bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Females and Males in the Prevalence of Depression in the Gulf Cooperation Council (GCC) Countries
Authors: Al Balushi Mitha , Javaid Syed , Al Maskari Fatima , Wanigaratne Shamil , Ahmad Amar 
Published: August 2024

AimsIn most populations, the prevalence of depression is more significant in women than in men. Nonetheless, the degree of gender disparity varies significantly across countries. The aim of this study is to consider the role of gender inequality in explaining these differences in the Gulf Cooperation Council (GCC) countries.MethodsData on the ecological prevalence of depression (males versus females) from 1990–2019 from the GCC countries were downloaded from Our World in Data and included in the statistical analysis. A mixed-effects linear model was used to examine the association between males and females, i.e. females regress on males. Year and country variables were used as random effect variables.ResultsThe prevalence of depression in the GCC countries shows a gender-specific pattern with a higher prevalence in females than in males 1.218 (95% CI: 1.149–1.285), p-value < 0.001. Higher levels of depression between men and women were observed in Kuwait and Saudi Arabia compared with the other four countries. The lowest depression prevalence was observed in the United Arab Emirates.ConclusionThe pattern of depression in the GCC countries is based on gender. However, the association between global measures of gender inequality and the gender gap in depression may depend on how the level of depression is measured. More research is needed to investigate the mechanisms that underlie the gendered nature of depression prevalence.
A Systematic Review of Estrogen Modulators as Augmentation to Antipsychotics for the Treatment of Post- and Perimenopausal Psychosis
Authors: Keen Cassidy , Hassoulas Athanasios , Richardson Jill 
Published: August 2024

AimsTo investigate if estrogen agents as an adjunct to antipsychotic medication are effective at treating psychosis in post-and perimenopausal females.MethodsA digital search focusing on controlled clinical trials was conducted. Studies were assessed for quality using the Cochrane Risk of Bias tool and GRADE system. The Joanna Briggs Institute (JBI) tools were used to critically appraise articles. The total Positive and Negative Symptom Scale (PANSS) scores were synthesised using a meta-analysis.ResultsOf the studies obtained (n = 11), two used estrogen HT as an augmentation agent, and nine used the SERM Raloxifene. Quality review and critical appraisal found inconsistencies in data and publication bias favouring trials that include Raloxifene. Meta-analysis results indicate Raloxifene plus antipsychotic did perform better than placebo [Std diff in means total = 0.340 (95% CI) p = 0.001] with a small effect size (g = 0.3392).ConclusionThough research appears promising, recommendations for the use of estrogen agent augmentation cannot be made at this time as more clinical trials that include a diverse range of treatments are needed.
Associations Between Adiposity Measures and Depression and Well-Being Scores: A Cross-Sectional Analysis of Middle- to Older-Aged Adults
Authors: Lonergan Caoimhe , Millar Seán , Kabir Zubair 
Published: August 2024

