bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Availability and Changes to Perceived Workplace Support and Their Impact on the Mental Health, Well-being and Burn-Out of Healthcare Professionals (HCP): Insight and Mitigating Strategies From the CoPE-HCP Cohort Study
Authors: Siddiqui Imrana , Gupta Jaya , McIntosh Iris , Komodromos Christina , Godec Thomas , Collett George , Ng Sher , Maniero Carmela , Antoniou Sotiris , Khan Rehan , Kapil Vikas , Khanji Mohammed Y. , Gupta Ajay K. 
Published: June 2022

AimsTo examine the relationship between self-reported level of workplace support (WS) and various mental health outcomes in HCPs and non-HCPs at different time-points during the COVID-19 pandemic, and to examine whether improved WS is associated with improved mental health outcomes over time. Lastly, to identify what support healthcare professionals (HCPs) perceive to be most helpful.MethodsCohort survey study at baseline (July-September 2020) and follow-up (approximately four months later).SettingHCPs working in primary or secondary care, from UK and other countries, and non-HCP controls from primarily London-based universities.Participants1574 HCPs and 147 non-HCPs (academic and research staff at London-based universities). The inclusion criteria for the study were: 1) aged 18 or older, 2) electronic consent given, and 3) identified as HCP or non-healthcare academic staff or self-declared non-HCPs.Main outcome measuresPresence of generalized anxiety disorder (assessed using the GAD-7), clinical insomnia (ISI), major depressive disorder (PHQ-9), well-being (SWEMWBS), and burnout (emotional exhaustion and depersonalization; EEDP2Q). Qualitative data exploring what support HCPs perceive as most useful was gathered using free-text inputs.ResultsAt baseline and follow-up, consistently, compared to those who felt unsupported, those who felt supported had significantly reduced risk (odds) of generalized anxiety disorder (baseline: 59% [95% CI of OR, 0.29 to 0.57], follow-up: 41% [0.38 to 0.92]), clinical insomnia (51% [0.34 to 0.69], 66% [0.20 to 0.55]), major depressive disorder (58% [0.31 to 0.58], 54% [0.31 to 0.74]), emotional exhaustion (65% [0.26 to 0.46], 61% [0.27 to 0.56]) and depersonalization (58% [0.28 to 0.61], 68% [0.21 to 0.50]).At follow-up, self-reported improved WS (vs. baseline) was associated with significantly improved GAD-7 (adjusted difference. −1.73 [-2.54 to −0.91]), ISI (-0.96 [-1.88 to −0.04]), PHQ−9 (-1.32 [-2.16 to −0.49]), SWEMWBS (0.97 [0.37 to 1.57]) and EEDP2Q (burnout) (-1.30 [-1.82 to −0.79]) scores, independent of baseline level of support.Five themes were identified constituting WS: ‘managerial support’ was the largest sub-theme.ConclusionA consistent association was observed between level of WS and the mental health of HCPs and non-HCPs. Improved WS was associated with improved mental health scores over a four-month period during the pandemic.
Uptake of COVID-19 Vaccination in a Medium Secure Psychiatric Hospital Population
Authors: Gibbon Simon , McPhail Emma , Mills Georgina , McBride Martin , Storer Rebakah , Taylor Nicholas , McCarthy Lucy 
Published: June 2022

