bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case-Control Study Measuring Mentalization in Individuals With PTSD Compared to Controls Using the STOMP Task
Authors: MacInnes Poppy , Wiseman Chantelle 
Published: June 2022

AimsSocial cognition is impaired in a variety of psychiatric conditions; evidence for impairment in individuals with PTSD is increasing. Mentalization is one domain of social cognition that refers to the capacity to understand other people by ascribing mental states to them. The STOMP task (Spontaneous Theory of Mind Protocol) involves an individual watching two minutes of a silent video and describing what they see. As part of a wider project examining social cognition in PTSD, we aimed to find out whether mentalization in the STOMP task differs between patients with PTSD compared to controls.Methods171 individuals undertook the task: 30 patients were recruited from centres in Cardiff and Bristol at the start of their psychological therapy; 141 controls were recruited through Prolific website. Participants watched a 2-minute silent video and were asked to write 7–10 sentences about the clip. Qualtrics software selected the video and collected the texts. The verbs of the texts were coded and given a score by PM using the Mental-Physical Verb Norms (MPVN) method. MVPN was developed by Orr et al. 2019, to give a value to 250 commonly used verbs based on their mental or physical attributes (the higher the value, the more ‘mental’ the verb). The total score of each text was divided by the number of verbs scored to produce an average that reflects how much mentalization was used. An unpaired t-test was used to calculate the significance in difference between the means of the two groups.ResultsThe overall average score of individuals with PTSD was higher than the controls (38.5 vs. 33.5, p value 0.0047). The median score of individuals with PTSD was 37.95 compared to 31.60 with an actual difference of -6.350 and a Hodges-Lehmann difference of -4.650. These results do not support the hypothesis that mentalization is impaired in patients with PTSD.ConclusionThis case-control study suggests that mentalization could be enhanced in patients with PTSD compared to controls. These results should be interpreted as part of a wider project being undertaken on the topic of social cognition in PTSD. Further studies with more participants from the population of interest and larger sample sizes could produce more reliable results, together with an expansion of the number of verbs coded in the MPVN method.
Exploring Mental Health Patient's Perceptions and Aspirations in Employment
Authors: Melvin Holly , Akinola Adeola 
Published: June 2022

AimsTo explore mental health in-patient's perceptions and aspirations in employment and to produce a lay document on employmentMethodsEmployment is beneficial, it improves mental health and betters social integration. Different interventions exist to support mental health patients into employment. However, patients experience many obstacles, including the characteristics of their condition and stigma.Literature review was undertaken, using a search string on PubMed focusing on mental health and employment.Developed and used a 17-question questionnaire exploring patients’ perceptions and aspirations in employmentCreated lay document containing information on benefits of employment, employment rights and accessing employment.Results100% of patients interviewed were interested in employment. 90.9% believed employment would improve their mental health and 100% believed it would improve their connection to their community. 100% felt there is a stigma around mental health problems which makes finding employment harder.ConclusionThe barriers mental health patients seeking employment face are varied and complex. Most wish to seek employment, and should be encouraged, as the health benefits are clear. Professionals need to acknowledge individual barriers patients face including different mental health characteristics, ethnicity, gender and personal circumstances and find a way to create a bespoke service tailored to patients’ needs in order to secure employment.
The Impact of the COVID-19 Pandemic on the Incidence of First Episode Psychosis in South London
Authors: Meyer Zeryab , Azlan Aryn , Spinazzola Edoardo , Quattrone Diego , Murray Robin 
Published: June 2022

