bluuebunny/crossref_metadata_2025_split huggingface dataset:
Behavioral Addictions Prevalence and Impact on Medical Sciences Students' Mental Health: A Systematic Review and Meta-Analysis
Authors: Mohammed Omer A. , Ibrahim Danya , Mohamed Shima Algam , Babikir Shaza K. , Zuhair Ayman 
Published: August 2024

AimsThis study aims to illuminate the prevalence of various behavioral addictions among health professions students and examine their negative effects on mental health.MethodsIn March 2023, a systematic literature search was conducted, encompassing randomized controlled trials, cohort, case-control, and cross-sectional studies from the past five years in PubMed and ScienceDirect. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 19 papers underwent qualitative analysis, while 15 studies were subjected to quantitative analysis following a quality assessment review.ResultsThe study included 9,994 health professions students, primarily in the field of medicine, aged between 18 and 23 years. The majority of the students were unmarried, females, and most were in clinical years. The prevalence of behavioral addiction was 36% (95% CI: 20–51), with smartphone addiction being the highest at 46%, followed by internet addiction (42%), social media disorder (22%), and gaming disorder (4%). Substantial heterogeneity was observed among the studies. A funnel plot analysis assessed the potential for publication bias, revealing no significant indication of bias. A significant difference was observed between the groups.ConclusionThis study identifies five distinct forms of behavioral addictions influencing the mental health and daily activities of health professions students. The findings underscore the need for longitudinal and interventional studies to address this technological threat.
Admissions to the National Forensic Mental Health Service Anteceding and Succeeding Its Relocation: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)
Authors: Iqbal Muhammad Umer , Umer Waqar M. , Kennedy Harry G , Davoren Mary 
Published: August 2024

AimsThe Central Mental Hospital is the Republic of Ireland's only secure forensic hospital and the seat of its National Forensic Mental Health Service (NFMHS). We scrutinised admission patterns in the NFMHS during the period 01/01/2018–01/10/2023; before and after relocating from the historic 1850 site in Dundrum to a modern facility in Portrane on 13/11/2022.MethodsThis prospective longitudinal cohort study included all patients admitted during the above period. The study initially commenced in Dundrum and continued afterwards in Portrane. Data gathered included demographics, diagnoses, capacity to consent to treatment, and the need for intramuscular medication (IM) after admission. Therapeutic security needs and urgency of need for admission were collated from DUNDRUM-1 and DUNDRUM-2 scores rated pre-admission. Hours spent in seclusion during the first day, week, and month after admission were calculated. Data were collected as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).ResultsThere were 117 admissions during the 69-month period. The majority were male (n = 98). Most were admitted from prisons (87%). Schizophrenia was the most common diagnosis (55.8%). Mean DUNDRUM-1 triage security scores were in the medium-security range (2.84–3.15) during this period. At the time of admission, 53.8% required seclusion, 25.6% required IM medication, and 79.5% lacked capacity to consent to treatment. Those who required seclusion on admission had worse scores on the DUNDRUM-2 triage urgency scale (F = 20.9, p < 0.001). On linear logistic regression, the most parsimonious model resolved with five predictors of hours in seclusion during the first day and week, which were: D1 item 8 – Victim sensitivity/public confidence issues, D1 item 10 – Institutional behaviour, D2 item 2 – Mental health, D2 item 4 – Humanitarian, and D2 item 6 – Legal urgency. 50% required IM medication during their first week of admission and these patients had significantly worse scores on: D1 item 8 – Victim sensitivity/public confidence issues, D1 item 10 – Institutional behaviour, D2 item 2 – Mental health, and D2 item 4 – Humanitarian (all p < 0.05).ConclusionThere was an increase in the frequency of admissions since relocating to Portrane. The results suggest that there was no change in overall triage security and urgency needs during the time period in question. Major mental illness related factors impacted the need for seclusion early in the admission, whereas factors linked to prison behaviour or personality-related factors were more associated with an ongoing need for seclusion at month one.
Ketamine Efficacy Across All Formulations in Treatment Resistant Depression in Adult Population: A Rapid Review
Authors: Jaiswal Bikramaditya , Singh Neha , Benjamin Benson 
Published: August 2024

