General Psychiatry最新文献

{"title":"Suicidal ideation and suicide attempt among pregnant adolescent girls in Ghana: a cross-sectional study.","authors":"Emmanuel Nii-Boye Quarshie, Erica Danfrekua Dickson, Sandra Naa-Shasha Quarshie, Sophia Ewuenye Adwoa Kpebu, Kwaku Oppong Asante","doi":"10.1136/gpsych-2024-101643","DOIUrl":"10.1136/gpsych-2024-101643","url":null,"abstract":"<p><strong>Background: </strong>Globally, suicide is the third leading cause of death among girls aged 15-19 years. However, there is a growing concern that suicide research has paid little attention to pregnant adolescent girls, particularly in low-income and middle-income countries, including Ghana, where nearly one in seven adolescents experiences (unwanted) pregnancy.</p><p><strong>Aims: </strong>To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.</p><p><strong>Methods: </strong>We collected cross-sectional data (between August 2022 and December 2023) using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls (aged 14-19 years) drawn from the three geographical zones of Ghana. We applied bivariable and multivariable analysis techniques to the data.</p><p><strong>Results: </strong>Overall, 28.51% (95% confidence interval (CI) 24.37% to 32.93%) reported suicidal ideation, and 18.04% (95% CI 14.59% to 21.91%) reported suicide attempt during the current pregnancy. Participants who reported attempted suicide endorsed more interpersonal reasons (eg, to communicate distress, to seek help or to influence others) than intrapersonal reasons for their attempted suicide. In the final adjusted logistic regression models, food insecurity (adjusted odds ratio (aOR)=2.69; 95% CI 1.34 to 5.41; p=0.005) was uniquely associated with increased odds of suicidal ideation. Adverse childhood experiences (aOR=3.04; 95% CI 1.33 to 6.97; p=0.008), history of attempted suicide before current pregnancy (aOR=3.47; 95% CI 1.27 to 9.47; p=0.0.015) and depression (measured by the 5-item World Health Organization Well-Being Index; aOR=0.31; 95% CI 0.12 to 0.77; p=0.012) were uniquely associated with increased odds of suicide attempt. Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt: conflict with parents, alcohol use, pregnancy-related anxiety, history of attempted suicide and intimate partner violence. While being in junior high school was uniquely associated with reduced odds of suicidal ideation, intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.</p><p><strong>Conclusions: </strong>Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana, additional research is needed to nuance our understanding of the correlates identified in this study. The evidence also highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"38 1","pages":"e101643"},"PeriodicalIF":5.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of non-invasive brain stimulation on impulsivity in patients with mental disorders: a systematic review and meta-analysis of randomised clinical trials.","authors":"Yuri de Castro Machado, Mariana Oliveira, Mateus Pereira Mundoca, Bernardo Viana, Debora Marques de Miranda, Marco Aurélio Romano-Silva","doi":"10.1136/gpsych-2023-101220","DOIUrl":"10.1136/gpsych-2023-101220","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), may offer an alternative treatment strategy for impulsive behaviour. By modulating brain activity, these techniques could potentially enhance impulse control and mitigate impulsivity.</p><p><strong>Aims: </strong>To provide a comprehensive analysis of the correlation between NIBS parameters, targeted brain regions and impulsivity.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus and Embase on 5 April 2023 for randomised controlled trials (RCTs) of NIBS on impulsivity. Unbiased Hedges' g with 95% CIs was used to define the effect size. Cochran Q test and I² statistics were used to assess for heterogeneity; p values inferior to 0.10 and I²>25% were considered significant for heterogeneity. Publication bias was investigated by funnel plot analysis of point estimates according to study weights, by Egger's regression test and by non-parametric rank correlation (Begg) test.</p><p><strong>Results: </strong>A total of 18 studies were included, comprising 655 patients from 14 RCTs and four randomised crossover studies. The meta-analysis of effect sizes from 9 tDCS studies on impulsivity did not show a significant effect (g=-0.18; 95% CI -0.46 to 0.10; p=0.210) and from 9 repetitive TMS (rTMS) studies also did not yield a statistically significant effect (g=0.21; 95% CI -0.38 to 0.80; p=0.490). When analysing active tDCS using Barratt Impulsiveness Scale version 11, the scores showed a trend towards improvement with active tDCS over placebo (g=-0.54; 95% CI -0.97 to -0.12; p<0.05; I²=0%).