bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey of remote consultations in psychiatry during the SARS-CoV-2 outbreak
Authors: Khodabux Nusra , Gangadharan Satheesh , Tromans Samuel , Hiremath Avinash 
Published: June 2021

AimsTo compare the usage of remote consultations before and after the first wave of the SARS-CoV-2 outbreak and explore mental health workers’ views on the usage of telemedicine.MethodAn online questionnaire survey was developed, and disseminated to mental healthcare professionals via e-mail and social media. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using Braun and Clarke's six step procedure for thematic analysis.1ResultThere were 40 responses from mental healthcare professionals of varying grades from different sub-specialties, predominantly from the UK. Compared to before the SARS-CoV-2 outbreak, there was an increase in usage of telephone (9(22.5% to (29)72.5%) and video consultations (4(10%) to 17(42.5%)). Respondents reported an increase in virtual MDTs (35(87.5%) during the pandemic, 9(22.5%) pre-pandemic).Based on a 5-point Likert scale, the mean technical quality of telephone consultations was 3.56/5 (Range 2-5), with 75% rating telephone consultations as not being as good as face-to-face consultations. The mean technical quality of video consultations was 3.58/5 (Range 2-5), with 63% rating video consultations as not being as good as face-to-face consultations. 25 (62.5%) respondents felt comfortable using telephone consultations during the pandemic, 20(50%) felt comfortable using video consultations. Recurring themes identified from the qualitative data regarding reasons for the technical quality ratings were: connection issues, poor infrastructure and security concerns.Nine (23%) respondents felt that using video conferencing consultations had a detrimental impact on the mental health of patients while 14(35%) felt that telephone consultations had a detrimental impact on patients’ mental health. Recurring themes for health practitioners’ perceived effect of the use of telemedicine on patients’ mental heath were the loss of personal touch and reduced patient engagement.ConclusionThere was a substantial increase in usage of remote consultations during the first wave of the SARS-CoV-2 pandemic among mental healthcare professionals. The results reported in the present study suggest there are numerous barriers to the use of telemedicine in psychiatry, which require future exploration, ideally through interview or ethnographic studies.
Glucose transporters in Alzheimer's disease
Authors: Kyrtata Natalia , Dickie Ben , Emsley Hedley , Parkes Laura 
Published: June 2021

BackgroundPhysiological brain function depends on tight glucose regulation, including transport and phosphorylation, the first step in its metabolism. Impaired glucose regulation is increasingly implicated in the pathophysiology of Alzheimer's disease (AD). Glucose hypometabolism in AD may be at least partly due to impaired glucose transport at the blood-brain barrier (BBB). Glucose transporters (GLUTs) are an integral component of the BBB. There is evidence of a significant reduction in vascular and non-vascular forms of GLUT1 and GLUT3 in AD brains compared to age-matched controls. Glucose transport, as well as phosphorylation, appears to be a rate limiting step for glucose metabolism in the brain. We have reviewed the literature on glucose transport abnormalities in AD and the effect such abnormalities have on the brain.MethodPublished literature between 1st January 1946 and 1st November 2019 was identified using EMBASE and MEDLINE databases and titles and abstracts were scanned. Human studies (autopsy and imaging) and data from animal models were included while reviews, letters and cellular or molecular studies were excluded from the search.ResultAutopsy studies in AD patients show significant reductions in GLUT3 in areas of the brain closely associated with AD pathology. Patients with AD and diabetes showed greater reductions of GLUT1 and GLUT3. A longitudinal study showed significant reductions in GLUT3 levels which correlated with greater amyloid-β (Aβ) and neurofibrillary tangle pathological burden in participants with AD pathology at post-mortem but without evidence of cognitive dysfunction in their lifetime. Some studies showed increased GLUT1, with others showing reduced GLUT1, levels in AD brain. A newly recognised GLUT12 appears to be increased in AD. Animal studies showed similar results with GLUT1 and GLUT3 knockout animal models exhibiting AD pathology, while overexpression of GLUT1 or treatment with metformin decreased Aβ toxicity in a Drosophila model of AD. GLUT2 levels were increased in both human AD brain and in an animal model of AD. Imaging studies using fluorodeoxyglucose [18F]FDG with positron emission tomography (FDG-PET) in AD subjects show reductions in glucose transport and glucose metabolism in areas most affected in AD. A small randomised control trial showed anti-diabetic medications improved the glucose transport in AD subjects.ConclusionGLUTs play a significant role in AD pathology with evidence suggesting that GLUT3 reductions may precede the onset of clinical symptoms, while GLUT2 and GLUT12 may have a compensatory role. Repurposing anti-diabetic drugs shows promising results in both animal and human studies of AD.
To what extent does the COVID-19 pandemic impact patients with anorexia nervosa?
Authors: Mehta Krishna 
Published: June 2021

