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Tsiglopoulos J, Pearson N, Mifsud N, Castagnini E, Allott K, Thompson A, Killackey E, McGorry P, O'Donoghue B. The prevalence of vitamin D deficiency and associated factors in first-episode psychosis. Early Interv Psychiatry 2024; 18:237-242. [PMID: 37700506 DOI: 10.1111/eip.13465] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/29/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
AIM Vitamin D deficiency is prevalent in people with established psychotic disorders, but less is known about vitamin D levels in people with first-episode psychosis (FEP). This study aimed to determine the prevalence of vitamin D deficiency in people with FEP and identify the factors associated with vitamin D status. METHODS This was a prospective cohort study nested within a randomized controlled trial, which included 37 young people with an FEP with minimal antipsychotic medication exposure. RESULTS Twenty-four percent of participants were vitamin D deficient, and a further 30% were vitamin D insufficient. There was no association between vitamin D and demographic factors or clinical symptoms (positive, negative, general psychopathology and depressive symptoms) or cognition and functioning. However, vitamin D levels were associated with season of sampling. CONCLUSIONS Considering the longer-term adverse effects associated with vitamin D deficiency, it is warranted to ensure this clinical population receives supplementation if indicated.
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Affiliation(s)
- Jonathan Tsiglopoulos
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Nicholas Pearson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Nathan Mifsud
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Emily Castagnini
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Andrew Thompson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Eoin Killackey
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Patrick McGorry
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Brian O'Donoghue
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
- Department of Psychiatry, University College Dublin, Dublin, Ireland
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O'Donoghue B, Sexton S, Lyne JP, Roche E, Mifsud N, Brown E, Renwick L, Behan C, Clarke M. Socio-demographic and clinical characteristics of migrants to Ireland presenting with a first episode of psychosis. Ir J Psychol Med 2023; 40:336-342. [PMID: 33632349 DOI: 10.1017/ipm.2020.132] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service. METHODS All cases of treated FEP from three local mental health services within a defined catchment area were included. Psychotic disorder diagnoses were determined using the SCID and symptom and functioning domains were measured using validated and reliable measures. RESULTS From a cohort of 612 people, 21.1% were first-generation migrants and there was no difference in the demographic characteristics, diagnoses, symptoms or functioning between migrants and those born in the Republic of Ireland, except that migrants from Africa presented with less insight. Of those admitted, 48.6% of admissions for migrants were involuntary compared to 37.7% for the native-born population (p = 0.09). CONCLUSIONS First-generation migrants now make up a significant proportion of people presenting with a FEP to an Irish EI for psychosis service. Broadly the demographic and clinical characteristics of migrants and those born in the Republic of Ireland are similar, except for less insight in migrants from Africa and a trend for a higher proportion of involuntary admissions in the total migrant group.
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Affiliation(s)
- B O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - S Sexton
- Linndara, Child and Adolescent Mental Health Services, Health Service Executive, Kildare, Ireland
| | - J P Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
| | - E Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - N Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - E Brown
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, England, UK
| | - C Behan
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - M Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
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Gannon L, Pearson N, Tsiglopoulos J, Mifsud N, Castagnini E, Thompson A, Langstone A, Killackey E, McGorry P, O'Donoghue B. Longitudinal study of the prevalence of sleep disorders in first episode psychosis and its clinical correlates. Schizophr Res 2023; 258:81-83. [PMID: 37523870 DOI: 10.1016/j.schres.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/09/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Affiliation(s)
- Louisa Gannon
- Department of Psychiatry, University College Dublin, Ireland; St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Nicholas Pearson
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Jonathan Tsiglopoulos
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Nathan Mifsud
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Emily Castagnini
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Alison Langstone
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Brian O'Donoghue
- Department of Psychiatry, University College Dublin, Ireland; St Vincent's University Hospital, Elm Park, Dublin, Ireland; Centre for Youth Mental Health, University of Melbourne, VIC, Australia; Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Department of Psychiatry, Royal College of Surgeons, Ireland.
