condition. Major depressive disorder is one of the most common causes of ill health and functional impairment.Our goal was to assess the real world clinical effectiveness of Mindfulness Based Cognitive Therapy (MBCT) for Recurrent Depressive Disorder in three domains:-Depression, anxiety and stress levels-Mindfulness level-Self-compassion levelMethodPatients with a diagnosis of Recurrent Depressive Disorder (primary or secondary diagnosis) were referred by their community mental health team to participate in an 8-week educational MBCT programme. Participants completed the Depression, Anxiety and Stress (DASS), 5-Facet Mindfulness and Self Compassion self-rated scales prior to commencing and at the end of the course. They were also invited to give qualitative feedback at the end of the course.Data were collected from four groups who completed the course over a period of twelve months. A paired samples test was used to compare pre and post intervention scores to determine effect size.ResultWe had complete data for 19 participants out of a cohort of 34. Pre intervention scores were similar for both groups.The mean age of the cohort was 47 years (SD of 10 years), 3 male, 16 female.Patients showed a clinically significant reduction of symptoms in depression, anxiety and stress, with respective reductions of 48%, 26% and 43% post intervention. Results were statistically significant for depressaion and stress p <0.001 but not for anxiety p = 0.130.Positive trends were seen in all domains of the 5-Fact Mindfulness and Self Compassions scales, with mean improvements of 28.2% and 35.3% respectively. All results were statistically significant.We also collected anonymized qualitative feedback which highlighted themes of empowerment, skill acquisition and improved coping.ConclusionNumerous studies have demonstrated poor compliance with antidepressant treatments commonly prescribed in Recurrent Depressive Disorder. This small scale study demonstrates a statistical and clinical benefit of MBCT for these patients, supporting greater use of such novel non-pharmacological therapeutic options as treatment strategies..
Are drug consumption facilities an effective intervention to reduce drug related mortality? A critical review of the literature
Authors: Melvin Holly 
Published: June 2021

AimsTo critically appraise the literature regarding the effect of Drug Consumption Facilities in reducing overdose mortalityDrug consumption facilities (DCF) are places where people can use illicit drugs in the presence of medically trained staff, they aim to reduce fatal overdose risk, reduce risky injecting practices, and to serve as a bridge for users into mainstream treatment, healthcare and social services. Increasing numbers of fatal overdoses due to illicit drug use are a significant public health concern. The UK's statutory independent advisory body (the Advisory Council on the Misuse of Drugs) has recommended DCFs as a mechanism to reduce fatal overdoses due to illicit drugs. However, current UK legislation prohibits their provision.MethodSystematic extraction of relevant literature from PubMed, using a search string with a focus on observational cohort studies with fatal overdose as the outcome. Appraisal of identified papers using the CASP toolResult184 papers were identified, two of these met the inclusion criteria. Quality was fair/good. Neither demonstrated a clear effect of DCFs in reducing overdose mortalityConclusionIt is difficult to draw firm conclusions due to design weaknesses and potential confounding variables. Robust design is difficult in this research area, due to lack of suitability for RCTs. Despite the lack of a clear effect on overdose mortality, DCFs may exert other positive effects and are a pragmatic and humane response to reducing risk in this target population