AimsTransmission of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic. Many studies are underway to ascertain the mental health impact of this seismic event, however no study has investigated its effect on psychosis incidence. We hypothesise that the overall crude incidence rates of first episode psychosis (FEP) will be higher during the pandemic when comparing the same area of South London in defined pre-pandemic and pandemic time periods.MethodsClinical records for all patients aged 18 to 64 years presenting to early intervention in psychosis services in the London boroughs of Southwark and Lambeth between July 1st 2019 to December 31st 2019 (pre-pandemic period) and July 1st 2020 to December 31st 2020 (pandemic period) were extracted from the Clinical Record Interactive Search (CRiS), an online database containing anonymised patient records. All patients were manually screened using the Screening Schedule for Psychosis to confirm FEP, with 104/235 cases meeting criteria for FEP in the pre-pandemic period compared with 158/376 in the pandemic period. Crude, age-standardised, and sex-standardised incidence rates and ratios were calculated for interpretation.ResultsThe crude incidence rate of FEP was significantly higher in the pandemic period (68.3, 95% CI:[57.6 ; 78.9]) than the pre-pandemic period (44.9, 95% CI:[36.3 ; 53.6]). The crude incidence ratio was 1.52 (95% CI:[1.28 ; 1.77]), indicating that the overall crude incidence of FEP in the pandemic period was significantly higher (52%) than in the pre-pandemic period. The directionality and statistical significance of this ratio was unperturbed by standardisation for age (SIR = 1.45, 95% CI[1.23 ; 1.70]) and sex (SIR = 1.56, 95% CI[1.33 ; 1.83]).ConclusionOur results suggest that the COVID-19 pandemic has had a significant impact on the incidence of FEP in the South London boroughs of Southwark and Lambeth. Further research is required to elucidate the factors contributing to this increase to inform targeted interventions and prevent deterioration in at-risk patients.
Frailty in Individuals With Mental Disorders: Longitudinal Analyses of All-Cause Mortality
Authors: Mutz Julian , Dregan Alexandru 
Published: June 2022

AimsFrailty is a medical syndrome that is strongly associated with mortality risk, and an emerging global health burden. Mental disorders are associated with reduced life expectancy and elevated levels of frailty. In this study, we examined the mortality risk associated with frailty in individuals with a lifetime history of mental disorders compared to non-psychiatric controls.MethodsThe UK Biobank study recruited >500,000 adults, aged 37–73 years, between 2006–2010. We derived the two most common albeit distinctive measures of frailty, the frailty phenotype and frailty index. Individuals with lifetime depression, bipolar disorder or anxiety disorders were identified from multiple data sources. The primary outcome was all-cause mortality. We have also examined differences in frailty, separately by sex and age.ResultsAnalyses included up to 297,380 middle-aged and older adults with a median follow-up of 12.19 (IQR = 1.31) years, yielding 3,516,706 person-years of follow-up. We observed higher levels of frailty in individuals with mental disorders for both frailty measures. For key comparisons, individuals with a mental disorder had greater all-cause mortality hazards than their controls. The highest hazard ratio (3.65, 95% CI 2.40–5.54) was observed among individuals with bipolar disorder and frailty, relative to the non-frail controls.ConclusionOur findings highlight elevated levels of frailty across three common mental disorders. The increased mortality risk associated with frailty and mental disorders represents a potentially modifiable target for prevention and treatment to improve life expectancy.
How Does an Observational Assessment Adapted for Online Delivery Perform Compared to an In-Person Assessment? Learning From the National Autism Service for Adults
Authors: Blackmore Charlotte , Nolan Alexandra , Stoencheva Vladimira , Greenwood Natalie , Liu-Thwaites Natasha , Maltezos Stefanos , McAlonan Grainne 
Published: June 2022

