ABSTRACT
Psychiatric readmissions have long been considered significant indicators for healthcare planning. The aim of this study was to identify factors influencing early (30-day) readmissions to acute psychiatric wards. A meta-analysis and systematic review were conducted according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Comprehensive database searching was conducted using online databases, including PubMed and Google Scholar, to search for articles identifying factors associated with early (30-day) readmissions to acute psychiatric wards. Keywords used to search for relevant articles included "Mental illness," "readmission," and factors along with their synonyms and Medical Subject Headings (MeSH) terms. The search included studies published between 2011 and June 2023. A total of 13 studies were included in this meta-analysis. The pooled rate of the 30-day readmission was 16% (95% confidence interval: 13%-20%). A pooled analysis showed that factors significantly associated with an unplanned hospital readmission included gender, length of stay, and insurance status as predictors of the unplanned hospital readmission among individuals with psychiatric illness. Additionally, we also found that the rate of 30-day unplanned admissions was greater in patients with schizophrenia, followed by personality disorder, bipolar disorder, depression, and substance use. This study highlights the importance of providing targeted interventions and support for individuals with these conditions to reduce the risk of readmissions.
ABSTRACT
This narrative review provides an overview of the current advances, challenges, and opportunities in nanoparticle drug delivery for central nervous system (CNS) disorders. The treatment of central nervous system disorders is challenging due to the blood-brain barrier (BBB), which limits the delivery of therapeutic agents to the brain. Promising approaches to address these issues and improve the efficacy of CNS disease therapies are provided by nanoparticle-based drug delivery systems. Nanoparticles, such as liposomes, polymeric nanoparticles, dendrimers, and solid lipid nanoparticles, can be modified to enhance targeting, stability, and drug-release patterns. They allow for the encapsulation of a variety of therapeutic compounds and can be functionalized with ligands or antibodies for active targeting, minimizing off-target effects. Additionally, nanoparticles can circumvent drug resistance processes and provide versatile platforms for applications that combine therapeutic and diagnostic functions. Although the delivery of CNS medications using nanoparticles has advanced significantly, there are still challenges to be resolved. These include understanding the BBB interactions, doing long-term safety studies, and scaling up the production. However, improvements in nanotechnology and a deeper comprehension of CNS disorders provide opportunities to enhance treatment results and address unmet medical requirements. Future research and ongoing clinical trials are required to further explore the potential of nanoparticle drug delivery for CNS disorders.
ABSTRACT
The aim of this meta-analysis is to compare the efficacy of meta-cognitive therapy (MCT) and cognitive behavioral therapy (CBT) in patients with generalized anxiety disorder (GAD). This study is reported according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic electronic literature search was conducted on April 20, 2023, to find studies reporting on the efficacy of MCT for GAD. The search keywords included "Generalized anxiety disorders," "meta-cognitive therapy," "cognitive behavior therapy," and "randomized control trials.: The following databases were searched to find relevant articles: PubMed, PsychInfo, CINAHL, and SCOPUS. Outcomes assessed in the present meta-analysis included the change in the Penn State Worry Questionnaire (PSWQ) from baseline to completion of treatment and after two years of follow-up. The PSWQ measures the trait of worry in adults. Worry is regarded as a dominant feature of GAD. Secondary outcomes assessed in this meta-analysis included symptom severity using the Beck anxiety inventory (BAI). Change in BAI was scored from baseline to completion of treatment and after two years of follow-up. A total of three studies were included in this meta-analysis. The results show that patients treated with MCT had greater reductions in PSWQ and BAI scores post-treatment and after two years of treatment, as well as higher rates of recovery compared to those treated with CBT. These findings suggest that MCT is a promising approach for treating GAD and may have advantages over traditional CBT approaches.