AimsCompared with the general population, people with mental health disorders are at increased risk of negative physical and mental health outcomes following SARS-CoV-2 infection. In the UK, all adult mental health in-patients were offered COVID-19 vaccination as a priority group. Patients admitted to medium secure care have greatly increased mortality compared with the general population. Understanding COVID-19 vaccine uptake, and reasons for refusal, in patients in medium secure hospitals is important given the high prevalence of chronic physical health comorbidities such as obesity and diabetes, as these conditions are also associated with poor clinical outcomes in COVID-19 disease. Aims: To assess the proportions of patients who accepted or declined the COVID-19 vaccine, and explore their reasoning. To examine vaccine uptake between White and Black Asian minority ethnic (BAME) patients, and between younger/older patients.MethodsThe study took place at a medium secure hospital with male and female inpatients. All patients were offered a COVID-19 vaccine, and had a capacity and physical health evaluation completed by their Consultant Forensic Psychiatrist.ResultsData regarding capacity to consent to the vaccine, acceptance/refusal, and demographics were retrospectively collected from the clinical records. In total, 85 patients (92.4% of eligible patients) had capacity to decide if they wanted the COVID-19 vaccine. Of these 68 (80.0%) consented and 17 (20.0%) declined to consent.A similar proportion of patients aged under and over 40 years old consented. Those from a BAME background were more likely to decline than White British patients. The reasons for capacitous refusal appeared similar to the general population.ConclusionCOVID immunisation was broadly acceptable for patients in medium secure hospitals. The prevalence and reasoning of capacitous refusal appears similar to the general English population.The indication that BAME patients were more likely than White patients to decline the vaccination echoes the findings of research conducted in the Leicester general hospital. Further consideration needs to be given to how the uptake of COVID-19 vaccination can be improved in people with BAME ethnicity, especially as this group is also overrepresented in secure hospital settings.The study demonstrates that similar services should be able to approach the vaccination process with confidence. As many people with severe mental disorder also have high physical comorbidity that would increase the risk of a poor clinical outcome if they contracted COVID-19, protecting this vulnerable population through vaccination must be a priority for mental health services.
A Prospective Cohort Study to Assess Neonatal Adaptation in Neonates Exposed to Psychotropic Medications in Utero
Authors: Murad Firdous 
Published: June 2022

AimsWe aimed to compare the NAS in neonatal exposed to antidepressants to unexposed neonates.MethodsA prospective cohort study was carried out comprising of women in 3rd trimester of pregnancy, data were collected on women exposed and unexposed to antidepressants. Approval from the Rotunda Hospital REC was obtained.Hospital records were used to collect pre-, peri- and postnatal information which was relevant to the study Aim. Neonatal Abstinence Score was completed within 0–48 hours of the birth, Moderate-Severe abstinence was defined as eight points or higher (on a scale with maximum 40 points), mild abstinence as 4 points or higher. Paediatric records were reviewed where the baby required NICU admission. Women were recruited between 2019–2021Results221 women in total were recruited,138 pregnant women were on no psychotropic medication (Control group) and 83 pregnant women were on antidepressant medication (exposed group).In the exposed group, 46% (38/83) were on Sertraline,19% (16/83) fluoxetine, 17% (14/83) Escitalopram and 17% (14/83) on other SSRI/SNRI.Six infants (3%) expressed signs of severe abstinence and 38 (28%) had mild abstinence symptoms in exposed group whereas in control group 10 (7%) of infants were observed to have mild abstinence which was seen in infants with low birth weight, poor feeding and poor sleep after feed. Neonatal hypoglycaemia in infants prenatally exposed to antidepressant was seen in 10% compared to 1% of control group.ConclusionSevere abstinence in infants prenatally exposed to antidepressants was found to be (3%) and mild abstinence in 28% this is in keeping with international findings. Low one minute APGAR sores and greater rates of hypoglycaemia were also noted.While neonatal withdrawal with all antidepressants are usually mild and self-limiting it is important to make the obstretric and neonatal teams aware of the mothers medication and mothers should be advised that their baby may need a review by neonatology after delivery.
The Effectiveness of Exercise as a Treatment of Major Depressive Disorder in Adolescents: A Systematic Literature Review of Randomised Control Trials
Authors: Pallot Jessica 
Published: June 2022