AimsThe National Autism Service for Adults receives over 600 referrals annually and with an extensive waitlist, COVID-19 restrictions on in-person assessments were a challenge for service delivery. We aimed to adapt the Autism Diagnostic Observation Schedule (ADOS) for online delivery and investigate whether it is comparable to the in-person ADOS in predicting Autism Spectrum Disorder (ASD) diagnostic outcome. We also aimed to obtain qualitative feedback from service users and clinicians regarding experiences of the online ADOS.MethodsA working group of staff who administer ADOS and representatives from psychiatry, psychology and management reached consensus that an online version of ADOS module 4 was feasible based on experience that a lot information required for coding is obtained verbally and some tasks were adaptable for online delivery. After the pilot, it was agreed all algorithm items could be coded except ‘unusual eye-contact’. Subsequently, 163 service users attended an online ADOS between August 2020 and February 2021. A matched-comparison group consisted of 198 service users seen for an in-person ADOS between May 2014 and February 2020. Algorithm scores were recorded and ASD diagnosis was made by a trained clinician. Qualitative feedback regarding the online ADOS was collected from 46 service users and 11 clinicians.ResultsThe working group agreed the online and in-person ADOS were closely matched regarding administration and coding. Mean scores for service users who received an ASD diagnosis were comparable for the online and in-person ADOS groups (7 and 8 respectively). This was also shown for those who were not diagnosed with ASD (3 and 4 respectively). A two-sample t-test showed no significant difference in total scores between the online and in-person ADOS (p = 0.38). Qualitative feedback suggested good service user and clinician satisfaction; only 27% of service users indicated they would have preferred an in-person assessment; 88% of clinicians reported there were gains from offering an online alternative. Although the online and in-person ADOS perform similarly, clinicians reported relying more on qualitative reports over scores from the online version to inform diagnostic decision.ConclusionTo our knowledge, this is the first study to examine using an online ADOS within an adult diagnostic service. Due to its comparable performance, the online-ADOS is a viable alternative option for service delivery when in-person assessments are not possible. As this clinic group has high rates of comorbid mental health difficulties, the applicability of online assessments could generalise to other services and have an impact beyond the pandemic.
Digital Phenotyping Methods to Measure or Detect Social Behaviour in Patients With Serious Mental Illness (SMI): A Systematic Review. a Closer Look at Bipolar Disorder
Authors: Pandey Samyak , Azlan Aryn , Gillett George 
Published: June 2022

AimsTo provide a fresh insight into the extent digital phenotyping methods have been employed to measure or detect social behaviour in patients with SMIs; with a closer look at those used in Bipolar Disorder (BD); to give findings on the validity, reliability, acceptability and tolerability of these digital phenotyping methods.MethodsUsing specified search terms relating to digital phenotyping metrics and terms related to SMIs, a thorough literature search strategy for studies was employed across the following electronic databases: PubMed, Embase, and PsychINFO - from inception to July 2021.Included studies employed digital phenotyping methods, collecting either passive, active or mixed-modal data, which in principle reported metrics representing social behaviour on patients with an SMI. Here we present a preliminary analysis of studies reporting results for patients with BD, with a particular focus on tolerability and acceptability.ResultsOf 4,646 records initially screened, a subgroup of 9 studies (n = 474) directly focusing on patients with BD are reported here. Across the studies, we find a modest adherence rate towards these applications by patients, ranging from 72.6% to 89.2%. Methods used by the studies include the frequency of phone calls and text messages, and self-reported and observer ratings of social and interpersonal functioning. The collection of such digital phenotyping data appears tolerable and acceptable to participants with BD, with patients reporting them to be supportive and only mildly intrusive.ConclusionOur preliminary analysis suggests that digital phenotyping of social behaviour may be acceptable and tolerable to participants with Bipolar Disorder. In an increasingly digital world, digital phenotyping methods of social behaviour may assist physicians with clinical assessment and prediction of clinical outcomes including relapse. Future analyses will assess the reliability and validity of the data that such methods yield, and their potential therapeutic value.
An Observational Study of the Mental Health Burden in Frail and Elderly Patients
Authors: Shanthakumaran Yathorshan , Rasheed Reshma , Patel Anjali 
Published: June 2022

