bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hatred Is a Mindset Triggered by Stressful External Events, Negative Personal or Group Interpretations and Unhealthy Social Environments
Authors: Shafiq Salman 
Published: August 2024

AimsTo carry out systematic literature search on an international medical database to find what the emerging categories in which the word hatred is used in medical literature are, and to gather information regarding the generation of the emotion of hatred in human beings by thematically analysing the relevant collected data.MethodsTo identify the information on hatred relevant for mental health professionals, we performed a systematic review using a systematic approach and criteria.ResultsSix themes regarding generation of hatred identified.Theme one: Targets of hatred.Theme two: Self-hatred.Theme three: Self-perceived hatred.Theme four: Hatred towards inanimate objects.Theme five: Reasons for hating other humans.Theme six: Internal reasons for development of hatred.ConclusionThe word ‘hatred’ is used in medical literature in a multiplicity of meanings that range from using it in its literal sense to describe a subtle attitude such as a phobia-philia relationship, or to describe a unique outcome that is generated as an interplay of several different kind of factors. These may include cognitions, behaviours, social interactions, attitudes, sentiments, developmental backgrounds, psychodynamic interactions with others in real and virtual worlds etc. Hatred is more like a mind-set that people can develop towards themselves, towards others and towards inanimate objects or situations too. Fear, anger and disgust are primary emotions (that we are born with); human psyche is naturally prone to several inevitable cognitive errors; human thought is subjected to unavoidable logical fallacies; and human ego cannot avoid utilising unhealthy ego-defence mechanisms. Every child is born in a family and culture that has its own unique background and history. We humans are prone to the generation of the hateful mindset as an unavoidable outcome in a variety of scenarios. Keeping these generational patterns in view, it would be reasonable to say that an early detection and addressing the early warning signs towards development of the hateful mind-set would be helpful for ourselves and for others. As the word is used in several different meanings, the background information, context, and overall scenario of the discussion needs to be kept in mind whilst attempting to draw any meanings about the use of hate/hatred in a verbal or written expression. In each case where the word ‘hatred’ is used, needs to be approached with epistemic curiosity and in some instances, it may need detailed epistemic inquiry to fully comprehend the meaning of this word in any given expression.
Changes in Early Childhood Irritability and Risk-Taking on the Cambridge Gambling Task (CGT) at 11 Years
Authors: Srinivasan Ramya , Lewis Gemma , Solmi Francesca , Lewis Glyn 
Published: August 2024

AimsIrritability is common and easily identified in childhood. It is transdiagnostic and a common reason for referral to mental health services. Irritability which does not decrease during early childhood is associated with adolescent depression. We hypothesised that irritability would be associated with increased risk-taking overall but reduced risk-taking in response to loss.MethodsWe used data from the Millennium Cohort Study, a population-based cohort of 18,552 children born in 2000–02. We examined whether irritability at 3, 5 and 7 years is associated with risk-taking on the CGT using multilevel mixed effect generalised linear models (MEGLMs). We also calculated the change in irritability between 3–7 years for each participant using multilevel mixed models. We then examined the association between this change measure and risk-taking on the CGT using MEGLMs. Analyses were adjusted for a broad range of confounders.ResultsWe found that children whose irritability did not decrease as would be expected from 3 to 7 years were more likely to stake a higher number of points per trial on the CGT at 11 years. This increase was most evident when the previous trial had been won. Irritability at 7 years was associated with staking a higher number of points per trial on the CGT (coefficient 0.52, 95%CI −0.04–1.08, p = 0.067) in fully adjusted model, whereas irritability at 3 and 5 years were not (3 years – coefficient 0.02, 95%CI -0.62–0.65, p = 0.961; 5 years – coefficient 0.14, 95%CI −0.45–0.73, p = 0.641). There was evidence of an interaction between irritability at seven years and whether the previous trial was won (p = 0.014). Childhood irritability which did not decrease between 3–7 years was associated with staking a higher number of points per trial on the CGT (coefficient 1.36, 95%CI 0.44–2.28, p = 0.004); there was evidence of an interaction between change in irritability and whether the previous trial was won (p = 0.056).ConclusionThis is the first longitudinal population-based study examining the relationship between changes in irritability during early childhood and risk-taking behaviour measured by the CGT. Our findings illustrate that irritability in children is characterised by an increase in risk-taking at age 11 years, reflecting differences in how children behave in relation to rewards and losses based on prior irritability. Further understanding of how the processes such as risk-taking which link childhood phenotypes such as irritability, relate to future mental health, may enable the development of new interventions focussing on reactions to rewards and losses.
A Comparative Study of Sleep Parameters in Opioid Dependent Patients on Opioid Substitution Therapy: Findings From India
Authors: Tripathi Richa , Rao Ravindra , Dhawan Anju 
Published: August 2024