AimsMajor depressive disorder (MDD) is the most prevalent mental health condition among adolescents. Current treatments have limited effectiveness, accessibility and questionable safety profiles. Exercise is becoming a more widely recognised intervention for MDD in adults. However, evidence and research for its effectiveness in adolescents is lacking. This review aimed to establish if exercise is effective at reducing MDD symptoms and severity in adolescents, and thus its first-line treatment potential.MethodsElectronic databases were searched for randomised control trials studying effects of exercise in adolescents, clinically diagnosed with MDD. Trials were excluded if participants’ depression was secondary to another disorder or health condition. The primary outcome measure was depression symptom severity, assessed by a validated depression symptom scale. Six trials met the eligibility criteria and were included in this review.ResultsFour trials found reduced depression scores in the exercise intervention group compared to control immediately post-intervention; of the four trials which included follow-up data, all reported higher rates of remission in the exercise intervention group compared to control. The length of exercise intervention programme seems important, needing to be greater than 6-weeks for a therapeutic effect. The type of exercise doesn't appear critical.ConclusionGiven the small sample sizes and methodological limitations presented by the trials, it is difficult to draw definitive conclusions. Further and larger-scale studies are needed before exercise can become a recognised and readily recommended treatment for MDD in adolescents; but thus far, it seems to have a promising therapeutic potential in both short and long term.
What Do Secure Care Stakeholders Want From the Forensic MDT? a Qualitative Study With Service Users, Carers, and Nurses
Authors: Hynes Fiona , Jack Alexander , Parkinson Eleanor , Hemblade Steven , Malik Talhah 
Published: June 2022

AimsClinical teams oversee the care of patients within secure psychiatric inpatient settings. They are made up of a number of professions, including psychiatrists, psychologists, occupational therapists, social workers and nurses. The effective collaboration of the different members of the clinical team is vital for its functioning. However, so is the team's interface with other key stakeholder groups, namely nursing teams, service users and carers. Understanding the needs and priorities of these groups regarding their relationships with the clinical team is also important to recognise and in the provision of good quality care. This study aims to understand the experiences, priorities and needs of stakeholder groups in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses) will help facilitate functioning of the clinical team in the delivery of excellent care to service users.MethodsEthical approval was granted by the host NHS trust. Between October 2019 and October 2021, three focus groups were conducted using a semi-structured interview to gather responses from carers, nurses and service users (6 participants in each group) respectively. The interviews were recorded and transcribed. Thematic analysis was used to code each transcript and themes were drawn from the coded data.ResultsDominant themes emerged from the three data sets. Consistent themes between groups included communication, hierarchy/power and representation. There were also differences in themes identified, with the carer group bringing the theme of education/ knowledge, and nursing group raising the value of human relationships, including compassion. The theme of transparency emerged strongly for the service user group.ConclusionThis study offers an interesting perspective on what distinct stakeholder groups want and value in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses and members of the MDT) can better inform a team about its functioning and help improve performance. Developing a tool to aid the systematic collection of multi-source feedback is the next step of this project, facilitating the voices of key stakeholder groups to be heard.
Assessing Serum Brain Derived Neurotrophic Factor and Matrix MetalloProteinase-9 Levels and Their Correlation With Neurocognitive and Psychosocial Functioning in Bipolar Disorder-I in Remission: A Case-Control Study
Authors: Penchilaiya Venkatalakshmi , Kattimani Shivanand , Hanumanthappa Nandheesha , Karunanithi Arivazhagan 
Published: June 2022