AimsPsychiatric illnesses are common among older adults and are associated with increased mortality and physical comorbidities. It is suggested that patients with frailty have a higher prevalence of depressive symptoms. (1) The eFI (electronic Frailty Index) is a tool used to assess the severity of frailty in elderly frail patients using a cumulative deficit model based on routine interactions with their GP.MethodsPatients were selected for annual frailty assessments by searching the electronic clinical system (SystmOne) using the eFI tool. Patients were assessed using the Comprehensive Geriatric Assessment (CGA) framework. In addition, all patients were screened for coexisting anxiety and depression using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaire.ResultsOf the 118 patients who ranged from mild to severe frailty, we found there was a positive correlation of the frailty severity eFI scores with increased rates of anxiety and depression evidenced by higher scores on the PHQ-9 and GAD-7 scoring tools. We found a positive correlation of the eFI with the PHQ-9 depression scores of (r = 0.819 p < 0.001). Within the same data set, we found correlation coefficients of eFI and anxiety GAD-7 scores (r = 0.651 p < 0.001). Increasing frailty was found to be associated with a higher rate of depression and anxiety.ConclusionWe found in this study higher (eFI) electronic frailty indices are associated with higher rates of anxiety and depression. We would recommend annual frailty assessments in patients with high electronic frailty indices and this should include screening for mental health deterioration. Early detection of deterioration will enable patient centered supportive measures and targeted treatment strategies. Health maintenance programs should ensure patient centered holistic assessment of both physical and mental health needs for early identification to avoid deterioration of both physical and mental health.
COVID-19 Vaccine Hesitancy Among Health Care Professionals of Allied Hospitals of Rawalpindi Medical University: A Mediation Analysis
Authors: Saeed Sajeel , Rauf Abdul , Younas Waqar , Arish Muhammad , Sannan Abdul 
Published: June 2022

AimsThis research assessed healthcare workers' vaccination practices for influenza, hepatitis, and pneumonia, as well as their desire to get COVID-19 vaccine when accessible, and investigated their 7C psychological antecedents (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). Stress variables and vaccination intention for COVID-19 were also compared to see whether psychological stress had a meditative impact on the relationship.MethodsAn analytical cross-sectional survey was conducted among health care professionals including nurses and doctors of tertiary care hospitals of Rawalpindi. Data were collected from February to April 2021 to get the COVID-19 vaccination when it became available, and looked into their 7C mental forebears (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). A total of 642 health care professionals voluntarily participated in our research. Demographic Details, questions like pneumonia vaccination, hepatitis vaccination, influenza vaccination and 7C questions were asked. Data were entered and analysed through SPSS 26.0 and Python. Correlation, linear and non linear regression, and mediation analysis were applied.ResultsThe immunization rates for influenza, hepatitis, and pneumonia vaccines, as well as the percentage of those who received COVID-19 vaccination, were 43.4%, 65.2%, 42.8%, and 39.7%, respectively. Hepatitis vaccination was significantly associated with the 7C model, influenza vaccination with conspiracy, whereas pneumonia was significantly associated with compliance. confidence (r = 0.11), complacency (r = −0.19), constraints (r = −0.20), calculation (r = 0.08), collective responsibility (r = 0.18), and compliance (r = 0.19) were significantly corelated with the COVID-19 Vaccine Intention. Contrary to direct effect, the indirect effect of patient contact frequency (β = −0.01, ρ<0.05) and terrified of contracting virus (β = −0.05, ρ<0.05) via psychological stress on COVID-19 Vaccination intention were significant depicting full mediation.ConclusionFor herd immunity, the probability for COVID-19 vaccination uptake among healthcare professionals was less than optimal. The 7C structures may help predict immunization against influenza, hepatitis, and pneumonia, but not vaccination against COVID-19.
A Qualitative Study Exploring the Experiences of Carers of Service Users With Complex Mental Health Needs
Authors: Saini Pooja , Roks Hana , Sambrook Laura , Balmer Anna , McIntyre Jason , Martin Antony , Tait Jackie , Ashley-Mudie Peter , Shetty Amrith , Nathan Rajan 
Published: June 2022

