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Trivedi C, Reddy P, Rizvi A, Husain K, Brown K, Mansuri Z, Nabi M, Jain S. Traumatic Brain Injury and Risk of Schizophrenia and Other Non-mood Psychotic Disorders: Findings From a Large Inpatient Database in the United States. Schizophr Bull 2024:sbae047. [PMID: 38639321 DOI: 10.1093/schbul/sbae047] [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: 04/20/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) is linked with an increased risk of schizophrenia and other non-mood psychotic disorders (psychotic disorders), but the prevalence and contributing factors of these psychiatric conditions post-TBI remain unclear. This study explores this link to identify key risk factors in TBI patients. METHODS We used the 2017 National Inpatient Sample dataset. Patients with a history of TBI (n = 26 187) were identified and matched 1:1 by age and gender to controls without TBI (n = 26 187). We compared clinical and demographic characteristics between groups. The association between TBI and psychotic disorders was explored using the logistic regression analysis, and results were presented as Odds ratio (OR) and 95% confidence interval (CI). RESULTS Psychotic disorders were significantly more prevalent in TBI patients (10.9%) vs controls (4.7%) (P < .001). Adjusted odds of psychotic disorders were 2.2 times higher for TBI patients (95% CI 2.05-2.43, P < .001). Male TBI patients had higher psychotic disorders prevalence than females (11.9% vs 8.4%). Younger age, bipolar disorder, anxiety disorders, substance abuse, personality disorders, and intellectual disability are associated with an increased risk of psychotic disorders in men. CONCLUSION Our study found that hospitalized TBI patients had 2.2 times higher odds of Schizophrenia non-mood psychotic disorder, indicating an association. This highlights the need for early screening of psychotic disorders and intervention in TBI patients, calling for more research.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA
| | - Preetam Reddy
- Department of Psychiatry, Baptist Health, UAMS Medical Education Program, Little Rock, AR, USA
| | - Abid Rizvi
- Department of Behavioral Medicine and Psychiatry West Virginia University, Morgan Town, WV, USA
| | - Karrar Husain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA
| | - Kimberly Brown
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Mahamudun Nabi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA
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Al Jumaili W, Muzwagi A, Shah K, Trivedi C, Durga P, Mansuri Z, Jain S, Al Jumaili Y. Pharmacological Interventions of Atypical Antipsychotics Induced Weight Gain in the Pediatric Population: A Systemic Review of Current Evidence. Child Psychiatry Hum Dev 2024; 55:479-487. [PMID: 36066654 DOI: 10.1007/s10578-022-01424-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Accepted: 08/22/2022] [Indexed: 12/18/2022]
Abstract
To systematically review studies evaluating pharmacological treatment intervention of the atypical antipsychotic induced weight gain in the pediatric population and summarize the current evidence of the pharmacological treatment. According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we searched the various databases Medline, PubMed, PubMed central (PMC), CINAHL, and clinicaltrial.gov. until Jan 30th, 2022 for relevant clinical studies. Medical subject heading (MeSH) terms or keywords were used, "Body Weight," "Weight Gain," "Weight Loss," "Body Weight Maintenance," "Pediatric Obesity" in "Pediatrics," "Adolescent," "Child" in context of "Antipsychotic Agents" and "Drug Therapy," "Therapeutics," "Treatment Outcome," "Early Medical Intervention." We used the PICO algorithm for our search (Population, Intervention, Comparison, Outcomes, and Study Design) framework. The initial search included 746 articles, nine studies were ultimately selected in the final qualitative review. We included relevant clinical reviews, case series, and randomized clinical trials that evaluated pharmacological intervention for antipsychotic-induced weight gain in the pediatric population. Non-peer-reviewed, non-human, non-English languages article was excluded. Metformin is the most studied medication for antipsychotic-induced weight gain in children. Three studies have shown that adding Metformin to the antipsychotics can significantly reduce the body weight and body mass index with mild transient side effects. Other adjunct medications like topiramate, amantadine, betahistine, or melatonin vary greatly in mitigating weight with various side effects. Lifestyle modification is the first step in dealing with AIWG, but the result is inconsistent. Avoiding the use of antipsychotic in children is preferred. Adding an adjuvant medication to the antipsychotic could prevent or mitigate their negative metabolic effect on the body weight and body mass index. Metformin has the most evidence, topiramate, betahistine, amantadine, and melatonin is possible alternatives in the pediatric patient without changing their antipsychotic medication. Other viable options show some benefits but need further clinical studies to establish efficacy and safety.
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Affiliation(s)
- Wisam Al Jumaili
- Texas Tech University Health Science Center at Permian Basin, Midland, TX, USA.
| | - Ashraf Muzwagi
- Texas Tech University Health Science Center at Permian Basin, Midland, TX, USA
| | - Kaushal Shah
- Griffin Memorial Hospital-Oklahoma State University, Tulsa, OK, USA
| | - Chintan Trivedi
- Texas Tech University Health Science Center at Permian Basin, Midland, TX, USA
| | - Priya Durga
- Texas Tech University Health Science Center at Permian Basin, Midland, TX, USA
| | - Zeeshan Mansuri
- Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Shailesh Jain
- Regional Chair of Psychiatry Department, Texas Tech University Health Science Center at Permian Basin, Midland, TX, USA
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Trivedi C, Rizvi A, Mansuri Z, Jain S. Mental health outcomes and suicidality in hospitalized transgender adolescents: A propensity score-matched Cross-sectional analysis of the National inpatient sample 2016-2018. J Psychiatr Res 2024; 172:345-350. [PMID: 38442450 DOI: 10.1016/j.jpsychires.2024.02.043] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/17/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Transgender adolescents have unique mental health needs. This demographic has increased rates of mood disorders, anxiety, and depression compared to their cisgender peers. Large-scale studies focused on mental health outcomes, including suicidality, in the transgender adolescent population remain unknown. This study tries to fill these gaps in the literature. Data for this study was taken from the National Inpatient Sample 2016-2018. Transgender adolescents were identified using the ICD-10 codes related to transsexualism diagnoses. These individuals were compared to adolescents without transsexualism diagnoses. To mitigate imbalances in baseline characteristics, we utilized a 1:2 nearest neighbor propensity score matching with a caliper width of 0.0001, considering variables such as age, year of hospitalization, and psychiatric disorders. Following propensity score matching, the study cohort comprised 2635 transgender and 5270 non-transgender adolescents (Mean age 15.2 years). The transgender group demonstrated a notably higher prevalence of mood disorders (91%) and anxiety disorders (65%). Furthermore, the prevalence of suicidal ideation was significantly higher in the transgender group (52.4% vs. 39.2%, p < 0.001). However, there was no significant difference in the prevalence of suicide attempts between the groups. After controlling for psychiatric comorbidities, age, and gender, the odds ratio for the composite outcome of suicidal ideation or attempt was 1.99 (95% CI 1.58-2.12, p < 0.001). Our study identifies elevated mood and anxiety disorders and suicidality rates in hospitalized transgender adolescents compared to cisgender peers. Mood disorders notably amplify the risk of suicidal attempts. These findings urgently call for targeted mental health interventions and policy changes to serve this vulnerable population in healthcare settings better.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA.
| | - Abid Rizvi
- Department of Behavioral Medicine & Psychiatry, West Virginia University, 936 Sharpe Hospital Road, Weston, WV, 26452, USA.
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA.
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Vadukapuram R, Trivedi C, Desai S, Mansuri Z, Jain S, Reddy A. Bullying Victimization in Children and Adolescents and Its Impact on Academic Outcomes. J Nerv Ment Dis 2024:00005053-990000000-00163. [PMID: 38573754 DOI: 10.1097/nmd.0000000000001782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
ABSTRACT Bullying victimization has been identified as a significant factor influencing academic outcomes. We sought to evaluate the educational outcomes and psychiatric comorbidities in children and adolescents who are victims of bullying using the National Survey of Children's Health dataset for the study. The participants were children and adolescents (age: 6-17 years) categorized into two groups: group 1, not bullied (n = 21,015), and group 2, bullied more than once (n = 21,775). Individuals whose health status was fair or poor have experienced more bullying (2.4% vs. 1.4%, p < 0.001). Individuals in the group 2 were more likely to repeat the grades than the group 1 (7.1% vs. 5.9%, p = 0.039). Individuals who were missing ≥11 school days and sometimes or never engaged in school were observed to be more in the group 2 compared with the group 1 (5.9% vs. 3.2% and 20.3% vs. 10.6%, p < 0.001). In conclusion, bullying victimization could be a risk factor and associated with decreased academic outcomes.