AimsSleep problems are common in opioid users and in patients receiving opioid agonist treatment. The aim of the present study was to study the pattern and prevalence of subjective sleep disturbances in opioid dependent subjects maintained on opioid agonist treatment (buprenorphine and methadone).Methods: A cross-sectional observational study was conducted in a tertiary health care center in India. 106 adult opioid dependent male patients maintained on buprenorphine and 50 adult opioid dependent male patients maintained on methadone who were initiated on medication at least six months prior, on stable dose of medication for last one month and were adherent on medication for at least 50% occasions in last one month were included in the study.ResultsThe mean age of the sample for buprenorphine-maintained group and methadone maintained group was 41.1 (SD: 14.3) years and 27.7 (SD: 7.8) years respectively. Tobacco, alcohol and cannabis were used by majority of the participants in both the groups. Most participants had used heroin by smoking before starting buprenorphine (n = 68, 64.1%) and methadone (n = 46, 88.5 %). The duration of use of illicit opioids was for median duration of 10 (IQR: 5, 22) years for buprenorphine group and 5 (IQR: 3, 7) years for methadone group.In buprenorphine group, the participants had been on buprenorphine for a median duration of sixty (IQR: 17, 120) months. The mean current dose of buprenorphine was 10.2 (SD 3.8) milligram per day. The mean PSQI score was 6.6 (SD 3.4). About 63.2% (n = 67) of the participants have scores more than five (PSQI > 5) suggesting sleep problems. The mean subjective total sleep time of the sample was 403.5 (SD 94.8) minutes and median sleep latency was 35 (IQR 18.8, 62.5) minutes.Similarly, in methadone group, the participants had been on methadone for a median duration of seventeen (IQR: 10, 22) months. The median current dose of methadone was 20 (IQR: 14, 36) milligrams per day. The mean PSQI score was 5.2 (SD 2.8). About 44.2% (n = 23) of the participants have scores more than five (PSQI > 5) suggesting sleep problems. The mean subjective total sleep time of the sample was 466.5 (SD 114) minutes and median sleep latency was 30 (IQR 15, 97.5) minutes. Subjective sleep problems were associated with past three months opioid use.ConclusionThe methadone group had relatively younger population with early onset of substance use. They were on relatively lesser dose of methadone. This group also had lesser sleep problems than the buprenorphine group.
Predictors of Functioning in Bipolar Disorder: Focused on Functioning Assessment Short Test (FAST)
Authors: Yoon Bo-Hyun , Kang Hangoeunbi 
Published: August 2024