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Brown E, Castagnini E, Langstone A, Mifsud N, Gao C, McGorry P, Killackey E, O'Donoghue B. High-risk sexual behaviours in young people experiencing a first episode of psychosis. Early Interv Psychiatry 2023; 17:159-166. [PMID: 35355426 DOI: 10.1111/eip.13301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
Abstract
AIM The sexual health of adults with schizophrenia is poorer than the general population; however, less is known about young people experiencing a first episode of psychosis (FEP). The aim of this study was to explore the high-risk sexual behaviours and sexual well-being indicators of a cohort of young people with FEP. METHODS Data collected from young people (15-24 years) with FEP attending the EPPIC service in Melbourne and participating in a physical health intervention were analysed. Baseline trial data collected on sexual health and high-risk behaviours, psychiatric symptomology, functioning, and substance use are presented by gender. Associations between symptomology and functioning with sexual behaviour are explored. RESULTS A total of 69 young people were included in this study; mean age was 19.6 years (SD±2.8), 53.6% were male, 59.6% identified as heterosexual, and 21.7% were currently in a relationship. Within the cohort, 78.3% had ever been sexually active. Of these, 44.2% consistently used a condom at last sex act and 35.7% used barrier contraception consistently, 22.5% had previously been pregnant, and 18.6% had tested positive for an STI. Finally, young people were more likely to have been sexually active if they were currently using substances. CONCLUSIONS These findings suggest that high rates of high-risk sexual behaviour remain an issue for young people experiencing a first episode of psychosis. Promoting sexual well-being and communication skills between sexual partners should be targeted to ensure that high-risk sexual health outcomes are mitigated as early as possible.
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Affiliation(s)
- Ellie Brown
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Emily Castagnini
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Alison Langstone
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nathan Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Caroline Gao
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Eoin Killackey
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Abstract
BACKGROUND Migration is an established risk factor for developing a psychotic disorder in countries with a long history of migration. Less is known for countries with only a recent history of migration. This study aimed to determine the risk for developing a psychotic disorder in migrants to the Republic of Ireland. METHODS We included all presentations of first-episode psychosis over 8.5 years to the DETECT Early Intervention for psychosis service in the Republic of Ireland (573 individuals aged 18-65, of whom 22% were first-generation migrants). Psychotic disorder diagnosis relied on SCID. The at-risk population was calculated using census data, and negative binomial regression was used to estimate incidence rate ratios. RESULTS The annual crude incidence rate for a first-episode psychotic disorder in the total cohort was 25.62 per 100000 population at risk. Migrants from Africa had a nearly twofold increased risk for developing a psychotic disorder compared to those born in the Republic of Ireland (IRR = 1.83, 95% CI 1.11-3.02, p = 0.02). In contrast, migrants from certain Asian countries had a reduced risk, specifically those from China, India, Philippines, Pakistan, Malaysia, Bangladesh and Hong Kong (aIRR = 0.36, 95% CI 0.16-0.81, p = 0.01). CONCLUSIONS Further research into the reasons for this inflated risk in specific migrant groups could produce insights into the aetiology of psychotic disorders. This information should also be used, alongside other data on environmental risk factors that can be determined from census data, to predict the incidence of psychotic disorders and thereby resource services appropriately.
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Affiliation(s)
- Brian O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - John Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Eric Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - Nathan Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
| | - Caragh Behan
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
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Griffiths O, Jack BN, Pearson D, Elijah R, Mifsud N, Han N, Libesman S, Rita Barreiros A, Turnbull L, Balzan R, Le Pelley M, Harris A, Whitford TJ. Disrupted auditory N1, theta power and coherence suppression to willed speech in people with schizophrenia. Neuroimage Clin 2023; 37:103290. [PMID: 36535137 PMCID: PMC9792888 DOI: 10.1016/j.nicl.2022.103290] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 11/17/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
The phenomenon of sensory self-suppression - also known as sensory attenuation - occurs when a person generates a perceptible stimulus (such as a sound) by performing an action (such as speaking). The sensorimotor control system is thought to actively predict and then suppress the vocal sound in the course of speaking, resulting in lowered cortical responsiveness when speaking than when passively listening to an identical sound. It has been hypothesized that auditory hallucinations in schizophrenia result from a reduction in self-suppression due to a disruption of predictive mechanisms required to anticipate and suppress a specific, self-generated sound. It has further been hypothesized that this suppression is evident primarily in theta band activity. Fifty-one people, half of whom had a diagnosis of schizophrenia, were asked to repeatedly utter a single syllable, which was played back to them concurrently over headphones while EEG was continuously recorded. In other conditions, recordings of the same spoken syllables were played back to participants while they passively listened, or were played back with their onsets preceded by a visual cue. All participants experienced these conditions with their voice artificially shifted in pitch and also with their unaltered voice. Suppression was measured using event-related potentials (N1 component), theta phase coherence and power. We found that suppression was generally reduced on all metrics in the patient sample, and when voice alteration was applied. We additionally observed reduced theta coherence and power in the patient sample across all conditions. Visual cueing affected theta coherence only. In aggregate, the results suggest that sensory self-suppression of theta power and coherence is disrupted in schizophrenia.
