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Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

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General Psychiatry 2024年第1期37卷 103-111页

作者： Viktor H Ahlqvist Christina Dardani Paul Madley-Dowd Harriet Forbes Jessica Rast Caichen Zhong Renee M Gardner Christina Dalman Kristen Lyal cRAIG Newschaffer Torbjorn Tomson Michael Lundberg Daniel Berglind Neil M Davies Brian K Lee Cecilia Magnusson Dheeraj Rai Department of Global Public Health Karolinska InstitutetStockholmSweden Medical Research Council Integrative Epidemiology Unit Bristol Medical SchoolUniversity of BristolBristolUK Centre for Academic Mental Health Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK Faculty of Epidemiology and Population Health London School of Hygiene and Tropical MedicineLondonUK A.J.Drexel Autism Institute Drexel UniversityPhiladelphiaPAUSA Department of Epidemiology and Biostatistics School of Public HealthDrexel UniversityPhiladelphiaPAUSA College of Health and Human Development Pennsylvania State UniversityState CollegePAUSA Department of Clinical Neuroscience Karolinska InstitutetStockholmSweden Centre for Epidemiology and Community Medicine Region StockholmStockholmSweden K.G Jebsen Center for Genetic Epidemiology Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway Division of Psychiatry University Collge LondonLondonUK Department of Statistical Sciences University Cllge LondonLondonK NIHR Biomedical Research Centre University of BristoBristolUK Avon and Wiltshire partnership NHS Mental Health TrustBristolUK

Background Psychiatric comorbidities are common in patients with *** for the co-occurrence of psychiatric conditions and epilepsy remain poorly *** We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these *** Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with *** then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score ***,we assessed the potential bidirectional relationships using two-sample Mendelian *** In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric *** example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric *** Psychiatric comorbidities are common in patients with *** correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric *** findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psy

关键词： epilepsy Psychiat lifetime

Sex differences in cognitive impairment in Alzheimer's disease

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World Journal of Psychiatry 2016年第1期6卷 54-65页

作者： Keith R Laws Karen Irvine Tim M Gale School of Life and Medical Sciences University of Hertfordshire hertfordshire partnership university nhs foundation trust

Sex differences in neurocognitive abilities have been extensively explored both in the healthy population andin many disorders. Until recently, however, little work has examined such differences in people with Alzheimer's disease(AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.

关键词： Dementia Gender Sex differences Cognition

Appraisal of the current guidelines for management of cholangiocarcinoma-using the Appraisal of Guidelines Research and Evaluation Ⅱ (AGREE Ⅱ) Instrument

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 126-135,中插1页

作者： Paschalis Gavriilidis Alan Askari Keith J.Roberts Robert P.Sutcliffe Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Upper Gastro-Intestinal Surgery West Hertfordshire Hospitals NHS TrustWatfordUK

Cholangiocarcinoma(CC)is the second most common primary liver ***-quality guidelines are essential for effective patient stratification and individualised *** study aimed to appraise the methodological quality of existing guidelines for the resection of CC using the Appraisal of Guidelines for Research&Evaluation(AGREE II)instrument.A systematic search of the literature in Cochrane,PubMed,Google Scholar,and Embase was *** of the clinical practice guidelines(CPGs)and consensuses was performed using the AGREE II instrument by four clinicians experienced in surgical practice and the AGREE II appraisal *** searches identified 13 guidelines of highly variable quality according to the AGREE II *** guidelines scored well in certain domains such as scope&purpose(median score across all guidelines;65%),clarity of presentation(76%),and editorial independence(56%).However,they scored poorly for applicability(13%),rigour of development(30%),and stakeholder involvement(39%).None of the 13 guidelines was recommended universally for use without ***,the methodological quality of guidelines on the surgical management of CC is *** updates should address and modify shortcomings detected by the AGREE II instrument,thereby facilitating better patient stratification and individualised treatment strategies.