AimsThis systematic review aims to discuss the extent to which the measures undertaken to control the COVID-19 pandemic in several countries have affected those with Anorexia Nervosa (AN). The coronavirus pandemic is still raging on in many countries and its effects will still be felt years from now and previous studies have shown that it has impacted other mental illnesses. AN cases are on the rise and the nature of the illness has deadly consequences, therefore it is paramount to discuss the relationship between the COVID-19 measures and symptomatology of AN to ensure appropriate services are in place to deal with potential outcomes.MethodSystematic search of the PubMed database gave thirty-three total results with seven of these used in this review. These studies met the inclusion criteria; examples include primary studies and use of the English Language. The exclusion criteria involved literature reviews, studies with less than ten participants and studies not separating AN from other eating disorders.ResultMany studies were cross sectional in nature except two longitudinal studies. Anorexic symptomology increased in the majority of papers in this review. Specifically restricting intake has increased compared to before lockdown measures. Physical activity has varied on an individual level in most studies potentially due to compensatory behaviours. Co-morbid psychopathologies were also noted during these studies. There are many factors behind these changes such as food insecurity, the effect of media and social media, uncertainty and the lack of social interaction. A number of participants across the studies were dissatisfied with treatment services during lockdowns. Variability in study results may be due to the differences in measures between countries and the use of self-reported cases compared to those contacted through care services. Limitations of this review are largely due to the how current the topic is and recommendations for the future include reviewing new studies that are published and to review the situation once the full impact of COVID-19 is known.ConclusionPatients with AN have struggled more due to the COVID-19 measures and the true effect of the pandemic is yet to be felt. Further studies and reviews should be conducted. The appropriate services should be put into place to ensure patients are supported effectively.
Prognostic evaluation of suicidality and development of risk factors in victims of physical and emotional child abuse and emotional/psychological neglect
Authors: Miah Latif 
Published: June 2021

AimsTo evaluate the effects of childhood maltreatment, specifically physical and emotional abuse and emotional/psychological neglect on the development of suicidal ideation, depressive symptoms and self-harm. It is hypothesised that there will be a strong causal link between the aforementioned types of maltreatment with suicidality, depression and self-harm.BackgroundChild abuse is a major public health issue with profound developmental and mental health consequences towards victims and their contributions to society as a whole. The impact of sexual abuse is well-established, however non-sexual child maltreatment and its sequelae are not as well understood or studied.MethodA literature search was carried out using the Pubmed, Cochrane, Scopus and Google Scholar databases. Articles were appraised according to set criteria and manually screened for relevance to the review.ResultThe results of this review demonstrate that there are statistically significant, potentially causal links between emotional and physical abuse, and emotional/psychological neglect with suicidal ideation, depressive symptoms and self-harm. More research is still required to elucidate the role of polyvictimisation in mental health outcomes and to further confirm these links between abuse and development.ConclusionChild maltreatment remains a large public health issue with major impact on the economy of the world. It has profound, potentially lifelong consequences on victims and is something that needs to lose its stigma so that it can be identified earlier and potential damage prevented as far as possible. The future may lie in working to remove the stigma surrounding it, standardise how it is studied and thus learn to recognise the signs earlier – ideally leading to implementation of policy to get victims to safety, preventing unncecessary harm.
Age-related changes in physiology in individuals with lifetime bipolar disorder
Authors: Mutz Julian , Lewis Cathryn M 
Published: June 2021