</p><p><strong>Conclusions: </strong>There is currently insufficient evidence to support the clinical use of rTMS or tDCS as a means of reducing impulsivity in individuals with mental disorders. The main limitations of this study are the lack of available patient-level data, a limited number of studies, the lack of consensus on the structure of impulsivity and variability in how impulsivity is measured and conceptualised.</p><p><strong>Prospero registration number: </strong>CRD42023413684.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101220"},"PeriodicalIF":5.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thorny but rosy: prosperities and difficulties in 'AI plus medicine' concerning data collection, model construction and clinical deployment.","authors":"Yujia Xia, Zhangsheng Yu","doi":"10.1136/gpsych-2023-101436","DOIUrl":"10.1136/gpsych-2023-101436","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101436"},"PeriodicalIF":5.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia in children, adults and older people with intellectual disability compared with the general population: a Swedish register study (IDcare).","authors":"Trine Lise Bakken, Magnus Sandberg, Anna Axmon","doi":"10.1136/gpsych-2024-101673","DOIUrl":"10.1136/gpsych-2024-101673","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>The knowledge about the prevalence of schizophrenia among people with intellectual disabilities (ID) is sparse, particularly concerning the distribution in different age groups.</p><p><strong>Aims: </strong>To investigate the prevalence of diagnoses in the schizophrenia spectrum among people with ID compared with the general population (gPop).</p><p><strong>Methods: </strong>This was an 8-year longitudinal register study. The participants were all residents of Skåne on 1 January 2014. People with a diagnosis of ID (F7 in International Statistical Classification of Diseases and Related Health Problems 10th Revision) or Down syndrome (DS; Q90), or service and support for people with ID/autism spectrum disorder (ASD) comprised the ID cohort (n=14 716). After excluding family members of people in the ID cohort, the remaining population of Skåne comprised the gPop cohort (n=1 226 955).The primary outcome measure was having at least one diagnosis in the schizophrenia spectrum (F20-F29). Secondary outcomes were single diagnoses within the schizophrenia spectrum.</p><p><strong>Results: </strong>The prevalence of schizophrenia spectrum diagnoses was 7.2% in the ID cohort. This was more than an eightfold increase compared with the gPop (relative risk (RR) 8.45; 95% CI 7.94 to 9.00). The risk was also high among children (aged 0-18 years at the start of the study period; RR 9.42; 95% CI 7.36 to 12.05). In the subcohort comprising those with a diagnosis of DS, the risk of schizophrenia diagnosis was more than twice as high as in gPop. Concomitant ASD or genetic syndrome did not carry an excess risk among people with ID when compared with the gPop.</p><p><strong>Conclusions: </strong>The findings of the present study support earlier assumptions that people with vulnerable brains develop psychotic disorders more frequently and that the onset age is lower than among people in the gPop. Habilitation services for children and adolescents, as well as general mental health services, should keep in mind that schizophrenia may be present when children and adolescents show severely decreased functioning, anxiety or aggressive behaviour.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101673"},"PeriodicalIF":5.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping survey of dietetic resourcing for eating disorders: why is the dietitian's role marginalised in community eating disorders?","authors":"Elizabeth Roberts, Mala Watts, Safiya Riley, Kathryn Hart","doi":"10.1136/gpsych-2024-101604","DOIUrl":"10.1136/gpsych-2024-101604","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101604"},"PeriodicalIF":5.