AimsThe primary aim of this rapid review was to evaluate the evidence base for the efficacy of ketamine across all formulations and routes of administrations in the treatment of adult patients with treatment resistant depression (TRD).MethodsThis rapid review retrieved controlled trials on use of ketamine across all of its formulations, including all isomers and across all routes of administration in TRD patients for achieving response and remission. This review included PubMed and PsycINFO databases. The retrieved studies were screened with the help of a screening tool and data were extracted by using data extraction forms by two authors. The studies were evaluated for quality of evidence, ethical issues and critically analyzed. Narrative synthesis was used for data synthesis.ResultsThis review retrieved 10 placebo controlled randomized controlled trials (RCT) on intravenous (IV) ketamine, IV esketamine, intranasal (IN) ketamine and IN esketamine in TRD patients. IV ketamine and esketamine showed higher rates of remission and response in comparison with placebo groups in TRD patients. There was no significant improvement in response and remission rates in TRD patients on IN esketamine in comparison with placebo. The adverse effects in the intervention groups were of mild to moderate severity and short lasting mostly resolving within a day.ConclusionThis review recommends IV ketamine and esketamine can help in achieving early response and remission in TRD patients and it seems to be a well-tolerated treatment option. Further studies are needed to assess these issues around safety, ease of administration and potential for dependence.
Vitamin-D Deficiency & Depression: Is There an Association? Average Data From Gulf Cooperation Council Countries
Authors: Wanigaratne Shamil , Ahamd Amar , Al Anouti Fatme , Al Balushi Mitha , Javaid Syed 
Published: August 2024

AimsThe evidence for the association between vitamin-D deficiency and depression, although equivocal, has been established in several populations in different countries and supported by meta-analytical studies1. Much of the evidence for this comes from Western countries2. Similarly, the evidence for the benefits of supplementation, although shown, also comes from similar populations and is equivocal3. Need for data from different populations and for randomized controlled trials to establish causality is stressed by most researchers. This study aims for presentation reviews of the association between vitamin-D and depression in the GCC, using the publicly available data of Our World in Data.MethodsThe statistical analysis used median prevalence depressive disorders data (from 1990–2019) in the GCC countries (both sex and age-standardized (%)), which was downloaded from Our World in Data and was last updated on August 28, 2022. Vitamin D deficiency data were collected through a literature review search using PubMed and Google Scholar. A linear regression model was performed with the median prevalence of depressive disorders data as an outcome. The prevalence of vitamin-D deficiency, population median age and the interaction term between prevalence of vitamin-D deficiency and population median age were used as predictors. The effects of prevalence of depressive disorders both sex age standardized (AS) percentage (%) were estimated with 95% confidence interval (95% CI) using bootstrap covariance matrix estimator. Fitted model's likelihood ratio chi-square (LR χ2) test with corresponding p-value was computed and reported.ResultsA positive association was observed between the median prevalence of depressive disorders and the prevalence of vitamin-D deficiency, adjusted for population median age, were observed (LR χ2 p-value = 0.005) and adjusted R2 = 0.706.ConclusionPrevalence of depressive disorders was associated with prevalence of vitamin D deficiency among the population of GCC countries. Future randomized control trials on Vitamin D supplementation are needed to confirm these observations.
Rapid Review: Ascertaining the Type of Potentially Life-Threatening Cardiovascular Events and Eventual Cardiovascular Mortality From Antipsychotic Use in Clinical Practice
Authors: Lee Reagan , Han Oscar , Wang Jingjing 
Published: August 2024

