bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Antipsychotic Drug Therapy for Treating Psychosis in People With Epilepsy – a Systematic Review
Authors: Arora Aryan , Prakash Priya , Rizzo Laura , Rogers Jonathan 
Published: August 2024

AimsIndividuals with epilepsy are at risk of developing pre-ictal, ictal, postictal or interictal psychoses. Antipsychotic drugs (APDs) are the main class of drugs used to treat psychosis and schizophrenia. The efficacy and safety of APDs as a treatment for epileptic psychosis is not well understood. Hence, we aimed to conduct a systematic review assessing the effectiveness and adverse effects of antipsychotic drugs to treat psychosis in people with epilepsy.MethodsWe adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, Embase, PsycInfo and AMED from database inception to 20/06/2023. We contacted experts in the field and performed citation searches to identify additional records. Title, abstract, full-text review, and data analysis were conducted in duplicate, with conflicts resolved by discussion among authors. Given the heterogeneity of study designs, meta-analysis was not deemed appropriate; instead, the results were tabulated in a narrative synthesis. The Joanna Briggs Institute Risk of Bias tool was used to assess study quality.ResultsWe identified 13 studies, with a total of 1,180 participants. In the 9 case series included, the psychotic symptoms of all but 3 out of 28 patients treated with APDs partially improved or fully resolved. 3 of the cohort studies reported an association between antipsychotic use and longer duration of psychotic episodes, 2 found similar results in both APD and non-APD groups, and 2 did not report control psychosis outcomes. When reported, seizure frequency was observed to remain unchanged or decrease following APD treatment.ConclusionAvailable evidence does not suggest that antipsychotics increase seizure risk in individuals with epilepsy. However, further data from randomised controlled trials and well-controlled cohort studies are urgently needed to draw more definitive conclusions.
Development and Preliminary Testing of App-Based Culturally-Adapted Psychoeducation for Bipolar Disorder in Pakistan
Authors: Asif Muqaddas , Khoso Ameer B. , Chaudhry Nasim , Chaudhry Imran B. , Husain Muhammad Ishrat 
Published: August 2024

AimsBipolar disorder (BD) leads to marked disability, morbidity, and premature death. Although pharmacological agents are an essential part of BD treatment, psychosocial interventions have played an important role in enhancing treatment adherence, functioning and quality of life in patients with BD. Building on a successful pilot randomised controlled trial (RCT) of a Culturally adapted PsychoEducation (CaPE) intervention for BD, CaPE is currently being evaluated in a large multicenter RCT for its clinical and cost-effectiveness across Pakistan. However, innovations are urgently needed due to limited human resources and disproportionately high clinical needs to bring effective interventions to scale. This study aims to develop and test a mHealth iteration of CaPE, digital CaPE (dCaPE), to be delivered via a mobile app.MethodsThe study will utilise a two-phased approach to i) develop a user-centred dCaPE mobile application and ii) assess the feasibility and preliminary efficacy of dCaPE for people with BD in a randomised controlled trial in Pakistan. For application development, we have conducted discussion groups with stakeholders i.e., mental health professionals (psychiatrists, psychologists, nurses) (n = 8) and patients and carers (n = 10) to gauge their valuable insights for app design, visual elements, cultural sensitivity, motivational and mood-monitoring features, and app functionality to improve user experience.ResultsThe findings from discussion groups informed the importance of visual elements, specifically font size and style. Participants recommended the use of soft and soothing colours like white, grey, and soft shades of pink to prevent overstimulation. Additionally, participants highlighted the need for culturally and linguistically inclusive features, including emojis and audio messages for effective engagement and to address the challenge of low literacy. The mHealth approach was deemed highly valuable, especially given the prevalence of mental health challenges and associated stigma. Endorsed by participants, the dCaPE application will offer customized psychoeducation messages along with daily 5-item (mood, energy, sleep, medication, and irritability) screening, a weekly comprehensive test for manic and depressive episodes based on DSM–5 criteria; weekly reminders to regulate sleep and eating habits, and visual representations of weekly mood monitoring reports with the incentive of badges or rewards for goal achievers.ConclusionThis research has the potential to enhance clinical outcomes, social and occupational functioning, and the overall quality of life for BD patients while addressing substantial mental health treatment gaps with impact and implications extending to various low-resource settings.
Assessing the Efficacy of a Brief Universal Family Skills Program on Child Behaviour and Family Functioning in Families in Gilgit Baltistan, Pakistan
Authors: Asif Muqaddas , El-Khani Aala , Husain Nusrat , Chaudhry Nasim , Chaudhry Imran B. 
Published: August 2024

