bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Gut-Brain Connection: Do Gut Bacteria Play a Role in the Development of Dementia? A Systematic Review
Authors: Pokharel Prakriti 
Published: August 2024

AimsDementia is a debilitating disease with multiple potential causes, no cure and rising incidence. New studies suggest that gut bacteria not only aid in the digestion of bowel products but also other bodily functions such as immune systems and relaying messages to the brain. This review aims to examine the potential link between gut microbiota and dementia by performing a systematic review to assess whether gut bacteria play a role in the development of dementia.MethodsThe systematic review was designed and conducted according to PRISMA guidelines. A modified PICO model was used to perform a literature search in Medline, CINAHL PLUS and APA PsychInfo databases. The search identified 401 articles, 49 of which met the predefined inclusion criteria. Twenty-one final studies were included in the results; 14 cross-sectional, two cohort, three case-control, one randomised control study and one case report. The reviewer extracted and analysed data from these studies for quality using the AXIS and CASP tools. A narrative synthesis of the results was performed due to the heterogeneity of the data.ResultsIndividuals with dementia have lower microbial diversity than healthy controls, including changes in specific bacterial taxa, pro-inflammatory and anti-inflammatory balance. The results of the review were subdivided into four identified themes which helped further identify that microbial metabolites, diet and gastrointestinal disease can also influence the composition of gut microbiomes and, therefore, the development of cognitive impairment and dementia.ConclusionThis systematic review found a link between gut bacteria, bacterial metabolites, gastrointestinal health, diet, and dementia. Although the studies were mostly observational, they suggest that gut microbiota can affect brain function through dysbiosis, which can lead to neuroinflammation and dementia. More research is needed to confirm a causal relationship, but targeting the gut microbiota could be a potential therapy for MCI and AD. Innovative strategies may help combat the growing challenge of dementia.
Understanding the Pro-Ana Subculture: Illness, Sickness or Choice
Authors: Popoola Iyinoluwa 
Published: August 2024

AimsThis digital ethnographic study explores the varying perceptions of anorexia within the pro-anorexia (pro-ana) subculture by utilizing Professor Marinker's framework of disease, illness, and sickness to qualitatively analyse how individuals within this community interpret anorexia as a personal experience, a societal role, or a deliberate choice.MethodsThis study examines insights from the pro-ana community, obtained through pro-ana spaces on social media platforms and dedicated pro-ana online forums contributing to understanding their viewpoints on anorexia. Drawing from established literature on anorexia nervosa and the pro-ana subculture, this study employs a qualitative analysis of online pro-ana spaces, examining discussions, narratives, and beliefs shared within these communities. The study also integrates historical perspectives, cultural critiques, and psychological theories to offer a comprehensive understanding.ResultsThe pro-ana subculture presents diverse perspectives on anorexia, challenging traditional definitions of illness and sickness. Some individuals view anorexia positively, perceiving it as a means of discipline and self-improvement. Cultural and historical influences, including the feminine expectation, the normalization of the disordered eating habits of the ‘gym bro', and societal beauty standards, further shape perceptions within the pro-ana community. There is some debate on how the media influences the proliferation of eating disorders and the evolving definitions of anorexia – including the introduction of atypical anorexia. There is also an ascetic spirituality associated with anorexia, which can be seen as a matter of faith or delusion.ConclusionThe concept of anorexia within the pro-ana subculture challenges traditional definitions of illness, sickness, and choice. This study highlights the cultural, historical, and gendered dimensions influencing these perspectives. Understanding this complex interplay can inform mental health professionals, educators, and policymakers about the potential risks posed by pro-ana communities. It emphasizes the importance of preventive measures, media responsibility, and a nuanced approach to engaging with individuals influenced by the pro-ana subculture. Recognizing the multifaceted nature of anorexia within this community is crucial for developing effective interventions and support strategies for patients with anorexia who engage with the online pro-ana community.
Determinants of Physical Health Outcomes in Individuals With Schizophrenia, Schizoaffective Disorder, and Bipolar Affective Disorder
Authors: Rubinsztein Ella , Kendall Kimberley 
Published: August 2024