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Affiliation(s)
- Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, Texas
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Midland, Texas
| | - Saral Desai
- Department of Psychiatry, Tower Health-Phoenixville Hospital, Phoenixville, Pennsylvania
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Midland, Texas
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
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Mansuri Z, Adnan M, Shah B, Trivedi C, Vadukapuram R, Patel S, Yadav G, Srinivas S, Ansari M, Makani R, Baweja R, Reddy A. Serotonin Syndrome With the Concomitant Use of Triptans and SSRIs/Serotonergic Medications: Is It Time to Revisit FDA Warning? J Clin Psychopharmacol 2024; 44:199-200. [PMID: 38227629 DOI: 10.1097/jcp.0000000000001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
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Mansuri Z, Shah B, Yadav G, Kainth T, Kochhar H, Srinivas S, Kamil SH, Bachu A, Reddy A. Drug Interactions Between Psychotropic Medications and Treatment of Mpox (tecovirimat and cidofovir). Prim Care Companion CNS Disord 2024; 26:23lr03608. [PMID: 38382079 DOI: 10.4088/pcc.23lr03608] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
- Corresponding Author: Zeeshan Mansuri, MD, MPH, Boston Children's Hospital/Harvard Medical School, 300 Longwood Ave, Boston, MA 02115
| | - Bhumika Shah
- Department of Psychiatry and Behavioral Science, University of Louisville, Kentucky
| | - Garima Yadav
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Tejasvi Kainth
- Department of Psychiatry, Bronx Care Health System at Icahn School of Medicine at Mount Sinai, New York
| | - Hansini Kochhar
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York
| | - Sushma Srinivas
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
| | - Sahar Hooda Kamil
- Department of Pediatrics, Dell Children's Medical Center, Austin, Texas
| | - Anil Bachu
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
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Mansuri Z, Shah B, Yadav G, Kamil SH, Kainth T, Srinivas S, Patel H, Reddy A, Bachu A. Is Intravenous Ketamine Better Than Intranasal Esketamine for Treating Treatment-Resistant Depression? Prim Care Companion CNS Disord 2024; 26:23lr03607. [PMID: 38382071 DOI: 10.4088/pcc.23lr03607] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
- Corresponding Author: Zeeshan Mansuri, MD, MPH, Boston Children's Hospital/Harvard Medical School, 300 Longwood Ave, Boston, MA 02115
| | - Bhumika Shah
- Department of Psychiatry and Behavioral Science, University of Louisville, Kentucky
| | - Garima Yadav
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Sahar Hooda Kamil
- Department of Pediatrics, Dell Children's Medical Center, Austin, Texas
| | - Tejasvi Kainth
- Department of Psychiatry, BronxCare Health System at Icahn School of Medicine at Mount Sinai, New York
| | - Sushma Srinivas
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
| | - Hiren Patel
- Penn State Milton S. Hershey Medical Center, Pennsylvania
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| | - Anil Bachu
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
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Mainali P, Vadukapuram R, Trivedi C, Yousufzai W, Mansuri Z, Jain SB. Prevalence of Psychiatric Disorders Among Children and Adolescents in Child Welfare Custody Admitted to the Hospital: A Nationwide Inpatient Sample Analysis. Prim Care Companion CNS Disord 2023; 25:22m03238. [PMID: 38055869 DOI: 10.4088/pcc.22m03238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
Objective: To assess the prevalence of psychiatric disorders among children and adolescents in child welfare custody admitted to the hospital. Methods: Data were collected from the 2016-2017 National Inpatient Sample of the US population of general hospital admissions. Data for patients aged 12-17 years who were in child welfare custody were obtained using the ICD-10 diagnosis code Z6221: child in welfare custody. The control group comprised patients not in child welfare custody. Groups were compared for demographic, clinical, and hospital characteristics. Results: The study group included 879 child welfare patients, of whom 38.9% were male, with a mean age of 14.7 years. The control group comprised 222,494 patients, of whom 41.2% were male, with a mean age of 14.9 years. In the study group, 69.4% of patients had mood disorders compared to 28.6% in the control group. Half of the patients in the study group had anxiety disorders and almost 44% had ADHD and other conduct disorders compared to 19.3% and 14.2%, respectively, in the control group. Prevalence of suicidal ideation/attempt was almost 3 times higher in the study group compared to controls (41.0% vs 14.8%), and 18.3% of study group patients had a substance use disorder compared to 8.3% of controls. Mood disorders were the most common reason for hospitalization (44.8% vs 19.2%), followed by ADHD/other conduct disorders (5.3% vs 1.1%) and anxiety disorders (4.9% vs 0.9%). Conclusions: Children and adolescents in the child welfare system are associated with a higher risk of mental health problems. More studies are needed to identify the factors that contribute to psychiatric comorbidities in this population and to determine and address the factors that can prevent mental health issues. Prim Care Companion CNS Disord 2023;25(6):22m03238. Author affiliations are listed at the end of this article.
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Affiliation(s)
- Pranita Mainali
- Department of Psychiatry, Case Western University/Metro Health Medical Center, Cleveland, Ohio
- Corresponding Author: Pranita Mainali, MD, Case Western University/Metro Health Medical Center, 2500 Metro Health Dr, Cleveland, OH 44109
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen
| | - Chintan Trivedi
- Texas Tech University Health Sciences Center at Permian Basin, Midland
| | | | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Massachusetts
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Brar KS, Trivedi C, Kaur N, Adnan M, Patel H, Beg U, Qureshi M, Mansuri Z, Ibrahim A, Zafar MK. Prevalence of Psychiatric Comorbidities in Patients With Neurofibromatosis. Prim Care Companion CNS Disord 2023; 25:23m03514. [PMID: 37816254 DOI: 10.4088/pcc.23m03514] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
Objective: To assess the prevalence of psychiatric comorbidities in patients with neurofibromatosis. Methods: In this cross-sectional study, we used the 2010-2014 National Inpatient Sample database. Patients ≥ 18 years of age with a primary or secondary diagnosis of neurofibromatosis and psychiatric comorbidities were queried. Results: A total of 43,270 patients with a mean age of 48.7 years (female: 55.7%, White: 70.1%) were included in the study. Overall, psychiatric comorbidities were present in 46.5% of patients; mood disorders (22.1%) and anxiety disorders (12.2%) were the most prevalent comorbidities. Although previous studies report prevalence rates of attention-deficit/hyperactivity disorder in up to 50% of patients with neurofibromatosis, our study found that the rate was much lower at 1.10%. Female sex and non-White race were less associated with psychiatric comorbidities (odds ratio = 0.868 [P = .003] and 0.689 [P < .001], respectively). The moderate-to-extreme loss of function illness severity category was associated with 1.35-times higher odds of having psychiatric comorbidities compared to mild-to-moderate or no loss of function (P < .001). The total length of stay was similar in patients with and without psychiatric comorbidities (mean = 4.98 [95% CI, 4.72-5.24] vs mean = 4.83 [95% CI, 4.60-5.07], respectively; P = .34). Conclusions: In adult patients with neurofibromatosis, 46.5% were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorders were mood disorders and anxiety disorders. Female sex and non-White race predicted a lower likelihood of having a psychiatric disorder. Prim Care Companion CNS Disord 2023;25(5):23m03514. Author affiliations are listed at the end of this article.
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Affiliation(s)
- Kanwarjeet S Brar
- Mindpath Health, Manteca, California
- Corresponding Author: Kanwarjeet Singh Brar, MD, 142 Grant Ave #142, Manteca, CA 95336
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Sciences Center, Odessa/Permian Basin, Texas
| | - Navdeep Kaur
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mahwish Adnan
- Department of Psychiatry, Texas Tech University Health Sciences Center, Odessa/Permian Basin, Texas
| | - Hiren Patel
- Department of Psychiatry, Penn State University, Hershey, Pennsylvania
| | - Uzma Beg
- Department of Psychiatry, Piedmont Hospital, Macon, Georgia
| | - Mustafa Qureshi
- Department of Psychiatry, Indiana University Ball Memorial Hospital, Muncie, Indiana
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
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Vadukapuram R, Perugula M, Trivedi C, Mansuri Z, Reddy A. Shortage of Mental Health Professionals Doing Research: A Cause for Concern. J Nerv Ment Dis 2023; 211:802-803. [PMID: 37782523 DOI: 10.1097/nmd.0000000000001674] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
ABSTRACT Research plays a crucial role in advancing health care. Physician scientists, who bring together clinical and scientific perspectives, are integral to this effort. However, the pursuit of research careers among physicians has declined due to several obstacles, including inadequate support, training, time, and financial constraints. Emergency medicine and psychiatric specialties receive less support than other specialties, and COVID-19 has worsened the challenges. The COVID-19 has made things harder for physician scientists, increasing clinical demands and causing research delays. To tackle this, future physician scientists should receive organized training that includes mandatory research activities during their training. Large-scale studies should identify barriers to research and offer mentoring for young physician scientists. Encouraging female researchers and involving research faculty in residency training is crucial. Collaboration between physician and PhD researchers is essential for the future of medical research. It is vital to address these to advance health care and improve mental health outcomes.
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Affiliation(s)
- Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, Texas
| | - Malathi Perugula
- Department of Psychiatry, Nathan Kline Institute, New York, New York
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
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Patel S, Silvi S, Desai S, Rahman F, Depa N, Hanif S, Rizvi S, Hsieh YC, Malik P, Patel U, Mansuri Z, Mercy RP, Aedma K, Parikh T. Effectiveness of Repetitive Transcranial Magnetic Stimulation in Depression, Schizophrenia, and Obsessive-Compulsive Disorder: An Umbrella Meta-Analysis. Prim Care Companion CNS Disord 2023; 25:22r03423. [PMID: 37788803 DOI: 10.4088/pcc.22r03423] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Objective: To analyze the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, schizophrenia, and obsessive-compulsive disorder (OCD) via umbrella meta-analysis. Data Sources: Meta-analysis studies were searched in PubMed from inception to May 2021 using the keywords anxiety, depression, ADHD, schizophrenia, mood disorder, OCD, psychiatric disorders, GAD, bipolar disorders, ASD, PTSD, transcranial magnetic stimulation, transcranial, magnetic, stimulation. PRISMA guidelines were followed. Study Selection: Abstracts and full-length articles were reviewed for meta-analysis studies with data on the safety and efficacy of rTMS and sham and were collected for quantitative analysis. The full texts of all identified studies were independently screened and assessed to determine eligibility. Any disagreement was resolved through consensus. Data Extraction: The descriptive variables extracted included the author names, study year, sample size, studies included in the meta-analysis, study period, and type of intervention. Results: 28 meta-analyses were included; 13 were on treatment-resistant depression, 9 on schizophrenia, and 6 on OCD. In treatment-resistant depression, the rTMS group had higher odds of response compared to sham (odds ratio [OR] = 3.27; 95% CI, 2.76-3.87; P < .00001) and higher odds of remission (secondary outcome) (OR = 2.83; 95% CI, 2.33-3.45; P < .00001). rTMS was superior to sham in the reduction of negative symptoms of schizophrenia (mean difference [MD]: 0.47; 95% CI, 0.23-0.7; P < .0001). However, no significant difference was found between the effects of rTMS and sham on auditory hallucinations (MD: 0.24; 95% CI, 0.26-0.74; P = .35), which resulted in 94% heterogeneity. TMS was better than sham in reducing the severity of OCD symptoms (MD: 0.81; 95% CI, 0.53-1.10; P < .00001). Conclusions: The effectiveness of rTMS for symptom reduction in various psychiatric disorders is associated with differences in neuropathology, disease-specific target site, and frequency of rTMS. Prim Care Companion CNS Disord 2023;25(5):22r03423. Author affiliations are listed at the end of this article.