Aims1.To determine the association between serum BDNF, serum MMP-9 and cognitive function test in BD-1 patients in remission and to compare with controls.2.To assess the current psychosocial functioning of BD-I patients in remission and their correlates.MethodsSingle center case control study.Cases were BD-I patients in Remission (n = 60) and controls (n = 60) were age and gender matched healthy persons. The diagnosis of BD-1 was confirmed using Structured Clinical Interview For DSM-IV-Tr Axis I Disorders –Research Version along with clinical record. Age group between18–60 years, in remission for at least 2 months [scoring ≤ 8 on the Hamilton Depression Rating Scale, and ≤ 6 on Young Mania Rating Scale] were included. Those with significant head injury, neurological disorder, substance use disorder, Diabetes/Hypertension and premorbid IQ < 70 were excluded.Control group were excluded if their first degree relative had any psychiatric illness as elicited using Family Interview for Genetic Studies scale (FIGS).Cognitive functioning was assessed using Addenbrooke's Cognitive Examination version III (ACE-III) and Trail making test A and B (TMT A and TMT B). Current psychosocial functioning was assessed with Functioning assessment short test (FAST).Five ml blood sample was taken for estimation of serum BDNF and MMP-9 levels by ELISA.Chi-square test used to compare categorical variables. Mann-Whitney U test for continuous variables. Spearman's correlation - evaluate the relationship between scores on the cognitive function tests and serum levels of BDNF and MMP-9, within the group of patients with BD-I.ResultsWith regards to cognitive functioning, compared to controls, cases performed significantly poor in domains of Memory (Z = −3.435, p = 0.001), Processing speed (z=−2.667, p = 0.008), and Executive functioning (Z= −4.084, p = 0.000).No statistical difference in levels of serum BDNF and MMP-9 between patients and controls were found.While BDNF serum levels were not associated with cognitive or psychosocial functioning, there were significant relation between serum MMP-9 and the various domains of FAST scale and total FAST score (rho = 0.447, p < 0.001).BD-I patients exhibited poor psychosocial functioning compared to controls even in euthymic state (U = 702.00, p < 0.000).ConclusionPatients with BD-I display poor performance in memory, executive function and psychosocial functioning even during euthymic state compared to controls.Serum BDNF and MMP-9 levels comparable to the healthy controls during remission- pointing towards them as state markers rather than trait.Need for routine evaluation of cognitive function during follow-up visits and focus on target deficits for rehabilitation for better recovery and improving the quality of life of BD patients.
Pardon My Sobbing: A Qualitative Study on Differentiating Generalised Mood Disorders From Premenstrual Dysphoric Disorder
Authors: Pradhan Alisha 
Published: June 2022

AimsTo assess current diagnostic methods used in the United Kingdom which have led to successful diagnoses of PMDD (Premenstrual Dysphoric Disorder).MethodsWomen suffering from PMDD were recruited across the United Kingdom. Participants were interviewed using a semi-structured interview guide about their paths to diagnoses and the impact of receiving a misdiagnosis. Interviews were transcribed and thematically analysed to assess for overarching themes and similarities across participants. The Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 survey, and Premenstrual Symptom Screening Tool were used to assess for each questionnaire's diagnostic ability.ResultsFour women aged 30–50 years all identifying as PMDD patients were interviewed. All four participants received misdiagnoses of major depressive disorder and/or generalised anxiety disorder. The key to achieving a PMDD diagnosis for all four women was awareness of the cyclical nature of their symptoms. All three surveys failed to fulfill all the diagnostic criteria for PMDD, however the Premenstrual Symptom Screening Tool performed the best and elicited the greatest number of symptoms from the population sample.ConclusionThis research showed the need for patient awareness of PMDD via research, or awareness of the relationship between symptoms and the menstrual cycle, to achieving a diagnosis and receiving adequate treatment. Specialist treatment was also imperative to achieving a formal diagnosis.
A-Systematic Review of the Level of Mental Health Literacy Among University Students Regarding Seeking Support From Counsellors in the UK
Authors: Serebel Areej 
Published: June 2022

AimsIntroduction: Mental health literacy (MHL) is defined as “one's knowledge and beliefs about mental disorders” (Nishida-Hikiji et al., 2021). Additionally, it includes the capability to recognise specific disorders, distinguish risk factors and causes, recognise self-treatments and available professional help, and it is an attitude that encourages recognition and appropriate help-seeking (Jorm et al., 1997). Background: In the UK mental health problems are one of the main public health issues as it affects one in four individuals. It specifically has a high prevalence among university students which is between the ages of 16–24 years (Kessler et al., 2005)MethodsThe study design used for this study was a systematic literature review in which data were collected from PubMed, EBSCO and ScienceDirect using specific keywords in the advanced search. The amount of papers found were 953 after abstract screening for keywords only 34 papers were left and then final abstract and full-text article screening for the inclusion and exclusion criteria was done leaving it with only 8 papers. A quality assessment was done for the eight papers using CASP tool for RCT papers and EPHH tool for cross-sectional papers.ResultsThe findings showed that there are different levels of MHL between university students depending on their gender, education year, faculty and ethnicity. It was also found that the professional help seeking behaviour is not significantly different between genders but there was a difference regarding those identifying themselves as bisexuals despite them having high MHL scores.ConclusionIn conclusion the MHL of university students in the UK was found to be lower than those in Australia thus stating that more attention should be drawn to the issue and the need for easily accessible counselling services should be provided and promoted by universities. So that students can know about their existence and make good use of it whenever needed.
An Overlooked Crisis: The Impact of COVID-19 on UK Medical Students and Their Mental Health
Authors: Shetty Aapti , Bhatia Gurleen 
Published: June 2022

