Depression screening in patients with aneurysmal subarachnoid haemorrhage and their caregivers: A systematic review.

BACKGROUND: Depression commonly occurs after aneurysmal subarachnoid haemorrhage (aSAH) which can negatively impact patients and their caregivers. Identification and validation of depression screening instruments specifically for patients with aSAH and their caregivers has not been performed. OBJECTIVES: The objectives of this study were to identify the common depression screening tools in patients with aSAH and their caregivers and to determine if they are validated for use in these populations. METHODS: Medical Subject Headings and keyword search terms were used in five electronic databases to identify randomised controlled, quasi-experimental and observational studies published between 1 January 2010 and 26 June 2022. Screening, data extraction and study quality assessments were conducted by two independent reviewers. RESULTS: Of the 3440 identified studies, 61 met inclusion, with 2 of 61 (3%) RCTs, 2 of 61 (3%) quasi-experimental, and 57 of 61 (93%) observational studies included. The majority of studies (58/61 [95%]) reported patient-only depression screening, 1 of 61 (2%) reported both patients' and caregivers' depression screening, and 2 of 61 (3%) reported caregiver-only depression screening. Nine depression screening instruments were identified. The Beck Depression Inventory-II (BDI-II) was the most commonly used (13/59; 22%), followed by the Hospital Anxiety and Depression Scale (HADS) (12/59; 20%). In the ischaemic stroke population, the BDI-II was reported to have excellent sensitivity (0.85) and specificity (0.75); the HADS was also found to have good sensitivity (0.62) and specificity (0.83) in the ischaemic stroke population. Only two depression screening instruments for caregivers were identified: HADS and Goldberg Depression Scale. Both were found to have good sensitivity (>0.80) and specificity (>0.80) in the general population. CONCLUSION: The BDI-II and HADS were the most commonly used depression screening instruments in patients with aSAH. Neither of these instruments has been specifically validated in an aSAH population. None of the nine depression instruments were validated for patients with aSAH. Due to an insufficient number of studies in caregivers' population, validity was unable to be determined.

Increased referrals to an Australian Consultation Liaison Psychiatry service during the COVID-19 pandemic.

OBJECTIVE: It has been widely predicted that the COVID-19 pandemic will have a detrimental impact on the mental health (MH) of individuals. This has been dubbed as the MH 'second wave'. In Australia, these impacts have been partly mitigated by institutional responses such as increased access to psychotherapy. Consultation Liaison (CL) psychiatry services provide MH care to acutely unwell patients in general hospitals. It was hypothesised that the number of referrals to the studied service had increased since the start of the pandemic. METHODS: From the Electronic medical records (eMRs), the authors collected daily referral numbers, over 3 consecutive years, to a large CL service in metropolitan Sydney. RESULTS: Referrals were significantly increased by 25%, 95% CI [1.14, 1.36], p < .001 since the start of the pandemic. This increase was delayed, and remained elevated despite a reduction in COVID-19 infections. CONCLUSION: This study adds evidence to the existence of the MH 'second wave', highlights a key impact on healthcare workers' well-being and will assist in guiding resource allocation decisions in the near future.

Dopamine dysregulation syndrome in non-Parkinson's disease patients: a systematic review.

OBJECTIVES: To explore the presence of dopamine dysregulation syndrome in non-Parkinson's disease patients receiving dopamine replacement therapy. METHODS: Electronic searches were conducted of Medline, Embase, PsycINFO and PreMedline to capture articles related to dopamine misuse or factitious disorder combined with the presence of dopamine replacement therapy or a non-Parkinson's disease population. In total, 430 articles were reviewed and studies that addressed dopamine dysregulation syndrome in non-Parkinson's disease patients were included. RESULTS: Nine case reports were identified. CONCLUSIONS: The pathophysiology underlying dopamine dysregulation syndrome has been thoroughly explored with numerous mechanisms posited. What remains unclear is whether dopamine dysregulation syndrome is a phenomenon specific to Parkinson's disease, as indicated in the proposed diagnostic criteria. A more useful predictor of susceptibility to dopamine dysregulation syndrome may be temperamental traits such as novelty seeking and impulsivity, which overlap with predisposing factors for an addiction disorder.