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Strudwick J, Gayed A, Deady M, Haffar S, Mobbs S, Malik A, Akhtar A, Braund T, Bryant RA, Harvey SB. Workplace mental health screening: a systematic review and meta-analysis. Occup Environ Med 2023; 80:469-484. [PMID: 37321849 PMCID: PMC10423530 DOI: 10.1136/oemed-2022-108608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/30/2023] [Indexed: 06/17/2023]
Abstract
Workplaces are an important location for population mental health interventions. Screening to detect employees at risk of or experiencing mental ill health is increasingly common. This systematic review and meta-analysis examined the efficacy of workplace mental health screening programmes on employee mental health, work outcomes, user satisfaction, positive mental health, quality of life, help-seeking and adverse effects. PubMed, PsycINFO, EMBASE, CENTRAL, Global Index Medicus, Global Health and SciELO were searched (database inception-10 November 2022) and results screened by two independent reviewers. Controlled trials evaluating screening of workers' mental health as related to their employment were included. Random effects meta-analysis was performed to calculate pooled effect sizes for each outcome of interest. Grading of Recommendations Assessment, Development and Evaluation was conducted to evaluate the certainty of findings. Of the 12 328 records screened, 11 were included. These reported 8 independent trials collectively assessing 2940 employees. Results indicated screening followed by advice or referral was ineffective in improving employee mental health symptoms (n=3; d=-0.07 (95% CI -0.29 to 0.15)). Screening followed by facilitated access to treatment interventions demonstrated a small improvement in mental health (n=4; d=-0.22 (95% CI -0.42 to -0.02)). Limited effects were observed for other outcomes. Certainty ranged from low to very low. The evidence supporting workplace mental health screening programmes is limited and available data suggest mental health screening alone does not improve worker mental health. Substantial variation in the implementation of screening was observed. Further research disentangling the independent effect of screening alongside the efficacy of other interventions to prevent mental ill health at work is required.
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Affiliation(s)
- Jessica Strudwick
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Sam Haffar
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Sophia Mobbs
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Aiysha Malik
- Department of Mental Health and Substance Use, World Health Organization, Geneve, Switzerland
| | - Aemal Akhtar
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Taylor Braund
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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Tan L, Strudwick J, Deady M, Bryant R, Harvey SB. Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis. BMJ Open 2023; 13:e064758. [PMID: 37438059 PMCID: PMC10347470 DOI: 10.1136/bmjopen-2022-064758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Mind-body exercise (MBE) interventions, such as yoga, are increasingly recognised as an adjunct treatment for trauma-related mental disorders but less is known about their efficacy as a preventative intervention. We aimed to systematically review if, and what type of, MBE interventions are effective at preventing the development of post-traumatic stress disorder (PTSD) or acute stress disorder (ASD) in trauma-exposed populations. DESIGN Systematic review and meta-analysis. METHODS A systematic search of MEDLINE, PsycINFO, EMBASE and CENTRAL databases was conducted to identify controlled trials of MBE interventions aimed at preventing the development of PTSD or ASD in high-risk populations. Risk of bias was assessed using the revised Cochrane risk-of-bias and ROBINS-I tools. Pooled effect sizes using Hedges' g and 95% CIs were calculated using random effects modelling for the main meta-analysis and planned subgroup and sensitivity analyses. RESULTS Six studies (N analysed=399) were included in the final meta-analysis. Overall, there was a small effect for MBE interventions in preventing the development of PTSD (g=-0.25, 95% CI -0.56 to 0.06) among those with previous or ongoing exposure to trauma. Although a prespecified subgroup analyses comparing the different types of MBE intervention were conducted, meaningful conclusions could not be drawn due to the small number of studies. None of the included studies assessed ASD symptoms. CONCLUSION Limited evidence was found for MBE interventions in reducing PTSD symptomology in the short term. Findings must be interpreted with caution due to the small number of studies and possible publication bias. PROSPERO REGISTRATION NUMBER CRD42020180375.