AimsIndividuals with bipolar disorder have reduced life expectancy and may experience accelerated biological ageing. In individuals with lifetime bipolar disorder and healthy controls, we examined differences in age-related changes in physiology.MethodThe UK Biobank study recruited >500,000 participants, aged 37–73 years, between 2006–2010. Generalised additive models were used to examine associations between age and grip strength, cardiovascular function, body composition, lung function and bone mineral density. Analyses were conducted separately in males and females with bipolar disorder compared to healthy controls.ResultAnalytical samples included up to 272,462 adults (mean age = 56.04 years, SD = 8.15; 49.51% females). We found statistically significant differences between bipolar disorder cases and controls for grip strength, blood pressure, pulse rate and body composition, with standardised mean differences of up to -0.238 (95% CI -0.282 to -0.193). There was limited evidence of differences in lung function, heel bone mineral density or arterial stiffness. Case-control differences were most evident for age-related changes in cardiovascular function (in both sexes) and body composition (in females). These differences did not uniformly narrow or widen with age and differed by sex. For example, the difference in systolic blood pressure between male cases and controls was -1.3 mmHg at age 50 and widened to -4.7 mmHg at age 65. Diastolic blood pressure in female cases was 1.2 mmHg higher at age 40 and -1.2 mmHg lower at age 65.ConclusionDifferences in ageing trajectories between bipolar disorder cases and healthy controls were most evident for cardiovascular and body composition measures and differed by sex.
Falling through the cracks’ – the role of assertive alcohol outreach teams in treating comorbid mental health problems in people with addictions
Authors: Naomi Smith E. , Finch Emily , Drummond Colin 
Published: June 2021

AimsInput from Assertive Alcohol Outreach Teams (AAOTs) reduces the ‘burden’ on already overstretched community mental health teams (CMHTs).AAOTs are specialist addictions services. This project focuses on an AAOT based in the London, which engages with people with severe alcohol and illicit substance misuse problems.Previous research has shown that input from AAOTs reduces hospital admissions. This project examined the impact of AAOT input on reducing the ‘burden’ on CMHTs.MethodThe full caseload of the Southwark-based AAOT was reviewed, including mental health records, general practitioner notes, hospital notes and discharge summaries. We collected data on diagnoses and previous hospital admissions. Patients were assessed to determine whether they met criteria to be open to a CMHT (the presence of complex or serious mental health problems, in addition to addictions).ResultThe caseload was made up of 39 patients, 85% of patients were deemed to meet criteria for being under the care of a CMHT. Only 15% of patients are currently under the care of a CMHT. 87% of patients had at least one comorbid psychiatric diagnosis. 72% of patients had had at least one emergency department or medical hospital admission due to mental health-related problems. 39% had previous admissions to mental health wards. 21% of patients has been admitted under Section of Mental Health Act.ConclusionThe majority of AAOT patients have severe mental health problems in addition to addictions. The patients are complex and often have a history of disengagement from standard mental health services. Formal diagnosis and treatment of comorbid mental health problems is challenging in the presence of protracted drug and alcohol misuse. AAOT input appears to address a serious ‘gap’ in supporting patients with complex mental health needs who are often ineligible for CMHT input or disengage from CMHT support.
What is the prevalence of self-harming and suicidal behaviour in under 18s with autism spectrum disorder, with or without an intellectual disability?
Authors: Oliphant Rosalind , Smith Eleanor , Grahame Victoria 
Published: June 2021