AimsObesity and mental health are significant global health concerns. Evidence has linked increased adiposity with depression and well-being; however, there is limited documented evidence in Ireland. Research also suggests that lifestyle factors and disease conditions are related to mental health. These may modulate relationships between adiposity and depression and well-being. The aim of this study was to examine associations between mental health scores and adiposity defined using body mass index (BMI) and waist-height ratio, and subsequently determine whether significant relationships persist following adjustment for lifestyle factors and common disease conditions.MethodsThis was a cross-sectional study of 1,821 men and women aged 46–73 years, randomly selected from a large primary care centre. Depression and well-being were assessed using the 20-item Centre for Epidemiologic Studies Depression Scale (CES-D) and the World Health Organization-Five (WHO-5) Well-Being Index. Linear regression analyses were performed to examine relationships between mental health scores (dependent variable) and adiposity defined using BMI and waist-height ratio (independent variable), while adjusting for demographic characteristics, lifestyle factors and disease conditions. These demographic, lifestyle and disease factors included gender, age, education, smoking status, alcohol intake, physical activity levels, dietary quality, type 2 diabetes, cardiovascular disease and cancer.ResultsBMI and waist-height ratio had a significant positive association with depression scores and a significant inverse association with well-being scores in males and females. These associations were maintained following adjustment for demographic variables and lifestyle factors. In final models where disease conditions were adjusted for, BMI (β = 0.743, p <0.001) and waist-height ratio (β = 0.719, p <0.001) associations with the CES-D score remained significant. In stratified analyses, relationships between measures of adiposity and depression were found to be stronger in females (BMI: β = 0.806, p = 0.007; waist-height ratio: β = 0.768, p = 0.01) than males (BMI: β = 0.573, p = 0.049; waist-height ratio: β = 0.593, p = 0.044) but no effect modification was identified.ConclusionThis study demonstrates a significant association between increased adiposity and poorer mental health in a middle- to older-aged population, which is in agreement with previous evidence. In addition, these findings suggest that the positive relationship between adiposity and depression is independent of lifestyle factors and disease conditions and is stronger in females. Targeted interventions for reducing depression should include better weight management population-level measures, particularly in the female population.
A Systematic Review of the Perinatal Mental Health Outcomes of Women With Neurodevelopmental Disorders
Authors: Mackintosh Isobel , Reed Sasha , Jayakody Surangi 
Published: August 2024

AimsNeurodivergent women have different experiences during pregnancy, childbirth, and parenthood than neurotypical women. However, little is known about the perinatal mental health outcomes and parenting experiences in women with Neurodevelopmental Disorders (ND). The systematic review aimed to summarise the literature on perinatal mental health outcomes and parenting experiences among women with ND.MethodsMEDLINE, Embase and PsycINFO databases were searched in October 2023 using the keywords related to pregnancy outcomes, perinatal period, mental health, neurodivergent, and neurodevelopmental disorders. Papers were also identified through citation and/or hand searching. Title, abstracts, and full-text articles were independently screened by two authors, and data were extracted using a custom data extraction spreadsheet. The Joanna Briggs Institute and the Mixed Methods appraisal tools were used for the critical appraisal. The heterogeneity across the included studies ruled out the use of meta-analysis. Therefore, results were summarised using a narrative synthesis.ResultsFourteen studies were included in the final review; four cohort, four case-control, three cross-sectional and three qualitative studies across 940,354 participants. The studies investigated women with Autism, Asperger's syndrome and Attention-Deficit Hyperactivity Disorder (ADHD), who were either clinically diagnosed or scored appropriately on diagnostic questionnaires. Perinatal mental health outcomes covered anxiety and depression. These were measured using questionnaires such as the Edinburgh Postnatal Depression Scale, participant interviews and clinical diagnosis from qualified healthcare professionals. All fourteen studies found a correlation between Neurodevelopmental Disorders and perinatal anxiety and/or depression symptoms. Seven studies found that neurodivergent women had adverse pregnancy and early parenting experiences. Results suggested this correlation may be mediated by factors such as unsatisfactory healthcare, lack of maternal-infant bond, increased sensory overload, issues with emotional attachment, difficulty reading the facial expression of the baby and problems with breastfeeding. Overall, women with ND were more likely to feel anxious and overwhelmed during the perinatal period, a potential risk factor for perinatal mental illness.ConclusionWomen with ND are at a higher risk of developing perinatal mental illness and adverse early parenting experiences. Abnormal physical and sensory challenges during pregnancy as well as difficulty with emotional connection and infant bonding during postpartum all contribute to the increased risk of perinatal mental illness. Adaptations to appointments and specialised perinatal care are required for women with ND yet are often not provided. To reduce the risk of perinatal mental illness in women with ND, improvements must be made to the delivery of perinatal care and the knowledge of those providing the care.
Connecting Past Trauma With Current Mental Health Challenges: A Photovoice Study Exploring Men's Experiences
Authors: McKenzie Sarah 
Published: August 2024