AimsAccording to the World Health Organization (WHO), there has been a 13% increase in mental health and substance abuse disorders within the last decade. Typical and atypical antipsychotics are the most common treatment mechanisms for mental health-related disorders such as schizophrenia, depression with psychotic symptoms and bipolar disorders. However, antipsychotic usage is associated with more than a 50% increase in CVD such as ischaemic heart disease, resulting in cardiovascular-related mortality.This review aims to investigate the most common type of cardiovascular event causing mortality due to antipsychotic use.MethodsA systematic search within PubMed and Medline was conducted on 3 October 2023. Selection criteria were limited to English, full-text studies excluding case reports. The time frame selected was up to 3 October 2023. All studies included adults only. Interventions of focus include typical and atypical antipsychotics licensed in the UK. Outcome measures include cardiovascular mortality/events post-antipsychotic prescription.Results13 studies were included out of 1088 records. Studies originated from 4 nations with the most studies coming from the USA (n = 7), UK (n = 2), Taiwan (n = 2) and Canada (n = 2).The most common antipsychotic reported in the records was risperidone (n = 11), followed by haloperidol (n = 9), olanzapine (n = 8) and quetiapine (n = 8).From data extraction, the most common cardiovascular events leading to death were sudden cardiac death/arrest (n = 6), ventricular arrhythmias (n = 6), myocardial infarction (n = 4), and heart failure (n = 2).Due to data heterogeneity, discrete outcome measures were extracted from each record. This included outcomes measuring: relative risk between various groups (n = 9), rate of cardiovascular event per 100 patient year (n = 3), and mortality post cardiovascular event (n = 1).ConclusionFrom this study, ventricular arrhythmias and sudden cardiac deaths were the most common cardiovascular events secondary to antipsychotic use leading to mortality. Owing to patient safety and benefits, patients with psychotic illness are unable to go untreated. They are consequently very vulnerable to the cardiovascular side effects of prescribed high-dose antipsychotic drugs. Despite current monitoring guidelines worldwide, cardiovascular-associated mortality in patients on antipsychotics is still elevated. This may indicate the potential inadequacy of current measures for these patients while demonstrating the need for more aggressive cardioprotective interventions and monitoring.
Neural Correlates of Disgust Processing in Childhood Maltreatment and Peer Victimisation
Authors: Lim Lena 
Published: August 2024

AimsChildhood maltreatment (CM) and peer victimisation (PV) are common sources of early-life interpersonal stress. CM is associated with atypical fronto-limbic emotion processing and regulation, and increased vulnerability for self-harm/suicide. However, few studies have compared the neurofunctional correlates between caregiver-inflicted versus peer-inflicted mistreatment. We compared the alterations of neurofunctional correlates of facial emotion processing in young people exposed to CM or PV and explored their associations with self-harm.MethodsfMRI data were collected from 114 age- and gender-matched youths (39 CM, 37 PV and 38 controls) during an emotion discrimination task. Region-of-interest (amygdala, insula) and whole-brain analyses were conducted.ResultsGroups differed significantly during processing of disgust only. Both CM and PV groups had lower activation in right amygdala and bilateral posterior insula than controls, where the left insular underactivation was furthermore related to increased self-harm in maltreated youths. At the whole-brain level, both CM and PV groups also had underactivation compared with controls in a cluster of bilateral limbic-thalamic-striatal, precuneus/posterior cingulate, temporal, fusiform/lingual and cerebellar regions, which was negatively associated with emotional problems in controls, as well as a cluster of somatosensory regions associated with increased self-harm in maltreated youths.ConclusionEarly-life interpersonal stress from caregivers or peers is associated with common underactivation of limbic-thalamic-striatal, precuneus/posterior cingulate and somatosensory regions during disgust processing. The hypoactivation of key emotion and sensory processing and self-referential brain regions could be a potential suppressive mechanism to cope with the aversive emotion; however, it may also entail increased risk of affective psychopathology in seemingly healthy youths.
Metabolic Syndrome, Sleep Quality and Lung Function in Persons With Schizophrenia: A Cross-Sectional Study
Authors: M Dinesh , Kataria Dinesh , Mondal Sunita , Prasad Shiv , Rehman Sajjadur 
Published: August 2024