关键词： Cholangiocarcinoma(CC) clinical practice guidelines(CPGs) Appraisal of Guidelines for Research and Evaluation instrument(AGREE II instrument)

Recovery approaches in mental health: A qualitative evaluation of the Whole Life Therapy programme for persons with schizophrenia

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Health 2013年第3期5卷 582-587页

作者： Brian Littlechild Andrew Henry Smith Glynis Meredith-Windle Tim Gale Michele Lloyd Christopher Hawley ArcHealth Bedfordshire UK hertfordshire partnership nhs foundation Mental Health trust Hertfordshire UK School of Health and Social Work University of Hertfordshire Hatfield UK

The recovery approach within mental health services has in recent years been influential in promoting more active participation from service users concerning their treatment and progress, within a move towards models of interventions based on social models and ideas of service user empowerment. Although mental health recovery models are often heralded as ideological goals, comparatively little has been documented about the means of achieving these. This article sets out the nature and content of the Whole Life Programme, used within the hertfordshire nhs partnership foundation trust, and the results of qualitative research into the programme that set out to analyse the impact of its delivery from the perspectives of service users. The research examined the experiences and views of participants receiving treatment several months after the completion of the programme, and also of those who withdrew prematurely, in order to learn from these experiences, adding to our understanding of how one recovery based approach, the Whole Life Manual, can be applied in practice.

关键词： Mental Health Recovery Whole Life Programme Evaluation Service User Perspectives

Connecting brain and body:Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression

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World Journal of Psychiatry 2021年第10期11卷 805-820页

作者： Harriet Emma Clare Sharp Hugo D Critchley Jessica A Eccles Department of Medical Neuroscience Brighton and Sussex Medical SchoolUniversity of SussexBrighton BN19PXEast SussexUnited Kingdom Department of Psychiatry Sussex Partnership NHS Foundation TrustWorthingBN133EPWest SussexUnited Kingdom

The mind is embodied;thoughts and feelings interact with states of physiological arousal and physical integrity of the *** this context,there is mounting evidence for an association between psychiatric presentations and the expression variant connective tissue,commonly recognised as joint *** hypermobility is common,frequently under-recognised,significantly impacts quality of life,and can exist in isolation or as the hallmark of hypermobility spectrum disorders(encompassing joint hypermobility syndrome and hypermobile Ehlers-Danlos syndrome).In this narrative review,we appraise the current evidence linking psychiatric disorders across the lifespan,beginning with the relatively well-established connection with anxiety,to *** next consider emerging associations with affective illnesses,eating disorders,alongside less well researched links with personality disorders,substance misuse and *** then review related findings relevant to neurodevelopmental disorders and stress-sensitive medical *** growing understanding of mind-body interactions,we discuss potential aetiopathogenetic contributions of dysautonomia,aberrant interoceptive processing,immune dysregulation and proprioceptive impairments in the context of psychosocial stressors and genetic *** examine clinical implications of these evolving findings,calling for increased awareness amongst healthcare professionals of the transdiagnostic nature of hypermobility and related disorders.A role for early screening and detection of hypermobility in those presenting with mental health and somatic symptoms is further highlighted,with a view to facilitate preventative approaches alongside longer-term holistic management ***,suggestions are offered for directions of future scientific exploration which may be key to further delineating fundamental mind-body-brain interactions.

关键词： Joint hypermobility Hypermobile Ehlers-Danlos syndrome Psychopathology Psychiatric disorders Neurodevelopmental disorders Mind-body relations

Management guidelines for behavioural and psychotic symptoms in persons with dementia—A review article

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Open Journal of Psychiatry 2014年第1期4卷 5-8页

作者： Premkumar Jeyapaul Simon Manchip Alderney Hospital Dorset HealthCare University Foundation Trust Poole UK Avon & Wiltshire Mental Health partnership nhs trust Swindon UK

This paper is a review article which has systematically gathered contemporary evidence, the best practice guidelines for the management, treatment of behavioural and psychological symptoms of dementia and the various approaches including pharmacological and non-pharmacological approaches. It sets out to outline the various types of behaviour in different subtypes of dementia and a practical approach for clinicians in managing these behaviours.

关键词： BPSD Dementia Mental Capacity Act Mental Health Act Medication Psychotropic Depression Psychosis Aggression

Acceptance and Commitment Therapy for Adults with ADHD during COVID-19: An Open Trial

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Open Journal of Psychiatry 2020年第4期10卷 205-215页

作者： Tim Fullen Nazmeen Galab Karl A. Abbott Marios Adamou Adult ADHD and Autism Service South West Yorkshire Partnership Foundation Trust NHS Manygates Clinic Wakefield UK School of Human and Health Sciences University of Huddersfield Huddersfield UK

