bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescent Psychopathology and Cognitive/Academic Functioning: Impact of Comorbidity Using a Genetically Sensitive Design
Authors: Oginni Olakunle , Rijsdijk Fruhling , Tarnoki Adam , Tarnoki David , Rimfeld Kaili 
Published: August 2024

AimsTo determine: i. the nature of the associations between three domains of psychopathology (depressive, hyperactivity and conduct symptoms) and cognitive/academic performance among adolescents i.e., whether these reflect causal processes and/or common genetic effects; ii. The extent to which these associations vary by comorbidity.MethodsThe sample comprised participants in the UK Twins Early Development Study (TEDS; n≈12,000 individuals) assessed for depressive, hyperactivity and conduct symptoms using standardised questionnaires. Cognitive and academic performance were assessed using Standard Progressive Matrices and GCSE scores respectively. Comorbidity was derived as a count of borderline/high psychopathology scores present per individual. Twin modelling was used to investigate preliminary correlations and moderation effects. Genetic models were further used to determine the most likely direction of causal effects with/without genetic correlations.ResultsThere were small to moderate negative correlations between adolescent psychopathology domains and cognitive performance (−0.01 ≤ r≤−0.15) and academic performance (−0.06 ≤ r≤−0.23). Correlations were smallest for depressive symptoms and larger for hyperactivity/conduct symptoms. The correlation between hyperactivity symptoms and cognitive performance was significantly more negative as comorbidities increased (moderation coefficient – βmod = 0.07, 95% CI: 0.02, 0.12). Similarly, the association between depressive symptoms and academic performance also became more negative as comorbidities increased (βmod = −0.08, 95% CI: −0.11, −0.05). Twin modelling indicated that hyperactivity symptoms were causally associated with poorer cognitive and academic performance. In contrast, poorer cognitive performance was causally associated with conduct symptoms.ConclusionThese preliminary findings indicate the impact of comorbidity on the functioning of adolescents with hyperactivity and depressive symptoms. They further suggest the need to specifically recognise these comorbidities during assessment and treatment planning to promote optimal functioning. Our findings also suggest differential mechanisms for the links between different psychopathology domains and impaired functioning. Further analyses will investigate moderation of the causal links and/or genetic correlations and whether these associations vary by indicators of marginalisation (sex and ethnicity).
Neurodevelopmental Disorders and Their Association With Neurodegenerative Disorders: A Systematic Narrative Review
Authors: Restorick Rebecca , Dunstall Huw , Umla-Runge Katja 
Published: August 2024

AimsNeurodevelopmental disorders (NDDs), such as dyslexia, dyspraxia, and dyscalculia affect cognitive function and therefore share symptomology with neurodegenerative disorders, such as Alzheimer's disease, vascular dementia, and frontotemporal lobe dementia. The primary aim of this narrative systematic review is to ascertain if there is an association between NDDs and neurodegenerative disorders. Secondary aims are what the prevalence of NDDs within a dementia population is and what effect these early life learning disorders have on patients as they get older. It was hypothesised that NDDs would overestimate the severity of cognitive impairment, thereby increasing the severity of dementia staging, and impacting patient care.MethodsUsing a Population, Exposure, Comparator, Outcome, Setting, and Study design (PECOS) framework, keywords of “dementia”, “dyslexia”, “Dyspraxia/clumsy child syndrome/developmental apraxia/motor learning difficulty/disorder of attention and motor perception” and “dyscalculia/mathematical learning disability” were searched for on 4 databases (SCOPUS, OVID, Cochrane Central Register of Controlled Trials and Web of Science) from January 1, 1960 – June 10, 2022. Studies were included if they discussed both neurodegenerative and neurodevelopmental disorders or compared an intervention typically used in one disorder on the other (e.g., dementia intervention being used on neurodevelopmental disorder). Studies were excluded from grey literature articles, or if they only discussed a neurodevelopmental or neurodegenerative disorder without reference to the other, or if it included acquired, rather than neurodevelopmental dyslexia, dyscalculia, or dyspraxia.ResultsA total of 8 studies were included for narrative synthesis. The main finding was an association between dyslexia and both Alzheimer's disease and frontotemporal dementia. Many studies suggested this was due to a genetic phenotype that caused a vulnerability in the language regions of patients’ cortices. There was also evidence of structural changes associated with NDDs and increased levels of grey and white matter atrophy in dementia subtypes, particularly in the language areas of the brain.ConclusionDue to screening and consequently formal diagnosis of neurodevelopmental disorders only recently coming into education systems, many adults currently attending memory clinics did not have a formal diagnosis. As there was limited research on dyspraxia and dementia, partly due to limited research into dyspraxia itself and without a standardized diagnostic tool for adolescents and adults, further research is needed in this area. The hypothesis of NDDs increasing the severity of dementia staging was also not supported by the literature results, and on the contrary, some studies suggested greater global preservation of cognitive function in patients with NDDs and dementia.
Decrypting the Thalamic Subnuclei and Functional Composites in Adolescents With Psychotic Experiences
Authors: Riaz Sahar , O'Connor Michael , Nasa Anurag , Cannon Mary , Roddy Darren 
Published: August 2024