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the door to supportive housing: addressing the challenge of post-discharge transitions in safety-net psychiatric care.","authors":"Yaara Zisman-Ilani, Jessica G Kovach, Meera Chatterjee, Mary F Morrison","doi":"10.1136/gpsych-2024-101608","DOIUrl":"10.1136/gpsych-2024-101608","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101608"},"PeriodicalIF":5.3,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAS macro programme for Bang's Blinding Index to assess and visualise the success of blinding in randomised controlled trials.","authors":"Zongshi Qin, Yongpei Yu, Hongqiu Gu, Dongdong Shi, Zhen Wang, Jiani Wu, Toshiaki Furukawa, Yangfeng Wu","doi":"10.1136/gpsych-2024-101578","DOIUrl":"10.1136/gpsych-2024-101578","url":null,"abstract":"<p><p>This paper aims to present a Statistical Analysis Software (SAS) macro %BBIplus, offering estimation and visualisation methods for the Bang's Blinding Index (BBI) for randomised controlled trials (RCTs) with various designs. We developed the SAS macro programme %BBIplus to facilitate the implementation of BBI. This user-friendly programme allows for easy and rapid estimation and visualisation of BBI across different scenarios, including pairwise comparison RCTs with two arms, double-dummy design RCTs with three arms and factorial design RCTs with four arms. The programme requires no pre-existing data set, and users only need to input the number of individuals of correct, uncertain or wrong guesses in each intervention or control group. We illustrate the functionality of %BBIplus using blinding assessment data from three previously published RCTs: BBR (adjunctive berberine reduces antipsychotic-associated weight gain and metabolic syndrome in patients with schizophrenia: a randomised controlled trial), SELECT-TDCS (the sertraline versus electrical current therapy for treating depression clinical study: results from a factorial, randomised controlled trial) and ELECT-TDCS (trial of electrical direct-current therapy versus escitalopram for depression) studies. The programme estimates the BBI for each arm, providing point estimates, 95% CI and associated p values. Additionally, %BBIplus can visualise the estimations through forest plots and make the judgement for the success of blinding easily and rapidly. This tool caters to the needs of clinical trial investigators, offering a comprehensive solution for estimating and visualising the blinding index under various RCT designs.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101578"},"PeriodicalIF":5.3,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic insights into male autism spectrum disorder in a small cohort of Indian simplex families: findings from whole exome sequencing.","authors":"Srividhya Durbagula, Snijesh Valiya Parambath, Ashitha Siddappa Niranjana Murthy, Meghana Rameshraju K, Chetan Ghati Kasturirangan, Gautham Arunachal Udupi, Nallur B Ramachandra, Aparna Huligerepura Sosalegowda, Vijaya Raman, Aruna Korlimarla, Naveen Kumar Chandappa Gowda","doi":"10.1136/gpsych-2024-101606","DOIUrl":"https://doi.org/10.1136/gpsych-2024-101606","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101606"},"PeriodicalIF":5.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do we mean when we talk about socioeconomic status? Implications for measurement, mechanisms and interventions from a critical review on adolescent mental health.","authors":"Mirela Zaneva, Tsvetomira Dumbalska, Aaron Reeves, Lucy Bowes","doi":"10.1136/gpsych-2023-101455","DOIUrl":"10.1136/gpsych-2023-101455","url":null,"abstract":"<p><p>Low socioeconomic status (SES) is a well-established risk factor for general and mental health problems. However, there is no widely accepted definition or operationalisation for SES, leading to varied interpretations in research. In a critical review of the child and adolescent mental health literature, we map how SES is defined and measured. We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES. Our analysis revealed fundamental problems such as the lack of clear definitions, insufficient detail on variables used and limited measures directly reported by adolescents. We discuss issues related to measurement techniques and their impact on reproducibility, policy development and intervention design. Based on our findings, we recommend using SES measures that directly assess the socioeconomic position of children and adolescents. Additionally, we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection. The wide range of distinct measures used to represent SES, coupled with insufficient reporting, likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships. This, in turn, makes the path to effective health interventions more challenging.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101455"},"PeriodicalIF":5.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental illness segregation and truncated autonomy within medical assistance in dying legislative frameworks in Colombia and Canada.","authors":"Hamer Bastidas-Bilbao, Ximena Palacios-Espinosa, Donna E Stewart, Vicky Stergiopoulos","doi":"10.1136/gpsych-2024-101675","DOIUrl":"https://doi.org/10.1136/gpsych-2024-101675","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"37 6","pages":"e101675"},"PeriodicalIF":5.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}