AimsIndividuals with schizophrenia, schizoaffective disorder, and bipolar affective disorder have higher rates of cardiometabolic disease and have a reduced life expectancy compared with healthy controls. These mental health conditions are highly heritable and neurodevelopmental copy number variants (CNVs) are known to increase the risk of these disorders. Neurodevelopmental CNVs have also been associated with a range of cardiometabolic disorders. The aim of this research was to examine the relationship between neurodevelopmental CNVs and cardiometabolic disease in individuals with schizophrenia, schizoaffective disorder, and bipolar disorder.MethodsUsing data from the UK Biobank, a group of individuals with schizophrenia, schizoaffective disorder and bipolar affective disorder was defined (n = 2,611) based on first-occurrence data. CNVs had previously been called using PennCNV and a set of 53 neurodevelopmental loci annotated. I carried out association analyses between neurodevelopmental CNVs and cardiometabolic disease phenotypes using logistic regression with age and sex as covariates.ResultsThere was a higher frequency of ischaemic heart disease, hypertension, obesity, and type 2 diabetes mellitus in individuals with schizophrenia, schizoaffective disorder and bipolar disorder than in controls. 2.1% of individuals with these mental health conditions carried a neurodevelopmental CNV. Carrying a neurodevelopmental CNV was significantly associated with type 2 diabetes mellitus (OR = 1.94, 95% CI 1.09–3.57, p = 0.025). However, this result did not survive Bonferroni correction for four tests (p value threshold 0.0125). I did not find any mediators of the neurodevelopmental CNV – type 2 diabetes mellitus association (of obesity, hypertension, cognition, smoking and socioeconomic status).ConclusionThe relationship between neurodevelopmental CNVs and type 2 diabetes mellitus should be examined in independent samples.
Does an Association Exist Between Food Insecurity and Eating Disorder Symptoms Among Young People Living in England?
Authors: Sampson Katie , Memory Katherine , Fazel Mina , Moran Paul , Bould Helen 
Published: August 2024

AimsFood insecurity, defined as lacking regular access to nutritious food due to financial hardship, is associated with a range of adverse developmental outcomes for children and adolescents. Emerging evidence suggests food insecurity in adults may be associated with disordered eating behaviours, including binge eating and unhealthy weight control strategies. However, the nature of this relationship in adolescents remains unclear. This study aimed to investigate whether an association exists between food insecurity and eating disorder symptomatology in a large and diverse sample of adolescents living in England.MethodsCross-sectional data were collected from 34,730 young people in school years 7 to 13 (aged 11 to 18) in classrooms across England, as part of the OxWell 2023 Student Survey. Eating Disorder symptomatology was measured, on a scale of 0 to 6, with five self-report screening questions from the Eating Disorder Section of the Development and Well-Being Assessment (DAWBA) and one additional question on meal skipping due to shape/weight concerns. Food insecurity was measured, on a scale of 0 to 6, with three questions adapted from the Wales Young People's Survey on Child & Family Poverty 2019. A complete case analysis was conducted using Stata, v18. Regression analyses were performed to test for associations between food insecurity and eating disorder symptomatology, stratified by gender and adjusting for age and ethnicity.Results12,571 (36.2%) participants were excluded due to missing data in key study variables. Our final sample comprised 22,159 adolescents with a mean age of 13.8 years (50.8% female, 54.4% white ethnicity). 63.6% of participants reported experiencing at least one eating disorder symptom and 45.7% scored ≥2 on the DAWBA screening items, a more stringent cut-off for possible eating disorder. Food insecurity was found to be a significant predictor of eating disorder symptomatology in participants of all genders (female: β 0.54, 95% CI 0.48–0.60, p < 0.001, male: β 0.40, 95% CI 0.36–0.44, p < 0.001, other: β 0.52, 95% CI 0.43–0.61, p < 0.001). The association was particularly marked amongst those reporting purging behaviours (OR 1.62, 95% CI 1.55–1.69, p < 0.001).ConclusionIn keeping with previous research, our findings indicate that adolescents experiencing food insecurity exhibit increased rates of eating disorder symptomatology. Further research is needed to explore potential mechanisms behind this association, as well as to develop effective intervention strategies. Our study adds to a body of evidence identifying a high-risk and disenfranchised group of young people who may benefit from targeted support.
The Role of Cognitive Behavioural Therapy, Family Therapy and Psychopharmacological Interventions in Internet Gaming Disorder: A Systematic Review
Authors: Rajan Sathyan Soundara , Uppal Gaurav , Kansal Khushboo , Okafor Ugo , Dhandapani Asha 
Published: August 2024