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Affiliation(s)
- Shweta Patel
- Department of Epidemiology, New York University, New York
- Corresponding Author: Saral Desai, MD, Department of Psychiatry, Tower Health/Phoenixville Hospital, 140 Nutt Rd, Phoenixville, PA 19460
| | - Suraiya Silvi
- Department of Psychiatry, Millwood Hospital, Arlington, Texas
| | - Saral Desai
- Department of Psychiatry, Tower Health/Phoenixville Hospital, Phoenixville, Pennsylvania
| | | | - Nishitha Depa
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Sarah Hanif
- Department of Child and Adolescent Psychiatry, Tulane University School of Medicine, New Orleans, Louisiana
| | - Syeda Rizvi
- Department of Child and Adolescent Psychiatry, BronxCare Health System, New York
| | - Ya-Ching Hsieh
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York
| | - Preeti Malik
- Department of Pathology, Montefiore Medical Center, New York
| | - Urvish Patel
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Massachusetts
| | - Rana Prathap Mercy
- Department of Psychiatry, Indiana University Health Ball Memorial Hospital, Muncie
| | - Kapil Aedma
- Department of Psychiatry, Unitypoint Health, Peoria, Illinois
| | - Tapan Parikh
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Ashraf S, Kochhar H, Jenson C, Griffin B, Shah K, Mansuri Z, Bachu A. Elevated Creatine Phosphokinase in a Patient on a Long-Acting Antipsychotic: A Challenging Presentation Similar to Neuroleptic Malignant Syndrome. Prim Care Companion CNS Disord 2023; 25:22cr03442. [PMID: 37748136 DOI: 10.4088/pcc.22cr03442] [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] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Affiliation(s)
- Sahar Ashraf
- Northpointe Psychiatry, Lewisville, Texas
- Corresponding Author: Sahar Ashraf, MD, Northpointe Psychiatry, 860 Hebron Pkwy, Ste 1101, Lewisville, TX 75057
| | | | | | | | - Kaushal Shah
- Wake Forest University, Winston-Salem, North Carolina
| | | | - Anil Bachu
- Baptist Health-UAMS, North Little Rock, Arkansas
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Sachdeva V, Ashraf S, Inam S, Shah K, Singla A, Mansuri Z, Jain B. Olanzapine-Induced Bradycardia. Prim Care Companion CNS Disord 2023; 25:22cr03453. [PMID: 37595163 DOI: 10.4088/pcc.22cr03453] [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] [Subscribe] [Scholar Register] [Indexed: 08/20/2023] Open
Affiliation(s)
- Vishi Sachdeva
- Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Sahar Ashraf
- Northpointe Psychiatry, Lewisville, Texas
- Corresponding Author: Sahar Ashraf, MD, Northpointe Psychiatry, 860 Hebron Pkwy, Ste 1101, Lewisville, TX 75057
| | | | - Kaushal Shah
- Wake Forest University, Winston-Salem, North Carolina
| | | | | | - Bobby Jain
- Texas Tech University Health Science Center at Permian Basin, Midland
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14
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Rizvi A, Ashraf S, Desai R, Trivedi C, Mansuri Z, Jain S. A Study of the Association of Ulcerative Colitis and Bipolar Disorder in an Inpatient Population. Prim Care Companion CNS Disord 2023; 25:22br03357. [PMID: 37567190 DOI: 10.4088/pcc.22br03357] [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] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Affiliation(s)
- Abid Rizvi
- Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland
| | - Sahar Ashraf
- Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland
- Corresponding Author: Sahar Ashraf, MD, Texas Tech University Health Sciences Center, Permian Basin, 3600N Garfield St, Mildand, TX 79705
| | - Rupak Desai
- Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland
| | - Chintan Trivedi
- Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland
| | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland
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15
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Sultana T, Kamil SH, Billoo F, Lahori S, Shah K, Vadukapuram R, Mansuri Z, Jain SB. New-Onset Psychosis Secondary to COVID-19 Infection. Prim Care Companion CNS Disord 2023; 25:22br03436. [PMID: 37471491 DOI: 10.4088/pcc.22br03436] [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: 07/22/2023] Open
Affiliation(s)
- Tania Sultana
- Department of Psychopharmacology Research, Manhattan Psychiatric Center, New York, New York
| | - Saher Hoda Kamil
- Department of Psychiatry, Austin Family Psychiatry, Austin, Texas
- Corresponding Author: Saher Hoda Kamil, MBBS, Department of Psychiatry, Austin Family Psychiatry, 4407 Bee Cave Road, Austin, TX 78746
| | - Fatima Billoo
- Department of Family Medicine, Family Medicine Associates, Northridge, California
| | - Simmy Lahori
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Kaushal Shah
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Bobby Jain
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Midland
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16
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Desai S, Vadukapuram R, Trivedi C, Xavier S, Mansuri Z. Bullying Victimization Among Children With Mental, Emotional, Developmental, or Behavioral Problems: A US Population-Based Study. Prim Care Companion CNS Disord 2023; 25:22br03406. [PMID: 37419455 DOI: 10.4088/pcc.22br03406] [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] [Subscribe] [Scholar Register] [Indexed: 07/09/2023] Open
Affiliation(s)
- Saral Desai
- Department of Psychiatry, Tower Health/Phoenixville Hospital, Phoenixville, Pennsylvania
- Corresponding Author: Saral Desai, MD, Tower Health/Phoenixville Hospital, 1427 Vine St, Philadelphia, PA 19102
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
| | - Sona Xavier
- Department of Psychiatry, Father Muller Medical College, Karnataka, India
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
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17
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Trivedi C, Nandakumar AL, Yousefzadehfard Y, Goriparthi TSK, Chaudhari G, Vora D, Mansuri Z, Jain S. Suicide Risk Among Adolescents With ADHD: An Overview From the National Inpatient Sample Data Set. J Nerv Ment Dis 2023; 211:216-220. [PMID: 36108281 DOI: 10.1097/nmd.0000000000001587] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Studies have shown an association between attention deficit hyperactivity disorder (ADHD) and suicide; however, it has not been studied from inpatient hospitalization data among adolescents. For this study, data from the National Inpatient Sample data set were used. Based on the diagnosis of ADHD, the patient sample was stratified into two groups. Study group was composed of patients with ADHD, and control group was selected by propensity score matching (1:1), which composed of patients without ADHD. The primary outcome was suicidal ideation/attempt between the groups. Prevalence of SI was 25.1% in patients with ADHD versus 10.3% among patients without ADHD. Prevalence of SA was also very high (8.0% vs 3.9%) among patient with ADHD compared with non-ADHD group. After controlling for covariates, ADHD was a strong predictor of suicidal ideation/attempt with an odds ratio of 2.18. It is important to screen for suicidality in patient with ADHD given the high prevalence of suicidality.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
| | | | - Yashar Yousefzadehfard
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
| | | | - Gaurav Chaudhari
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
| | - Darshini Vora
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa
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18
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Reddy A, Mansuri Z, Vadukapuram R, Shah K, Thootkur M, Trivedi C. Efficacy of Cognitive Behavioral Therapy for Insomnia for the Treatment of Child and Adolescent Anxiety and Depression: A Systematic Review From Randomized Controlled Trials. J Nerv Ment Dis 2023; 211:238-243. [PMID: 36827635 DOI: 10.1097/nmd.0000000000001613] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Indexed: 02/26/2023]
Abstract
ABSTRACT Cognitive behavioral therapy for insomnia (CBT-I) has shown promising results in the adult population. However, there is not enough evidence for children and adolescents. Hence, we evaluated the current evidence of CBT-I in the treatment of anxiety and depression in children and adolescents. Published randomized clinical trials published before June 2020 were searched from PubMed, Cochrane Library of database, clinicaltrials.gov, and Google Scholar. Out of seven included studies, six studies assessed the effect of CBT-I on depression, and five assessed the effect on anxiety. In this review, most studies in this review showed a strong effect of CBT-I on symptoms of depression. Although a positive effect of CBT-I on anxiety was noted, only a small number of studies have considered this management. These findings should be considered preliminary, and further large-scale studies are warranted to further explore this finding further.
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Affiliation(s)
- Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, Texas
| | - Kaushal Shah
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma
| | - Mounica Thootkur
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, Texas
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19
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Ashraf S, Shah K, Vadukapuram R, Shah B, Jaiswal S, Mansuri Z, Jain S. Impact of Paternal Depression on Child Neurodevelopmental Outcomes and Disorders. Prim Care Companion CNS Disord 2023; 25. [PMID: 36763820 DOI: 10.4088/pcc.22r03303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: To explore paternal depression (before, during, and after pregnancy) and its association with neurodevelopmental disorders in children. Data Sources: A systematic, English-language review was conducted in PubMed, PubMed Central, MEDLINE, Web of Science, BIOSIS Previews, and SciELO. All relevant literature published from inception to March 31, 2021, was included. The MeSH terms used in the search included paternal behavior, fathers, or father-child relations in the context of depression, postpartum depression, and neurodevelopmental disorders. Data Extraction: The PICOS (Population, Intervention, Comparison, Outcomes, and Study design) tool was used to enhance reporting of the findings. Twenty-six articles were included in the review. Results: Paternal depression during the perinatal period resembles maternal perinatal depression. Early paternal depression has considerable emotional, behavioral, and developmental impacts on their children. Genetic endowment and environmental factors induced by paternal depression-related behaviors may lead to adverse neurodevelopmental outcomes. Conclusions and Relevance: The findings suggest that paternal depression negatively influences neurodevelopmental disorders in the offspring.