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Affiliation(s)
- Oren Griffiths
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; Flinders Institute for Mental Health and Wellbeing, Adelaide, Australia.
| | - Bradley N Jack
- Research School of Psychology, Australian National University, Canberra, Australia
| | | | - Ruth Elijah
- School of Psychology, UNSW Sydney, Sydney, Australia
| | - Nathan Mifsud
- School of Psychology, UNSW Sydney, Sydney, Australia
| | - Nathan Han
- School of Psychology, UNSW Sydney, Sydney, Australia
| | - Sol Libesman
- School of Psychology, UNSW Sydney, Sydney, Australia
| | - Ana Rita Barreiros
- Specialty of Psychiatry, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, Australia; Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Luke Turnbull
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Ryan Balzan
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; Flinders Institute for Mental Health and Wellbeing, Adelaide, Australia
| | | | - Anthony Harris
- Specialty of Psychiatry, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, Australia; Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Thomas J Whitford
- Specialty of Psychiatry, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, Australia
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O'Donoghue B, Mifsud N, Castagnini E, Langstone A, Thompson A, Killackey E, McGorry P. A single-blind, randomised controlled trial of a physical health nurse intervention to prevent weight gain and metabolic complications in first-episode psychosis: the Physical Health Assistance in Early Psychosis (PHAstER) study. BJPsych Open 2022; 8:e189. [PMID: 36254811 PMCID: PMC9634606 DOI: 10.1192/bjo.2022.590] [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: 11/17/2022] Open
Abstract
BACKGROUND Factors that contribute to the early mortality observed in psychotic disorders, specifically obesity, smoking and sedentary behaviour, occur early in the disorder. AIMS We aimed to determine whether the integration of a physical health nurse in the care of young people with first-episode psychosis could prevent clinically significant weight gain (≥7% body weight). Secondary outcomes included rates of smoking, metabolic syndrome and sedentary behaviour. METHOD In this single-blind, randomised controlled trial, participants who had received under 4 weeks of antipsychotic medication were randomly allocated to either the intervention (addition of a physical health nurse to their care) or treatment as usual (TAU) for 12 weeks. RESULTS Of the 77 participants, there were follow-up data for 86.8% (n = 33) of the intervention group and 82.1% (n = 32) of the TAU group. After 12 weeks, 27.3% of the intervention group experienced clinically significant weight gain compared with 34.4% of the TAU group (odds ratio 0.72, 95% CI 0.25-2.06, P = 0.54). After 6 months, 40.7% of the intervention group gained clinically significant weight compared with 44.1% of the TAU group (P = 0.79). There was no difference in mean change in weight between groups after 12 weeks (2.6 kg v. 2.9 kg, P = 0.87) or 6 months (3.6 kg v. 4.3 kg, P = 0.64). There were no differences in the rates of tobacco smoking cessation, prevalence of metabolic syndrome or physical activity levels. CONCLUSIONS This intervention failed to prevent the metabolic complications that are highly prevalent in psychotic disorders in the short to medium term, indicating that more intensive interventions are required.