AimsMedicine is an undoubtedly challenging degree but studying medicine during the COVID-19 pandemic has posed added challenges for medical students across the UK. With teaching being moved online, practical exams cancelled, and final year students being fast-tracked onto the NHS frontline, there has been a dramatic change in how traditional medicine is being taught- with a ‘hands-on’ approach being swapped for video calls and remote teaching. This study will highlight the impact of the COVID-19 pandemic on the mental health of medical students, how they have coped through what has been an unprecedented two years and what can be done to support them through their medical training.MethodsA cross-sectional survey was performed on medical students at University College London. This involved a combination of face-to-face interviews and an online survey. They were asked about the impact on their overall mental well-being, as well as what the most challenging aspect of studying medicine during the pandemic was. They were also asked how optimistic they feel about their future in the medical profession. The data gathered were then analysed.ResultsThere were 30 responses, which were a combination of face to face and an online survey. Students unanimously agreed that the most challenging aspects were loneliness, lack of face-to-face teaching and minimal social interaction. 60% stated that their mental health has suffered significantly, and everyone felt that they have missed out on certain aspects of teaching during the pandemic, namely cadaveric dissections, time on wards and gaining vital communication skills. However, the benefits of online teaching included learning at their own pace and being able to take breaks to avoid burnout.ConclusionThere are limited studies looking at the long-term effect of COVID-19 on medical students in the UK. This survey highlights the detrimental impact of the pandemic on medical training and the mental health of these students. To address the possibility of burnout before they start their medical career, more resources could be signposted by medical schools to students during this challenging time. As we are transitioning out of the pandemic, we should be mindful not to forget the cohort of students who studied medicine alone in their homes. Most importantly, we must ensure this generation of doctors is well supported as they begin to care for members of the public.
Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Pregnant Women: A Systematic Review of Cohort Studies
Authors: Surendran Indu , Wijesinghe Kalpa , Johnson Joe 
Published: June 2022

AimsThe aim of this systematic review is to identify and appraise pharmacological options available for management of ADHD in pregnant women and adverse effects of ADHD medications on pregnancy and foetus (malformations or long-term effects).MethodsSystematic review of prospective or retrospective cohort studies, available on this topic till September 2021 after PubMed and MEDLINE search, carried out by 2 reviewers independently. The preliminary search was conducted in March 2021, though the reviewers carried out timely cross-referencing as required. All cohort studied except those with ambiguous methodology were included. The data were further extracted using Microsoft excel after Quality Assessment was completed using NewCastle Ottawa Scale. A narrative synthesis was undertaken as meta-analysis was not feasible owing to heterogeneity between studies included.ResultsEighteen Cohort studies were included (N = 28227 pregnant women with ADHD) of which 16 were deemed as good quality. Multiple confounders were identified.The review noted that use of stimulants/non-stimulants reduced symptoms and improved functionality in these expectant mothers. Findings from our review overall indicate low risk of developing malformations with ADHD medications, with only Methylphenidate (notably cardiac) and Modafinil showing slightly increased though statistically significant risk. We also noted slightly increased risk for reduced Apgar scores, abortions on maternal request, pre-eclampsia and preterm births. There was no conclusive association noted between neuro-developmental delay or future ADHD in baby/child.ConclusionA case-by-case approach needs to be adopted for every patient, looking at how ADHD affects daily functioning and balancing that against adverse pregnancy outcomes. Also, innovative practices like drug holidays, as required medications, drug free trial while planning pregnancy etc. will help practitioners streamline the treatment of this group of patients better. Issues like research being restricted to certain countries, small sample size, record-based analysis, issues in ascertaining adherence, confounding factors, ethical conundrums etc. were noted.