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Affiliation(s)
- Sahar Ashraf
- Northpointe Psychiatry, Lewisville, Texas.,Corresponding author: Sahar Ashraf, MD, Northpointe Psychiatry, 860 Hebron Pkwy, Ste 1101, Lewisville, TX 75057
| | - Kaushal Shah
- Griffin Memorial Hospital, Norman, Oklahoma.,Oklahoma State University, Tulsa, Oklahoma
| | | | | | | | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
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20
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Mainali P, Motiwala F, Trivedi C, Vadukapuram R, Mansuri Z, Jain S. Sexual Abuse and Its Impact on Suicidal Ideation and Attempts and Psychiatric Illness in Children and Adolescents With Posttraumatic Stress Disorder. Prim Care Companion CNS Disord 2023; 25. [PMID: 36705981 DOI: 10.4088/pcc.22m03239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: Sexual abuse in minors aged 6-17 years is a significant public health concern. Victims of sexual abuse are at risk of developing complex psychopathology and chronic suicidal thoughts. Posttraumatic stress disorder (PTSD) develops in one-third of minors with a history of sexual abuse. The primary objective of this study was to assess the baseline characteristics of minors with PTSD and a history of sexual abuse (PTSD+S) compared with minors with PTSD without sexual abuse (PTSD only). The secondary objective was to evaluate the psychiatric comorbidities and suicidal ideation/attempts between the groups. Methods: The National Inpatient Sample database from 2006 to 2014 was analyzed using the ICD-9 code for PTSD and history of sexual abuse. PTSD+S (n = 251) subjects were compared with those with PTSD only (n = 24,243) using t test and χ2 test. Univariate and multivariate logistic regression analyses were performed with suicidal behavior (suicidal ideation/attempt) as the outcome and PTSD with and without sexual abuse, sex, age, and other psychiatric comorbid conditions as independent variables. Results: More patients in the PTSD+S group were nonwhite (52% vs 42%, P < .001) and female (81% vs 66%, P < .001) compared to PTSD only patients. Also, more patients were Hispanic in the PTSD+S group compared to the PTSD only group (28% vs 13%). Major depressive disorder (MDD; 23% vs 14%, P < .001) and substance use disorder (SUD; 20% vs 11%) were more commonly diagnosed psychiatric comorbidities in the PTSD+S group (P < .001). Suicidal behavior (suicidal ideation/attempt) was higher in the PTSD+S group than in PTSD only patients (36% vs 30%, P = .05). Overall, the risk of suicidal behavior was 29% higher in the PTSD+S group than in PTSD only patients (odds ratio [OR] = 1.29, P = .05). In the multivariate analysis, after controlling for age and sex, comorbid diagnosis of MDD (OR = 1.66, P < .001) and SUD (OR = 1.18, P < .001) was associated with increased suicidal behavior. However, PTSD+S showed no association with suicidality (OR = 1.16, P = .29) in the multivariate analysis. Conclusions: Sexual abuse is associated with PTSD and higher risk of comorbid psychiatric illnesses, including MDD, SUD, and suicidal behavior. In-depth research on the relationship between child and adolescent sexual abuse and chronic suicidality is warranted.
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Affiliation(s)
- Pranita Mainali
- Department of Psychiatry, Case Western Reserve University/Metro Health Medical Center, Cleveland, Ohio.,Corresponding author: Pranita Mainali, MD, Department of Psychiatry, Case Western Reserve University/Metro Health Medical Center, 2500 Metro Health Dr, Cleveland, Ohio 44109
| | - Fatima Motiwala
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, Massachusetts
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, Texas
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, Texas
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, Texas
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21
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Trivedi C, Adnan M, Shah K, Manikkara G, Mansuri Z, Jain S. Psychiatric Disorders in Hospitalized Homeless Individuals: A Nationwide Study. Prim Care Companion CNS Disord 2022; 24. [PMID: 36548172 DOI: 10.4088/pcc.21m03209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: To compare the incidence of inpatient psychiatric admissions and evaluate the prevalence of psychiatric disorders among homeless individuals. Methods: This cross-sectional study utilized the Nationwide Inpatient Sample dataset for the year 2016-2017. US adult homeless patients (age ≥ 18 years) admitted to the hospital were age and sex matched (1:1) with non-homeless individuals using the propensity score matching technique. Results: The study included a total of 614,390 homeless patients (mean age = 46.1 years, 71.9% male). Most of the homeless patients were Black (24.8% vs 17.3% of the non-homeless population). Mood, anxiety, and psychotic disorders were highly prevalent in homeless patients compared to those who were non-homeless (P < .001). Composite of psychiatric disorders was also significantly higher in the homeless group (64.9% vs 29.1%, P < .001). Suicidal ideation was present in 19.4% of the homeless individuals and in 2.9% of the non-homeless (P < .001). Hospital admissions related to any psychiatric condition were 33.9% in the homeless and 6.7% in the non-homeless (P < .001). Compared to the non-homeless, homeless patients admitted for psychiatric disorders had longer inpatient psychiatric admissions (8.7 vs 7.7 days, P < .001). Conclusions: The results revealed a positive association between homelessness, comorbid psychiatric disorders, and suicidal ideations/attempts. Appropriate psychiatric screening measures are needed for the homeless. Homelessness is associated with longer inpatient psychiatric stay. The challenges faced in treating and preventing mental illness in the homeless should be investigated further.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Odessa, Texas.,Corresponding author: Chintan Trivedi, MD, MPH, Texas Tech University Health Science Center, 3600N Garfield St, Mildand, TX 79705
| | - Mahwish Adnan
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Odessa, Texas
| | | | - Geetha Manikkara
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Odessa, Texas
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Odessa, Texas
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22
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Perugula M, Vadukapuram R, Trivedi C, Adam D, Mansuri Z, Jain S. Pregnancy Outcomes After Second-Generation Antipsychotic Exposure: Extracting More Information From the Data. J Clin Psychiatry 2022; 84. [PMID: 36449477 DOI: 10.4088/jcp.22lr14594] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Malathi Perugula
- Department of Psychopharmacology, Manhattan Psychiatric Center, Nathan Kline Institute, New York, New York.,Corresponding author: Malathi Perugula, MD, 197 Liberty Ave, Apt 2, Jersey City, NJ 07306
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, Texas
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland, Texas
| | | | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, Massachusetts.,Drs Jain and Mansuri share equal credit for senior authorship
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland, Texas.,Drs Jain and Mansuri share equal credit for senior authorship
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23
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Mansuri Z, Patel K, Shah B, Trivedi C, Adnan M, Vadukapuram R, Zafar MK, Makani R, Reddy A. Charles Bonnet Syndrome: A Case Report and Review of the Literature. J Nerv Ment Dis 2022; 210:880-882. [PMID: 36302083 DOI: 10.1097/nmd.0000000000001523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 02/04/2023]
Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | | | - Bhumika Shah
- De Sousa Research Foundation, Mumbai, Maharashtra, India
| | | | | | | | | | | | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
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24
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Trivedi C, Desai R, Rafael J, Bui S, Husain K, Rizvi A, Hassan M, Mansuri Z, Jain S. Prevalence of Substance use disorder among young adults hospitalized in the US hospital: A decade of change. Psychiatry Res 2022; 317:114913. [PMID: 37732859 DOI: 10.1016/j.psychres.2022.114913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/27/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Mental health disorders (MHD) and substance use disorders (SUD) lead to outstanding socioeconomic costs and increased hospital visits. However, very few studies have quantified this trend over time and across specific conditions. Our study aims to investigate and compare the prevalence of MHDs and SUDs in hospitalizations between 2007 and 2017. METHODS We used hospital records for 2007 and 2017 from the National Inpatient Sample (NIS) datasets to identify young adults (18-44 years) hospitalized with MHD and SUD. The prevalence of MHD in hospitalized patients in 2017 vs. 2007 was measured and compared. We generated a multivariable logistic regression analysis controlled for confounders, including age, sex, race, and payer status. We evaluated these outcomes using Odds Ratio (OR) and 95% Confidence Interval (CI). RESULTS A total 10,353,890 patients were included in 2007, and 8,569,789 patients were included in 2017. The prevalence of drug abuse among hospitalized patients was 8.4% in 2017 vs. 6.2% in 2007. Prevalence increased in both genders (15.7% vs. 13.0% among male, 5.7% vs. 3.9% among females) in 2017 vs. 2007. All psychiatric disorders showed a higher prevalence in 2017 compared to 2007. When stratified by race, the prevalence of substance use disorder increased among all races except Black race between 2017 vs. 2007. On multivariable analysis, widespread drug abuse was significantly associated with hospital admissions in 2017 vs. 2007 (OR: 1.27, 95% CI: 1.20-1.34, p<0.001). These associations held across many substance abuse cases and mental health disorders except cocaine abuse (OR: 0.84, 95%CI: 0.76-0.93, p<0.001). CONCLUSION There was a significant rise in substance use disorder and psychiatric disorder a decade later, from 2007, in hospitalized patients in the age group 18-44 years. The most increase was observed in amphetamine use disorder and anxiety disorder. Suicide and intentional self-inflicted injury increased in all races, with a maximum increase observed in Native Americans. Further studies evaluating the factors responsible for this upward trend would be beneficial.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Rupak Desai
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - John Rafael
- School of Medicine, Texas Tech University Health Science Center at Lubbock, TX, United States.
| | - Stephanie Bui
- School of Medicine, Texas Tech University Health Science Center at Lubbock, TX, United States.
| | - Karrar Husain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Abid Rizvi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Mudasar Hassan
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, MA, United States.
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, MA, United States.