AimsThe aims of this systematic review are to summarise data on the prevalence of suicidal behaviours and self-harm in under 18s with Autism Spectrum Disorder (ASD) and consider the impact of Intellectual Disability (ID). It was hypothesised that the prevalence of these behaviours may be higher in under 18s with ASD than in the general population.BackgroundIn the general population, rates of self-harm and suicide in under 18s are of increasing concern. Whilst there is an emerging evidence base considering suicidality in autistic adults, less in known about the experience of under 18s. There has been very little research focused on how self-harm seen within the general population presents in the context of ASD and whether it continues to be a predictor of future suicidal behaviour. This may be partly due to self-harm being considered alongside Self-Injurious Behaviours (SIB), which have long been recognised as part of the clinical presentation of ASD and may have other functions (e.g. fulfilling sensory stimulation needs).MethodA systematic literature search was conducted in line with PRISMA guidelines. For this review, all papers that included data on prevalence of self-harm and/or suicidal behaviours in under 18s with ASD were included. Studies that only reported on the prevalence of the broader entity of SIB (characterised as stereotypic or habitual) were excluded.Result338 papers were initially identified and 9 met eligibility criteria. There was considerable variation in how different aspects of self-harm and suicidal behaviours were addressed between groups and also between population samples, making it difficult to generalise the findings. The prevalence of self-harming and suicidal behaviours ranged from 7% to 73%, indicating that this is a clinically significant problem for this patient group. The only study that considered the impact of co-existing ID did not identify significant differences between groups (ID vs no ID).ConclusionThere was variation in the reported prevalence rates but results suggested that rates of both self-harm and suicidal behaviour may be elevated in under 18s with ASD compared to the general population. This is in keeping with literature relating to autistic adults but in contrast to conclusions of a previous systematic review. This review highlights the need for further research to explore the experience of self-harm and suicidal behaviour in autistic children and young people.
A two-year mirror-image study of the effect of treatment with paliperidone and aripiprazole long-acting injections on need for inpatient care and home treatment intervention
Authors: Pantall Shay-Anne , Pilsbury Joseph , Gan Le , Brownell Lisa 
Published: June 2021

AimsTo evaluate the effect of the use of aripiprazole and paliperidone long acting injections on healthcare resource useBackgroundLong acting injections of second-generation antipsychotics such as paliperidone and aripiprazole have become more commonly prescribed over the past decade. They have much higher acquisition costs when compared to first generation depot antipsychotics. It is therefore essential to demonstrate their tolerability and cost-effectiveness.MethodWe undertook an observational, retrospective two-year mirror study for all patients who started treatment with paliperidone long acting injection between January and June 2016 (n = 47) or aripiprazole long acting injection between April 2014 and July 2017 (n = 93). Clinical notes were examined to determine the number of admissions, inpatient days, home treatment episodes and number of home treatment days, in the 12 months preceding and following the commencement of the long acting injection.Result70% remained on paliperidone and 62% remained on aripiprazole at the end of the one-year period.There was a significant reduction in occupied bed days in those treated with paliperidone from 78.2 days in the year before this treatment was started to 25.4 days in the year after (p = 0.002). There was a significant reduction in occupied bed days in those treated with aripiprazole from 66.51 days to 32.7 days (p = 0.0006).There was no significant reduction in days spent under the care of home treatment teams for individuals treated with either of these medicines.ConclusionTreatment with either paliperidone or aripiprazole long-acting injection was associated with a reduction in admissions and occupied bed days of a magnitude that delivered an overall cost-saving despite the high drug acquisition costs. It remains to be determined how these reductions compare with other second-generation long-acting injections and first-generation depot antipsychotics.
Prevalence and correlates of depressive symptoms among professional drivers in Saudi Arabia: a cross-sectional study
Authors: Alnaser Adnan Raed , Zitoun Osama A. , Rajab Tawfik , Khojah Abdullah , Saquib Juliann , Saquib Nazmus 
Published: June 2021