AimsWhile evidence suggests men experience high rates of trauma, there is little qualitative research investigating men's experiences of past trauma and current mental health challenges. This study aimed to obtain a richer understanding of the trauma histories embedded in men's accounts of living with depression, anxiety, and suicidality, and how men responded to these challenges.MethodsTwenty-one New Zealand-based men were recruited from the community and asked to take photographs depicting their experiences of living with depression, anxiety, and suicidality including what had helped or hindered their recovery. Participants shared their narratives and photographs in semi-structured interviews.ResultsThe findings show an array of participant experiences of past trauma at the individual, family and community level. Three themes were inductively derived to describe how men responded to these traumas: (1) struggling to survive which describes the isolation and emotional pain of men's ever-present trauma, heightened by engaging in risky coping strategies; (2) connecting with past trauma referred to the participants' understanding of their trauma, disclosure (or not) and help-seeking; and (3) moving forward detailed the strategies employed by participants to overcome these challenging experiences and mend and sustain their mental health.ConclusionThe findings reinforce the importance of in-depth qualitative work towards revealing the impact of past trauma on men's current mental health as well as how men make sense of, disclose and cope with experiences of trauma. These findings have important implications for mental health practitioners working with men. Addressing trauma histories in men seeking help for current mental health challenges may play a key role in improving mental health services and interventions for men.
Benzodiazepine Use Disorder Observed and Diagnosed in a Tertiary Care Pediatric Specialty Clinic: A Descriptive Retrospective Chart Review
Authors: Smithers Alex , Miller Laura , MacInnis Melanie , Etches Selene 
Published: August 2024

AimsObjectives: In youth and young adults, it is common to encounter non-medical use of benzodiazepines, defined as use without a prescription or use for reasons other than that for which the medication is intended. Benzodiazepine use disorder remains understudied and overlooked, especially in youth and young adults. The primary objective of our study was to highlight the proportion of youth and young adults with aberrant use of benzodiazepines and diagnosed with benzodiazepine use disorder in a single centre. The secondary objective was to determine factors associated with aberrant benzodiazepine use and benzodiazepine use disorder in that sample.MethodsThis retrospective chart review screened for benzodiazepine use in 310 adolescent patients aged 12–19 seen for the first time in a concurrent disorders clinic, at a tertiary care clinic in Canada. Of those 310 patients, 167 were included in the final chart review.Results97.6% of patients who used benzodiazepines demonstrated aberrant use, and 39.3% of patients received a diagnosis of benzodiazepine use disorder.ConclusionThis review showed that a substantial percentage of youth and young adults in a concurrent disorders clinic in Canada are presenting with aberrant benzodiazepine use and are being diagnosed with benzodiazepine use disorder. Despite this prevalence, there is little by way of literature to guide treatment of benzodiazepine use disorder in this population.
Is Body Dissatisfaction a Risk Factor for Diabulimia and How Is It Assessed? A Rapid Systematic Review
Authors: Natarajan Navaneeth , Obousy Shaymaa 
Published: August 2024