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
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25
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Desai R, Jain A, Sultan W, Gandhi Z, Raju AR, Varughese VJ, Jnaneswaran G, Agarwal C, Rizvi B, Mansuri Z, Gupta P, Kumar G, Sachdeva R. Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis. Medicina (Kaunas) 2022; 58:medicina58101465. [PMID: 36295625 PMCID: PMC9609556 DOI: 10.3390/medicina58101465] [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] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18−44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015−December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06−1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01−1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55−12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38−2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02−2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Correspondence: or
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19153, USA
| | - Waleed Sultan
- Department of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USA
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, USA
| | - Athul Raj Raju
- Department of Medicine, Karuna Medical College, Chittur-Thathamangalam 678103, Kerala, India
| | - Vivek Joseph Varughese
- Department of Internal Medicine, Government Medical College, Thiruvananthapuram 695011, Kerala, India
| | - Geethu Jnaneswaran
- Department of Medicine, SUT Academy of Medical Sciences, Thiruvananthapuram 695028, Kerala, India
| | - Charu Agarwal
- Department of Medicine, Sri Siddhartha Medical College, Tumakuru 572107, Karnataka, India
| | - Bisharah Rizvi
- Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA 93720, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Puneet Gupta
- Department of Cardiology, Baptist Health Deaconess Madisonville, Madisonville, KY 42431, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
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Vadukapuram R, Elshokiry AB, Trivedi C, Abouelnasr A, Bataineh A, Usmani S, Rodrigues SP, Mansuri Z, Jain SB. Sex Differences in Psychiatric Comorbidities in Adolescents With Autism Spectrum Disorder. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21m03189] [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: 10/14/2022] Open
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Jolly T, Vadukapuram R, Trivedi C, Mansuri Z, Adnan M, Cohen SP, Vu TN. Risk of Suicide in Patients With Major Depressive Disorder and Comorbid Chronic Pain Disorder: An Insight From National Inpatient Sample Data. Pain Physician 2022; 25:419-425. [PMID: 36122252] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Approximately 17.3 million adults in the United States have had a minimum of one major depressive episode. Comorbidity of depression and pain can affect individuals of any age, but is more prevalent in the elderly affecting up to 13% of people in the elderly population. Given that depression and suicidal ideation (SI) pose a considerable burden resulting in enormous suffering, there is a need to understand the factors of the relationship between chronic pain (CP), depression, and SI. OBJECTIVES Our primary objective in this study was to compare suicidality (SI/attempt [SA]) between patients with major depressive disorder (MDD) and CP and a matched control group. The secondary objective was to compare length of stay, total hospital costs, and discharge disposition in these populations. STUDY DESIGN The National Inpatient Sample (NIS) dataset developed by the Healthcare Cost and Utilization Project was used for this study. The NIS is a database of hospital inpatient stays derived from billing data submitted by hospitals to statewide data organizations across the United States. We obtained patient records from the NIS dataset for the years 2006 to 2017. All data were de-identified so Institutional Review Board approval was waived. METHODS We used mean and standard error to describe continuous data and counts (percentage) to describe categorical data. Categorical data were compared using Rao-Scott adjusted chi-square tests and continuous data were compared using Student's t tests. Matching was performed using propensity scores in random order with a caliper size of 0.001. To assess predictors associated with suicidality, logistic regression analysis was performed. RESULTS A total of 393,481 patients having MDD with CP (MDD+CP) were included in the analysis. The mean age was 49.4 years, and 54.9% of patients were women. Overall, rate of composite outcome of SI/SA was more prevalent in MDD+CP group (51% vs 41%, P < 0.001). Rate of SI was 48% vs 39% (P < 0.001) in the MDD+CP and MDD without CP (MDD-CP) groups, respectively. MDD+CP was one of the strongest predictors of suicidality, responsible for 48% more risk of SI/SA compared to MDD-CP group. In comparison to non-Whites, the rate of suicidality was 7.5% less in White population. Alcohol abuse and substance abuse were associated with 17% and 8% greater risk of SI/SA, respectively. For women, the odds of having SI/SA was 1.20 greater compared to men. LIMITATIONS No information was available on the causal relationship between MDD+CP disorder and SI/SA. Retrospective studies are susceptible to recognition, reporting, and coding bias. There is no information available on medications use or the duration and severity of CP and bipolar disorder, which can all be confounding factors. CONCLUSIONS Psychiatrists and other physicians must be cognizant of the presence of CP and the risk of suicide, especially when patients present with depressive symptoms. The treatment plan for this patient population should include routine screening for pain symptoms and risk assessment for SI.
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Affiliation(s)
- Taranjeet Jolly
- Department of Psychiatry & Behavioral Health, Penn State University College of Medicine, Hershey, PA
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, TX
| | - Chitan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, TX
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, MA
| | - Mahwish Adnan
- Department of Psychiatry, Mercy Hospital and Medical Center, Lincolnwood, IL
| | - Steven P Cohen
- Department of Anesthesiology & Critical Care Medicine, Neurology and Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
| | - To-Nhu Vu
- Department of Anesthesia & Pain Medicine, Penn State University College of Medicine, Hershey, PA
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Patel H, Vadukapuram R, Mansuri Z, Trivedi C, Brar KS, Beg U, Patel J, Ibrahim A, Zafar MK. Psychiatric Comorbidities in Adults with DiGeorge Syndrome. Clin Psychopharmacol Neurosci 2022; 20:498-503. [PMID: 35879034 PMCID: PMC9329110 DOI: 10.9758/cpn.2022.20.3.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022]
Abstract
Objective DiGeorge Syndrome (DGS) is a common multisystem disorder associated with deletions on chromosome 22q11.2. Our objective is to evaluate the psychiatric comorbidities and demographics of patients suffering from DGS in a nationally representative dataset on inpatient hospitalizations. Methods The Nationwide Inpatient Sample for the year 2005−2017 was used for this study. Data on patients with DiGeorge syndrome were collected by using the International Classification of Diseases code. Univariate and multivariate logistic regression analysis was performed. Results In our study, the average age was 30.4 years (n = 6,563), with 59.9% male, and 61.8% of patients were white. There was a high prevalence of mood disorders (24.7%) and anxiety disorders (16.4%), followed by schizophrenia and other psychotic condition (14.0%). In patients with mood disorders, 8% had Major Depressive Disorder, and 7% had bipolar depression. Overall composite of psychiatric comorbidities was present in 2,959 (45.1%) of patients. The mean length of stay was 6.58 days, and 77% of patients had routine discharge to home. In the adjusted analysis, the average length of stay was 8.6 days vs. 6.7 days (p < 0.001) in patients with and without psychiatry comorbidities. In comparison to routine discharge, patients with psychiatry comorbidities were more likely to be discharged to other healthcare facilities (odds ratio [OR] 1.28, p < 0.001) and discharged against medical advice (OR 3.45, p < 0.001). Conclusion Patients with DGS have worse outcomes with a higher rate of discharge to other healthcare facilities and a higher rate of being discharged against medical advice. Further large scale randomize studies are indicated.
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Affiliation(s)
- Hiren Patel
- Department of Psychiatry, Penn State Health Milton S. Hersey Medical Center, Hershey, PA, USA
| | | | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Kanwarjeet Singh Brar
- Department of Child and Adolescent Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Uzma Beg
- Central State Hospital, Milledgeville, GA, USA
| | - Jigar Patel
- University of Texas, San Antonio, TX, 8Vituity, Boston, MA, USA
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Mansuri Z, Patel K, Trivedi C, Desai S, Patel S, Desai R, Vadukapuram R, Lodhi A, Reddy A. Burden of Psychiatric Disorders in Moyamoya Disease. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21m03157] [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: 10/15/2022] Open
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Mansuri Z, Patel K, Parekh T, Trivedi C, Patel S, Desai S, Desai R, Vadukapuram R, Reddy A, Baweja R. Frequency of Psychiatric Disorders in Adult Patients Hospitalized With Marital Problems. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21br03156] [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: 10/15/2022] Open
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Vadukapuram R, Trivedi C, Mansuri Z, Jain S. Common Methods of Suicide and Self-Inflicted Poisoning/Injury by Individuals With Major Depressive Disorder and Bipolar Disorder. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21m03159] [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: 10/15/2022] Open
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Trivedi C, Vadukapuram R, Chaudhari G, Ashraf S, Tazin F, Mansuri Z, Jain S. Risk of Suicide in Patients With Bipolar Disorder Having Comorbid Chronic Pain Disorders: Insights From the Nationwide Inpatient Sample Data From 2016 to 2018. J Nerv Ment Dis 2022; 210:564-569. [PMID: 35394970 DOI: 10.1097/nmd.0000000000001506] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Bipolar disorders (BDs) are associated with significant risk of suicide. BD patients (age ≥18 years) admitted to the hospital were identified from the National Inpatient Sample dataset. Based on the secondary diagnosis of chronic pain disorder (CPD), patients were stratified into two groups (1) BD with CPD (BD + CPD) and (2) BD without CPD (BD - CPD). Groups were matched (1:1) for the type of BD and compared for baseline characteristics and suicidal ideation/attempt (SI/SA). Compared with BD - CPD, most patients in the BD + CPD group were older (mean age, 47.6 vs. 40.4 years), female (58.4% vs. 55.2%), and white (77.2% vs. 66.7%). After adjusting for covariates, compared with the BD - CPD group, the BD + CPD group had 21% more risk of SI/SA (odds ratio, 1.21, p < 0.001). CPD is independently associated with the increased risk of suicide among patients with BD. Thus, comorbid CPD among patients admitted for BD can be an essential risk factor for suicide.
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Affiliation(s)
- Chintan Trivedi
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | | | - Gaurav Chaudhari
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | | | - Faria Tazin
- East Liverpool City Hospital, East Liverpool, Ohio
| | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Jain
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
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Tourjman V, Louis-Nascan G, Ahmed G, DuBow A, Côté H, Daly N, Daoud G, Espinet S, Flood J, Gagnier-Marandola E, Gignac M, Graziosi G, Mansuri Z, Sadek J. Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP. Brain Sci 2022; 12:brainsci12081023. [PMID: 36009086 PMCID: PMC9406006 DOI: 10.3390/brainsci12081023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind–Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms.