AimsThe thalamus, a dual grey matter formation within the diencephalon is thought to be involved in psychosis. It consists of distinct nuclei with specific functions. To date no study has investigated the volumes of the thalamic nuclei in young adolescents with Psychotic Experiences (PEs).MethodsThis study used T1 imaging with Freesurfer analysis to investigate the differences in thalamic nuclei in 98 young people (53 with PEs) over three time points, from ages 11 to 18. A linear mixed effects (LME) model was used to examine the longitudinal nature of the data.ResultsThe findings were entirely left sided – specifically a smaller left whole thalamus (p = 0.04), significant reduction in the size of the left pulvinar (p = 0.008) and a slight increase in the size of left ventral nucleus (p = 0.005).ConclusionThis study found significant volumetric differences in thalamic functional composite nuclei between adolescents with a history of PE compared with healthy controls. Two such nuclear groups survived post-hoc DTR testing, the left ventral and left pulvinar nuclei. The pulvinar nucleus demonstrated a reduced volume over time in PE groups compared with healthy controls whilst the left ventral nucleus demonstrated an increased volume over time in PE groups compared with controls. The thalamus has been shown to be actively involved in the modulation of cortico-cortical communication via cortico-thalamo-cortical pathways, thus synchronizing the activity of the cortex during tasks that require attention. One of the core deficits believed to be a part of psychotic illnesses is the inappropriate modulation of attention through various cortical networks. This disrupted modulation results in a lack of control of goal-directed behaviour and can be attributed to the changes seen in pulvinar in psychotic illnesses, thus resulting in impairment in the integrity of sensory information and context processing. The affiliation of the ventral thalamic nucleus to the dopaminergic system, particularly the substantia nigra, may aid in explaining why this nucleus demonstrates larger volumes in adolescents with PEs compared with healthy controls over time.More research needs to be done on following this cohort up, specifically investigating changes in thalamic nuclei in those who develop a diagnosable psychotic disorder.
The Body Multiple: Conceptualizing the Body to Explain Functional Somatic Symptoms
Authors: Saunders Chloe , Burton Chris , Pedersen Heidi Frølund , Rask Charlotte , Frostholm Lisbeth 
Published: August 2024

AimsFunctional somatic symptoms (FSS) is an umbrella term for symptoms inadequately explained by structural disease or damage. FSS show complex causality, and fall between the gaps in mainstream medical epistemology and/or mind-body dualism. Lack of explanations for FSS exacerbates uncertainty, anxiety and stigma for patients, and contributes to fragmented care and inappropriate management. We aimed to develop an open access health-educational resource that provides an acceptable, relevant, and usable explanatory model of FSS to internet users.MethodsWe carried out a participatory design study to develop the website bodysymptoms.org. Explanatory concepts were developed through iterative stages of dialogue between individuals with lived experience of multi-system FSS (n = 7), researchers, healthcare professionals and designers/developers. Initial explanatory components were collected from currently existing patient education about FSS, a review of the literature, and participants’ illness narratives. Principles were developed to filter, and organize these explanatory components into a coherent model. The model was translated into 5 European languages and through iterative rounds of feedback incorporated a diverse range of perspectives.ResultsWe describe the explanatory model that developed through the bodysymptoms project, and considerations that arose through the dialogic process. The model is based on the body as a complex adaptive system with causal interactions operating across bio-psycho-socio-ecological levels. Mechanistic processes that can maintain persistent symptoms were chosen as the main nodes (or topics) of the model, and minor topics were structured to demonstrate interactions between mechanisms. Considerations that arose during the process included coherence across philosophic, scientific and clinical levels of explanation; a therapeutic model of agency, within which explanations empowered without blame; the need to introduce notions of biological time, like body rhythms and body memory; and the role of multi-media, embodied metaphors and lived experience narratives in communication of the explanatory model. Personalisation of the model was achieved through embedding the structure of the model into the graphical and navigational structure of the website, which allows website visitors to explore the model in a non-linear manner, tailored by relevance, acceptability, and prefered level of information.ConclusionWe present results from a research in action study to develop a novel resource for understanding functional somatic symptoms. bodysymptoms.org is based on the model of the body as a complex system that adapts in personal ways. To explain FSS there is a need for new ways to understand the body and how we become unwell. Bringing diverse perspectives into dialogue generated new forms of knowledge and allowed the power of scholarship to be harnessed for immediate shared value.
Hidden Harm: Detection of Abnormal Urinary Analysis in Alcohol and Polysubstance Abuse
Authors: Shaikh Ghazanfar 
Published: August 2024