AimsDiabulimia is an increasingly used term referring to “an eating disorder (ED) with type 1 diabetes”. It is difficult to detect and presents in multiple ways, which can potentially include feelings of body dissatisfaction (BD), which in itself is a complex symptom to quantify clinically.This rapid systematic review aimed to identify whether feelings of BD are a risk factor for diabulimia by researching if and how BD is assessed in patients with the condition.MethodsA rapid systematic review was undertaken. A literature review was performed on Ovid Medline (all) and Ovid Embase databases using search terms for Type 1 Diabetes, ED, and BD and looked at cross-sectional studies only. One reviewer performed the literature search and screened titles and abstracts. Out of 589 papers screened, four papers met the inclusion criteria. These papers then went through critical appraising using the Appraisal tool for Cross-Sectional Studies, with all papers showing mid-level quality clearing 16 to 17/20 questions. Therefore, data was extracted from all of them.ResultsAll four papers came from different countries and used a wide range of sample sizes (43–477).There was widespread heterogeneity between the data collected in each study due to the various tools used to identify BD, paired with differences in analysing extracted data.To ensure transparency and quality of the results provided, the Synthesis Without Meta-analysis tool was used. Three studies looked at effects on adolescents and three had a higher proportion of females. All papers used previously established and tested BD screening methods. Two papers found female diabetics were more likely to have BD symptoms, and one paper saw that males were more at risk. All four papers concluded that BD had some correlations with one or more aspects of diabetes and/or other ED symptoms related to diabulimia. Two commented on positive correlations between BD and HbA1c levels and one commented on BD symptoms and insulin restriction trending together. Two papers also saw BD symptoms and depressive symptoms correlating in patients as well.ConclusionAll four studies showed that BD was related to diabulimia, both from a psychological and diabetic perspective, and most highlighted how BD manifested between the different sexes of diabetics. This review highlights the need for more standardised and comprehensive BD questionnaires to draw out key signs of EDs in diabetics that could improve screening, detection and management of diabulimia.
The Harm in Euphoria: Exploring the Benefit of Harm Reduction Strategies in the Narrative of Rue Bennett From ‘Euphoria'
Authors: Popoola Iyinoluwa 
Published: August 2024

Aims"Euphoria,” an American television show portraying the lives of teenagers, centers around Rue Bennett, a seventeen-year-old biracial girl grappling with substance misuse and comorbid mental health conditions, including obsessive-compulsive disorder and bipolar disorder. Rue's risky behaviors in the series mirror real-life challenges faced by adolescents dealing with substance misuse. This study aims to explore harm reduction strategies that could benefit Rue, emphasizing the need for such approaches to improve safety in non-abstinent adolescents. By focusing on harm reduction rather than strict abstinence, the goal is to meet individuals where they are in their journey and foster sustainable positive change.MethodsEmploying a qualitative approach, this study conducted a thematic content analysis of relevant episodes from seasons 1 and 2 of “Euphoria.” Additionally, a literature search was carried out using online databases, including PubMed, PsychINFO, and Google Scholar, to identify relevant literature on harm reduction strategies for adolescent opiate users from 2019 to 2024.ResultsThe analysis uncovered multiple instances of Rue's risky behavior. Major themes included polydrug use, self-medication, overdose, association with dangerous individuals, self isolation and withdrawal management. Examining Rue's journey identified harm reduction strategies which could minimise her risk of harm, such as fentanyl test strips, Narcan, and psychoeducation in safer consumption practices, supported by existing literature.ConclusionRue Bennett's character in “Euphoria” underscores the imperative need for harm reduction approaches in substance use interventions for adolescents. The study highlights the potential effectiveness of harm reduction strategies, including Narcan and psychoeducation in minimizing risks associated with opiate use. Rue's narrative emphasizes how these methods could contribute to creating a safer consumption environment for non-abstinent individuals. Integrating harm reduction principles into real-world interventions is crucial for promoting holistic well-being and challenging stigmatizing attitudes toward substance use.
Introduction of High-Fidelity Simulation (HFS) for Teaching Undergraduate Medical Students About Electro convulsive Therapy (ECT) and Its Impact on Their Knowledge and Attitudes Towards ECT
Authors: Sachdeva Vishi , Dastidar Supriya , Murugan Meena , Rourke Thomas , Deol Jasleen 
Published: August 2024