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Affiliation(s)
- Valerie Tourjman
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Gill Louis-Nascan
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
- Department of Psychology, Université du Québec à Montréal, Montreal, QC H2X 3P2, Canada
| | - Ghalib Ahmed
- Departments of Family Medicine and Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Anaïs DuBow
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Hubert Côté
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Nadia Daly
- Department of Psychiatry, Harvard University, Boston, MA 02115, USA;
- Boston Children’s Hospital, Harvard University, Boston, MA 02115, USA;
| | - George Daoud
- Department of Psychiatry, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Stacey Espinet
- CADDRA—Canadian ADHD Resource Alliance, Toronto, ON M5A 3X9, Canada;
| | - Joan Flood
- Department of Psychiatry, The Shoniker Clinic, Scarborough, ON M1E 4B9, Canada;
| | | | - Martin Gignac
- Child and Adolescent Psychiatry Division, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Gemma Graziosi
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada;
| | - Zeeshan Mansuri
- Boston Children’s Hospital, Harvard University, Boston, MA 02115, USA;
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence:
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Depa N, Desai S, Patel S, Silvi S, Hanif S, Rizvi S, Rahman F, Ortega G, Hsieh YC, Malik P, Pathrose RPM, Parikh T, Mansuri Z. Mental health disparities amongst sexual-minority adolescents of the US - A national survey study of YRBSS-CDC. Psychiatry Res 2022; 314:114635. [PMID: 35640323 DOI: 10.1016/j.psychres.2022.114635] [Citation(s) in RCA: 2] [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: 07/02/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to evaluate the prevalence and trend of identifying as a sexual minority among the American adolescent population. Additionally, we aimed to evaluate the prevalence and odds of substance abuse, hopelessness, and suicidality among the sexual minority adolescents compared to their heterosexual peers. METHODS We performed a retrospective cross-sectional study using Youth Risk Behavior Surveillance System (YRBSS) data from 2015 to 2019. YRBSS divides "Sexual identity" into three groups: heterosexuals, sexual minorities (gay or lesbian or bisexual), and unsure. We identified "hopelessness and suicidality" using the survey questions exploring if participants felt sad or hopeless for >2 weeks, considered suicide, made a suicide plan, and attempted suicide requiring medical care. Univariate and multivariable survey logistic regression analyses were performed to establish an association between hopelessness, suicidality, substance abuse, and identifying as a sexual minority. RESULTS Out of 41,377 adolescents, 4055 (9.8%) identified as a sexual minority. An increasing percentage of adolescents identified themselves as a sexual minority between 2015 to 2019 (8% to 11.2%) (pTrend<0.0001). The sexual minority had a higher prevalence of feeling sad and hopeless (63.4 vs. 28.6%), considering suicide (46 vs. 14.2%), planning suicide (38.9 vs. 11.5%), attempting suicide, and having injurious suicide attempts compared to heterosexuals. (p<0.0001) Amongst sexual minorities, the prevalence of substance abuse was higher compared to their heterosexual peers, which includes cigarettes (15 vs 7.8%), e-cigarette (27.2 vs 23.2%), inhalants (14.1 vs 5.3%), cocaine (8.4 vs 3.9%), marijuana (31.2 vs 20.2%), alcohol (36.9 vs 30.3%), steroids (6.4 vs 2.2%), heroin (4.4 vs 1.2%), and injectable drugs (4.0 vs 1.1%) (p<0.0001). In regression analysis, the sexual minority had higher odds of substance abuse, feeling sad and hopeless (aOR:4.6; 95%CI:4.0-5.2; p<0.0001), considering suicide (3.2; 2.8-3.7; p<0.0001), planning suicide (2.0; 1.7-2.3; p<0.0001) compared to heterosexual. CONCLUSION Sexual minorities not only have higher prevalence and odds of hopelessness and suicidality but also have higher prevalence and odds of substance abuse like cigarettes, marijuana, cocaine, heroin, inhalants, and steroids. Hence, early identification, risk stratification, and interventions to reduce mental health disparities are needed.
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Affiliation(s)
- Nishitha Depa
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Saral Desai
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, NY, United States.
| | - Shweta Patel
- Department, Government Medical College, Surat, Gujarat, India
| | - Suraiya Silvi
- Department of Psychiatry, Millwood Hospital, Arlington, TX, United States
| | - Sarah Hanif
- Department of Child and Adolescent Psychiatry, Tulane University School of Medicine, LA, United States
| | - Syeda Rizvi
- Department of Child and Adolescent Psychiatry, Bronx Care Health System, NY, United States
| | | | - Gizelle Ortega
- Centros de Integracion Juvenil A.C., Monterrey, Nuevo Leon, Mexico
| | - Ya-Ching Hsieh
- Department of Public Health, Icahn School of Medicine Mount Sinai, NY, United States
| | - Preeti Malik
- Department of Public Health, Icahn School of Medicine Mount Sinai, NY, United States
| | | | - Tapan Parikh
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, IL, United States
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Brighton, MA, United States
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Vadukapuram R, Chaudhari G, Trivedi C, Vora D, Memon A, Giri D, Tazin F, Reddy P, Mansuri Z, Jain SB. The Association of Psychological Stressors With Cannabis Use During Pregnancy: Findings From the National Survey on Drug Use and Health 2017-2019. J Nerv Ment Dis 2022; 210:633-637. [PMID: 35353076 DOI: 10.1097/nmd.0000000000001507] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Even though marijuana is illegal on the federal level, it is one of the most used drugs in the United States during pregnancy. Our study investigates the relationship between numerous socioeconomic, demographic, and mental health risk variables and substance use during pregnancy. We examined data from the National Survey on Drug Use and Health from 2017 to 2019. Compared with the no serious psychological distress (SPD) group, the odds of using cannabis were higher in pregnant women with past-month SPD. In this study, in comparison with unmarried pregnant women, married pregnant women had a 67% lower chance of currently using cannabis. Racially, Hispanic pregnant women had 3 to 4 times higher odds for current use of cannabis as compared with the other races. Preventing cannabis use and its adverse effects by screening pregnant women could be part of the current strategy for reducing cannabis use.
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Affiliation(s)
| | - Gaurav Chaudhari
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Chintan Trivedi
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Darshini Vora
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Aksha Memon
- Creighton University School of Medicine, Phoenix, Arizona
| | | | - Faria Tazin
- East Liverpool City Hospital, East Liverpool, Ohio
| | - Preetam Reddy
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shailesh Bobby Jain
- Texas Tech University Health Science Center at Permian Basin, Midland, Texas
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Ashraf S, Shah K, Vadukapuram R, Bhela J, Chaudhari G, Mansuri Z, Jain S. Homelessness in the Child and Adolescent Population. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21br03146] [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: 10/17/2022] Open
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Adnan M, Motiwala F, Trivedi C, Chaudhari G, Mansuri Z, Jain S. Human Umbilical Cord Blood Infusions in the Management of Autism Spectrum Disorder. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21r03042] [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: 10/18/2022] Open
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Jaiswal S, Trivedi C, Shah K, Bishay Elshokiry A, Adnan M, Tazin F, Mansuri Z. Trends in ECT (Electroconvulsive Therapy) Utilization During Pregnancy and Post-Partum Period: National Inpatient Sample 2002-2015. Eur Psychiatry 2022. [PMCID: PMC9566959 DOI: 10.1192/j.eurpsy.2022.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction The use of Electroconvulsive therapy (ECT) during pregnancy and in the post-partum period is a critical decision for both providers and their patients. ECT utilization during this critical period needs to be better understood to assess the need and allocate resources for this valuable treatment option. Objectives 1) To evaluates baseline characteristics and analyze ECT utilization trends for pregnant and post-partum patients hospitalized in the US. 2) To provide insight into ECT use among inpatient pregnant women with different age groups with various comorbid psychiatric disorders. Methods The study used the 2002-2015 National (Nationwide) Inpatient Sample (NIS) data. Descriptive statistical and trend analyses were conducted to evaluate data. Results A study found that a total of 924 pregnancy-related hospitalizations required ECT treatment; 92.2% of these ECTs were conducted in urban hospitals. The mean age of women was 30.3 years, and the majority (71%) were of the White race. Mood disorders (major depressive disorder- 51.9% and bipolar disorder- 37.9%) accounted for the most common comorbid psychiatric illnesses. The payer source (Medicare/Medicaid vs. Private Insurance) was almost equal (47.9 vs. 46.8). Though not statistically significant, the trend analysis showed that the proportion of ECTs during pregnancy out of the total ECT performed for the year almost doubled (0.24% to 0.47%) from 2008 to 2015. Conclusions Though not statistically significant, the use of ECT in pregnant women has increased in 2015 compared to 2002. Results will help clinicians, policymakers, and various stakeholders to optimize ECT utilization, reimbursement and ultimately improve clinical outcomes. Disclosure No significant relationships.
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Abstract
Introduction Adolescents patients presenting with mood disorders, including disruptive mood dysregulation disorder (DMDD), often present with the comorbid disorders such as oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD). Objectives 1) Evaluate the association between suicide in adolescents and various mood disorders. 2) To study the impact of comorbid conditions in DMDD on suicide ideation and attempt in adolescents. Methods We used 2016-2017 National Inpatient Sample dataset to select patients with mood disorders. Rao Scott adjusted Chi-Square test used to compare the groups with SPSS v26. Results In this study, 15195 patients were in the DMDD group (Mean age:12.1,F: 38%) and 219205 in the ‘other mood disorders’ group (Mean age:14.4,F:67%). The odds of SI/SA were two times more in patients with the ‘other type of mood disorder’ (OR:2.07, 95%CI: 1.77-2.14). Patients with the primary diagnosis of DMDD sub-classified into four groups (Group 1: DMDD only (n=5160), Group 2: DMDD+ADHD (n=7240), Group 3: DMDD +ODD (n=700), and Group 4: DMDD+ADHD+ODD (n=2095). SI/SA was prevalent in 30.8%, 26.0%, 22.9% and 26.3% in Group 1, 2, 3 and 4 respectively (p: 0.03). SI/SA was more prevalent in females compared to males (31.3% vs. 25.2%). An increase of 1 year in age was associated with a higher SI/SA (OR:1.05, 95%CI:1.01-1.08, 0.01). The SI/SA odds were 5% more in female patients (OR:1.27, p:0.01). Conclusions The study reveals that the risk of suicide ideation or suicide attempt is almost twice in the adolescent with mood disorders without DMDD compared to the DMDD group. Disclosure No significant relationships.
