14 research outputs found
The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review
BACKGROUND: There is some evidence that more social media use is related to poorer mental well-being and that social media use can become problematic when it starts to interfere with a person's daily life and mental well-being. To address this issue and improve users' mental well-being, social media use interventions (eg, abstinence from social media) have been developed and evaluated. However, there is limited understanding of the effectiveness of these interventions in improving mental well-being. OBJECTIVE: This systematic review aimed to synthesize the literature on the effectiveness of social media use interventions in improving mental well-being in adults. METHODS: A systematic search (January 1, 2004, to July 31, 2022) was completed across 3 databases in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Experimental studies evaluating the impact of social media use interventions on mental well-being in adults were included. Outcomes related to mental well-being, such as depression, anxiety, stress, and loneliness, were included. A narrative synthesis without meta-analysis was completed to summarize the study characteristics and effectiveness by outcome and intervention type. The Effective Public Health Practice Project Quality Assessment Tool was used to measure the quality of the studies. RESULTS: Of the 2785 studies identified through the systematic search, 23 (0.83%) were included in the analysis. Many of the included studies (9/23, 39%) found improvements in mental well-being, some (7/23, 30%) found mixed effects, and others (7/23, 30%) found no effect on mental well-being. Therapy-based interventions that used techniques such as cognitive behavioral therapy were more effective than limiting use of social media or full abstinence from social media, with 83% (5/6) of these studies showing improvements in mental well-being compared with 20% (1/5) and 25% (3/12), respectively. Depression was the most frequently investigated and improved outcome with 70% (7/10) of the studies showing a significant improvement in depression after the intervention, whereas other outcomes showed more varied results. Quality was poor, with 96% (22/23) of the studies receiving a weak global score, mostly for issues related to selection bias because most of the studies (16/23, 70%) used a convenience sampling of university students. CONCLUSIONS: This review provides some evidence that social media use interventions are effective in improving mental well-being, especially for depression and when using therapy-based interventions. Further experimental and longitudinal research is needed with representative samples to investigate who may benefit most from social media use interventions. This will help to develop guidance and recommendations for policy makers and clinicians on how best to manage problematic social media use
Association of Recent Fatherhood With Antidepressant Treatment Initiation Among Men in the United Kingdom
IMPORTANCE: There is some evidence that men may be at higher risk of depression directly following the birth of their child and that approximately 1 in 10 men will experience depression in the year after birth, but less is known about men's antidepressant treatment during this time. Likewise, few direct comparisons have been made with antidepressant treatment in men who have not recently become fathers. OBJECTIVES: To determine whether recently having a child was associated with increased odds of antidepressant treatment in men. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used UK primary care electronic health records from the IQVIA Medical Research Database. Participants included men aged 15 to 55 years who had had a child in the previous year, from January 2007 to December 2016, and compared with up to 5 men who did not have a child in the same calendar year. Data were analyzed from January 2022 to March 2023. EXPOSURE: A record of having a child in the previous year was identified through linked primary care records using a family identification number. MAIN OUTCOMES AND MEASURES: The main outcome was antidepressant initiation in the year after childbirth or in the year after this index date for men who did not have a child. Random-effects Poisson regression was used to determine associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after index date using prevalence risk rates (PPRs). RESULTS: Analysis included 90 736 men who had had a child in the previous year and 453 632 men in the comparison cohort. Most men in the study (463 879 men [85.2%]) were aged between 25 and 44 years, and there were more men living in the least deprived areas (130 277 men [23.9%]) than the most deprived areas (72 268 men [13.3%]). Overall, 4439 men (4.9%) had at least 1 antidepressant prescription in the year after they had a child, compared with 26 646 men (5.9%) who did not have a child in the same year. However, after adjustment there was no difference in antidepressant treatment between groups (adjusted PRR [aPRR], 1.01; 95% CI, 0.98-1.04). In fathers, those who had recently received antidepressant treatment were much more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment (aPRR, 32.31; 95% CI, 30.37-34.38). Fathers living in the most deprived areas were 18% more likely to have an antidepressant prescription compared with fathers living in the least deprived areas (aPRR, 1.18; 95% CI, 1.07-1.30). CONCLUSIONS AND RELEVANCE: These findings suggest that recently having a child was not associated with an increase in antidepressant treatment among men, but previous antidepressant treatment in fathers was strongly associated with treatment after childbirth. Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment
Assessing potential nondirected altruistic kidney donors: a case note audit
Kidney transplantation is now generally accepted as the preferred mode of renal replacement therapy, as it has superior long-term survival compared with dialysis treatment. However, kidney transplantation is limited by the shortage of donor organs; currently, approximately 7,500 patients are on the transplant list for a kidney donation in the UK
Reduced specificity of autobiographical memories following a negative mood induction
Reduced autobiographical memory specificity (AMS) to emotional and neutral cue words appears to be a stable cognitive marker of clinical depression. For example, reduced AMS is present in remitted/recovered depressed patients and shows no reliable relationship with current levels of depressed mood in correlational studies. The present study examined whether reduced AMS could be induced in healthy volunteers with no history of depression, using a negative mood manipulation and whether levels of AMS and induced mood were positively correlated. Results showed a reduction in AMS following negative mood induction, compared to a neutral induction, whereas positive mood induction had no effects on AMS. Furthermore, lower happiness following the induction phase correlated positively with reduced AMS, and the extent of happiness reduction from pre- to post-induction correlated positively with reduction in AMS. These results suggest that AMS is, at least in part, a function of current emotion state. The implications for the literature on AMS as a stable marker of clinical depression are discussed
Hypertension and cardiovascular risk factor management in a multi-ethnic cohort of adults with CKD: a cross sectional study in general practice.
