The Frequency of Neuropsychiatric Sequelae After Traumatic Brain In-jury in the Global South: A systematic review and meta-analysis

Countries in the 'global south' are characterized by factors that contribute to the increased incidence of traumatic brain injury (TBI). This systematic review and meta-analysis aimed to assess the prevalence of neuropsychiatric sequelae following a TBI, specifically among the Western Asian, South Asian, and African regions of the global south. A literature review was conducted until August 20, 2021, for publications that measured psychiatric or cognitive impairment after TBI from the 83 countries that constitute the aforementioned regions. The main databases, such as PsycINFO, Scopus, PubMed/MEDLINE, ProQuest (English), Al-Manhal (Arabic) and Google Scholar, were selected for grey literature. Following the evaluation of the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, posttraumatic stress disorders (PTSD), sleep disturbance related to TBI (TBI-SD), obsessive–compulsive disorder (OCD), and cognitive impairment. Of 56 non-duplicated studies identified by the initial search, 27 studies were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in a total sample of 1882 was 35·35% (95% CI=24·64–46·87%), of anxiety in a total sample of 1211 was 28·64% (95% CI=17·99–40·65%), of PTSD in a total sample of 426 was 19·94% (95% CI=2·35–46·37%), of OCD in a total sample of 313 was 19·48% (95% CI=0·23–58·06%), of TBI–SD in a total sample of 562 was 26·67% (95% CI=15·63–39·44%), and cognitive impairment in a total sample of 941 was 49·10% (95% CI=31·26–67·07%). To date, this is the first critical review that has examined the spectrum of post–TBI neuropsychiatric sequelae in the specified regions. While existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north. Keywords: traumatic brain injury; neuropsychiatric sequelae; global south; systematic review; meta-analysis; cognitive impairment; anxiety; depressio

A Comprehensive Neuropsychological Study of Familial Hypercholesterolemia and Its Relationship with Psychosocial Functioning: A Biopsychosocial Approach

BACKGROUND: Over the past few years, there has been an increasing interest in viewing the diagnosis of familial hypercholesterolemia (FH) through the lens of the biopsychosocial model. However, other than a few epidemiological surveys, there is a dearth of studies from emerging economies that have examined FH using the biological, psychological, and socio-environmental facets of the aforementioned model. AIM. The three aims of the current study were as follows: (i) to examine the psychosocial status among patients with genetically confirmed FH, (ii) to compare their intellectual capacity and cognitive outcomes with a reference group, and (iii) to examine the relationship between health literacy and cognitive functioning. METHOD: Consecutive FH patients referred to the lipid clinic at a tertiary care center for an expert opinion were recruited into this study conducted from September 2019 to March 2020. Information regarding psychosocial functioning, health literacy, quality of life, and affective ranges was surveyed. Indices of current reasoning ability and cognition (attention and concentration, memory, and executive functioning) were compared with a socio-demographically-matched reference group. The current hypothesis also explored the impact of FH on health literacy and cognition. RESULT: A total of 70 participants out of 106 (response rate: 66.0%) initially agreed to participate. However, 18 out of 70 dropped out of the study, yielding a final total of 52 FH patients. With 27 (51.9%) males and 25 (48.1%) females, the mean participant age stood at 37.2 years (SD = 9.2), ranging from 21 to 52 years of age. In the psychosocial data, thirty-two percent (n = 17) of them had anxiety (HADS ≥ 8), and twenty-five percent (n = 13) had depressive symptoms (HADS ≥ 8). The performance of the FH patients was significantly impaired compared to the control group on the indices of current reasoning ability and all domains of cognitive functioning. In the univariate analysis conducted to compare cognitive functioning with health literacy status, only indices of attention and concentration emerged as being significant. CONCLUSION: The current study indicates that the FH population is marked with impediments in biopsychosocial functioning, including indices tapping into the integrity of health literacy, quality of life, affective ranges, and higher functioning such as cognition and current reasoning ability when compared with a socio-demographically-matched reference group. The present results support the hypothesis that chronic diseases vis-à-vis the sequelae of coronary artery disease can potentially impede biopsychosocial functioning