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Vadukapuram R, Trivedi C, Mansuri Z, Shah K, Reddy A, Jain S. Bullying victimization in children and adolescents and its impact on academic outcomes. Eur Psychiatry 2022. [PMCID: PMC9567400 DOI: 10.1192/j.eurpsy.2022.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Bullying is a serious problem in schools because of the negative impact on a child’s educational outcomes, especially academic achievement. However, the underlying mechanisms and causes are unknown. Objectives To evaluate the educational outcomes, and psychiatric comorbidities in children and adolescents who are victims of bullying Methods We used 2018–2019 Nationwide Survey of Children’s Health (NSCH) dataset for the study. The participants were children and adolescents (age: 6-17 years, n = 42,790). Data was stratified into two groups: 1) never bullied 2) bullied more than once. Prevalence of different educational outcomes were compared between the groups. Results In the never bullied group 21,015 participants were included, and in the bullied more than once group 21,775 participants were included. More females were in the bullied group compared to never bullied group (50.4% vs 47.5%, p=0.006). More White non- Hispanic individuals were in bullied group in contrast to never bullied group (56.7% vs 43.9%, p< 0.001). Individuals whose health status was fair, or poor were bullied more (2.4% vs 1.4%, p=<0.001). Individuals in bullied group were more likely to be repeating the grades compared to the never bullied group (7.1% vs 5.9%, p:0.039). Individuals who were missing >=11 school days, and sometimes or never engaged in school were observed more in bullied group compared to never bullied group (5.9% vs 3.2% and 20.3% vs 10.6% p < 0.001). Conclusions Our findings suggest that bullying victimization could be a risk factor and associated with decreased academic outcomes. Disclosure No significant relationships.
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Vadukapuram R, Trivedi C, Mansuri Z, Shah K, Reddy A. Bright Light Therapy for MDD in Children and Adolescents: a narrative review of literature. Eur Psychiatry 2022. [PMCID: PMC9567062 DOI: 10.1192/j.eurpsy.2022.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Major Depressive Disorder (MDD) is a common mood disorder diagnosed in children and adolescents. Bright light therapy has been effective for seasonal affective disorders, however its role in the treatment of MDD is under studied. Objectives Our objective is to evaluate if bright light therapy (BLT) is a practical approach in treating Child and Adolescents having MDD. Methods We performed an extensive literature search using a wide range of MeSH terms in PubMed, PubMed Central and Google Scholar. We reviewed the literature for studies (published between 1983-2021) assessing the efficacy of BLT in the treatment of MDD in children and adolescents. Results
The final search results yielded 8 randomized clinical trials and 1 case report from 1983 to 2021. BLT showed a superior effect in children and adolescents with MDD compared to the control group in the majority of the randomized trials and a case report. In six studies BLT showed good effect, however in a study by Magnusson et al. and Sonis et al., found a milder degree of improvement in depression symptoms when compared to the control group. In the majority of the studies, patients’ age range was 7 years 18 and in most of the studies, patients were not on antidepressants. Conclusions
The use of BLT in children and adolescents suffering from MDD can be a promising alternative method of biological treatment, which is effective as well as well tolerated. Future long-term studies on large sample size are necessary in this field. Disclosure No significant relationships.
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Ashraf S, Shah K, Aedma K, Mansuri Z, Jain S. 0694 Safety and Efficacy of Ashwagandha for sleep: A Systematic Review. Sleep 2022. [DOI: 10.1093/sleep/zsac079.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Ashwagandha has been around for about two thousand years. It is known as Indian Ginseng, winter cherry, and poison gooseberry. In recent years, the benefits of Ashwagandha tohave been explored in various studies due to the popularity of alternative therapeutic options in masses worldwide. Sleep is vital to the rejuvenation of the mind and body by replenishing the energy to carry on life activities. Sleep disorder is a major limitation in living life to full potential and Ashwagandha, known as beneficial for reducing stress and anxiety, is proven to improve the quality of sleep in individuals. In this systematic review, we study the efficacy of Ashwagandha in improving sleep and its safety for its users.
Methods
A literature search was conducted using relevant MeSH keywords, “Withania” and “Aswagandha” in the context of “Sleep,” “Sleep-Wake Disorders,” or “Sleepiness” in PubMed, PubMed Central, Medline, Web of Science, Biosis, and SciELO databases. We identified all published relevant articles from inception until 11/20/2021 and included 8 studies in our final qualitative synthesis review.
Results
Ashwagandha has been shown to have beneficial effects in decreasing time to fallasleep, improving duration, quality of sleep, and mood upon awakening. Many studies demonstrated these beneficial effects with clinical significance using multiple rating scales of assessment. Most studies explored the safety profile of Ashwagandha for the subjects. In most studies, there were no adverse events reported, and its use is termed safe and beneficial. Few studies reported some minor side effects, such as in a randomized clinical trial, RCT, by Deshpande A. et al. (2020), headaches, fever, acid reflux, and allergic dermatitis were reported.1A randomized clinical trial by Langade D. et al. in 2019 showed that Ashwagandha shortens the sleep onset latency significantly (p,0.019) after 10 weeks of with test [29.00(7.14)] compared to placebo [33.94(7.65)]. There was a significant improvement in sleep efficiency, SE scores at 83.48 (2.83) after 10 weeks 75.63(2.70) for the test at the baseline compared to placebo.2 In another pilot study by Sharma H. et al. (2007), there was a significant improvement in sleep duration, sleep quality (91.67%, p<0.001), and mood upon awakening (88.89%, p<0.001).3
Conclusion
The findings support the efficacy of Ashwagandha for improving sleep quality. Due to the limited availability of data and well-designed studies warrants further research through cohort studies and clinical trials to determine the exact mechanism of action and benefits for sleep.
Support (If Any)
References:1. Deshpande, A., Irani, N., Balkrishnan, R., & Benny, I. R. (2020). A randomized, double-blind, placebo-controlled study to evaluate the effects of Ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep medicine, 72, 28–36. https://doi.org/10.1016/j.sleep.2020.03.0122. Langade, D., Kanchi, S., Salve, J., Debnath, K., & Ambegaokar, D. (2019). Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus, 11(9), e5797. https://doi.org/10.7759/cureus.57973. Sharma, H., Chandola, H. M., Singh, G., & Basisht, G. (2007). Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 2--Ayurveda in primary health care. Journal of alternative and complementary medicine (New York, N.Y.), 13(10), 1135–1150. https://doi.org/10.1089/acm.2007.7017-B
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Mansuri Z, Reddy A, Vadukapuram R, Thootkur M, Trivedi C. Does Insomnia Increase the Risk of Suicide in Hospitalized Patients with Major Depressive Disorder? A Nationwide Inpatient Analysis from 2006 to 2015. Behav Sci (Basel) 2022; 12:117. [PMID: 35621414 PMCID: PMC9137701 DOI: 10.3390/bs12050117] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction. Insomnia is an important symptom associated with major depressive disorder (MDD). In addition, it is one of the risk factors for suicide. Studies have shown the relationship be-tween insomnia and suicidal behavior in patients with MDD. However, this association has not been evaluated in a large sample of hospitalized patients. Objectives. To evaluate the suicidal be-havior in MDD patients with insomnia compared to those without insomnia. Methods. From the National Inpatient Sample (NIS 2006−2015) database using the ICD-9 code, patients’ data were obtained with the primary diagnosis of MDD and comorbid diagnosis of insomnia disorders (MDD+I). These patients were compared with MDD patients without insomnia disorders (MDD−I) by performing a 1:2 match for the primary diagnosis code. Suicidal ideation/attempt da-ta were compared between the groups by multivariate logistic regression analysis. Results. After the diagnostic code matching, 139061 patients were included in the MDD+I group and 276496 patients in the MDD−I group. MDD+I patients were older (47 years vs. 45 years, p < 0.001) com-pared to the MDD−I group. The rate of suicidal ideation/attempt was 56.0% in the MDD+I group and 42.0% in the MDD−I group (p < 0.001). After adjusting for age, sex, race, borderline personal-ity disorders, anxiety disorders, and substance use disorders, ‘insomnia’ was associated with 1.71 times higher odds of suicidal behavior among MDD patients admitted to the hospital. (Odds ratio: 1.71, 95% confidence interval 1.60−1.82, p < 0.001). Conclusions. Insomnia among MDD patients is significantly associated with the risk of suicide. MDD patients with insomnia need to be closely monitored for suicidal behavior.
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Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA;
| | - Ramu Vadukapuram
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Mounica Thootkur
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA;
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Odessa, TX 79763, USA;
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Vadukapuram R, Trivedi C, Shah K, Mansuri Z, Reddy A. The Promise of Predictive Biomarkers for Antipsychotic Efficacy. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21nr03048] [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: 10/18/2022] Open
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Adnan M, Motiwala F, Trivedi C, Sultana T, Mansuri Z, Jain S. Clozapine for Management of Childhood and Adolescent-Onset Schizophrenia: A Systematic Review and Meta-Analysis. J Child Adolesc Psychopharmacol 2022; 32:2-11. [PMID: 35099269 DOI: 10.1089/cap.2021.0092] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Indexed: 11/12/2022]
Abstract
Background: Schizophrenia at a young age deserves investigation because of the greater severity and burden of illness on individuals and health care than its adult onset. For this study, we included both childhood-onset schizophrenia and early-onset schizophrenia. We used the common term "childhood and adolescent-onset schizophrenia (CAOS)" for either type. This systematic review provides an overview of the clinical use, efficacy, and safety of clozapine treatment in managing CAOS. Methods: We conducted a systematic literature search in PubMed, Embase, and PsycINFO databases. We searched for randomized controlled trials (RCTs), open-label studies (OLSs), review articles, meta-analytic and observational studies. Our literature search resulted in 1242 search results. After the title, abstract, and full article review, 18 studies qualified (double-blind RCTs n = 4; OLS n = 4; observational studies n = 7; case reports n = 3). Results: Clozapine use in CAOS was generally well tolerated and not associated with any fatalities. Clozapine use in the short term (6 weeks) and long term (2-9 years) was superior in efficacy than other antipsychotics in CAOS management. Improvement in overall symptoms was maintained during long-term follow-up over the years in OLSs. Clozapine appeared to have a favorable clinical response and shorter hospital stays. Sedation and hypersalivation were commonly reported (90%), constipation was next in frequency (13%-50%). Neutropenia was seen in 6%-15% of cases and agranulocytosis (<0.1%). Although weight gain was common (up to 64%), followed by metabolic changes (8%-22%), treatment-onset diabetes was less frequent (<6%). Akathisia, tachycardia, and blood pressure changes were less commonly seen. Conclusions: Limited studies indicate that clozapine is a safe and efficacious option for CAOS management. We need large-scale and well-designed long-term RCTs for the use of clozapine in the management of CAOS.