AimsInternet gaming disorder (IGD) is a recognised mental health condition characterised by impulsive gaming, where gaming takes precedence over all other activities and negatively impacts the life of a person. IGD has an estimated prevalence of 2–5% of all mental health disorders. Limited research exists on the treatment effects of various therapeutic interventions for gaming disorder, highlighting the need for comprehensive investigations of evidence-based approaches and to improve intervention strategies.This systematic review aims to identify most of the intervention studies on internet gaming disorder using a control group, to determine the effect of the interventions and to examine moderators for these interventions.MethodsWe reviewed available treatment interventions for children and adolescents. A search on Pubmed central, PsycINFO, Embase, MEDLINE, Cochrane, CINAHL and Google Scholar Library was conducted. Various interventions, whether individual or group-based, incorporate Cognitive Behavioural Therapy (CBT), family therapy and pharmacological treatments for gaming disorder and these were selected for this review among all the other interventions examined. Some exclusively use CBT, while others combine it with different treatments. This includes both online and in-person CBT, encompassing behavioural including limited exposure and cognitive elements.The comprehensive search resulted in 113 studies from 2018–2023 and we ended up with 25 studies by excluding studies according to the exclusion criteria.ResultsThis systematic review identified a total of 113 studies, of which 25 studies were finally selected and were included. It examined interventions for internet gaming disorder (IGD). Cognitive Behavioural Therapy (CBT), Family Therapy, and Psychopharmacological treatments were assessed across diverse studies.Findings indicate significant improvements post-intervention, with CBT and family therapy showing promising results in reducing IGD symptoms. Pharmacotherapy combined with psychotherapy emerged as the most effective treatment option. The study underscores the need for multifaceted approaches in addressing IGD, contributing valuable insights for future treatment strategies.ConclusionThe review highlights promising outcomes for Internet Gaming Disorder interventions, with Cognitive Behavioural Therapy and Family Therapy demonstrating effectiveness. Combining pharmacotherapy with psychotherapy is most beneficial, emphasising the importance of comprehensive treatments needed for IGDs.
Irritability and Risk-Taking Behaviour on the Cambridge Gambling Task (CGT) in Adolescents With a Family History of Depression
Authors: Srinivasan Ramya , Lewis Glyn , Roiser Jon , Rice Frances 
Published: August 2024