AimsLearning about and appreciating the use of Electroconvulsive therapy remains an integral part of the undergraduate psychiatry curriculum. The existing literature indicates that medical students frequently have unfavourable views regarding ECT and its adverse effects.Therefore, this study aimed to introduce a new teaching tool that supplements traditional didactic ECT teaching with simulation-based procedural demonstration thus providing a real-life experience of an ECT room and subsequently evaluate the learning gains conferred by such a curriculum.MethodsThe demonstration was carried out by Clinical teaching Fellow with the help of a high-fidelity manikin and a live actor who played the role of the patient, in the ECT suite in Birmingham.Participants of the study were fourth year medical students who completed a self-administered questionnaire before and after the simulation session. This survey was designed to explore changes in knowledge, attitudes, and perceptions of the students towards ECT and its side effects.ResultsWithin a cohort of 88 students, 52 students successfully completed the pre-session questionnaire, and 43 students completed the post-session questionnaire. Students reported a global improvement in knowledge regarding ECT, when comparing results from both questionnaires. Prior to the simulation, many students used negative terms to describe ECT such as ‘torture’, ‘barbaric’ and ‘uncontrolled’, suggesting outdated stigmas around ECT. However, after the simulation, many students expressed a positive change in opinion, describing ECT as ‘controlled’, ‘beneficial’ and effective’.Additionally, students reported improved knowledge about the side effects of ECT, especially regarding pain, memory loss and brain injury. Many students reported that their initial apprehension had been addressed over the course of the ECT simulation. Many noted ECT was more effective and beneficial than originally thought and the process was less extreme and invasive than they believed.ConclusionThe results of the study reflect that the use of simulated ECT within medical students can help disperse some of the stigma and myths regarding this treatment. Simulation can humanise the process and shift attitudes around ECT by allowing students to become fully immersed into an almost real-life scenario. It can also address knowledge gaps around ECT indications, process, risks, side effects and benefits. This will in turn help educate future clinicians have a better understanding about ECT in the treatment of severe mental illness, thus optimising the utilisation of this effective treatment. Furthermore, such technique can be a useful tool for demonstrating ECT to potentially wider group of students, trainees and other health practitioners.
Designing a Virtual Reality Café to Treat Eating Disorders: A Thematic Analysis of Stakeholder Viewpoints
Authors: Shackshaft Lydia , Chapman Laura , Biddle Lucy , Yardley Lucy , Bould Helen 
Published: August 2024

AimsEating disorders (ED) have significant physical and psychosocial impacts, and the highest mortality rates of any psychiatric illness. About a third of patients with Anorexia Nervosa or Bulimia Nervosa do not recover and develop persistent ED. Development of novel treatments is a priority to prevent adverse effects on young people's physical, relational and educational development. Virtual reality (VR) has shown promising efficacy as an innovative mental health treatment, and has potential therapeutic value within ED. People with lived experience (PWLE) and clinicians have demonstrated enthusiasm for a VR café intervention to practice social and food-related challenges. A VR café would enable gradual exposure to challenges in a protected environment, aiming to support people with ED to return to real-life cafés and social eating. This study aims to explore the opinions of key stakeholders to help inform the development of a VR café scenario as an adjunctive treatment for ED.MethodsWe conducted semi-structured focus groups and 1:1 interviews with PWLE aged 14–25 years (n = 15), parents/carers (n = 4), and clinicians (n = 6). Participants were recruited via social media, advertisement via ED charities, posters in public places, and snowballing. Following completion of an online screening survey, eligible individuals were invited to participate using purposive sampling to ensure diversity of ages, ethnicities, genders, ED diagnoses, and health professional roles. Data were analysed thematically.ResultsPreliminary analysis indicates that PWLE, parents/carers and clinicians expressed mostly positive opinions regarding a VR café adjunctive treatment. Expressed concerns related to themes of intervention efficacy, translation of learnt skills to real life, and use of VR technology. Most participants agreed a VR café intervention should be a repeated experience (many suggested graded exposure), realistic, and maximally individualised. All stakeholder groups identified a similar range of challenges to experience within a VR café, with themes including choosing food, other people, eating socially or alone, and the café environment. Differences in specific aspects of the scenario that might make challenges harder or easier reflected the unique experiences of individual participants.ConclusionThese findings build upon previous research demonstrating support from PWLE, parents/carers, and clinicians for the development of a VR café adjunctive treatment for ED. Themes identified are largely consistent across stakeholder groups and relate to the design of a VR café scenario and its implementation as a treatment. This analysis enables the perspectives of key stakeholders to be incorporated into the design of a novel VR café intervention to optimise efficacy and acceptability.