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Affiliation(s)
- Mahwish Adnan
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Fatima Motiwala
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland, Texas, USA
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland, Texas, USA
| | - Tania Sultana
- Department of Psychiatry, Manhattan Psychiatric Center, New York, New York, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, Midland, Texas, USA
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Vadukapuram R, Trivedi C, Mansuri Z. Does a Mental Health Diagnosis Worsen Outcomes From COVID-19? Prim Care Companion CNS Disord 2022; 24. [PMID: 35052023 DOI: 10.4088/pcc.21com03152] [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: 10/19/2022] Open
Affiliation(s)
- Ramu Vadukapuram
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York bTexas Tech University Health Sciences Center at Permian Basin, Midland, Texas cBoston Children's Hospital/Harvard Medical School, Boston, Massachusetts *Corresponding author: Ramu Vadukapuram, MD, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029 .,Corresponding author: Ramu Vadukapuram, MD, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029
| | - Chintan Trivedi
- Texas Tech University Health Sciences Center at Permian Basin, Midland, Texas
| | - Zeeshan Mansuri
- Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
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Sun CF, Mansuri Z, Trivedi C, Vadukapuram R, Reddy A. Homicidal ideation and psychiatric comorbidities in the inpatient adolescents aged 12-17. Front Psychiatry 2022; 13:933524. [PMID: 36465293 PMCID: PMC9709343 DOI: 10.3389/fpsyt.2022.933524] [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] [Received: 05/01/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Adolescents with a homicidal tendency is a growing concern in the United States. Studies in the past have showcased the relationship between homicidal ideation (HI) and psychiatric illnesses, but very limited information is available on the adolescent and inpatient population. We aim to evaluate the prevalence of demographic characteristics and psychiatric disorders in adolescents with and without HI. MATERIALS AND METHODS Adolescent (age 12-17) population admitted to the hospital with the diagnosis of homicidal ideation was identified from the 2016-2018 National Inpatient Sample Dataset (NISD). Patients without HI were defined as the control group. The prevalence of psychiatric comorbidities between the groups was compared by applying the Rao-Scott adjusted chi-square test. We used multivariable logistic regression to generate odds ratio (OR) of homicidal ideation as an outcome; we adjusted age, sex, race, socioeconomic status, substance use disorders, alcohol use disorders, and psychiatric comorbidities. RESULTS A total of 18,935 patients (mean age: 14.5) with HI diagnosis were identified in this study. Majority of the patients were male subjects in the HI group compared to the control group (58.7 vs. 41.2%, p < 0.001). Racially, HI was more prevalent in white race (56.0 vs. 52.6%, p < 0.001) and black race (22.3 vs. 17.8%, p < 0.001), compared to Hispanic race (14.9 vs. 21.3%, p < 0.001). Major depression (Odds ratio [OR]: 2.66, p < 0.001), bipolar disorder (OR: 3.52, p < 0.001), anxiety disorder (OR: 1.85, p < 0.001), ADHD, and other conduct disorders (OR: 4.01, p < 0.001), schizophrenia (OR: 4.35, p < 0.001) are strong predictors of HI. Suicidality was prevalent in 66.9% of patients with HI. CONCLUSION We found a higher prevalence of psychiatric illnesses such as depression, anxiety, and bipolar disorder in adolescents with homicidal ideation in the inpatient setting. White and black races were more prevalent in patients with homicidal ideation. Further large-scale longitudinal research studies are warranted to establish the correlation between psychiatric disorders and homicidal ideation among adolescents.
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Affiliation(s)
- Ching-Fang Sun
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Odessa, TX, United States
| | - Ramu Vadukapuram
- Department of Psychiatry, The University of Texas Rio Grande Valley, Harlingen, TX, United States
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
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Mansuri Z, Reddy A, Vadukapuram R, Trivedi C, Amara A. Pimavanserin in the Treatment of Parkinson's Disease Psychosis: Meta-analysis and Meta-regression of Randomized Clinical Trials. Innov Clin Neurosci 2022; 19:46-51. [PMID: 35382074 PMCID: PMC8970241] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Up to 60 percent of patients with Parkinson's disease (PD) develop Parkinson's disease psychosis (PDP). PDP is associated with a significant economic burden. The management of PDP has been divided into two approaches-one focuses on decreasing the doses of anti-Parkinsonian medications and the other involves prescribing atypical antipsychotics. Of these atypical antipsychotics, pimavanserin is United States (US) Food and Drug Administration (FDA)-approved specifically for the treatment of PDP. OBJECTIVE The goal was to evaluate the safety and efficacy of pimavanserin in the treatment of PDP based on data from randomized clinical trials. METHODS All the articles, which assessed pimavanserin's effect on the treatment of PDP, were retrieved from Google Scholar, PubMed, and abstracts from annual scientific sessions. The data on dose, therapy duration, patient numbers, and study duration were collected. These data were analyzed with random effect modeling using the inverse variance method and the Mantel-Haenszel method. RESULTS Four studies comparing pimavanserin to a placebo provided data on 680 patients (263 placebo, 417 pimavanserin). Treatment with pimavanserin was associated with a significant reduction in scores using the Scale of Assessment of Positive Symptoms, Hallucinations, and Delusion (SAPS-H+D) (mean difference [MD]: -1.55 [-2.71, -0.379], p=0.009). The groups had similar composite scores for Unified Parkinson's Disease Rating Scale II and III (UPDRS II and III) (MD: 0.093 [-1.28, 1.46], p=0.89). Interestingly, pimavanserin was protective against orthostatic hypotension (risk ratio: 0.33 [0.30, 0.37], p<0.001). All other adverse events were similarly distributed across both groups. CONCLUSION There was a significant improvement in psychosis symptoms in patients with PD who took pimavanserin. Pimavanserin was also shown to be protective against orthostatic hypotension.
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Affiliation(s)
- Zeeshan Mansuri
- Dr. Mansuri is with the Department of Psychiatry, Boston Children's Hospital/Harvard Medical School in Boston, Massachusetts
| | - Abhishek Reddy
- Dr. Reddy is with the Department of Psychiatry, Virginia Tech Carilion School of Medicine in Roanoke, Virginia
| | - Ramu Vadukapuram
- Dr. Vadukapuram is with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai in New York, New York
| | - Chintan Trivedi
- Dr. Trivedi is with St. David Medical Center in Austin, Texas
| | - Amy Amara
- Dr. Amara is with the Department of Neurology at the University of Alabama at Birmingham in Birmingham, Alabama
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Tondehal NR, Hawa S, Malik AS, Hamid KN, Malekunnel A, Adnan M, Trivedi C, Mansuri Z, Jain S. Commentary: Correlation analysis of serum vitamin D levels and post-operative cognitive disorder in elderly patients with gastrointestinal tumor. Front Psychiatry 2022; 13:971412. [PMID: 36387001 PMCID: PMC9650129 DOI: 10.3389/fpsyt.2022.971412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/05/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Saadiya Hawa
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, United States
| | | | | | | | - Mahwish Adnan
- Department of Psychiatry, Texas Tech University of Health Sciences, Midland, TX, United States
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University of Health Sciences, Midland, TX, United States
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University of Health Sciences, Midland, TX, United States
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Mansuri Z, Makani R, Trivedi C, Adnan M, Vadukapuram R, Rafael J, Lodhi A, Reddy A. The role of metformin in treatment of weight gain associated with atypical antipsychotic treatment in children and adolescents: A systematic review and meta-analysis of randomized controlled trials. Front Psychiatry 2022; 13:933570. [PMID: 36458118 PMCID: PMC9705964 DOI: 10.3389/fpsyt.2022.933570] [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] [Received: 05/01/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Second-generation antipsychotics are associated with significant weight gain. The aim of this systematic review and meta-analysis was to determine the efficacy and safety of metformin for the treatment of weight gain in children and young adults treated with second-generation antipsychotics. METHODS We followed PRISMA guidelines to evaluated studies published before March 2020 in Medline, Google Scholar, PubMed, Cochrane library database, annual scientific sessions of the American Psychiatric Association, American Academy of Child and Adolescent, Psychiatry, and American Society of Clinical Psychopharmacology. Studies included compared metformin with the placebo for management of weight gain in children and adolescents taking atypical antipsychotics. Non-randomized studies, animal experiment studies, editorials, and review studies were excluded. Multiple parameters, including change in anthropometric-biochemical parameters, drug discontinuation rate, and side effects among the groups were assessed. The random-effects method was used for meta-analysis. RESULTS Four studies with were included in the final analysis (213 patients; metformin: 106; control: 107). After pooled analysis, 12-16 weeks of metformin therapy was associated with a significant reduction in weight [(mean difference (MD): -4.53 lbs, confidence interval (CI): -6.19 to -2.87, p-value < 0.001)], and BMI z score [MD, -0.09, CI: -0.16, -0.03, p-value: 0.004] compared to control. Metformin was also associated with a significant reduction in insulin resistance [MD: -1.38, CI: -2.26 to -0.51, p-value: 0.002]. There were higher odds of nausea-vomiting [OR: 4.07, CI: 1.32-12.54, p-value: 0.02] and diarrhea [OR: 2.93, CI: 1.50-5.71, p-value: 0.002] in the metformin group. However, there was no difference in drug discontinuation rate [OR: 1.45, CI: 0.41-5.06, p-value: 0.56]. CONCLUSION Metformin may prove beneficial in the treatment of weight gain in children treated with second-generation antipsychotics. The pooled treatment effect showed a significant reduction in BMI Z-score and weight in just 12-16 weeks. The limitations include small sample size, variation in metformin dose, and duration of treatment. This meta-analysis should be interpreted as promising, and further larger studies are warranted before drawing a conclusion.
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Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Ramkrishna Makani
- Department of Psychiatry, AtlantiCare Health System, Egg Harbor Township, NJ, United States
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Odessa, TX, United States
| | - Mahwish Adnan
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Odessa, TX, United States
| | - Ramu Vadukapuram
- The University of Texas Rio Grande Valley, Harlingen, TX, United States
| | - John Rafael
- MS4, Texas Tech University Health Sciences Center at Permian Basin, Odessa, TX, United States
| | | | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
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