AimsFunctional outcome can be even more important than syndromic outcomes, as the ability to meet role expectations at work, home, or school and the quality of interpersonal relationships are often cited as the most important outcomes for people with bipolar disorder (BD) and their families. We investigated the factors correlated with functioning by using the Functioning Assessment Short Test (FAST).MethodsA total of 197 bipolar disorder out-patients were involved in this study, 166 (84.3%) were bipolar I disorder (BD-I) patients and 31 (15.7%) were bipolar II (BD-II) patients. We used the FAST for functioning of the patients and the severity of depressive and manic/hypomanic symptoms were measured by bipolar depression rating scale (BDRS) and Young Mania Rating Scale (YMRS). We also examined the disturbances in biological rhythm by the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN).ResultsThere were significant positive correlations between FAST and numbers of depressive episode, YMRS, BDRS and BRIAN and showed negative correlation between FAST and age at onset of mood disorder. FAST was associated with YMRS (β=0.3768, p < 0.001), BDRS (β=0.293, p < 0.001), BRIAN (β=0.167, p = 0.011), with 47.1% of the variance explained (R2=0.471, Durbin-Watson test = 1.51, p < 0.001) in multiple linear regression. In other words, residual mood symptoms and biological rhythm imbalance have a negative impact on the functioning of BD patients.ConclusionAlthough the other factors must be present to predict the functioning of bipolar disorder patients, manic symptoms, depressive symptoms and biological rhythm imbalance have negative impacts on functioning of BD patients in this study.
Understanding Psychiatrists' Knowledge of Eating Disorders
Authors: De Silva Daniel , Jurewicz Isabella 
Published: August 2024

AimsWales is the only member of the home nations without Specialist Eating Disorders Training (SEDT) and does not currently have any Specialist Eating Disorder Units (SEDU). This has resulted in varied exposure and experience to eating disorder (ED) psychiatry within psychiatrists working in Wales. Patients with ED have the highest mortality out of all conditions in psychiatry and with hospital admissions for ED on the rise it is important that we understand current attitudes towards ED and use this data to improve understanding and services provided for these patients.The aims of this project are to
1.Gauge the experience and knowledge of eating disorders of psychiatrists in Wales.2.Examine attitudes towards management of different risks and which individuals should manage what aspects of care regarding eating disorders.3.Identify future avenues of development for eating disorders services in Wales.MethodsAn online survey was sent to the 518 members in the Royal College of Psychiatrists in Wales mailing list identifying their current position within psychiatry, experience in working with ED patients and then different questions regarding their attitudes towards ED, ED management, their opinions on development of SEDT posts and their opinions on the development of SEDU in Wales.There were 36 anonymous responses from doctors working in or around psychiatry in Wales. Responses were collected between March and April 2022 with the survey taking on average less than 5 minutes to complete.Results36 individuals answered the survey with consultant/SAS (Senior) level doctors making up 69% of responses, the remaining 31% being psychiatry or GP trainees. Senior doctors mostly comprised general adult or CAHMS specialists, but other specialities were also present. 75% of responses reported some expertise in ED. 50% reported they were confident in the management of ED however there were varying responses when asked about the management of physical health in ED. 89% of responses indicated they would like to see the development of ED psychiatry posts and 78% of responses would like to see the development of SEDU in Wales for severely ill patients.ConclusionMany of the responses indicated some exposure to ED however 50% of responders did not feel confident in the management of ED. The development of ED psychiatry posts and SEDU would likely aid in increasing confidence of ED management.
SPEED (Supporting Psychiatry Experience and Education in District-Hospitals), a Pilot Program for Foundation Doctors
Authors: Fraser Sam , Clark Sophie 
Published: August 2024