AimsPersons with schizophrenia typically have a 20% shorter lifespan and mortality rates two times higher than the general population. More than 2/3 of this is due to different forms of physical diseases, like cardiovascular and metabolic syndrome. Systematic meta-analyses and various studies in schizophrenic patients revealed the prevalence of metabolic syndrome to range from 11 to 69%, poor sleep quality 30% to 80%, and impaired lung function ~30%. Both in the general population and in persons with schizophrenia, poor sleep quality and impaired lung function are associated with a heightened risk of metabolic and cardiovascular diseases. Hence, this study aimed to look for the magnitude of metabolic syndrome, poor sleep quality, and impaired lung function, and any association among them, if proven, may be helpful in better management.MethodsWe included sixty cooperative patients through purposive sampling with an age range of 18 to 65 years, meeting the DSM–5 criteria for schizophrenia, and excluded patients with co-morbid substance use disorder except for smokeless tobacco and caffeine. Harmonized criteria were used to diagnose metabolic syndrome; the Pittsburgh Sleep Quality Index (PSQI) for sleep quality and lung function was interpreted as per the Spirometry for Health Care Providers, Global Initiative for Chronic Obstructive Lung Disease.Results55% were found to have metabolic syndrome. Poor sleep quality (PSQI > 5) was found in 60% of cases, with the most common sleep abnormality being increased sleep latency (95%). Restrictive Lung Dysfunction (RLD) was found in 46.7% of cases. 66.7% of the participants with metabolic syndrome had RLD, whereas only 22.2% without metabolic syndrome had RLD. The difference was statistically significant. No statistically significant difference was found between metabolic syndrome and sleep quality or sleep quality and RLD.ConclusionFrom the results obtained, it is clear that the prevalence of metabolic syndrome in people with schizophrenia is twice that of the general population, which also contributes to their increased mortality. Thereby, early identification of metabolic disturbances and correcting poor sleep quality and impaired lung function that are associated with an increased risk of metabolic syndrome will lead to increased life expectancy and a decrease in the mortality rate. Since lung function is studied in only a very few studies all over the world and ours being a novel approach in India showing significant association, it needs to be replicated in a larger sample size.
Management of Benzodiazepine Use in Youth and Young Adults: A Scoping Review
Authors: Kakamousias Nia , Miller Laura , Etches Selene , MacInnis Melanie 
Published: August 2024

AimsBenzodiazepines are commonly used medications that have the potential for dependence and use disorder. Despite these harms, they are regularly prescribed and acquired from non-prescription sources. It has been established that benzodiazepine use is a widespread problem in youth and young adults. Little evidence exists to guide management of benzodiazepine use in this population. This scoping review aims to gather literature on the management of benzodiazepine use and identify the gaps in the literature to guide further research, particularly in youth and young adults.MethodsMethodology followed the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews guidelines. MEDLINE (Ovid), Embase, Cochrane, and Cumulated Index to Nursing and Allied Health Literature (CINAHL) were searched, together with a search of the grey literature. A survey of experts in the field of addiction medicine was completed. Broad inclusion criteria were used to capture any available literature. Data were compiled using Covidence software, and two independent reviewers screened titles, abstracts, and full texts against the eligibility criteria. Data were extracted using a modified JBI data charting table. Descriptive statistics and a simple thematic analysis were performed to summarize the data collected.ResultsOf the 835 papers retrieved, 104 papers published from December 1982 to March 2023 were included in the final review. Two of the papers included in this review pertained to youth and young adults. The rest of the papers were based on the adult population. Gradual dose reduction is the only method with evidence for efficacy in youth. Several therapies show efficacy in adults and could be future areas of research in youth, including benzodiazepine maintenance therapy, carbamazepine, gabapentin, pregabalin, trazodone, flumazenil slow infusion, and buprenorphine in various clinical contexts. Valproic acid, agomelatine, tricyclic antidepressants, paroxetine, buspirone, progesterone, cyamemazine, magnesium aspartate, clonidine, lithium, hydroxyzine, chlorpromazine, alpidem, captodiame, and ondansetron were deemed ineffective, unsafe in youth, or were not available for use in Canada. Topiramate, lamotrigine, oxcarbamazepine, phenobarbital, propranolol, baclofen, mirtazapine, and nicotinic acid had preliminary, low-quality evidence in adults, and would require further study.ConclusionBenzodiazapine use disorder in youth is dangerous and common, and the lack of pharmacotherapeutic options has been deemed significant by our research team. The results of this review are promising in that they provide some further guidance on the management of this condition.
Comparison of the Legal Infrastructure Governing Psychiatric Practice and Its Implementation in Tanzania and the UK
Authors: Morgan Jessica 
Published: August 2024

