scholarly journals Predictors of the Length of Stay of Psychiatric Inpatients: Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Farid Carranza ◽  
Neri Alejandro Álvarez ◽  
Andrea Muriel Contreras ◽  
Andrea Fernanda Guerrero ◽  
Natalia Sofía Tamayo ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background: Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there are no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients.Methods: We will conduct a systematic search in PubMed, MEDLINE, EMBASE and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies.Discussion: The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic Review Registration: PROSPERO ID CRD42020172840

scholarly journals Predictors of the length of stay of psychiatric inpatients: protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Farid Carranza Navarro ◽  
Neri Alejandro Álvarez Villalobos ◽  
Andrea Muriel Contreras Muñoz ◽  
Andrea Fernanda Guerrero Medrano ◽  
Natalia Sofía Tamayo Rodríguez ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning, and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there is no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients. Methods We will conduct a systematic search in PubMed, MEDLINE, EMBASE, and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies. Discussion The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic review registration PROSPERO ID CRD42020172840 

scholarly journals Predictors of the Length of Stay of Psychiatric Inpatients: Protocol for a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Farid Carranza ◽  
Natalia Sofía Tamayo ◽  
Neri Alejandro Álvarez ◽  
Andrea Muriel Contreras ◽  
Andrea Fernanda Guerrero ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background : Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Prediction of which patients have a higher risk for prolonged LOS has been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there are no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients. Methods : We will conduct a systematic search in PubMed, MEDLINE, EMBASE and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of risk factors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies. Discussion : The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals at a higher risk for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic Review Registration : PROSPERO ID CRD42020172840

scholarly journals Death Anxiety in the Elderly in Iran: A Systematic Review and Meta-analysis

Salmand ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. 151-171
Author(s):  
Maliheh Khalvati ◽  
◽  
Masoudeh Babakhanian ◽  
Mahboube Khalvati ◽  
Ayub Nafei ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Old Age ◽  
Meaning In Life ◽  
Death Anxiety ◽  
Service Providers ◽  
Meta Analysis ◽  
The Elderly ◽  
Older Men ◽  
Men And Women

Objectives: Aging is one of the most critical stages of human development that has its own characteristics and conditions. One of the most common issues in old age is the mental health whose achievement requires special attention from both health system policymakers and service providers to the elderly. Death anxiety is one of the most common mental health issues in old age, because this period is full of feelings of shortcomings and disabilities. Since death anxiety is a multidimensional factor, it is expected to affect many aspects of the elderly. The present study aims to review and analyze published studies in the field of death anxiety in the elderly in Iran. Methods & Materials: This is a systematic review and meta-analysis conducted on the studies related to the death anxiety of the elderly in Iran published in Persian from 2011 to 2019. A search was conducted in national databases, including SID, IranDoc, MagIran, IDML, and CIVILICA using the keywords: Death anxiety, elderly, and older adult. Initial search yielded 61 articles. After screening, 33 studies that met the entry and exit criteria were selected for the final review. We used Stata v. 14 and SPSS v. 22 applications to perform meta-analysis. Results: In the studies, 40.35% of the participants were older women and the rest were older men with a mean age of 67.80±6.44 years. The mean score of death anxiety was higher in men than in women, and the elderly living in nursing homes had the highest score (11.8). Studies were categorized into three sections: comparison (3 studies), intervention (11 studies), and factors affecting the death anxiety (18 studies). The results of meta-analysis showed no significant relationship between spiritual therapy and reduction of death anxiety in the elderly (P>0.05). In studies with spiritual and behavioral therapies, the heterogeneity was significant and, thus, a significant positive relationship was observed between the reduction of death anxiety and these treatments methods. Conclusion: The death anxiety level of the elderly in Iran is low. Religious beliefs, hopes for the intercession of imams and religious leaders, and hopes for freedom from the hardships of worldly life seem to have contributed to low death anxiety in Iran. Different death anxiety scores have been reported for older men and women in Iran may be due to the effect of culture, religion, and traditions, the difference in the roles of men and women, and even the expression of fear and anxiety. Most of men have less tendency to express their emotions, including fear, while women are more likely to express their feelings. Behavioral and spiritual interventions lead to a decrease in the elderly’s death anxiety through affecting their finding meaning in life.

Four decades of military posttraumatic stress: Protocol for a meta-analysis and systematic review of treatment approaches and efficacy (Preprint)

2021 ◽  
Author(s):  
Jenny Jing Wen Liu ◽  
Anthony Nazarov ◽  
Bethany Easterbrook ◽  
Rachel A. Plouffe ◽  
Tri Le ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Clinical Decision Making ◽  
Ptsd Symptom ◽  
Service Providers ◽  
Meta Analysis ◽  
Well Being ◽  
Effect Sizes ◽  
Treatment Approaches

BACKGROUND Over 85% of active members of the Canadian Armed Forces (CAF) have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as one in eight Veterans has a diagnosis of PTSD. Given high rates of PTSD in military and Veteran populations, the provision of effective treatment with considerations for their unique challenges and lived experiences is critical in the support of their mental health and well-being. OBJECTIVE The current paper overviews the protocol for conducting a meta-analysis and systematic review substantiating evidence of treatment approaches and effectiveness in treating military-related PTSD. METHODS The PROSPERO pre-registered meta-analysis is being conducted in accordance with PRISMA and Cochrane guidelines. A comprehensive search of the literature was conducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertations and Theses. After removal of duplicates, a total of 12,002 studies were screened for inclusion. RESULTS Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multi-level meta-analysis will examine the overall effects, between-studies effects, and within-studies effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and sub-group analyses will explore the moderating roles of clinical characteristics (e.g., PTSD symptom clusters), treatment approaches (e.g., therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), and treatment characteristics (e.g., length of intervention) on treatment outcomes. CONCLUSIONS This meta-analysis will provide the current state of evidence on the efficacy and effectiveness of various treatment approaches in military-related PTSD while identifying factors that may influence treatment outcomes. Results will inform clinical decision-making for service providers and service users. Finally, findings will provide insights for future treatment development and practice recommendations to better support the well-being of military and Veteran populations.

scholarly journals Post-traumatic Stress Disorder in Prisoners’ Offspring: A Systematic Review and Meta-analysis

2020 ◽  
Vol 16 (1) ◽  
pp. 36-45
Author(s):  
Giacomo Gualtieri ◽  
Fabio Ferretti ◽  
Alessandra Masti ◽  
Andrea Pozza ◽  
Anna Coluccia
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Parental Incarceration ◽  
Effect Sizes ◽  
Post Traumatic Stress ◽  
Post Traumatic

Background: Parental incarceration can produce serious effects on the offspring’s mental health. The presence of Post-Traumatic Stress Disorder (PTSD) in prisoners’ offspring is understudied and the few literature data showed heterogeneous evidence, with some studies suggesting that about 25% of prisoners’ offspring have PTSD and other reporting much lower prevalence rates around 2-3%. There is no systematic review and meta-analysis about PTSD in prisoners’ offspring. Objectives: The present systematic review and meta-analysis aimed to provide a first quantitative synthesis of the prevalence of the PTSD diagnosis in prisoners’ offspring. Moderator variables of the effect sizes were assessed, including offspring’s and parents’ gender, offspring’s generational cohort (children/adolescents versus adults), reasons for parental incarceration (political/war versus crime), and country type (Western versus Non-Western countries). Methods: A systematic review and a meta-analysis were conducted according to the PRISMA guidelines. Studies were included if they assessed the presence of a PTSD diagnosis in child, adolescent or adult offspring of prisoners through a diagnostic classification system, a clinician-administered interview or a self-report questionnaire, if they reported data necessary to calculate the effect sizes or the authors were available to provide them. Studies might have been based upon any design except review, single-case, case series, and case reports. Outcomes might have been measured at any time after parental incarceration. Parental imprisonment was defined as any kind of custodial confinement of a parent by the criminal justice system, including being held as a prisoner of war or for political reasons. Independent reviewers searched published/unpublished studies through electronic databases and additional sources and extracted the data. A random-effect meta-analysis was carried out by calculating the effect sizes as event rates. Heterogeneity was examined by the I2 and the Q statistics. Moderators were assessed through meta-regressions. Results: Six studies (2512 participants) were included. Fifteen percent of prisoners’ offspring had PTSD, as shown by a significant mean effect size of 0.14 without evidence of publication bias (95% CI: 0.081 – 0.249, p< 0.001). There were no significant differences on the mean effect sizes between the studies on adults and those on children/adolescents [Q(1) = 0.00, p = .999], between the studies on parents incarcerated for political/war reasons and those for crime [Q(1) = 0.00, p = .979], and between the studies conducted in Western and non-Western countries [Q(1) = 0.854, p = .355]. While offspring’s gender was not related to the effect sizes [β = -0.01, 95% CI: -0.02 – 0.02, p = .452], parents’ gender was significantly and positively associated with the effect sizes suggesting that in studies with higher percentages of incarcerated mothers, the prevalence of offspring’s PTSD was higher [β = 0.01, 95% CI: 0.0 – 0.01, p = .019]. Conclusion: PTSD is a serious mental health condition among prisoners’ offspring, particularly when mothers are incarcerated. The present findings point out the importance of thorough assessment and timely intervention/prevention strategies implemented by professionals of mental health settings and detention systems. The cross-sectional design of the studies does not allow causal conclusions to be drawn about the effect of parental incarceration as a risk factor for PTSD. Other variables related to parental incarceration may explain these findings. This limitation points out the importance of further longitudinal research.

scholarly journals The mental health of young people who are not in education, employment, or training: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Geneviève Gariépy ◽  
Sofia M. Danna ◽  
Lisa Hawke ◽  
Joanna Henderson ◽  
Srividya N. Iyer
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Random Effects ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Youth Mental Health ◽  
Random Effects Models ◽  
Substance Use Problems

Abstract Purpose There are increasing concerns about the intersection between NEET (not in education, employment, or training) status and youth mental ill-health and substance use. However, findings are inconsistent and differ across types of problems. This is the first systematic review and meta-analysis (PROSPERO-CRD42018087446) on the association between NEET status and youth mental health and substance use problems. Methods We searched Medline, EMBASE, Web of Science, ERIC, PsycINFO, and ProQuest Dissertations and Theses (1999–2020). Two reviewers extracted data and appraised study quality using a modified Newcastle–Ottawa Scale. We ran robust variance estimation random-effects models for associations between NEET and aggregate groups of mental ill-health and substance use measures; conventional random-effects models for associations with individual mental/substance use problems; and subgroup analyses to explore heterogeneity. Results We identified 24 studies from 6,120 references. NEET status was associated with aggregate groups of mental ill-health (OR 1.28, CI 1.06–1.54), substance use problems (OR 1.43, CI 1.08–1.89), and combined mental ill-health and substance use measures (OR 1.38, CI 1.15–1.64). Each disaggregated measure was associated with NEET status [mood (OR 1.43, CI 1.21–1.70), anxiety (OR 1.55, CI 1.07–2.24), behaviour problems (OR 1.49, CI 1.21–1.85), alcohol use (OR 1.28, CI 1.24–1.46), cannabis use (OR 1.62, CI 1.07–2.46), drug use (OR 1.99, CI 1.19–3.31), suicidality (OR 2.84, CI 2.04–3.95); and psychological distress (OR 1.10, CI 1.01–1.21)]. Longitudinal data indicated that aggregate measures of mental health problems and of mental health and substance use problems (combined) predicted being NEET later, while evidence for the inverse relationship was equivocal and sparse. Conclusion Our review provides evidence for meaningful, significant associations between youth mental health and substance use problems and being NEET. We, therefore, advocate for mental ill-health prevention and early intervention and integrating vocational supports in youth mental healthcare.

scholarly journals Digital Shared Decision-Making Interventions in Mental Healthcare: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Tobias Vitger ◽  
Lisa Korsbek ◽  
Stephen F. Austin ◽  
Lone Petersen ◽  
Merete Nordentoft ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Decision Making ◽  
Meta Analysis ◽  
Patient Activation ◽  
Mental Healthcare ◽  
Decisional Conflict ◽  
Controlled Trials ◽  
Shared Decision ◽  
Digital Interventions

Background: Shared decision-making (SDM) in mental healthcare has received increased attention as a process to reinforce person-centered care. With the rapid development of digital health technology, researchers investigate how digital interventions may be utilized to support SDM. Despite the promise of digital interventions to support SDM, the effect of these in mental healthcare has not been evaluated before. Thus, this paper aims to assess the effect of SDM interventions complimented by digital technology in mental healthcare.Objective: The objective of this review was to systematically examine the effectiveness of digital SDM interventions on patient outcomes as investigated in randomized trials.Methods: We performed a systematic review and meta-analysis of randomized controlled trials on digital SDM interventions for people with a mental health condition. We searched for relevant studies in MEDLINE, PsycINFO, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials. The search strategy included terms relating to SDM, digital systems, mental health conditions, and study type. The primary outcome was patient activation or indices of the same (e.g., empowerment and self-efficacy), adherence to treatment, hospital admissions, severity of symptoms, and level of functioning. Secondary outcomes were satisfaction, decisional conflict, working alliance, usage, and adherence of medicine; and adverse events were defined as harms or side effects.Results: Sixteen studies met the inclusion criteria with outcome data from 2,400 participants. Digital SDM interventions had a moderate positive effect as compared with a control condition on patient activation [standardized mean difference (SMD) = 0.56, CI: 0.10, 1.01, p = 0.02], a small effect on general symptoms (SMD = −0.17, CI: −0.31, −0.03, p = 0.02), and working alliance (SMD = 0.21, CI: 0.02, 0.41, p = 0.03) and for improving decisional conflict (SMD = −0.37, CI: −0.70, −0.05, p = 0.02). No effect was found on self-efficacy, other types of mental health symptoms, adverse events, or patient satisfaction. A total of 39 outcomes were narratively synthesized with results either favoring the intervention group or showing no significant differences between groups. Studies were generally assessed to have unclear or high risk of bias, and outcomes had a Grading of Recommendations Assessment, Development and Evaluation (GRADE) rating of low- or very low-quality evidence.Conclusions: Digital interventions to support SDM may be a promising tool in mental healthcare; but with the limited quality of research, we have little confidence in the estimates of effect. More quality research is needed to further assess the effectiveness of digital means to support SDM but also to determine which digital intervention features are most effective to support SDM.Systematic Review Registration: PROSPERO, identifier CRD42020148132.

scholarly journals Substance use disorders and suicidality in youth: A systematic review and meta-analysis with a focus on the direction of the association

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255799
Author(s):  
Charlie Rioux ◽  
Anne-Sophie Huet ◽  
Natalie Castellanos-Ryan ◽  
Laurianne Fortier ◽  
Myriam Le Blanc ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Psychiatric Disorder ◽  
Web Of Science ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Secondary Substance ◽  
Bidirectional Associations ◽  
Meta Analyses

Background Reviews and meta-analyses suggest that substance use and suicidality (i.e., suicidal ideations and attempts) are associated in youth, but the direction of this association remains unclear. Theoretically, the secondary psychiatric disorder hypothesis (SPDH) posits that substance use leads to suicidality, while the secondary substance use disorder hypothesis (SSUDH) posits that suicidality leads to substance use. To clarify these associations, this meta-analysis systematically reviewed studies that examined the prospective associations between SUDs and suicidality in youth (age 25 and younger) and compared results according to the direction of the association. Methods Web of Science, Embase, PsycINFO, PubMed, Medline and ProQuest Dissertations & Theses Global were searched from inception to March 8, 2020, and 55 effect sizes from 23 samples were included and analyzed using a three-level meta-analysis. Results SUDs significantly predicted subsequent suicidality (OR = 2.16, 95%CI 1.57–2.97), suicidality significantly predicted subsequent SUDs (OR = 2.16, 95%CI 1.53–3.04), and these effect sizes did not differ (p = 0.49). Conclusions Considering that 65% of reviewed studies only examined the SPDH, this review highlights that more attention should be given to the SSUDH, and that studies should examine bidirectional associations between SUDs and suicidality across time. Clinically, because SUDs and suicidality were found to influence each other, results suggest that mental health and SUDs should ideally be detected and treated early, and that co-occurring disorders should be assessed and treated concomitantly.

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