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Affiliation(s)
- Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Australia; Early Psychosis Prevention and Intervention Centre, Orygen, Australia; and Department of Psychiatry, St Vincent's University Hospital, Ireland
| | - Nathan Mifsud
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
| | - Emily Castagnini
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
| | - Alison Langstone
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, Australia; and Early Psychosis Prevention and Intervention Centre, Orygen, Australia
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Burke T, Thompson A, Mifsud N, Yung AR, Nelson B, McGorry P, O'Donoghue B. Proportion and characteristics of young people in a first-episode psychosis clinic who first attended an at-risk mental state service or other specialist youth mental health service. Schizophr Res 2022; 241:94-101. [PMID: 35101839 DOI: 10.1016/j.schres.2021.12.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Received: 03/12/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Services for young people identified as having an 'at-risk mental state' (ARMS) aim to prevent transition to first-episode psychosis (FEP), in addition, early intervention services for other mental health disorders have also been developed. The aim of the current study was to determine the proportion of young people attending a specialist FEP service who had been referred via other early intervention clinics, including an ARMS clinic, and compare the characteristics to those who presented directly to the FEP service. METHODS We included young people diagnosed with FEP who received treatment at Orygen between 01.01.2012 and 31.12.2016. We examined rates of direct entry to the First Episode Psychosis service and rates from other early intervention services, specifically ARMS, personality disorders, mood disorders and a primary care youth mental health service clinics. RESULTS 1138 young people were diagnosed with a FEP, of whom 13.7% first attended an ARMS clinic and a further 7.6% attended other youth mental health services. Individuals who first presented to an ARMS clinic were more likely to be female, younger, and less likely to be migrants or use substances. Rates of both voluntary and involuntary hospital admissions were significantly reduced for young people who transitioned from the ARMS clinic, the personality disorder clinic or the primary care service compared to those who presented directly with FEP. CONCLUSIONS A significant proportion of young people with FEP initially attended another specialist youth mental health service, and importantly, they had much lower rates of hospital admission at the time of transition to FEP.
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Affiliation(s)
- Tara Burke
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Andrew Thompson
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Nathan Mifsud
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Alison R Yung
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Barnaby Nelson
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Patrick McGorry
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Brian O'Donoghue
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia.
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Tsiglopoulos J, Pearson N, Mifsud N, Allott K, O'Donoghue B. The association between vitamin D and symptom domains in psychotic disorders: A systematic review. Schizophr Res 2021; 237:79-92. [PMID: 34509104 DOI: 10.1016/j.schres.2021.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 04/23/2021] [Revised: 07/24/2021] [Accepted: 08/02/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Vitamin D deficiency is prevalent among people with psychosis and may play a role in the aetiology of psychotic disorders. However, its impact on clinical symptom severity has not been independently reviewed. METHODS We conducted a systematic search of randomized trials and observational studies that assessed the relationship between vitamin D and symptom domains (positive and negative psychotic symptoms, total and general psychopathology, cognitive and depressive) in people with a psychotic disorder. RESULTS 1040 articles were identified, of which 29 were eligible for inclusion: 26 observational studies and 3 randomized trials. Five studies included people with First-Episode Psychosis (FEP) and 24 included people with enduring psychosis. Most observational studies found that vitamin D was inversely associated with negative symptoms (57%; 13/23), positively associated with cognitive performance (63%; 5/8), and bore no association with positive symptoms (68%; 15/22), total psychopathology (64%; 7/11), general psychopathology (57%; 4/7) or depressive symptoms (64%; 9/14). Randomized controlled trials indicated that vitamin D supplementation improved cognitive performance (100%; 1/1) and, in some cases, reduced total psychopathology (50%; 1/2), general psychopathology (50%; 1/2) and negative symptoms (30%; 1/3), but had no effect on positive (100%; 3/3) or depressive (100%; 3/3) symptoms. Some positive associations were attenuated when controlled for potential confounders. CONCLUSION Low vitamin D was found to be inversely associated with more severe clinical symptoms in some, but not all symptom domains in people with psychosis. These preliminary findings warrant further exploration, particularly in regard to cognitive performance and negative symptoms.
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Affiliation(s)
- Jonathan Tsiglopoulos
- Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, VIC, Australia
| | - Nicholas Pearson
- Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, VIC, Australia
| | - Nathan Mifsud
- Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, VIC, Australia
| | - Kelly Allott
- Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, VIC, Australia
| | - Brian O'Donoghue
- Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, VIC, Australia; St Vincents University Hospital, Elm Park, Dublin, Ireland.