AimsThis pilot program aimed to enhance the psychiatry experience for foundation doctors (FYs) working at Ayr Hospital by identifying perceived areas where psychiatric support would benefit training, development or education. Subsequently strategies were aimed to be implemented by the psychiatry liaison service to enrich FYs' experience during their medical and surgical rotations. Feedback was aimed to be obtained to determine if the program would have value to other district hospitals and grades of junior doctors.MethodsUnstructured interviews with 4 FYs were conducted in October 2023 to explore the current experience of psychiatry in medical or surgical placements at Ayr Hospital. Identified themes included barriers to completing supervised learning events (SLEs) for mental health cases (a requirement of the 2021 Foundation Curriculum), limited exposure to psychiatry teaching opportunities, and obstacles to pursuing development of interest in psychiatry (such as time to shadow psychiatry, or discuss career prospects in psychiatry).A pilot program was initiated in November 2023 to improve the experience and education of psychiatry for FYs. This involved:
•Providing dedicated time on wards for FYs to complete SLEs with a member of the liaison service.•Providing time for FYs to shadow the role of liaison psychiatry.•Providing additional teaching tutorials, focused on topics chosen by FYs.•Providing the opportunity to discuss and develop interest in psychiatry.A survey to obtain both quantitative and qualitative feedback was sent to each FY that engaged in the program.Results17 FYs engaged in the pilot program, with 13 providing feedback. All respondents felt the program increased their knowledge and confidence in approaching cases with a psychiatry element. They also all found the experience positive and a productive use of time. All deemed the program would be useful for other foundation trainees in medical hospitals. Free text feedback highlighted the program's value in facilitating case discussions, removing obstacles in completing mental health SLEs, providing useful relevant tutorials and providing opportunity to discuss further interest of psychiatry.ConclusionThe pilot program successfully achieved its aim to improve FYs' experience of psychiatry. Although not measured in the survey, the program also appeared to foster positive relationships between the liaison service and junior medical staff. It also helped identify new appropriate referrals for the liaison service. An expansion of the program is planned to other district hospitals in Ayrshire and Arran, including consideration of expanding the participation to wider members of the junior doctor cohort.
A Practical Guide to Developing a Research Communication Strategy for Low Income and Middle-Income Countries
Authors: Shah Bushra Ali , Gire Nadeem , Kashif Syed , Farooqui Salman , Fofana Mohamad Khalifa 
Published: August 2024

AimsDespite increasing research activities in low- and middle-income countries (LMICs), the impact of research is challenging to measure and assess, given the myriad of systemic challenges that exist in these settings. Socio-political constraints, limited education prospects, cultural stigma, restricted access to training and development, and the poor research infrastructure in low-resource settings contribute to the widening gap between evidence and policy, and in turn, creates serious barriers to mental health care in these countries. One of the main barriers to the effective implementation of research in LMIC settings is poor governance and dissemination. Given the lack of standard guidelines, there is an unmet need to develop a communication framework that will strengthen the implementation of evidence-based findings in policy and practice. As a first step towards this goal, our aim was to develop a research communication strategy to enhance research outcomes in LMICs.MethodsWe conducted a narrative synthesis to understand the key factors which may be used to measure both the reach and depth of research impact and communication within LMIC settings.ResultsOur analysis outlined metrics and indicators of research impact including academic outputs, social media insights, capacity building, Patient, Public Involvement & Engagement, policy development, collaboration and partnership, and health and economic benefits. Based on our findings, we formulated steps to support the development of a research communication strategy which has the potential to guide an effective research impact framework and ultimately help bridge the evidence-treatment gap in LMICs. 1) Identify stakeholder groups, 2) Employ Theory of Change approaches and community engagement, 3) Explore channels of communication, 4) Developing a ‘Plain English’ summary, 5) Incorporating cultural and contextual factors, 6) Leverage digital technology and social media.ConclusionParticipatory approaches to research communications are of paramount importance in informing and implementing evidence-based findings in low-resource settings. Research communication is a prerequisite to the development of an effective impact assessment framework that supports the prioritisation of key areas of public mental health in low-resource settings. Developing a comprehensive communication strategy which leverages culturally appropriate communication strategies targeted at diverse stakeholder groups, may amplify research impact, under a holistic framework which prioritises the delivery of evidence-based mental health care in LMICs.
Narrative Review of Learning Methods for Junior Doctors Around Presenting Evidence at Mental Health Review Tribunals
Authors: Keat Lee Kenn Cheng 
Published: August 2024