AimsTo examine the legal framework governing psychiatric practice, specifically focusing on the Mental Health Act, within a singular psychiatric centre in Moshi, Tanzania. The primary objective was to explore the intersection of culture and legalities in shaping ethical practice within this emerging unit. Drawing on a comparative analysis of contents and the implementation of the MHA in Tanzania and in the UK, the study aims to understand the ways in which cultural contexts influence the legal and ethical dimensions of psychiatric care.MethodsThis was a multi-method study that combined literature analysis, structured interviewing, and structured reflective practice.
1.Direct comparison of the UK and Tanzanian MHA.2.Evaluation of clinician understanding of the MHA through structured interviewing of clinicians with respect to their knowledge of the MHA, its existence, and its key components.3.Analysis of implementation of the MHA in liaison psychiatry in both centers. Compared through unstructured interviewing and reflective practice.Results1.The most striking difference is the length of the documents. The Tanzanian MHA is 27 pages while the UK MHA is 173. This additional length covers: Admission and Discharge Procedures, explanation of the Roles and Powers of Professionals, and further discussion on Safeguards and Rights of Individuals.2.When interviewed, only 15% of Tanzanian physicians could explain what the MHA is, compared with 100% of UK physicians (N = 40).3.In the UK, all doctors use the MHA and implement DOLS. In Tanzania, this falls under the role of liaison psychiatrists. This is likely because, the MHA is included in the UK's medical curricula but not in Tanzania's.ConclusionLack of understanding of the MHA and other key laws in psychiatry is a global issue, not limited to the UK or Tanzania. However, physicians with strong understanding are more scarce in Tanzania. This scarcity puts additional pressures on psychiatric services, as psychiatrists are called to assess issues of capacity or consent that could be assessed by any doctors in the UK. However, this means that the MHA and MCA are almost solely used by psychiatrists and therefore often assessed to a very high standard. It must be considered that on reflection, I have also observed physicians with limited understanding of the MHA, capacity and consent within the NHS. Imposing a higher standard on another culture would be unethical. Efforts into educating medical students and professionals is required in the UK and Tanzania.
Association Between Problematic Online Gaming and Subsequent Psychotic Experiences in Adolescents: A Birth Cohort Study
Authors: Narita Zui , Yamasaki Syudo , Yamaguchi Satoshi , Ando Shuntaro , Nishida Atsushi 
Published: August 2024

AimsThere is still little information available on the negative impact of online activities on psychotic experiences. This limitation is further compounded for online gaming, where even a beneficial impact has been suggested via the evocation of positive emotions. We aimed to examine how problematic online gaming (POG) is associated with subsequent psychotic experiences in adolescents.MethodsThis birth cohort study employed randomly sampled adolescents born between September 2002 and August 2004. The eligibility criterion was those who did not have psychotic experiences at age 14. We analyzed the association between POG at age 14 and subsequent psychotic experiences at age 16. Adolescents were categorized into the no, low, and high POG groups based on the behaviors and emotions related to online gaming at age 14. Missing data were handled using random forest imputations.ResultsA total of 1722 adolescents without psychotic experiences at age 14 were analyzed. At age 16, 55 adolescents exhibited psychotic experiences, while 225 showed potential psychotic experiences. Compared with the no POG group, a higher risk of psychotic experiences was shown in both the low (RR 1.93, 95% CI 1.74–2.15) and high (RR 2.81, 95% CI 2.50–3.15) POG groups. Findings were consistent when analyzing potential psychotic experiences.ConclusionPOG appears detrimental to the development of psychotic experiences in adolescents. Our findings provide public health implications in the context of policymaking.