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  1. Article ; Online: Aripiprazole and Other Third-Generation Antipsychotics as a Risk Factor for Impulse Control Disorders: A Systematic Review and Meta-Analysis.

    Williams, Benjamin David / Lee, Kenn / Ewah, Silas Okey / Neelam, Kishen

    Journal of clinical psychopharmacology

    2023  Volume 44, Issue 1, Page(s) 39–48

    Abstract: Background: Increasing evidence suggests an association between third-generation antipsychotics (TGAs) and impulse control disorders (ICDs). This is thought to be due to their partial agonism of dopamine receptors. However, neither the relative nor ... ...

    Abstract Background: Increasing evidence suggests an association between third-generation antipsychotics (TGAs) and impulse control disorders (ICDs). This is thought to be due to their partial agonism of dopamine receptors. However, neither the relative nor absolute risks of ICDs in those prescribed TGAs are well established. To inform clinical practice, this systematic review and meta-analysis summarizes and quantifies the current evidence for an association.
    Methods: An electronic search of Medline, PsychINFO, EMBASE, and the Cochrane Clinical Trials Database was undertaken from database inception to November 2022. Three reviewers screened abstracts and reviewed full texts for inclusion. A random-effects meta-analysis was conducted with eligible studies.
    Results: A total of 392 abstracts were retrieved, 214 remained after duplicates were removed. Fifteen full texts were reviewed, of which 8 were included. All 8 studies found that TGAs were associated with increased probability of ICDs. Risk of bias was high or critical in 7 of 8 studies. Three studies were included in the pooled analysis for the primary outcome, 2 with data on each of aripiprazole, cariprazine, and brexpiprazole. Exposure to TGAs versus other antipsychotics was associated with an increase in ICDs (pooled odds ratio, 5.54; 2.24-13.68). Cariprazine and brexpiprazole were significantly associated with ICDs when analyzed individually. Aripiprazole trended toward increased risk, but very wide confidence intervals included no effect.
    Conclusions: Third-generation antipsychotics were associated with increased risk of ICDs in all studies included and pooled analysis. However, the risk of bias is high, confidence intervals are wide, and the quality of evidence is very low for all TGAs examined.
    MeSH term(s) Humans ; Antipsychotic Agents/adverse effects ; Aripiprazole/adverse effects ; Disruptive, Impulse Control, and Conduct Disorders/chemically induced ; Disruptive, Impulse Control, and Conduct Disorders/drug therapy ; Risk Factors
    Chemical Substances Antipsychotic Agents ; Aripiprazole (82VFR53I78) ; brexpiprazole (2J3YBM1K8C)
    Language English
    Publishing date 2023-11-25
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 604631-9
    ISSN 1533-712X ; 0271-0749
    ISSN (online) 1533-712X
    ISSN 0271-0749
    DOI 10.1097/JCP.0000000000001773
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Pandemics and pre-existing mental illness: A systematic review and meta-analysis.

    Neelam, Kishen / Duddu, Venu / Anyim, Nnamdi / Neelam, Jyothi / Lewis, Shôn

    Brain, behavior, & immunity - health

    2020  Volume 10, Page(s) 100177

    Abstract: Introduction: Pandemics are known to affect mental health of the general population and various at-risk groups like healthcare workers, students and people with chronic medical diseases. However, not much is known of the mental health of people with pre- ...

    Abstract Introduction: Pandemics are known to affect mental health of the general population and various at-risk groups like healthcare workers, students and people with chronic medical diseases. However, not much is known of the mental health of people with pre-existing mental illness during a pandemic. This systematic review and meta-analysis investigates, whether people with pre-existing mental illness experience an increase in mental health symptoms and experience more hospitalizations during a pandemic.
    Materials and methods: A systematic search was conducted in the EMBASE, OVID-MEDLINE and PsycINFO databases to identify potentially eligible studies. Data were extracted independently and continuous data were used in calculating pooled effect sizes of standardized mean difference (SMD) using the random-effects model.
    Results: Of 1791 records reviewed 15 studies were included. People with pre-existing mental illness have significantly higher psychiatric symptoms, anxiety symptoms and depressive symptoms compared to controls during a pandemic with pooled effect sizes (SMD) of 0.593 (95% confidence interval (CI) 0.46 to 0.72), 0.616 (95% CI 0.49 to 0.73) and 0.597 (95% CI 0.38 to 0.80) respectively. Studies also found a reduction in psychiatric hospitalizations and utilization of psychiatric services during pandemics.
    Conclusion: The review highlights the need for mental health services to address the increased mental health symptoms in people with pre-existing mental illnesses during a pandemic. Future research should focus on better designed controlled studies of discrete illness groups, so as to provide a robust basis for policy makers to plan appropriate level of support and care for people with mental illness during a pandemic.
    Language English
    Publishing date 2020-11-24
    Publishing country United States
    Document type Journal Article
    ISSN 2666-3546
    ISSN (online) 2666-3546
    DOI 10.1016/j.bbih.2020.100177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A systematic review and meta-analysis of neurological soft signs in relatives of people with schizophrenia.