AimsIrritability is a common symptom in children and adolescents, often resulting in referral to mental health services and is associated with depression. Depression in adolescents and adults at familial risk of, and with depression, is associated with reduced risk-taking on the Cambridge Gambling Task (CGT) particularly when the chance of winning is high. However, little is known about risk-taking in irritability. This study tests the hypothesis that increased irritability is longitudinally associated with later risk-taking behaviour on the CGT; specifically, that increasing irritability is associated with lower risk-taking when the chance of a favourable outcome is high.MethodsWe conducted a longitudinal study of the biological offspring of parents of children with depression (n = 337). Irritability, the exposure, was measured at wave one using the Child and Adolescent Psychiatric Assessment (CAPA). The primary outcome was risk-taking to obtain reward at varying probability ratios (6:4, 7:3, 8:2 and 9:1) measured by the Cambridge Gambling Task (CGT) at waves two and three. We investigated the longitudinal association between irritability at wave one and average risk-taking at each ratio across waves two and three using multi-level models. The extent to which risk-taking according to probability ratio varied with irritability was tested with interaction terms. We ran univariable models and then multivariable models.ResultsIn univariable (n = 207; Coef. 0.006, 95%CI −0.011–0.023, p = 0.470), and fully adjusted (Coef. 0.011, 95%CI −0.007–0.029, p = 0.213) models there was no evidence of a main association between irritability and risk-taking on the CGT. There was evidence of an interaction between irritability and risk-taking ratio (p = 0.019). In fully adjusted models including the interaction, a one-point increase in irritability was associated with relatively higher risk-taking at the less favourable ratios (6:4 – 0.018 (95%CI −0.002–0.037) and 7:3 – 0.015 (95%CI −0.005–0.035)) relative to the more favourable ratios (9:1 – 0.001 (95%CI −0.019–0.021) and 8:1 – 0.011 (95%CI −0.008-0.031)).ConclusionWe found no evidence of relationship between irritability and subsequent risk-taking on the CGT overall. However, there was some evidence that those with higher irritability were relatively more risk-taking when less likely to win compared with when a favourable outcome was more likely. These findings warrant further investigation of the association between prior irritability and later depression in a larger community cohort. If prior irritability and depression are both associated with risk-taking, this strengthens the case for focussing on risk-taking as a potential target for preventive intervention.
The Prevalence of Attention-Deficit Hyperactivity Disorder in Functional Neurological Disorder: An Integrative Literature Review
Authors: Staunton Catriona , Rudrappa Roopa , Rathnaiah Mohanbabu 
Published: August 2024

AimsFunctional Neurological Disorders (FNDs) affect motor or sensory functions without a detectable underlying disease. FNDs encompass a range of presentations including non-epileptic seizures, cognitive changes, weakness, and sensory symptoms. The prevalence of FND as a diagnosis is increasing rapidly. Following our clinical observations of a high prevalence of Attention-Deficit Hyperactivity Disorder (ADHD) in people referred with a previous diagnosis of FND to our tertiary Neuropsychiatry pilot service in Derbyshire, we conducted an integrative literature review with the aim to investigate the prevalence of ADHD in people diagnosed with FND.MethodsWe conducted an integrative literature review using a systematic approach. A literature search was performed on two databases, PubMed and ScienceDirect. The keywords ‘Functional Neurological Disorder’, ‘Attention-Deficit Hyperactivity Disorder’, ‘Non-Epileptic Seizures’, ‘Functional’ were used. Databases were searched for initial search on 31 November 2023 and the search was repeated on 31 January 2024. Only articles in English language were included. Studies were eligible if reporting the prevalence of ADHD in FND populations. Studies involving adults and children were included. A further search was conducted on reference lists from the selected articles.ResultsDatabase searches on PubMed and ScienceDirect had 298 and 11,837 results, respectively. Only seven studies were identified that explored the prevalence of ADHD in individuals diagnosed with a FND and were included. In the adult population an association between a FND diagnosis, and ADHD traits identified on screening, or a final ADHD diagnosis was identified. The findings also demonstrate an increased incidence of comorbid ADHD and FND with the presence of another co-existing neurodevelopmental disorder such as Autism Spectrum Disorder. Furthermore, results indicated that the prevalence of an ADHD diagnosis in children with a FND was higher compared with adults. The literature suggests that, in both adults and children with FND-related functional seizures there is an increased prevalence of comorbid ADHD.ConclusionIn conclusion, the findings from this review demonstrate a lack of evidence looking into the prevalence of Attention-Deficit Hyperactivity Disorder in complex presentations being labelled as Functional Neurological Disorder. However, the existing literature indicates there is an association between FND and ADHD. These findings highlight the importance of considering potential ADHD comorbidity in the assessment and management of FND, potentially informing targeted treatment approaches for affected individuals. Further research could explore the efficacy of ADHD medication and similar dopamine modulating molecules in treating sub-cohort of people with FND.
A Pilot Study to Assess Suicidal Risk in Women Reporting Domestic Violence to a Law Enforcement Agency in South India
Authors: Thatavarthi Lakshmi Keerthana , Chintala Hari Priya 
Published: August 2024