AimsThe burden of mental health difficulties is a global problem and preventing them from childhood is paramount. Children living in challenged and underserved settings can suffer various harmful lifelong consequences including alcohol and substance abuse, low self-esteem, health issues, poor school performance, self-harm and suicide. This study aims to assess the feasibility, acceptability and efficacy of the culturally adapted Strong Families program in improving child behaviour and family functioning in families living in a challenged setting i.e. Gilgit-Baltistan (GB), Pakistan.MethodsThis is a two-arm, multisite feasibility randomised controlled trial with 90 families (n = 45 in intervention, and n = 45 in waitlist group) including a female primary caregiver (mostly mother) and at least one of their children between the age of 8–15 years in three districts of GB. There will be three raters’ blind assessments: at baseline, week 2, and 6 weeks after Strong Families Program sessions.ResultsStrong Families Program is a brief evidence-based prevention programme designed to improve parenting skills, child well-being and family mental health. The primary outcome measures include the feasibility of Strong Families, as determined by families' recruitment, attendance rates, and program completeness (mean number of sessions attended, attrition rates). Additionally, purposefully selected participants, including up to 5 caregivers from each study site, researchers, and facilitators delivering the intervention, will be interviewed. Descriptive statistics will be used to analyse primary and secondary outcomes. The process evaluation will be conducted in terms of program context, reach, fidelity, dose delivered and received, implementation, and recruitment.ConclusionThe findings from this feasibility trial hold the potential to carry out the large multicentre trial of clinical and cost-effectiveness and scale-up across Pakistan and other similar settings to meaningfully impact child behaviour and family dynamics in culturally diverse contexts.
Knowledge of Psychogenic Polydipsia Within Mental Health Services
Authors: De Leon Ewelina , Dunford Louise , Yorston Graeme 
Published: August 2024

AimsPsychogenic polydipsia (PP) is a term used to describe a repetitive behaviour that characterises compulsivity in psychiatric patients resulting in excessive fluid consumption. It is a common clinical problem in patients with severe mental illness, learning disability, autism and acquired brain injury. Up to 20% of patients with schizophrenia have polydipsia, and many develop hyponatraemia and water intoxication, which can lead to irreversible brain damage or death.Psychogenic polydipsia may not be obvious to staff in a busy care setting, leading to delayed identification and appropriate care.The objective of this study is to assess the existing knowledge of psychogenic polydipsia among mental health staff and promote greater awareness of the condition.MethodsTo investigate the understanding of psychogenic polydipsia among healthcare staff, an online survey has been chosen as the research method. This survey will help identify any knowledge deficiencies in this area. It consists of both closed and open-ended questions, allowing for quantitative and qualitative analysis. The open-ended questions are designed to provide an opportunity for participants to share their individual experiences. Additionally, the survey will collect information on participants' age groups, years of experience in mental health services, and level of expertise. The survey was created using Qualtrics online survey software. Participant recruitment will be conducted at St Matthews Healthcare, with an estimated sample size of n = 101. The collected data will be analysed using statistical software such as SPSS, NVivo, or other appropriate tools.ResultsThe results of this study will be presented. Data are being collected and analysis will be completed in March. The abstract will be updated. These findings will serve as the basis for future recommendations and suggestions.ConclusionComprehending patients' illnesses is a crucial aspect of providing quality healthcare. However, identifying psychogenic polydipsia has proven to be challenging within mental health settings. Failure to recognize excessive fluid intake can result in ineffective treatment, exacerbation of psychiatric symptoms, and in severe cases, coma or even death. The findings of this study have the potential to contribute to the creation of a training program for healthcare providers. Such a program would enable the development of improved care plans for patients who engage in excessive fluid consumption and are at risk of developing hyponatremia and water intoxication.
Linguistic Creativity and Formal Thought Disorder in Schizophrenia
Authors: Robinson Louise , Archer Dawn , Bartha Alex , Chatzidamianos Gerasimos , Delgaram-Nejad Oliver 
Published: August 2024