    Neelam, Kishen / Garg, Deepak / Marshall, Max

    BMC psychiatry

    2011  Volume 11, Page(s) 139

    Abstract: Background: Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain. Neurological soft signs are common in schizophrenia. It has been established that soft signs ...

    Abstract Background: Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain. Neurological soft signs are common in schizophrenia. It has been established that soft signs meet two of five criteria for an endophenotype, namely: association with the illness, and state independence. This review investigated whether soft signs met a further criterion for an endophenotype, namely familial association. It was hypothesized that if familial association were present then neurological soft signs would be: (a) more common in first-degree relatives of people with schizophrenia than in controls; and (b) more common in people with schizophrenia than in their first-degree relatives.
    Method: A systematic search identified potentially eligible studies in the EMBASE (1980-2011), OVID - MEDLINE (1950-2011) and PsycINFO (1806-2011) databases. Studies were included if they carried out a three-way comparison of levels of soft signs between people with schizophrenia, their first-degree relatives, and normal controls. Data were extracted independently by two reviewers and cross-checked by double entry.
    Results: After screening 8678 abstracts, seven studies with 1553 participants were identified. Neurological soft signs were significantly more common in first-degree relatives of people with schizophrenia than in controls (pooled standardised mean difference (SMD) 1.24, 95% confidence interval (c.i) 0.59-1.89). Neurological soft signs were also significantly more common in people with schizophrenia than in their first-degree relatives (SMD 0.92, 95% c.i 0.64-1.20). Sensitivity analyses examining the effects of age and group blinding did not significantly alter the main findings.
    Conclusions: Both hypotheses were confirmed, suggesting that the distribution of neurological soft signs in people with schizophrenia and their first-degree relatives is consistent with the endophenotype criterion of familial association.
    MeSH term(s) Endophenotypes ; Family ; Humans ; Neurologic Examination/methods ; Neurologic Examination/statistics & numerical data ; Publication Bias ; Schizophrenia/complications ; Schizophrenia/diagnosis
    Language English
    Publishing date 2011-08-22
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ISSN 1471-244X
    ISSN (online) 1471-244X
    DOI 10.1186/1471-244X-11-139
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A systematic review and meta-analysis of neurological soft signs in relatives of people with schizophrenia

    Neelam Kishen / Garg Deepak / Marshall Max

    BMC Psychiatry, Vol 11, Iss 1, p

    2011  Volume 139

    Abstract: Abstract Background Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain. Neurological soft signs are common in schizophrenia. It has been established that ... ...

    Abstract Abstract Background Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain. Neurological soft signs are common in schizophrenia. It has been established that soft signs meet two of five criteria for an endophenotype, namely: association with the illness, and state independence. This review investigated whether soft signs met a further criterion for an endophenotype, namely familial association. It was hypothesized that if familial association were present then neurological soft signs would be: (a) more common in first-degree relatives of people with schizophrenia than in controls; and (b) more common in people with schizophrenia than in their first-degree relatives. Method A systematic search identified potentially eligible studies in the EMBASE (1980-2011), OVID - MEDLINE (1950-2011) and PsycINFO (1806-2011) databases. Studies were included if they carried out a three-way comparison of levels of soft signs between people with schizophrenia, their first-degree relatives, and normal controls. Data were extracted independently by two reviewers and cross-checked by double entry. Results After screening 8678 abstracts, seven studies with 1553 participants were identified. Neurological soft signs were significantly more common in first-degree relatives of people with schizophrenia than in controls (pooled standardised mean difference (SMD) 1.24, 95% confidence interval (c.i) 0.59-1.89). Neurological soft signs were also significantly more common in people with schizophrenia than in their first-degree relatives (SMD 0.92, 95% c.i 0.64-1.20). Sensitivity analyses examining the effects of age and group blinding did not significantly alter the main findings. Conclusions Both hypotheses were confirmed, suggesting that the distribution of neurological soft signs in people with schizophrenia and their first-degree relatives is consistent with the endophenotype criterion of familial association.
    Keywords Psychiatry ; RC435-571 ; Neurology. Diseases of the nervous system ; RC346-429 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Psychiatry ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 150
    Language English
    Publishing date 2011-08-01T00:00:00Z
    Publisher BioMed Central
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: A survey of British senior psychiatry trainees' ethnocultural personal values.

    Neelam, Kishen / Duddu, Venugopal / Chaudhry, Imran Bashir / Antonysamy, A S / Husain, Nusrat

    Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry

    2009  Volume 33, Issue 5, Page(s) 423–426

    Abstract: Objective: The authors explored the ethnocultural values of a group of senior psychiatry trainees in the northwest region of England.: Methods: The authors surveyed senior psychiatry trainees using the Personal Values Questionnaire and analyzed ... ...

    Abstract Objective: The authors explored the ethnocultural values of a group of senior psychiatry trainees in the northwest region of England.
    Methods: The authors surveyed senior psychiatry trainees using the Personal Values Questionnaire and analyzed responses under the headings of ethnic stereotypes, ethnocultural service issues, and perceptions of racism. They also explored training requirements on cultural issues in a subsample of trainees.
    Results: The majority of the trainees disagreed with certain commonly held ethnic stereotypes and acknowledged the role of culture in mental health. However, they had contrasting views on the need for culture-specific services and on perceptions of racism. They expressed interest in training programs on cultural issues in psychiatric practice.
    Conclusion: In multicultural settings, personal beliefs, perceptions, and values are likely to influence psychiatric practice. A training program on cultural aspects of mental health could help improve awareness and sensitivity of these issues and the quality of care.
    MeSH term(s) African Continental Ancestry Group/psychology ; Attitude of Health Personnel ; Career Choice ; Cultural Competency ; Cultural Diversity ; Culture ; Curriculum ; Emigrants and Immigrants/psychology ; England ; Humans ; Prejudice ; Psychiatry/education ; Quality Assurance, Health Care ; Social Values ; Stereotyping ; Surveys and Questionnaires ; Training Support
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1045331-3
    ISSN 1545-7230 ; 1042-9670
    ISSN (online) 1545-7230
    ISSN 1042-9670
    DOI 10.1176/appi.ap.33.5.423
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 2043: Show issues Location:
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  6. Article ; Online: Assessment of fibrinolytic markers in patients with deep vein thrombosis.

    Sharma, Saniya / Uppal, Varun / Senee, Hari Kishan / Ahluwalia, Jasmina / Das, Reena / Varma, Neelam / Malhotra, Pankaj / Kumar, Narender

    Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis

    2022  Volume 33, Issue 2, Page(s) 113–118

    Abstract: The association of the fibrinolytic markers with deep vein thrombosis (DVT) is still a matter of debate. The present study aimed to investigate the association between fibrinolytic markers and DVT. This observational study recruited 52 adult cases with ... ...

    Abstract The association of the fibrinolytic markers with deep vein thrombosis (DVT) is still a matter of debate. The present study aimed to investigate the association between fibrinolytic markers and DVT. This observational study recruited 52 adult cases with lower limb DVT and 52 healthy adult volunteers as controls. The quantitative determination of plasminogen activator inhibitor-1 (PAI-1), plasminogen, thrombin activable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (tPA) and α2-antiplasmin (α2-AP) was performed by ELISA. TAFI, plasminogen and t-PA were significantly higher in cases than controls and PAI-1 was significantly lower in cases than controls. In addition, TAFI, plasminogen and t-PA levels were significantly increased in unprovoked and idiopathic DVT cases than controls. The present study suggests that the fibrinolytic markers tested in patients with a remote history of DVT are different than in individuals with no history of DVT and, with further study, may prove useful as screening assays for DVT risk.
    MeSH term(s) Adult ; Fibrinolysis ; Humans ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Tissue Plasminogen Activator ; Venous Thrombosis/diagnosis ; alpha-2-Antiplasmin
    Chemical Substances Plasminogen Activator Inhibitor 1 ; alpha-2-Antiplasmin ; Plasminogen (9001-91-6) ; Tissue Plasminogen Activator (EC 3.4.21.68)
    Language English
    Publishing date 2022-02-09
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 1033551-1
    ISSN 1473-5733 ; 0957-5235
    ISSN (online) 1473-5733
    ISSN 0957-5235
    DOI 10.1097/MBC.0000000000001114
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Inherited thrombophilia profile in patients with recurrent miscarriages: Experience from a tertiary care center in north India.

    Kumar, Narender / Ahluwalia, Jasmina / Das, Reena / Rohilla, Meenakshi / Bose, Sunil / Kishan, Hari / Varma, Neelam

    Obstetrics & gynecology science

    2015  Volume 58, Issue 6, Page(s) 514–517

    Abstract: The cause of recurrent miscarriage (RM) remains unexplained in approximately 30% to 50% cases. The association of inherited thrombotic factors and RM patients has not been documented from the northern part of India. A total of 40 patients had been ... ...

    Abstract The cause of recurrent miscarriage (RM) remains unexplained in approximately 30% to 50% cases. The association of inherited thrombotic factors and RM patients has not been documented from the northern part of India. A total of 40 patients had been investigated for inherited thrombophilia workup (protein C, protein S [PS], antithrombin III, and factor V Leiden [FVL] mutation) over a period of 10 years (2005 to 2014). RM patients were divided in to three groups. Group I (only 1st trimester loss), group II (only 2nd and 3rd trimester), and group III (mixed). Each group comprised of the following numbers of patients respectively: I, 24; II, 2; III, 14. Heterozygous FVL mutation was found in 10% (4/40) cases. PS deficiency was detected in 2.7% (1/37) cases. In the present study FVL and PS were seems to be associated with a subset of patients however further studies with larger numbers of patients are recommended for better evaluation.
    Language English
    Publishing date 2015-11-16
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2814367-X
    ISSN 2287-8580 ; 2287-8572
    ISSN (online) 2287-8580
    ISSN 2287-8572
    DOI 10.5468/ogs.2015.58.6.514
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