This exploratory study reports the outcomes of a remotely delivered manualised form of Acceptance and Commitment Therapy (ACT) to adults with Attention Deficit Hyperactivity Disorder (ADHD) during the COVID-19 imposed “lockdown”. Adults completing this intervention (N = 12) reported statistically and clinically significant improvements on outcomes relating to self-reported mood F(1.356, 14.917) = 21.64, p η2 = 0.66), anxiety F(2, 22) = 22.93, p η2 = 0.68), psychosocial adjustment (χ2(4) = 26.51, p < 0.001) and treatment acceptability was good. Preliminary findings suggest this cost effective and remotely delivered psychotherapeutic approach might be one appropriate method for supporting the well-being and adjustment of adults with ADHD during future COVID-19 or other pandemic related lockdowns. Further research is urgently required to establish efficacy using larger sample sizes and the implementation of wait list and treatment comparison groups. Future research might also explore the use of this manualised approach in other clinical subgroups and the general population.

关键词： ADHD COVID-19 Coronavirus ACT Adjustment Psychotherapy

Erratum to “Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life Therapy Programme for Persons with Schizophrenia” [Health 5 (2013) 582-587]

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Health 2014年第21期6卷 3054-3054页

作者： Brian Littlechild Jan Woodward Andrew Henry Smith Glynis Meredith-Windle Tim Gale Michele Lloyd Christopher Hawley School of Health and Social Work University of Hertfordshire Hatfield UK hertfordshire partnership nhs foundation trust hertfordshire partnership nhs foundation trust UK ArcHealth Bedfordshire UK

The original online version of this article (Littlechild, B., Smith, A. H., Meredith-Windle, G., Gale, T., Lloyd, M. and Hawley, C. (2013) Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life Therapy Programme for Persons with Schizophrenia. Health, 5, 582-587. http://***/10.4236/health.2013.53A077) was published mistakenly with a co-author (who also developed the Whole Life Programme) missing. To reflect the contribution and responsibility of the co-author as well as the affiliations of the authors at the time of the study, we revised authorship and author affiliations of the article.

关键词： Mental Health Recovery Whole Life Programme Evaluation Service User Perspectives

Effect of Behavioural Therapy on Depression in Adolescents with Sickle Cell Disease

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Open Journal of Psychiatry 2020年第3期10卷 127-140页

作者： Tolulope Taiwo Olayinka Atilola Cornelius Ani Bola A. Ola Lagos State university Teaching Hospital Lagos State University Lagos Nigeria Department of Behavioral Medicine Lagos State University College of Medicine Lagos Nigeria Division of Psychiatry Imperial College London and Surrey and Borders Partnership NHS Foundation Trust UK

Background: Depression, one of the commonest mental health problems in SCD, has high prevalence rates. While psychological therapies have been found to be beneficial in mild to moderate depression, their use as non-pharmacological methods amongst adolescents in sub-Saharan Africa, particularly Nigeria, is still at its infancy. Objective: To determine the effect of behavioural activation therapy on depression in adolescents living with Sickle Cell Disease attending out-patient clinic at the Lagos State university Teaching Hospital, Lagos, Nigeria. Method: The study was conducted in Lagos State university Teaching Hospital, Lagos, Nigeria, between November 2017 to February 2018 (4 months) among adolescents living with SCD and depression attending out-patient clinic. A randomized control trial (RCT) was conducted among participants assigned to treatment (30) versus control (30) group. A manualized behavioral therapy programme developed was delivered to the treatment group. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 23. Pair T-test was used to compare the two groups across continuous variables, pre- and post intervention. Analysis of Covariance (ANCOVA) was used to determine treatment effects controlling for baseline scores. Result: After the intervention, the mean depression score reduced from 22.13 ± 3.08 to 13.02 ± 4.56 while Paediatric quality of life score increase from 62.57 ± 17.85 to 67.90 ± 7.99 in the treatment group (BDI, p < 0.001;PedsQL, p = 0.045). However, the pre- and post-intervention mean depression scores in the control group showed insignificant reduction from 22.23 ± 3.24 to 21.60 ± 2.75 and mean PedsQL from pre-intervention scores of 59.67 ± 12.60 to 56.73 ± 8.94 post intervention (BDI, p = 0.388;PedsQL, p = 0.242). From multivariate analysis (ANCOVA), only the Quality of Life scores ceased to show any significant effect of the interventi

关键词： Behavioral Therapy Depression Adolescent Sickle Cell Disease RCT