AimsThe present investigation was interested in whether formal thought disorder (FTD) in schizophrenia was in any way related to linguistic creativity. The project's main aims and research questions were the development of operational definitions of linguistic creativity and FTD in schizophrenia, an investigation of creative language processing in schizophrenia, and an investigation of creative language output in schizophrenia.MethodsWe designed a psycholinguistic experiment and collected natural language data to build a specialised schizophrenia corpus. Recruitment for the psycholinguist experiment was challenged by the COVID pandemic and the technical abilities of clinical participants. Those data are thus underpowered and not reported in the results. We collected sufficient data for the construction of the specialised corpus.ResultsWe tested an operational definition of FTD in schizophrenia (the '4TD Framework') against our natural language dataset. There was good support for the framework, with grammatical and discourse tracking features reliably distinguishing clinical and comparison speakers (p < 0.05). We also examined concordance lines and grouped random concordances into error types. Error types were consistently similar across groups, suggesting that speech disturbances in schizophrenia are on a continuum with those of nonclinical speakers. We also conducted a keyness analysis to examine the key terms and semantic categories present in the corpus and noted significant differences in the clinical cohort. Clinical participants found discussion of the topic of linguistic creativity more challenging, deviating from topic more often. They also involved topics of emotional and personal concern at rates of up to 16 to 32 times more often than comparison participants in some cases.ConclusionOur results provide support for the dysexecutive and dyssemantic hypotheses of FTD, as well as work on the Thought Language Index (TLI) that also suggests that language disturbances in schizophrenia and FTD are on a continuum with nonclinical speech. Further research is needed to understand how these phenomena are positioned in relation to FTD as a transdiagnostic entity.
What Are the Precipitating Factors of Suicide in South Korea? A Systematic Review
Authors: Gasimzade Fatima , Edney Sian Marie , Kirov George 
Published: August 2024

AimsToday the problem of suicide remains one of the topical issues among Asian countries like South Korea. The primary objective of this Systematic Review (SR) was the identification of the risk factors in suicide attempts and completions in South Korea. South Korea has one of the highest reported suicide rates in the world, and there was no prior systematic review on this topic. The main intention was to provide evidence-based results for future research studies and to inform suicide prevention policies.MethodsPubMed, Science Direct, and Medline databases were searched from 1990 to October 2022. Studies focused on the problem of suicide in South Korea were selected with an emphasis on risk factors. Since the rate of suicide rises with age, studies examining 18-year-olds and above were included. Studies examining people of different sociodemographic backgrounds and people diagnosed with psychiatric/psychological disorders and those who attempted suicide, as well as those without a psychiatric/psychological problem, were also included. To assess the overall quality of the included studies, the Critical Appraisal Skills Programme (CASP) checklist was applied for the evaluation of case-control and cohort studies. The National Institutes of Health (NIH) Quality Assessment Tool was implemented for the evaluation of cross-sectional studies. The Jadad Scale was used to assess the risk of bias. PRISMA reporting guidelines were followed.ResultsTen studies met the eligibility criteria to be included in SR: Four cross-sectional, two cross-cultural, and four cohort studies. Risk of bias assessment demonstrated low quality and moderate risk of bias. The quality assessment showed an acceptable level of relevance and quality. Findings suggested factors leading to suicide in South Korea were mental health conditions, financial status, such as unemployment and low income, education level less than high school, and households with poor living conditions. The identified risk factors significantly increased the likelihood of suicide ideation, suicide attempt and suicide completion among people in South Korea. Stigma was identified as a barrier to those with mental health conditions seeking professional help.ConclusionThe identified risk factors are similar across the world; however, the suicide rates are not as high in other Western cultures as they are in South Korea. Future studies could compare Western countries to hierarchical countries to identify if there are any local risk factors that can help guide local prevention policies and educational programs with city officials’ engagement. Moreover, it would be essential to investigate the impact of stigma thoroughly since it is still hard to clarify whether it is a cultural issue or a worldwide issue preventing individuals from getting professional help.
Longitudinal Trend Evaluation and Prescription Cost Analysis (PCA) of Clozapine in the United Kingdom
Authors: Gire Nadeem , Asif Atta , Husain Nusrat 
Published: August 2024

AimsSevere Mental Illnesses (SMI) are a group of disorders which can have a debilitating impact on an individual's daily life functioning. The National Institute for Health and Care Excellence (NICE) has set out clinical guidelines for the treatment of SMI including the use of Second Generation Antipsychotic (SGA) medication as well as psychological therapies. However, Treatment Resistant Schizophrenia (TRS) affects approximately 34% of patients with schizophrenia. Clozapine, a SGA, has shown superiority in treatment resistant schizophrenia as well as its potential benefits in reducing suicidality and improving functioning.MethodsThe following study aimed to examine the longitudinal trends in prescribing clozapine based on the NHS Digital prescription cost analysis (PCA) between 2015–2023.ResultsThe results show that a number of prescriptions decrease simultaneously from the financial year 2015 (n = 5536) to 2023 (n = 3059). The cost was also found to be reducing until the financial year 2018–19 where there was an increase in costs which reached the maximum (14%) despite the number of prescriptions being lower as compared with 2015–16. In addition, it was found that clozapine prescribing trends have been reducing over time, despite a large proportion of service users with schizophrenia experiencing TRS (34%). Overall, since 2015–2023 a total of n = 34,440 items of clozapine were prescribed costing £1,252,052.27.ConclusionConsidering clozapine's superior efficacy in the treatment of TRS, further research is required to better understand prescribing practices, monitoring compliance of clozapine and treatment adherence. Further qualitative research is needed to better understand the views and perspectives of both service users and prescribers in the clinical use of clozapine. Future research may also look at referrals of clozapine-prescribed patients to psychological services, the impact of clozapine in TRS patients who are offered psychological therapy, and the potential clinical and cost implications of not prescribing clozapine.
The Acceptability of Yoga as a Family Intervention: Using Family Journals as a Data Collection Tool
Authors: Graves Hayley , Merdian Hannah , Smith Sharron , Miller Kirsty 
Published: August 2024