AimsIntroduction: During involuntary hospital commitment, patients are detained and receive treatment involuntarily without prior judicial authorisation. Instead, detentions are scrutinised after-the-fact through mental health review tribunals (MHRTs), where psychiatrists must satisfy the panel that hospital detention is the least restrictive option. Such settings are different from what doctors are typically trained to do – namely provide care to willing patients. Yet, presenting evidence at MHRTs is part of regular psychiatric practice. Thus, doctors training in psychiatry would need to learn this skill.Objective: Review the available literature on learning methods that are effective at developing junior doctors’ capability to present evidence at MHRTs.MethodsMethodology: Seven electronic databases (Medline, Embase, PsycINFO, Web of Science, Education Source, ERIC, Westlaw UK) were searched for studies evaluating the teaching/training of junior doctors to deliver evidence at MHRTs and related settings (inquests, criminal courts), published within the last 25 years. Due to the heterogeneity in methodology, the studies were reviewed narratively.Results2,206 articles were found, of which six met criteria (four quasi-experimental studies, two qualitative studies). All quasi-experimental studies were from the UK whilst both qualitative studies were of non-UK origin. Sample sizes were uniformly small (3–16 participants) or unclear/undocumented (2 studies). One study revolved around interprofessional learning in criminal court setting. The remainder were about MHRTs, using a mix of modalities (simulation = 2, workshop = 1, lecture with demonstration = 1, instructional document = 1). Simulation, lecture with demonstration, and workshop were effective at developing skills in oral presentation and being cross-examined. All methods were effective at developing report writing skills. However, articles mainly assessed efficacy through pre/post self-assessment of confidence without control/comparator.Discussion: MHRT guidelines indicate hands-on learning as mainstay of how doctors develop their capabilities in MHRT. However, this is not reflected in or supported by the published evidence. Likewise, evidenced methods (e.g. simulation, workshops) are resource-intensive and may be difficult to replicate at scale. Additionally, identified articles lacked clear articulation of the pedagogy or theory underpinning the learning, though they appeared constructivist in nature.ConclusionThe literature around training junior doctors to deliver evidence at MHRT is underdeveloped. Current standard methods are not supported by evidence whilst evidence-backed methods may be difficult to implement cohort-wide. What evidence that exists is weak and based on subjective self-assessment. Further research on the topic is needed, both around standard training/learning methods and more objective methods of assessing efficacy.
Evaluation of the Extended Induction Programme for International Medical Graduate Core Psychiatry Trainees in CNWL
Authors: Moghrabi Sara , Roy Saikat , Matras Bartlomiej 
Published: August 2024

AimsInternational Medical Graduate (IMG) doctors make up a significant proportion of the British medical workforce. In 2022, 26% of doctors in training graduated outside the UK. Psychiatry was one of the most frequently chosen specialties by IMGs. Doctors joining the NHS face several challenges such as differential attainment and discrimination. Increasing recognition of such issues led to the recent publication of a national guidance for IMG induction. In 2021, CNWL appointed an IMG lead to design and implement a comprehensive induction and ongoing support programme for all IMG doctors joining the trust. The first induction for new IMG core trainees consisted of six sessions and included a mixture of communication skills workshops and tutorials. It started in February 2021 and was delivered over four weeks. Since then, the programme has run twice a year with each intake of new core trainee doctors.MethodsNineteen CNWL IMG core trainees who participated in the induction programme between 2021 and 2023 were invited to complete an online survey. The data was collected between December 2023 and January 2024. It consisted of Likert scale ratings of the content of the programme, its relevance, and its impact on trainees’ confidence. The usefulness of each session was also measured. Trainees were encouraged to provide free-text comments with suggestions for improvements.ResultsSixteen out of nineteen trainees submitted responses. There was a consensus amongst all trainees that the induction covered essential topics. Fifteen out of sixteen participants felt more confident in their role after the sessions. The first communication skills workshop covering history taking and mental state examination was considered to be the most useful with twelve participants rating it as excellent. The workshop on managing conflict with simulation scenarios was ranked second most helpful. Tutorials on NHS structure and a training portfolio did not receive as high ratings. Areas for improvement highlighted in free-text answers were: adding more face-to-face sessions and discussions about on-call scenarios.ConclusionTransition into NHS can be a challenging experience for doctors at all stages of their careers. However, early intervention and a comprehensive induction programme appear to have had a positive impact on new trainee doctors’ confidence and preparedness for work. The programme's structure and the sessions content were modified in response to feedback. Additionally, individual support sessions and a writing group were organised for trainees and SAS doctors.