AimsCarers of individuals presenting with complex behavioural and mental health needs report that service users may not receive the provision of care they require, particularly when presenting following suicide attempts and self-harm. Carers are an integral part of the care system and often feel ignored and marginalised by services; there is a lack of involvement of carers and paucity of their views of support needs to be explored. The aim of the study is to understand carers’ experiences of caring for service users with complex mental health needs who self-harm and/or attempt suicide, and the support received from mental health care services.MethodsTen carers of service users with complex mental health needs were interviewed about their views on the psychiatric admission, treatment and discharge process for the people they were caring for. Data were gathered during semi-structured, one-to-one interviews remotely over the phone or online platforms. Interviews were audio-recoded and transcribed verbatim. A transcript-based conceptual analysis was conducted to identify and explore emerging themes.ResultsCarers identified both positive and negative aspects of the psychiatric admission and care within community settings. The following key themes emerged from the interviews: lack of control and information from mental health services, the importance of support from staff, or conversely its absence; concerns about service users’ vulnerability, negative staff attitudes and opportunities for involvement; negative experiences of generic psychiatric settings; positive experiences were encountered when there were supportive and caring staff, good information sharing and satisfactory discharge arrangements.ConclusionImportant areas for service improvements are highlighted. Recommendations included: the need for support; information about suicidal behaviour and advice on managing further incidents at home; more support in coping with regular and escalating self-harming and suicidal behaviours, particularly, severe consequences of staff safeguarding errors and inappropriate discharge, and the importance of supportive and adept staff. These findings identify the need for tailored support for carers regarding the management of self-harm and suicidal behaviours in the community.
A Qualitative Study Exploring the Role of Hindsight Bias in the Process of Reviewing Clinical Practice Prior to Adverse Incidents
Authors: Hadjioannou Irene , Lewis Emily , Scott Leo , Thomas Catrin , Salmoiraghi Alberto , Nathan Rajan 
Published: June 2022

AimsTo explore the effect of hindsight bias on retrospective reviews of clinical decision making prior to adverse incidents to inform future approaches to incident investigations.MethodsWe have undertaken focus groups with doctors of varying grades across the North West of England and North Wales. A vignette based on a real-life case from the publicly available NHS England Homicide Independent Investigation report database was presented to each group in one of three versions which differed in terms of the ending of the vignettes (i.e. suicide, homicide, no adverse incident). Using a semi-structured interview approach, the group participants were encouraged by the facilitators to reflect on issues relating to risk and risk management. All groups were provided with the same vignette which initially made no reference to the outcome and asked to comment on matters of risk and risk management. Halfway through the discussion, one of the three outcomes was disclosed, and further group discussion was held. The recorded interviews were transcribed and thematic analysis was undertaken using an adapted Framework Method.ResultsPreliminary results (n = 10) indicate that participants identified the potential for significant harm, particularly to others, and identified evidence of key psychopathological and historical correlates to support assertive management of risk and admission to hospital.Whilst knowledge of the outcome did not lead to participants changing their favoured management plans, it did alter how they appraised the case and led to participants constructing “narrative” explanations for the outcome given. The level of conviction participants held for their management plan reduced when their expectations about the outcome were confounded.Participants presented with the suicide outcome vignette described their difficulties appraising risk to others and their over-sensitivity to that risk. Participants faced with the ‘no adverse outcome’ vignette perceived the original management plan far more favourably in hindsight. The groups that were presented with the homicide outcome vignette initially focused on both risks to self and others as well as the perceived need for further information. Following knowledge of the outcome, there was a tendency to highlight parts of the letter pertaining to risk to others which they previously had not given as much attention.ConclusionThe initial analysis of our data confirms the findings from previous studies that hindsight colours the appraisal of adverse events. However, this study is novel in that it describes the nature of the thought processes underpinning the influence of hindsight on appraisals of risk.