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Affiliation(s)
- Leona Tan
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Black Dog Institute, Randwick, New South Wales, Australia
| | | | - Mark Deady
- Black Dog Institute, Randwick, New South Wales, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Morandini J, Strudwick J, Menzies R, Dar-Nimrod I. Differences between Australian Bisexual and Pansexual Women: An assessment of minority stressors and psychological outcomes. Psychology & Sexuality 2022. [DOI: 10.1080/19419899.2022.2100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- James Morandini
- School of Psychology, University of Sydney, Sydney, Australia
| | | | - Rachel Menzies
- School of Psychology, University of Sydney, Sydney, Australia
| | - Ilan Dar-Nimrod
- School of Psychology, University of Sydney, Sydney, Australia
- The Charles Perkins Centre, University of Sydney, Sydney, Australia
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Harvey SB, Epstein RM, Glozier N, Petrie K, Strudwick J, Gayed A, Dean K, Henderson M. Mental illness and suicide among physicians. Lancet 2021; 398:920-930. [PMID: 34481571 PMCID: PMC9618683 DOI: 10.1016/s0140-6736(21)01596-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/09/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.
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Affiliation(s)
- Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia.
| | - Ronald M Epstein
- Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Nicholas Glozier
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Katherine Petrie
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Jessica Strudwick
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Kimberlie Dean
- School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia; Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Max Henderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Wong S, Strudwick J, Devenney E, Hodges JR, Piguet O, Kumfor F. Frontal variant of Alzheimer's disease masquerading as behavioural-variant frontotemporal dementia: a case study comparison. Neurocase 2019; 25:48-58. [PMID: 31044682 DOI: 10.1080/13554794.2019.1609523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The current clinical diagnostic criteria for Alzheimer's disease (AD) recognize an atypical, non-amnestic presentation of AD, characterized by prominent executive dysfunction. Increasing evidence, however, indicates that the clinical phenotype of this so-called "frontal-variant" of AD (fv-AD) includes behavioral symptoms and deficits in social cognition, together with disproportionate frontal lobe atrophy. As these features resemble those characteristic of behavioral-variant frontotemporal dementia (bvFTD), differential diagnosis can be challenging. Here, we report a case of fv-AD who met clinical diagnostic criteria bvFTD, but had in vivo amyloid neuroimaging evidence of AD pathology. We compare this case against two individuals who were clinically diagnosed with bvFTD and early-onset AD, with in vivo amyloid neuroimaging confirmation of pathology. We highlight the challenges in differential diagnosis by contrasting their behavioral, cognitive and structural neuroimaging findings.
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Affiliation(s)
- Stephanie Wong
- a Brain and Mind Centre , The University of Sydney , Sydney , Australia.,b School of Psychology , The University of Sydney , Sydney , Australia.,c ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia
| | - Jessica Strudwick
- b School of Psychology , The University of Sydney , Sydney , Australia
| | - Emma Devenney
- a Brain and Mind Centre , The University of Sydney , Sydney , Australia.,d Sydney Medical School , The University of Sydney , Sydney , Australia
| | - John R Hodges
- a Brain and Mind Centre , The University of Sydney , Sydney , Australia.,d Sydney Medical School , The University of Sydney , Sydney , Australia
| | - Olivier Piguet
- a Brain and Mind Centre , The University of Sydney , Sydney , Australia.,b School of Psychology , The University of Sydney , Sydney , Australia.,c ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia
| | - Fiona Kumfor
- a Brain and Mind Centre , The University of Sydney , Sydney , Australia.,b School of Psychology , The University of Sydney , Sydney , Australia.,c ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia
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Strudwick J. Jackie Strudwick was sickened by the care her son received on entering hospital with acute appendicitis. Nurs Times 1999; 95:45. [PMID: 10745840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Strudwick J. Teenagers need to be given special attention. Nurs Times 1998; 94:31. [PMID: 9919274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Gamble JG, Rinsky LA, Strudwick J, Bleck EE. Non-union of fractures in children who have osteogenesis imperfecta. J Bone Joint Surg Am 1988; 70:439-43. [PMID: 3346270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Although a fracture rarely fails to unite in a healthy child, non-union is not a rare occurrence in a child who has osteogenesis imperfecta. We identified twelve non-unions in ten patients from a population of fifty-two patients who had osteogenesis imperfecta. The average age of these patients when the diagnosis of non-union was made nine years, and the average age at the time of treatment was 12.5 years. All of the patients had had a decrease in functional ability as a result of the non-union. There were five femoral, four humeral, one radial, one ulnar, and one pubic non-union. Five of the non-unions were hypertrophic, and seven were atrophic. Eight of the nine ununited fractures that were operated on healed after excision of the non-union, intramedullary nailing, and bone-grafting. Three of the non-unions (in two patients) were not operated on, and the one patient in whom surgery failed had an amputation. Non-union was frequently associated with repeated fractures at a progressively deforming site.
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Affiliation(s)
- J G Gamble
- Children's Hospital at Stanford, Palo Alto, California 94304
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