BACKGROUND: Hypertension, especially if poorly controlled, is a key determinant of chronic kidney disease (CKD) development and progression to end stage renal disease (ESRD). AIM: To assess hypertension and risk factor management, and determinants of systolic blood pressure control in individuals with CKD and hypertension. DESIGN AND SETTING: Cross-sectional survey using primary care electronic health records from 47/49 general practice clinics in South London. METHODS: Known effective interventions, management of hypertension and cardiovascular disease (CVD) risk in patients with CKD Stages 3-5 were investigated. Multivariable logistic regression analysis examined the association of demographic factors, comorbidities, deprivation, and CKD coding, with systolic blood pressure control status as outcome. Individuals with diabetes were excluded. RESULTS: Adults with CKD Stages 3-5 and hypertension represented 4131/286,162 (1.4%) of the total population; 1984 (48%) of these individuals had undiagnosed CKD without a recorded CKD clinical code. Hypertension was undiagnosed in 25% of the total Lambeth population, and in patients with CKD without diagnosed hypertension, 23.0% had systolic blood pressure > 140 mmHg compared with 39.8% hypertensives, p < 0.001. Multivariable logistic regression revealed that factors associated with improved systolic blood pressure control in CKD included diastolic blood pressure control, serious mental illness, history of cardiovascular co-morbidities, CKD diagnostic coding, and age < 60 years. African ethnicity and obesity were associated with poorer systolic blood pressure control. CONCLUSION: We found both underdiagnosed CKD and underdiagnosed hypertension in patients with CKD. The poor systolic blood pressure control in older age groups ≥ 60 years and in Black African or obese individuals is clinically important as these groups are at increased risk of mortality for cardiovascular diseases
Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial
Background Online patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST — the electronic Clinical Reasoning Educational Simulation Tool. Methods A feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after 1 week and a patient case after 1 month. Results Across schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After 1 week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students’ ability to gather essential information from patients over controls (OR = 1.4; 95% CI 1.1–1.7, n = 148). Of the intervention group, most (80/98, 82%) agreed eCREST helped them to learn clinical reasoning skills. Conclusions eCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness
Diagnosis and terminology in hypogonadism
Hypogonadism (testosterone deficiency) is a clinical and biochemical syndrome that stems from a
reduced production of testosterone and sperm cells by the testis. It can adversely affect multiple
bodily systems and is associated with a marked decrease in quality of life. Hypogonadism is primarily
classified according to it being a congenital or acquired disorder; the anatomical level of dysfunction:
at testicular (primary hypogonadism), hypothalamic- pituitary (secondary hypogonadism) or
combined levels and recognises affected men with idiopathic, metabolic or iatrogenic conditions
resulting in testosterone deficiency. Treatment decisions should include lifestyle measures and a holistic review of the patient.
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This chapter aims at:
1. Shedding some light on definitions and terminology in patients with
testosterone deficiency (hypogonadal patients).
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2. Outlining its epidemiology.
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3. Exploring the underlying pathophysiology.
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4. Discussing issues surrounding diagnosis.
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5. Drawing a conclusion
Anabolic-androgenic steroids. Use, misuse and abuse in men
Androgens, also referred to as anabolic-androgenic steroids (AAS), are a cluster of hormones comprising natural androgens, such as testosterone, as well as synthetic steroidal derivatives. Performance and image enhancing drugs (PIEDs) are categorised based on their reason for use: AAS, the focus of this chapter and the most widely used PIED, promote growth of the skeletal muscle, development of male sexual characteristics in both males and females, reduce body fat and can improve overall well-being. Muscle dysmorphia is not only a gateway to commencing AAS use but also feeds dependence as individuals are petrified of losing their muscular physique. The use of AAS can cause many adverse effects ranging from the mild to life-threatening. AAS contribute to the development of cardiovascular disease by increasing low-density lipoprotein (LDL) and decreasing high-density lipoprotein (HDL), an effect seen soon after starting AAS
Prevalence of perinatal depression and anxiety in both parents
Importance New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad).
Objective To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads.
Data Sources Ovid (MEDLINE, Embase, and PsycINFO) and Web of Science were searched from January 1, 1990, to June 8, 2021, for observational studies reporting on the prevalence of perinatal depression or anxiety in a parental dyad.
Study Selection Studies reporting the prevalence of anxiety or depression in both members of a parental dyad were included, with diagnosis according to established criteria (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition], International Classification of Diseases, 11th Revision) or use of validated screening tools.
Data Extraction and Synthesis Prevalence data were extracted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were analyzed in subgroups: antenatal depression, early postnatal depression (0-12 weeks), late postnatal depression (3-12 months), and perinatal anxiety. Pooled prevalence was calculated using a random-effects meta-analysis model. Quality assessment was performed using Joanna Briggs Institute Appraisal Checklist for Studies Reporting Prevalence Data. Data were analyzed in June 2021.
Main Outcomes and Measures Prevalence of perinatal anxiety and perinatal depression in parental dyads.
Results Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis.
Conclusions and Relevance In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders