Exposure to parental psychopathology and offspring's risk of suicide-related thoughts and behaviours: a systematic review

Aims.The primary objective of this systematic review was to identify and synthesise analytic studies examining the association between exposure to parental psychopathology in childhood and the nature of subsequent suicide-related thoughts (SRT) and suicide-related behaviour (SRB) (severity of ideation, planned/unplanned attempts/lethality) and to describe the direction, and magnitude of associations. The secondary objective was to determine if the associations from the primary objective differ by the type(s) and timing of parental psychopathology, sex/gender of the parent and child and is mediated by child psychiatric symptoms and family functioning.Methods.A systematic review was conducted using guidelines from the PRISMA statement. MEDLINE, CINAHL, EMBASE, psycINFO, Web of Science and grey literature sources were searched by two reviewers to March, 2017. Studies were included if they examined any parental psychopathology (Diagnostic and Statistical Manual of Mental Disorders criteria or equivalent) or SRT or SRB and offspring SRT or SRB occurring from birth <25 years of age.Results.Out of 10 231 studies identified, 54 were included for review. Studies were clinically and methodologically heterogeneous with none at low risk of bias (ROB). Nine studies with moderate ROB indicated a significantly increased risk of offspring SRT, suicide attempts (SA) and suicide among those exposed to maternal SA and suicide in childhood or adolescence. In the remaining 45 studies with higher ROB this association persisted. Several studies (67%) did not confirm that the exposure occurred in the offspring's childhood or adolescence. Findings were suggestive of a mediating effect of offspring psychiatric symptoms, however, few studies examined mediation and effect modification of contextual variables.Conclusions.Offspring exposed to maternal SA are at an increased risk of these same behaviours early in life. Prospective attention to the types and timing of maternal and paternal psychopathology and the intermediate pathways to offspring SRT and SRB onset is needed and could have implications for informing modifiable targets for early intervention and prevention.

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PARENT-CHILD AGREEMENT ON CHILD PSYCHIATRIC SYMPTOMS ASSESSED VIA STRUCTURED INTERVIEW

Journal of Child Psychology and Psychiatry ◽

10.1111/j.1469-7610.1986.tb02282.x ◽

1986 ◽

Vol 27 (2) ◽

pp. 181-190 ◽

Cited By ~ 354

Author(s):

Craig Edelbrock ◽

Anthony J. Costello ◽

Mina K. Dulcan ◽

Noelle Calabro Conover ◽

Robert Kala

Keyword(s):

Psychiatric Symptoms ◽

Structured Interview ◽

Child Psychiatric ◽

Child Psychiatric Symptoms ◽

Parent Child

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P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽

10.1017/cem.2017.272 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S102

Author(s):

S.W. Kirkland ◽

A. Soleimani ◽

B.H. Rowe ◽

A.S. Newton

Keyword(s):

Systematic Review ◽

Health Care ◽

Emergency Department ◽

Health Care Services ◽

Grey Literature ◽

Study Data ◽

Care Utilization ◽

Alternative Source ◽

Increased Risk ◽

The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

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Preditores de idealização suicida entre estudantes de medicina: uma revisão sistemática

International Journal of Health Education ◽

10.17267/2594-7907ijhe.v3i1.2413 ◽

2019 ◽

Vol 3 (1) ◽

pp. 78

Author(s):

Victor Meireles Campos ◽

Ieda Aleluia

Keyword(s):

Systematic Review ◽

Medical Students ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Training Methods ◽

Increased Risk ◽

The World ◽

The Subject ◽

Health Objective ◽

De Medicina

BACKGROUND: Suicidal ideation is one of the main symptoms indicative of suicide attempts and suicide. According to the WHO, about 800,000 cases of suicide were reported around the world in 2014, which translates to an index of 1 suicide every 40 seconds. Medical students constitute a population at risk for the development of suicidal ideation. Several life factors may influence the risk of suicidal ideation, those being personality traits, social factors and mental health. OBJECTIVE: Identify the indicators of suicidal ideation among medical students during their academic training. METHODS: This is a systematic review carried out in the electronic databases Pubmed and BVS. Articles that addressed the subject of suicidal ideation among medical students in Portuguese, English and Spanish from 2008 to 2018 were included. RESULTS: We found 263 articles, of which 12 articles met the inclusion and exclusion criteria. After the application of the STROBE statement, 6 articles were selected for the creation of this systematic review. The prevalence of suicidal ideation varied from 3.7% to 35.6% around the world and several factors were linked to the increase of suicidal ideation risk. CONCLUSION: A suicidal ideation is a frequent and multifactorial phenomenon that involves several realms of a medical student's life. The risk factors identified in this review were linked to the increased risk of suicidal ideation development.

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Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis

PLoS ONE ◽

10.1371/journal.pone.0254956 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254956

Author(s):

Elizabeth R. Ralston ◽

Priscilla Smith ◽

Joseph Chilcot ◽

Sergio A. Silverio ◽

Kate Bramham

Keyword(s):

Systematic Review ◽

Chronic Disease ◽

Chronic Diseases ◽

Perceived Risk ◽

Risk Perceptions ◽

Grey Literature ◽

Pregnancy Risk ◽

Thematic Synthesis ◽

Increased Risk ◽

In Pregnancy

Background Women with chronic disease are at increased risk of adverse pregnancy outcomes. Pregnancies which pose higher risk, often require increased medical supervision and intervention. How women perceive their pregnancy risk and its impact on health behaviour is poorly understood. The aim of this systematic review of qualitative literature is to evaluate risk perceptions of pregnancy in women with chronic disease. Methods Eleven electronic databases including grey literature were systematically searched for qualitative studies published in English which reported on pregnancy, risk perception and chronic disease. Full texts were reviewed by two researchers, independently. Quality was assessed using the Critical Appraisal Skills Programme Qualitative checklist and data were synthesised using a thematic synthesis approach. The analysis used all text under the findings or results section from each included paper as data. The protocol was registered with PROSPERO. Results Eight studies were included in the review. Three themes with sub-themes were constructed from the analysis including: Information Synthesis (Sub-themes: Risk to Self and Risk to Baby), Psychosocial Factors (Sub-themes: Emotional Response, Self-efficacy, Healthcare Relationship), and Impact on Behaviour (Sub-themes: Perceived Risk and Objective Risk). Themes fitted within an overarching concept of Balancing Act. The themes together inter-relate to understand how women with chronic disease perceive their risk in pregnancy. Conclusions Women’s pregnancy-related behaviour and engagement with healthcare services appear to be influenced by their perception of pregnancy risk. Women with chronic disease have risk perceptions which are highly individualised. Assessment and communication of women’s pregnancy risk should consider their own understanding and perception of risk. Different chronic diseases introduce diverse pregnancy risks and further research is needed to understand women’s risk perceptions in specific chronic diseases.

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PP39 What is the risk of major trauma following a fall down stairs? – A systematic review

Emergency Medicine Journal ◽

10.1136/emermed-2021-999.39 ◽

2021 ◽

Vol 38 (9) ◽

pp. A16.2-A16

Author(s):

Christopher Holt ◽

Samuel Keating ◽

Michael Tonkins ◽

Daniel Bradbury ◽

Gordon Fuller

Keyword(s):

Systematic Review ◽

Major Trauma ◽

Alcohol Intoxication ◽

Grey Literature ◽

Developed Countries ◽

Risk Of Bias ◽

Qualitative Synthesis ◽

Increased Risk ◽

Study Heterogeneity ◽

Serious Injury

BackgroundSpecific mechanisms of injury are stated in pre-hospital triage tools to identify suspected cases of major trauma. Falls down stairs are common presentations in UK emergency departments, yet are frequently overlooked as a causative mechanism of major trauma. No prior systematic review has examined this association.MethodsSeven internationally recognised literature databases and seven grey literature databases were screened utilising a common search strategy from inception until 31 December 2019. Abstracts were screened for relevance by a single reviewer. Full texts were screened and subsequently extracted by 3 separate reviewers against strict inclusion/exclusion criteria. A risk of bias assessment based on GRADE recommendations was performed. In the absence of study heterogeneity, a narrative synthesis was planned. The reporting of this systematic review followed PRISMA 2009 statement guidelines.Results5240 articles were identified from database searching, 89 articles had their full texts assessed for eligibility and 6 articles were included for qualitative synthesis. All studies were retrospective in nature and originated from more economically developed countries. 7431 patients who fell down stairs were analysed, of which, 707 (9.5%) met major trauma definitions. Falls down stairs resulted in a significantly increased risk of serious injury compared to other fall mechanisms (OR: 1.621, 95% CI: 1.381 – 1.902, p<0.0005). Analysis of confounding factors demonstrated age (OR: 2.59, 95% CI: 1.57 – 4.28, p<0.001) and alcohol intoxication (OR: 2.6, 95% CI: 1.4 – 4.7, p=0.001) to be significantly associated with major trauma. Risk of bias was moderate to high across all 6 studies.ConclusionThis systematic review highlighted the paucity of literature surrounding the incidence of major trauma following falls down stairs.A retrospective cohort study is currently being undertaken to analyse the risk of major trauma following falls down stairs. On completion, the results will be incorporated with the results of this systematic review.

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Delirium prevention and treatment in the emergency department (ED): a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-037915 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037915

Author(s):

Elijah Blue Dahlstrom ◽

Jin Ho Han ◽

Heather Healy ◽

Maura Kennedy ◽

Glenn Arendts ◽

...

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Grey Literature ◽

Primary Objective ◽

Forest Plot ◽

Significant Heterogeneity ◽

Geriatric Population ◽

Duration Of Symptoms ◽

Prevention And Treatment ◽

Delirium Prevention

IntroductionDelirium is a dangerous syndrome of acute brain dysfunction that is common in the emergency department (ED), especially among the geriatric population. Most systematic reviews of interventions for delirium prevention and treatment have focused on inpatient settings. Best practices of effective delirium care in ED settings have not been established. The primary objective of this study is to identify pharmacologic and non-pharmacologic interventions as applied by physicians, nursing staff, pharmacists and other ED personnel to prevent incident delirium and to shorten the severity and duration of prevalent delirium in a geriatric population within the ED.Methods and analysisSearches using subject headings and keywords will be conducted from database inception through June 2020 in MEDLINE, EMBASE, Web of Science, PsychINFO, CINAHL, ProQuest Dissertations and Theses Global and Cochrane CENTRAL as well as grey literature. Database searches will not be limited by date or language. Two reviewers will identify studies describing any interventions for delirium prevention and/or treatment in the ED. Disagreements will be settled by a third reviewer. Pooled data analysis will be performed where possible using Review Manager. Risk ratios and weighted difference of means will be used for incidence of delirium and other binary outcomes related to delirium, delirium severity or duration of symptoms, along with 95% CIs. Heterogeneity will be measured by calculating I2, and a forest plot will be created. If significant heterogeneity is identified, metaregression is planned using OpenMeta to identify possible sources of heterogeneity.Ethics and disseminationThis is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. This review will be prepared as a manuscript and submitted for publication to a peer-reviewed journal, and the results will be presented at conferences.PROSPERO trial registration numberCRD42020169654.

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Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis

Psychological Medicine ◽

10.1017/s0033291718003823 ◽

2019 ◽

Vol 49 (07) ◽

pp. 1057-1078 ◽

Cited By ~ 33

Author(s):

Ioannis Angelakis ◽

Emma Louise Gillespie ◽

Maria Panagioti

Keyword(s):

Systematic Review ◽

Childhood Abuse ◽

Childhood Maltreatment ◽

Emotional Abuse ◽

Suicide Attempts ◽

Meta Analysis ◽

Current Evidence ◽

Bibliographic Databases ◽

Increased Risk ◽

Different Types

AbstractThis comprehensive systematic review and meta-analysis aims to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using theI2statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from 68 studies based onn= 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR 5.18, 95% CI 2.52–10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.

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2.59 DOES PARENTAL EXECUTIVE FUNCTION MODERATE THE RELATIONSHIP BETWEEN HOUSEHOLD FOOD INSECURITY, DIET QUALITY, AND CHILD PSYCHIATRIC SYMPTOMS?

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2016.09.125 ◽

2016 ◽

Vol 55 (10) ◽

pp. S139-S140

Author(s):

Robert Althoff ◽

Merelise Ametti

Keyword(s):

Executive Function ◽

Food Insecurity ◽

Diet Quality ◽

Psychiatric Symptoms ◽

Household Food Insecurity ◽

Household Food ◽

Child Psychiatric ◽

Child Psychiatric Symptoms ◽

The Relationship

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Characteristics and Recovery Methods of Studies Falsely Excluded During Literature Screening –A Systematic Review

10.21203/rs.3.rs-745015/v1 ◽

2021 ◽

Author(s):

Lisa Affengruber ◽

Andreea Dobrescu ◽

Emma Persad ◽

Irma Klerings ◽

Gernot Wagner ◽

...

Keyword(s):

Systematic Review ◽

Information Science ◽

Citation Index ◽

Grey Literature ◽

Case Series ◽

Rapid Review ◽

Reference List ◽

Search Methods ◽

Increased Risk ◽

The Impact

Abstract Background: Due to the growing need to provide evidence syntheses under time constraints, researchers have begun focusing on the exploration of rapid review methods, which often employ single-reviewer literature screening. However, single-reviewer screening misses, on average, 13% of relevant studies, compared to 3% with dual-reviewer screening. Little guidance exists regarding methods to recover studies falsely excluded during literature screening. Likewise, it is unclear whether specific study characteristics can predict an increased risk of false exclusion. This systematic review aimed to identify supplementary search methods that can be used to recover studies falsely excluded during literature screening. Moreover, it strove to identify study-level predictors that indicate an elevated risk of false exclusions of studies during literature screening. Methods: We performed literature searches for eligible studies in Medline, Science Citation Index Expanded, Social Sciences Citation Index, Current Contents Connect, Embase, Epistemonikos.org, and Information Science & Technology Abstracts from 1999 to June 23, 2020. We searched for grey literature, checked reference lists, and conducted hand searches in two relevant journals and similar articles searches current to January 28, 2021. Two investigators independently screened the literature; one investigator performed the data extraction, a second investigator checked for correctness and completeness. Two reviewers assessed the risk of bias of eligible studies. We synthesized the results narratively. Results: Three methods studies, two with a case study design and one with a case series design, met the inclusion criteria. One study reported that all falsely excluded publications (8%) could be recovered through reference list checking compared to other supplementary search methods. No included methods study analyzed the impact of recovered studies on conclusions or meta-analyses. Two studies reported that up to 8% of studies were falsely excluded due to uninformative titles and abstracts, and one study showed that 11% of non-English studies were falsely excluded. Conclusions: Due to the limited evidence based on two case studies and one case series, we can draw no firm conclusion about the most reliable and most valid method to recover studies falsely excluded during literature screening or about the characteristics that might predict a higher risk of false exclusion. Systematic review registration: https://osf.io/v2pjr/

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