AimsThe number of children and young people across the UK experiencing mental health difficulties is rising, with 1 in 6 young people aged 6–16 with a diagnosable mental health condition.The school environment can be a crucial setting for mental health promotion as it can reach such a large number of young people.The application of mindfulness for wellbeing is becoming increasingly popular. Research demonstrates mindfulness is an effective treatment for many psychological conditions and adding a yoga element is thought to bring additional benefits.Interventions focusing on wellbeing are found to demonstrate more consistent improvements when parents are involved, supporting the concept of a family intervention.A 6 week family intervention was developed specifically for children, to promote overall wellbeing.Aim:
1.To ascertain the acceptability of yoga as a family intervention.2.To ascertain the acceptability of family journals as method to collect data.Methods•6 weekly, 1hr, yoga and mindfulness intervention.•9 children aged 6–11, 9 adults.•A weekly family journal was used collect data.•Data from the journals were analysed using Thematic Analysis.•A Linear Numeric Scale was used pre and post intervention rating 1–5: asking the participants to rate their confidence in relation to breathing techniques, yoga, working as part of a group, and understanding mindfulness.Results1. Acceptability of yoga as a family interventionResults from the pre post tests, indicate a significant relationship between the intervention and the participants.Confidence in yoga P < 0.008 (mean pre test 1, post test 4).Confidence with breathing P < 0.008 (mean pre test 3, post test 5).Confidence with mindfulness P < 0.004 (mean pre test 1, post test 4).Working as part of a group P < 0.004 (mean pre test 3, post test 5).2. Acceptability of family journals as a method to collect dataThe journals provided sufficient qualitative responses and meaningful quantitative data to consider the intervention acceptable. The weekly logs in the family journals were thematically analysed and four key themes were identified as having a positive impact: yoga, breathing techniques, mindfulness activities, improved connection.ConclusionThis study has highlighted promising findings relating to yoga as a family intervention.Families reported applying the techniques, outside of the sessions to manage emotions. The family journals were a space where adults had the freedom to choose what they wrote, this method allowed us to identify the intervention had a positive impact upon family connections. Using the journals was a simple way to capture the voices of the participants.
Developing a Framework for Examining and Improving Decision-Making in Complex Mental Health Systems
Authors: Nathan Rajan , Harris Dave 
Published: August 2024

AimsWhether focusing on clinical or non-clinical roles, activity within organizations (and, by extension, outcomes) depends on decision-making. The conscious experience of decision-making (as if it is the outcome of an objective and explicit appraisal of pertinent information) belies the complex nexus of influences on this process. Whilst extensive research has been undertaken on both organizational and clinical decision-making, these literatures have largely remained separate. The authors contend that, when account is taken not only of the interplay between decisions that are deemed either ‘organizational’ or ‘clinical’, but also that this dichotomy itself is invalid, there is an imperative to take a whole system approach to decision-making in health organizations.The aim of this study was to develop a framework for understanding decision-making that has applicability across a complex mental health system.Methods•Step 1: Define the domain of discourse (i.e. decision-making in a complex adaptive mental health system including clinical and non-clinical settings);•Step 2: Generate a dataset of domain-relevant statements by iterative reflection on the respective areas of practice (clinical and non-clinical);•Step 3: Thematically analyse the dataset to identify a thematic structure.ResultsA hierarchical thematic structure was identified. At the highest order, this structure comprises a dichotomy between embodied and disembodied conceptualizations. The embodied theme is further divisible by perspectives that are intra- or inter-personal. The former includes ways of thinking, assumptions, approximations, uncertainty, holding the model, and epistemic humility; and the latter includes relationships, trust/resentment, and disagreeing well. The disembodied theme incorporates both broad-brush characteristics of the system (such as holistic, connections, relata and complexity) and those characteristics with explanatory power (such as nonlinear, fuzziness and nondeterministic).ConclusionThe framework defined by this analysis has the potential to facilitate the examination of facets of, and influences on, decision-making across a mental health organization. With further empirical testing and revision, such a framework can be used to inform the improvement of approaches to making decisions.