General hospital psychiatry
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Gen Hosp Psychiatry · Nov 2017
Review Meta AnalysisExercise effects on depression: Possible neural mechanisms.
Depression is a syndrome of stress- and emotion-dysregulation, involving compromised structural integrity of frontal-limbic networks. Meta-analytic evidence indicates that volumetric reductions in the hippocampus, anterior cingulate cortex, prefrontal cortex, striatum, and amygdala, as well as compromised white matter integrity are frequently observed in depressed adults. ⋯ The prefrontal cortex, anterior cingulate cortex, hippocampus, and corpus callosum emerged as structural neural markers that may serve as targets for exercise-based treatments for depression. These findings highlight the need for randomized exercise interventions to test these proposed neurobiological mechanisms of exercise on depression.
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Gen Hosp Psychiatry · Nov 2016
Review Meta AnalysisAnxiety symptoms in survivors of critical illness: a systematic review and meta-analysis.
To evaluate the epidemiology of and postintensive care unit (ICU) interventions for anxiety symptoms after critical illness. ⋯ One third of ICU survivors experience anxiety symptoms that are persistent during their first year of recovery. Psychiatric symptoms during admission and memories of in-ICU delusional experiences were associated with post-ICU anxiety. Physical rehabilitation and ICU diaries merit further investigation as possible interventions.
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Gen Hosp Psychiatry · Mar 2015
Review Meta Analysis Comparative StudySchizophrenia and the risk of fractures: a systematic review and comparative meta-analysis.
People with schizophrenia experience increased rates of osteoporosis and may be at heightened risk of fractures. We conducted a systematic review and meta-analysis to investigate fractures among people with schizophrenia compared to people without mental illness. ⋯ People with schizophrenia are at significantly increased risk of fractures. Future research is required to understand the mechanisms and should seek to validate fracture prediction algorithms used in the general population. Importantly, there is a need to develop preventative strategies to improve bone health and reduce fracture risk involving the wider multidisciplinary team and incorporating falls-prevention strategies.
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Gen Hosp Psychiatry · Nov 2014
Review Meta AnalysisThe Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis.
To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults. ⋯ The MMSE cannot be recommended as a case-finding confirmatory test of delirium, but may be used as an initial screen to rule out high scorers who are unlikely to have delirium with approximately 93% accuracy.
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Gen Hosp Psychiatry · Sep 2014
Review Meta AnalysisA meta-analysis of critically ill patients reveals several potential risk factors for delirium.
To investigate potential risk factors for delirium in critically ill patients through a meta-analysis of clinical observational studies. ⋯ Age, history of hypertension, clinical use of mechanical ventilation and higher APACHE II score are associated with increased risk of delirium in critically ill patients.