AimsThis research study aims to identify the adverse effects of alcohol and polysubstance misuse on kidneys. The study also highlights the hidden harm caused by prescribed treatments such as PPI (Proton Pump Inhibitors) and other medications.MethodsThe study was conducted in the summer of 2022 at an outpatient addiction treatment service. 63 patients (10% of the total prescribers), 49 males and 14 females participated in the study. All participants gave their consent, and data were collected including demographic details, substance misuse history, physical and mental health history, and prescribed treatments. We used a Combur-7 urinary dipstick to analyze the results provided in the kit.ResultsSeven patients were not able to provide a sample. 60/63 patients' result showed abnormalities.21 out of the 63 samples appeared dark and hazy. 7 samples were foul-smelling. 40 of the 63 patients were detected with a variable amount of leukocytes. 1 of the 63 patients was positive for nitrogen. The pH values range from 5 to 8. Specific gravity values were variable. 3/63 samples were positive for bilirubin. 58/63 samples were positive for protein. 19/63 samples detected variable amounts of red blood cells. 5/63 samples detected for ketones and glucose were negative in all samples.ConclusionLong-term alcohol abuse can compromise the ability to manage fluid volume and electrolyte balance. Extreme serious abuse can also impact acid-base balance, homeostasis, and even hormonal control regulated by the kidneys could be affected. This situation further complicates the presence of liver disease.Cocaine abuse can cause acute kidney injury (AKI), malignant hypertension, and vasculitis and can lead to chronic kidney disease (CKD). Heroin-associated nephropathy (HAN) can lead to nephrotic syndrome and could progress to end-stage renal failure.Tobacco, solvents, amphetamines, and ecstasy can aggravate a wide range of kidney diseases by their direct or indirect effect on kidney functions.Long-term use of proton pump inhibitor and other medications such as NSAID, pregabalin, and diuretics, may affect kidney functions.The Opiate substitute treatment dose needs to be adjusted in the presence of poor kidney functions to reduce morbidity and mortality. Early screening is required for all patients on long-term OST and other medications for comorbid illnesses.
IRAMP: Investigation of Risk Assessment and Management Processes Using Datix Report Analysis and Observation of Clinical Team Meetings
Authors: Sunderland Kay , Drysdale Emma , Gillatt Brian , Mackenzie Alan , McCahon Paula 
Published: August 2024

AimsTo investigate risk assessment and management processes across a health board in the context of the implementation of a new risk screening tool and risk policy using comparison of DATIX incidents before and after implementation of the CRAFT tool.In mental health services, risk assessment and management are key responsibilities for clinical staff. A risk management tool that is structured and evidence-based aims to assist staff in managing risks including violence, self-harm, suicide and self-neglect.It is not clear whether risk tools have clinical utility in influencing risk-related decision making and previous reviews within the health board indicated that risk policy was not being adhered to, prompting a review of the policy. Furthermore, policy recommends service user and carer collaboration with staff in all areas of mental health in Scotland but despite these recommendations there is little evidence to suggest they are routinely involved in risk assessment and management processes.The present study is an opportunity to explore how teams think about and discuss risk management.MethodsWe looked at data on patient incidents that occurred over 30 months from 1/1/19 to 30/09/21. The Datix data were subdivided into five main categories: Violence & Aggression, Challenging behaviour, self-harm, absconding/missing and Suicide.ResultsThroughout the study period the category of Violence & Aggression was the most frequently reported Datix category for 28 out of 30 months, followed by Challenging Behaviour which was the second most frequent category for 22 out of 30 months and in the last year reports in this category have increased by 39.35%. The third most frequently reported category was self-harm and the fourth most reported category was Abscondment/Missing. The frequency of reports in this category increased over the study period.The rate of suicide was consistently the lowest reported category and remained stable throughout the study period. With the exception of Violence and Aggression, all categories showed a general upwards trend in Datix report numbers.ConclusionWe have seen an increase in significant incidents in all categories reported using the DATIX system with the exception of suicide and violence and aggression during the study period. This suggests that further work is required to ascertain the reasons for this and what impact, if any, the change in CRAFT risk assessment tool has had.
The Experiences of Autistic Adults Who Were Previously Identified as Having BPD/EUPD: A Phenomenological Study
Authors: Tamilson Bruce , Shaw Sebastian , Eccles Jessica 
Published: August 2024