AimsIn a recent national study in India, 35% of women reported experiencing domestic violence. The association between domestic violence and mental health outcomes especially suicidal risk has been less studied in Asia especially in India. With this context in mind, we aimed to establish a preliminary prevalence of suicidal risk in women reporting domestic violence using self-injurious thoughts and behaviors as proxy measures. We also wanted to probe the feasibility of assessing suicidal risk in a community center for vulnerable women with limited access to referral care and to determine the acceptability of safety plans as well as referral to a hospital setting for women with increased suicidal risk.MethodsA single center cross-sectional pilot study was conducted among 50 females who have officially reported Domestic Violence. The participants had reported this domestic violence to a ‘SHE Teams’ center in Telangana state, India, which is a women safety surveillance initiative launched by the state government. HARK (Humiliation, Afraid, Rape, Kick) questionnaire to assess the type of domestic violence experienced and SITBI (Self Injurious Thoughts and Behaviors Interview) questionnaire to evaluate the type of self-harm in victims were used.ResultsIt was found that 100% of the study population experienced emotional abuse, 50% sexual abuse, 74% physical abuse and 80% of them were afraid of their partners. It was also found that 64% had suicidal ideation, 40% had made a suicidal plan, 22% made suicidal gestures, 34% have attempted to commit suicide at least once. 12% had thoughts of Non-Suicidal Self Injury and 10% have committed Non-Suicidal Self Injury. Women who were unemployed and those who were harassed for dowry/endowment by the spouse or spouse's family had a statistically significant association with elevated suicidal risk. 17 participants were referred to a psychiatrist in the nearby hospital and 32 requested for shelter in fear of future violence.ConclusionDomestic violence is a risk factor for poor mental health among women and suicide is one of the main causes of premature death in this population. To prevent more suicides in women, identifying risk and referral of domestic violence victims should be an essential part of health care systems apart from adequate legal support. This pilot study provides preliminary data for a future study of risk factors mediating suicidal risk in women who are victims of domestic violence and to develop targeted interventions as well.
Increases in Daily Defined Doses of Incident Benzodiazepine Prescriptions in the Netherlands During the Second and Third COVID-19 Lockdowns
Authors: Visser Damian , Everaerd Daphne , Tendolkar Indira , Zinkstok Janneke , Schellekens Arnt 
Published: August 2024

AimsThe aim of this study is to investigate incident and total benzodiazepine prescribing in the Netherlands during the COVID-19 pandemic, including the impact of lockdown periods.MethodsA national Dutch pharmacological registry was used, investigating extramural psychiatric drug prescriptions, between March 2020 and March 2022. Data included incident and total prescriptions as well as daily defined doses (DDDs) of benzodiazepines. The data covered 96% out of a total Dutch population of 17.5 million people. This was compared with the previous calendar year as a reference expressed as a monthly risk ratio (RR) and was corrected for population growth. Changes over time will be discussed if the RR was above 1.1 or below 0.9.ResultsA total of 13.4 million prescriptions over a period of three years were included of which 5.8% were incident prescriptions. Three lockdown periods were identified during pandemic.When analysing the total benzodiazepine prescription group, prescriptions and DDDs remained mostly stable throughout the pandemic. A brief relative increase in prescription DDD amounts was found during the second lockdown (RR: 1.11). When viewing the incident benzodiazepine prescriptions, there was a short period between the first and second lockdown when both prescription numbers and DDDs decreased (RR: 0.86 and RR: 0.83 respectively). The DDDs of incident prescriptions increased sharply during the second and third lockdown period and remained elevated between both, with an average RR of 1.13.ConclusionTotal monthly benzodiazepine prescriptions and DDDs remained mostly stable during the COVID-19 pandemic in the Netherlands. COVID-19 related lockdowns seem to have mainly influenced incident benzodiazepine DDDs dispensed during the second and third lockdown. Increased incident DDDs, but not prescription numbers, imply that new patients on average received larger benzodiazepine prescriptions. The increase in incident prescription DDDs could be indicative of decreased accessibility to (psychiatric) healthcare. It could also have been driven by an increase of the incidence and/or severity of sleep and anxiety symptoms during the second and third lockdown. A better understanding of exact causes and mechanisms behind these changes is relevant in order to limit the psychiatric repercussions of future (inter)national emergencies.