AimsDue to the nature of their work, professional drivers face a considerable risk of developing depression and other mental illnesses. We sought to assess the prevalence and the factors influencing depressive symptoms among professional drivers in Saudi Arabia.MethodUsing convenience sampling, we have conducted an interviewer-administered survey on 324 professional drivers in Qassim Region in Saudi Arabia using Depression subscale from the Depression, Anxiety and Stress Scale 21 (DASS-21). Participants were interviewed in their native language, and responses were outlined directly into an online form in English. Data were then extracted and analyzed using SPSS software.ResultParticipants’ mean age was 38.6 years, and mean driving hours per day were 9.86 hours/day. The mean DASS-21 depression score among the professional drivers was 2.88. Overall, 21.9% of the included drivers had variable degrees of depressive symptoms, with 7.4% suffered from extremely severe symptoms. Depressive symptoms were influenced by the driver's nationality, educational level, vehicle type, driving years, BMI, presence of chronic medical conditions, physical activity, and sexual activity. Moreover, poor sleep quality increased the risk of developing depressive symptoms among the drivers by 31.9 times (OR: 31.9, CI: 9.03–112.63, P < 0.001).ConclusionNearly one-fifth of professional drivers in Saudi Arabia (Qassim region) suffer from depressive symptoms. Unhealthy lifestyle practices (i.e. being obese and physically inactive) have been closely related to depressive symptoms. Education, sexual activity, type of driven vehicle, and the number of chronic conditions were also associated with depressive symptoms. Also, poor and fair sleep quality was strongly associated with the development of depressive symptoms as compared with excellent sleep quality. As drivers are always on the move and hardly reachable, we would propose psychological support and counseling to be administered via telemedicine services. Future research is needed to better comprehend the needs of this vulnerable population.
Prevalence of mental disorders in prisons in the UK: a systematic review and meta-analysis
Authors: Rebbapragada Nivedita , Furtado Vivek , Hawker-Bond George William 
Published: June 2021

AimsTo report pooled prevalence of all mental disorders among the general prison population in the United Kingdom (UK). This includes individuals in Young Offender Institutions (YOI), youth custody and adult prisons across all categories. A secondary aim explores possible sources of heterogeneity by performing subgroup and meta-regression analysis across certain covariates (e.g. sex of prisoner). We hypothesise that contemporary estimates of mental disorders are higher than the general population.BackgroundPrevalence of mental health problems among prisoners are considerably higher than the general population; this poses an important public health concern. Individuals who require diversion to appropriate psychiatric services are becoming embroiled in the revolving door of the criminal justice system. However, there are no up-to-date reviews assessing prevalence of mental disorders across the general prison population in the UK. This study aims to address this gap.MethodWe conducted a systematic search of PsycINFO (1923 – October 2019), MEDLINE (1946 – October 2019), EMBASE (1947 – October 2019) and Web of Science (all years) of articles reporting prevalence of mental disorders in UK prison populations (PROSPERO registration number: CRD42019132685). The Joanna Briggs Institute (JBI) Appraisal Checklist for Studies Reporting Prevalence Data assessed study quality and bias. Pooled prevalence of each mental disorder was calculated using Stata statistical software 16.0 via the metaprop command. Forest plots present prevalence estimates with study weights and associated 95% confidence intervals (CI). Overall, 20 studies satisfied inclusion criteria, comprising of 12,335 prisoners across England, Wales and Scotland.ResultWe identified higher rates of neurotic disorders (28.9%, 95% CI 0.71–74.7%), personality disorders (23.5%, 95% CI 13.6–35.2%), alcohol (22.7%, 95% CI 12.2–35.1%) and drug dependence (26.7%, 95% CI 15.0–40.4%). The lowest prevalence rates included schizophrenia (2.42%, 95% CI 0.78–4.84%), panic disorders (3.88%, 95% CI 3.17% – 4.64%), adjustment disorders (3.83%, 95% CI 1.19–7.84%) and intellectual disability (2.90%, 95% CI 0.90–5.80%). Meta-regressions for psychotic disorder and personality disorder revealed no significant differences across study year, sample size and gender.ConclusionOur prevalence estimates of mental disorders in prisons are higher than the general English population. However, we should acknowledge the influence of considerable heterogeneity. These findings demonstrate the need to quantify current prevalence of mental disorders amongst prisoners in the UK. We recommend for the government to consider performing an up-to-date census of psychiatric morbidity to facilitate service provision.