AimsThis study aims to explore the experiences of autistic adults who were previously diagnosed with Borderline Personality Disorder (BPD).MethodsThis interpretive phenomenological study aims to explore the experiences of autistic adults who were previously diagnosed with BPD. Data were collected using sixty-minute, one-to-one, virtual, semi-structured interviews. The audio-recordings of the interviews were transcribed and analysed using an interpretive phenomenological analysis.ResultsParticipants had autistic features since childhood which went unnoticed. Camouflaging, gender and lack of awareness of the spectrum nature of autism had contributed to missing autism in childhood. The commonality of trauma, suicidality and self-harm, in the context of wider systemic issues, resulted in participants receiving a diagnosis of BPD. It was revealed that the diagnosis of BPD was readily given and inappropriately disclosed. This diagnosis was emotionally damaging for participants and highly stigmatising. Treatment for BPD was inadequate, ineffective, and distressing. There were several negative impacts of the BPD label, including diagnostic overshadowing. Participants felt that misdiagnosis is preventable with various measures. Autism diagnoses were difficult to obtain in adulthood, but receipt of one was beneficial for participants in various ways. However, participants felt there was a need for more autism awareness and autism-friendly services.ConclusionThe BPD label in autistic people can be harmful to their physical, mental and social health. In contrast, an autism diagnosis in adulthood can be beneficial despite the multiple barriers in receiving such diagnosis. Misdiagnosis is preventable by training clinicians, screening risk groups and developing dedicated autism services.
Self-Stigma and Quality of Life in Patients With Depressive Disorder in Psychiatric Outpatient Setting
Authors: Wan Chun Wah 
Published: August 2024

AimsSelf-stigma is common among patients suffering from depressive disorders and negatively affects their quality of life. Quality of life reflects individuals' general well-being, an important measure of treatment outcomes. However, local research on the relationship between self-stigma and quality of life in patients with depressive disorder is lacking. Information on clinical and personal characteristics associated with self-stigma in depression is also limited.The primary aim of this cross-sectional study was to examine the relationship between self-stigma and the quality of life of patients suffering from depressive disorder in an outpatient department. The secondary aim was to identify socio-demographic, clinical, or personal characteristics associated with self-stigma in these patients.MethodsOne hundred and thirty-one patients with depressive disorders were recruited from the outpatient clinic of a psychiatric centre in Hong Kong. Depressive disorder was diagnosed with the Chinese-bilingual version of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders. Socio-demographic and clinical information were obtained. Self-stigma was measured with the Self-Stigma Scale-Short Form. The quality of life was evaluated with the World Health Organization Quality of Life-BREF Hong Kong Version. Self-esteem, coping strategies, personality traits, and social functioning were evaluated. Bivariate analyses were performed to explore the association between the above factors with self-stigma or quality of life. Regression analyses were conducted to explore the relationship between self-stigma and quality of life, and to identify the factors independently associated with self-stigma.ResultsSelf-stigma was independently associated with the four main quality of life domains after controlling for socio-demographic, clinical, and personal characteristics among patients with depressive disorder. A multiple regression model showed that high levels of neuroticism and low self-esteem were independently associated with higher levels of self-stigma.ConclusionThis cross-sectional study supported the negative association between self-stigma and quality of life among individuals with depressive disorder. Neuroticism and self-esteem were found to be independently associated with self-stigma in depressive patients. Considering the associations found, identifying and focusing on depressive patients with a higher risk of self-stigma and implementing self-stigma interventions is important. Specific self-stigma reduction strategies should be introduced to mitigate the self-stigma in depressive patients and to improve their quality of life.