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10
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Moore D, Castagnini E, Mifsud N, Geros H, Sizer H, Addington J, van der Gaag M, Nelson B, McGorry P, O'Donoghue B. The associations between migrant status and ethnicity and the identification of individuals at ultra-high risk for psychosis and transition to psychosis: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1923-1941. [PMID: 33641006 DOI: 10.1007/s00127-021-02047-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Migrant and ethnic minority populations exhibit a higher incidence of psychotic disorders. The Ultra-High Risk for psychosis (UHR) paradigm provides an opportunity to explore the stage at which such factors influence the development of psychosis. In this systematic review, we collate and appraise the literature on the association between ethnicity and migrant status and the rate of identification of individuals at UHR, as well as their rate of transition to psychosis. METHODS We conducted a systematic review in the Ovid Medline, PsychINFO, Pubmed, CINAHL and EMBASE databases according to PRISMA guidelines. We included studies written in English that included an UHR cohort, provided a measure of ethnicity or migrant status, and examined the incidence, rate, or risk of UHR identification or transition to psychosis. RESULTS Of 2182 unique articles identified, seven fulfilled the criteria. One study found overrepresentation of UHR individuals from black ethnic groups, while another found underrepresentation. Two studies found increased rates of transition among certain ethnic groups and a further two found no association. Regarding migrant status, one study found that first-generation migrants were underrepresented in an UHR sample. Lastly, a lower transition rate in migrant populations was identified in one study, while two found no association. CONCLUSION Rates of UHR identification and transition according to ethnic and migrant status were inconsistent and insufficient to conclusively explain higher incidences of psychotic disorders among these groups. We discuss the clinical implications and avenues for future research, which is required to clarify the nature of the associations.
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Affiliation(s)
- Danielle Moore
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Emily Castagnini
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nathan Mifsud
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Hellen Geros
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Holly Sizer
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Barnaby Nelson
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
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O'Donoghue B, Castagnini E, Langstone A, Mifsud N, Thompson A, Killackey E, McGorry P. Sedentary behaviour in young people presenting with a first episode of psychosis before and during the covid-19 pandemic restrictions. Schizophr Res 2021; 233:31-33. [PMID: 34225024 DOI: 10.1016/j.schres.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/11/2021] [Accepted: 06/18/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Brian O'Donoghue
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia; St Vincents University Hospital, Elm Park, Dublin 4, Ireland.
| | - Emily Castagnini
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Alison Langstone
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Nathan Mifsud
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Andrew Thompson
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Eoin Killackey
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Patrick McGorry
- Orygen, 35 Poplar rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
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12
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Abstract
BACKGROUND Certain migrant groups are at an increased risk of psychotic disorders compared to the native-born population; however, research to date has mainly been conducted in Europe. Less is known about whether migrants to other countries, with different histories and patterns of migration, such as Australia, are at an increased risk for developing a psychotic disorder. We tested this for first-generation migrants in Melbourne, Victoria. METHODS This study included all young people aged 15-24 years, residing in a geographically-defined catchment area of north western Melbourne who presented with a first episode of psychosis (FEP) to the Early Psychosis Prevention and Intervention Centre (EPPIC) between 1 January 2011 and 31 December 2016. Data pertaining to the at-risk population were obtained from the Australian 2011 Census and incidence rate ratios were calculated and adjusted for age, sex and social deprivation. RESULTS In total, 1220 young people presented with an FEP during the 6-year study period, of whom 24.5% were first-generation migrants. We found an increased risk for developing psychotic disorder in migrants from the following regions: Central and West Africa (adjusted incidence rate ratio [aIRR] = 3.53, 95% CI 1.58-7.92), Southern and Eastern Africa (aIRR = 3.06, 95% CI 1.99-4.70) and North Africa (aIRR = 5.03, 95% CI 3.26-7.76). Migrants from maritime South East Asia (aIRR = 0.39, 95% CI 0.23-0.65), China (aIRR = 0.25, 95% CI 0.13-0.48) and Southern Asia (aIRR = 0.44, 95% CI 0.26-0.76) had a decreased risk for developing a psychotic disorder. CONCLUSION This clear health inequality needs to be addressed by sufficient funding and accessible mental health services for more vulnerable groups. Further research is needed to determine why migrants have an increased risk for developing psychotic disorders.
