Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Predictors of response to electroconvulsive therapy in major depressive disorder: A review of research findings(Springer, 2024) Baminiwatta, A.; Menon, V.PURPOSE OF REVIEW In the context of the current global move towards precision medicine, considering the adverse effects, costs and efficacy limitations of electroconvulsive therapy (ECT) in major depression, this review aimed to identify predictors of ECT response based on recent research.RECENT FINDINGS Established predictors such as older age, psychotic symptoms, melancholic features, shorter episode duration, higher baseline severity, medication failure, and comorbid personality disorder were replicated in recent studies. Genetic polymorphisms showed little utility, whereas potentially useful epigenetic predictors were identified. Neurotrophic factors offer some predictive value. Some evidence for inflammatory markers emerged. Structural neuroimaging mainly implicates the hippocampal structures, amygdala, cingulate cortex, and other frontal lobe regions. Functional neuroimaging suggests an important role of brain functional connectivity, especially involving the default mode network.SUMMARY Many previously recognized demographic and clinical predictors of ECT response were supported, but evidence for biological predictors remains largely inconclusive, and requires further exploration and replication in future research.Item Improving psychological well-being among healthcare workers during the COVID-19 pandemic with an online mindfulness intervention: A randomised waitlist-controlled trial(Wiley, 2024) Baminiwatta, A.; Fernando, R.; Solangaarachchi, I.; Abayabandara-Herath, T.; Wickremasinghe, A.R.; Hapangama, A.The high prevalence of psychological problems observed among healthcare workers (HCWs) during the COVID-19 pandemic called for interventions to safeguard their mental health. We assessed the effectiveness of a 6-week online mindfulness-based intervention in improving well-being and reducing stress among HCWs in Sri Lanka. Eighty HCWs were recruited and randomised into two groups: waitlist-control (WLC) and intervention groups. In the intervention, 1-hour online sessions were conducted at weekly intervals and participants were encouraged to do daily home practice. Stress and well-being were measured pre- and post-intervention using the Perceived Stress Scale and WHO-5 Well-being Index, respectively. One-way analysis of covariance was used to evaluate the effectiveness, in both intention-to-treat (ITT) and complete-case (CC) analyses. A significantly greater improvement in well-being occurred in the intervention arm compared to WLC on both ITT (p = .002) and CC analyses (p < .001), with medium-to-large effect sizes (partial η2 = .117-.278). However, the reduction in stress following the intervention was not significant compared to the WLC group on both ITT (p = .636) and CC analyses (p = .262). In the intervention arm, the median number of sessions attended by participants was 3. Low adherence to the intervention may have contributed to the apparent non-significant effect on stress.Item Electroconvulsive therapy in South Asia: Past, present, and future(Elsevier, 2024) Menon, V.; Kar, S.K.; Gupta, S.; Baminiwatta, A.; Mustafa, A.B.; Sharma, P.; Abhijita, B.; Arafat, S.M.Y.The practice of electroconvulsive therapy (ECT) varies both between and within countries. We aimed to review historical and current trends in ECT practices, perceptions, and legislations in South Asia, a region with a high burden of mental illness and suicide. We searched MEDLINE (PubMed) and Google Scholar databases for relevant literature on ECT from each country. Additionally, a team of country-specific investigators performed supplemental searches and contacted key country contacts for relevant information. Relevant data were abstracted under the following headings: ECT practices, perceptions, and legislations. Knowledge gaps and research priorities were synthesized. Modified bitemporal ECT, delivered using brief pulse devices, was most commonly offered across institutions. Schizophrenia, not affective illness, was the most common indication. Electroencephalographic monitoring of seizures was rarely practiced. Thiopentone or propofol was preferred for anesthetic induction, while the favored muscle relaxant was succinylcholine. In India and Sri Lanka, perceptions about ECT were largely favorable; not so in Pakistan and Nepal. Only India and Pakistan had laws that governed any aspect of ECT practice; ECT practice guidelines were available only in India. There is a lack of research on efficacy, ECT in special populations, continuation ECT practices, and interventions to improve ECT-related perceptions. Most regional institutions offered modified brief-pulse ECT, and schizophrenia was the most common indication. Knowledge of and attitude towards ECT varied between countries. There is a need to develop a regional ECT consortium to facilitate uniform training, advocacy efforts, and the development of regional practice guidelines.Item Screen addiction among children and adolescents and the self-efficacy of mothers in screen use management during the COVID-19 lockdown in Sri Lanka(Sri Lanka College of Psychiatrists, 2023) Baminiwatta, A.; Nanayakkara, T.D.; Fernando, A.; Wijethunga, S.BACKGROUND: The prevalence of problematic screen use (PSU) or “screen addiction” among children and adolescents may have escalated during the COVID-19 pandemic. The self-efficacy of the mothers in managing screen use in their children may play an important preventive role in children developing PSU. AIMS: This study aimed to assess PSU among children aged 4-18 years during the lockdown period imposed during the COVID-19 pandemic and to explore the association between PSU and self-efficacy of mothers in managing screen use. METHODS: An online survey was conducted using social media groups among mothers of children aged 4-18 years. The PSU in their children was measured using the Problematic Media Use Measure (PMUM), and maternal self-efficacy in managing screen use was assessed using the Parental Screen Use Management Scale (PSUMS). The two questionnaires were translated and validated into Sinhala prior to this study. RESULTS: A total of 320 mothers responded to the survey. Based on the PMUM cut-off score, 25.3% of the children were found to have PSU. PSU was inversely correlated with maternal self-efficacy in managing screen use (r=-0.63, p<0.001). All three subscales of the PSUMS; reactive management (r=-0.56, p<0.001), proactive management (r=-52, p<0.001), and monitoring (r =-45, p<0.001), were significantly correlated with PSU. Younger age at screen use onset showed a marginal correlation (rho=-0.11, p=0.05) with PSU. The child’s age, gender and the educational level of the mother were not associated with PSU. CONCLUSION: Maternal self-efficacy in managing screen use among children was associated with lower PSU in children.Item Historical developments, hotspots, and trends in tardive dyskinesia research: a scientometric analysis of 54 years of publications(Frontiers Research Foundation, 2023) Baminiwatta, A.; Correll, C.U.BACKGROUND: Since being recognized as an important drug-induced clinical entity during the 1960s, tardive dyskinesia (TD) has generated an extensive body of research seeking to understand its clinical characteristics, epidemiology, pathophysiology and management. Modern scientometric approaches allow interactive visualization of large bodies of literature to identify trends and hotspots within knowledge domains. This study thus aimed to provide a comprehensive scientometric review of the TD literature. METHODS: Web of Science was searched for articles, reviews, editorials and letters with the term "tardive dyskinesia" in the title, abstract, or keywords through 12/31/2021. A total of 5,228 publications and 182,052 citations were included. Annual research output, prominent research areas, authors, affiliations and countries were summarized. VOSViewer and CiteSpace were used for bibliometric mapping and co-citation analysis. Structural and temporal metrics were used to identify key publications in the network. RESULTS: TD-related publications peaked in the 1990s, gradually declined after 2004, and showed a further small increase after 2015. The most prolific authors were Kane JM, Lieberman JA, and Jeste DV overall (1968-2021), and Zhang XY, Correll CU and Remington G in the last decade (2012-2021). The most prolific journal was the Journal of Clinical Psychiatry overall, and the Journal of Psychopharmacology in the last decade. Knowledge clusters in the 1960-1970s dealt with clinical and pharmacological characterization of TD. In the 1980s, epidemiology, clinical TD assessment, cognitive dysfunction and animal models predominated. During the 1990s, research diverged into pathophysiological studies, especially oxidative stress, and clinical trials on atypical antipsychotics, with a focus on clozapine and bipolar disorder. In the 1990-2000s, pharmacogenetics emerged. More recent clusters include serotonergic receptors, dopamine-supersensitivity psychosis, primary motor abnormalities of schizophrenia, epidemiology/meta-analyses, and advances in TD treatment, particularly vesicular monoamine transporter-2 inhibitors since 2017. CONCLUSION: This scientometric review visualized the evolution of scientific knowledge on TD over more than five decades. These findings will be useful for researchers to find relevant literature when writing scientific articles, choosing appropriate journals, finding collaborators or mentors for research, and to understand the historical developments and emerging trends in TD research.Item Improving medical students' understanding of dementia using a movie ( The Father)(Taylor & Francis, 2023) Baminiwatta, A.; Fernando, R.; Williams, S.No abstract availableItem Gender distribution of editors in psychiatry journals of South Asia(lsevier/North-Holland Biomedical Press, 2022) Arafat, S.M.Y.; Amin, R.; Baminiwatta, A.; Hussain, F.; Singh, R.; Kar, S.K.; Mubashir, A.S.No abstract availableItem Psychometric evaluation of a Sinhalese version of the five facet mindfulness questionnaire and development of a six-facet short form in a Sri Lankan buddhist context(Springer, 2022) Baminiwatta, A.; Alahakoon, H.; Herath, N.C.; Kodithuwakku, K.M.; Nanayakkara, T.OBJECTIVES: This study aimed to evaluate the psychometric properties of a Sinhalese version of the Five Facet Mindfulness Questionnaire (FFMQ), including its factor structure, internal consistency and convergent validity, in an exclusively Buddhist population. METHODS: The FFMQ was translated to Sinhalese using forward and backward translation, expert consensus and pretesting. The translated questionnaire was administered to a sample of 415 nurses (90.8% female; mean age = 39 years; 100% Buddhists), from 4 hospitals in Sri Lanka. The Depression, Anxiety and Stress Scale (DASS)-21 was administered concurrently. A series of empirical factor models were tested for fit using confirmatory factor analysis (CFA). Exploratory factor analysis (EFA) was used to explore alternative factor structures. Internal consistency was measured using Cronbach α. RESULTS: The original five-factor structure, either as first-order or hierarchical models, showed poor fit in the present population. EFA supported a six-factor structure, where the original Actaware facet splits into two facets, namely, Distract and Autopilot. A 20-item short form composed of 3–4 items from each of the six facets, selected based on factor loadings and item-total correlations, showed excellent CFA model fit. Internal consistencies of the 20-item scale (α = 0.7) and the five subscales (α = 0.67–0.72) were satisfactory. Overall mindfulness showed moderate negative correlations with depression, anxiety and stress; and all facets except Observe and Describe correlated negatively with psychological problems. CONCLUSIONS: Our findings endorse a six-factor structure of mindfulness, which had been proposed in a few previous studies. A modified 20-item short form with six facets shows satisfactory psychometric properties.Item Validation of a Sinhalese version of the mindful attention awareness scale(Elsevier, 2022) Baminiwatta, A.No abstract availableItem Global trends of machine learning applications in psychiatric research over 30 years: A bibliometric analysis(Elsevier Ltd, 2022) Baminiwatta, A.This bibliometric analysis aimed to identify active research areas and trends in machine learning applications within the psychiatric literature. An exponential growth in the number of related publications indexed in Web of Science during the last decade was noted. Document co-citation analysis revealed 10 clusters of knowledge, which included several mental health conditions, albeit with visible structural overlap. Several influential publications in the co-citation network were identified. Keyword trends illustrated a recent shift of focus from "psychotic" to "neurotic" conditions. Despite a relative lack of literature from the developing world, a recent rise in publications from Asian countries was observed. DATA AVAILABILITY: Bibliographic data for this study were downloaded from the Web of Science. The search strategy is included in the Supplementary file.