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Affiliation(s)
- Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen Youth Health, Melbourne, Australia
| | - Linglee Downey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Scott Eaton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nathan Mifsud
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, England
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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13
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Maguire J, Sizer H, Mifsud N, O'Donoghue B. Outcomes for migrants with a first episode of psychosis: A systematic review. Schizophr Res 2020; 222:42-48. [PMID: 32561236 DOI: 10.1016/j.schres.2020.05.048] [Citation(s) in RCA: 4] [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] [Received: 12/02/2019] [Revised: 04/06/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
Migrants are at a greater risk of developing a psychotic disorder, but knowledge about their outcomes has not yet been collated. We reviewed the literature concerning outcomes (symptomatic, functional, morbidity and mortality and service utilisation) for migrants with first-episode psychosis. Medline, EMBASE and PsycINFO were systematically searched for studies whose population included first- or second-generation migrants with first-episode psychosis, where outcome measures were examined after a minimum follow-up period of 6 months. Fourteen of the 1554 articles identified in the search fulfilled the inclusion criteria. Remission and disengagement rates in migrants were equal or greater than those in non-migrants. Migrants experienced more negative and fewer positive symptoms at follow-up. Functioning scores varied, with studies reporting lower, equivalent or higher functioning at follow-up for migrants. Migrants were less likely to die by suicide compared to native-born individuals affected by first-episode psychosis. Most included studies showed greater rates of involuntary hospitalisation among migrant populations but there were mixed findings regarding number of hospitalisations. Level of insight at follow-up and occupational outcomes for migrants was not found to be different than for non-migrants. No studies were identified which examined relapse rates or physical health outcomes. Migrants affected by psychotic disorders have been shown to be more likely to achieve remission, and often experience higher rates of involuntary admission and disengagement. For all other outcomes, migrants have largely similar outcomes to native-born populations.
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Affiliation(s)
- James Maguire
- Orygen, Melbourne, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Holly Sizer
- Orygen, Melbourne, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Nathan Mifsud
- Orygen, Melbourne, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, Melbourne, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Australia.
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14
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Geros H, Sizer H, Mifsud N, Reynolds S, Kim DJ, Eaton S, McGorry P, Nelson B, O'Donoghue B. Migrant status and identification as ultra-high risk for psychosis and transitioning to a psychotic disorder. Acta Psychiatr Scand 2020; 141:52-59. [PMID: 31520527 DOI: 10.1111/acps.13099] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Accepted: 09/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Certain migrant groups are more likely to develop a psychotic disorder compared to the native-born populations, and a younger age at migration is associated with greater risk. However, it is not known at which stage migration has an effect on the development of psychotic disorders. We examined whether migrants were more likely to be identified as ultra-high risk for psychosis (UHR) compared to native-born young people and whether migrant status was associated with the risk of transition to a full-threshold psychotic disorder. METHODS The cohort included all young people aged 15-24 who were identified as UHR at a specialist clinic over a five-year period (2012-16). Australian census data were used to obtain the at-risk population. Poisson regression was used to calculate rate ratios and Cox regression analysis determined hazard ratios. RESULTS 467 young people were identified as UHR, of which 13.5% (n = 63) were born overseas. First-generation migrants were 2.6-fold less likely to be identified as UHR compared to Australian-born young people (IRR = 0.39, 95% CI [0.30, 0.51], P < 0.001). There was no difference between migrant and native-born young people in their risk of transitioning to a psychotic disorder (HR = 0.90, 95% CI [0.39, 2.08], P = 0.81). CONCLUSIONS UHR first-generation migrants may be under-accessing mental health services.
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Affiliation(s)
- H Geros
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - H Sizer
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - N Mifsud
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - S Reynolds
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - D J Kim
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - S Eaton
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - P McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - B Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - B O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia.,Orygen Youth Health, Parkville, Vic., Australia
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Lee AL, Button BM, Denehy L, Roberts S, Bamford T, Mu FT, Mifsud N, Stirling R, Wilson JW. Exhaled Breath Condensate Pepsin: Potential Noninvasive Test for Gastroesophageal Reflux in COPD and Bronchiectasis. Respir Care 2014; 60:244-50. [DOI: 10.4187/respcare.03570] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Opat S, Mifsud N, Banerjee A, Bird R, Forsyth C, Szer J, Tam C, Kellner S, Grigg A, Motum P, Bentley M, Grigoriadis G. P-240 Haematopoietic improvement following iron chelation may result from deferasirox-induced restoration of T cell immune surveillance. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70287-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lin E, Snell G, Levvey B, Mitchell L, Marasco S, Kotsimbos T, Mifsud N, Sharland A, Myles P. 532 Remote Ischemic Pre-Conditioning (RIPC) To Improve Lung Transplant (LTx) Outcomes: A Randomized, Placebo-Controlled, Clinical and Mechanistic Trial. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Dunstone M, Kjer-Nielsen L, Kostenko L, Ely L, Beddoe T, Mifsud N, Purcell A, Brooks A, McCluskey J, Rossjohn J. The structure of CD3∊γ in complex with the therapeutic antibody, OKT3. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305096133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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