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Purpose Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, to assess its variability across subgroups, and to identify associated factors within each subgroup. Methods PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. Results A total of 26 studies representing a total of 49217 participants were included. Overall, the pooled prevalence of depression was 20.3% (95% CI: 14.8–27.2%). Among subpopulations, the highest prevalence was reported among young persons (41%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 19.7%, respectively. Prevalence estimates were higher when they were based on screening instruments (22.8%) compared to diagnostic interviews (4.3%).A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances, and broader environmental factors, is reported for each age group. Conclusion Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. Heterogeneity of studies limits the inferences drawn from this review.

This study aimed to assess the perceived impact of the COVID-19 pandemic on undergraduate psychiatry training in Sri Lanka and to explore several potentially associated factors.An online survey was distributed among students from eight medical schools who recently faced their final exam. Their perceptions on the impact of the pandemic on the psychiatry training and exam performance were rated on a 10-point scale. Resilience was assessed using a two-item scale.A total of 644 students responded (69.5% female, mean age=27.5 years). Among them, 164 (25.5%) reported being quarantined; 25 (4%) reported becoming infected with COVID-19; and 170 (28.6%) reported ward closure for over a week during the clerkship. Greater impact was reported for patient availability (mean=7.08), mental status assessments (mean=6.3), developing rapport (mean=6.2), and diagnostic skills (mean=5.9), whereas the impact on peer-learning (mean=5.5) and self-study (mean=3.6) was relatively lower. Impact on clinical components of the final exam (mean=6) was rated higher than on theory components (mean=4.5). The majority (70.3%) reported that COVID-19-related stress affected their exam preparations. Higher resilience predicted lower perceived impact on all aspects of training/exam performance. Female gender and ward closure predicted greater impact on diagnostic skills, overall training, and clinical exam performance, whereas being quarantined predicted greater impact on peer-learning and self-study.The pandemic has significantly affected the undergraduate psychiatry training in Sri Lanka, particularly its clinical components. Increasing clinical exposure to patients, managing students' stress, and building their resilience should be key concerns for medical educators during the pandemic.

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 enable interactive visualizations of large bodies of literature to identify the 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, up to 12/31/2021. Altogether, 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, declined gradually after 2004, and showed another small surge 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. Conclusions 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.

OBJECTIVE Lack of test norms is a major limitation in neuropsychological assessment in many non-English-speaking countries. Our objective was to generate sex-, age-, and education-adjusted, regression-based norms for three pen-and-paper-based executive function/working memory tests, viz. Victoria Stroop Test (VST), Digit Span, and Verbal Fluency, for Sinhala-Speaking Sri Lankan adults. METHOD Six-hundred and six healthy, community-living, Sinhala-speaking adults (273 men) aged 19-83 years completed VST, Digit Span (forward and backward), and Phonemic (Sinhala phonemes "N," "P," and "S") and Category (animals and vegetables) Fluency tests. We conducted multiple linear regression analyses with sex, age, and years of education fitted as predictors to model the test outcome variables. RESULTS Younger age was associated with better performance in all tests except in Phonemic Fluency. Longer education was associated with better performance in all outcomes except VST errors and interference. Women had a significant but small advantage over men in VST Neutral and Color Word tests, and Phonemic Fluency. We report regression equations to predict norms for the test performance measures based on sex, age, and years of education; and the test variances accounted by these factors. CONCLUSIONS We propose demographically adjusted norms for VST, Digit Span, and Verbal Fluency for Sinhala-speaking Sri Lankans aged 19-83 years, and supplement the regression formulae with a calculator that produces predicted and standard scores. These norms would help in interpreting the results of clinical samples in the future, taking into account the variability introduced by sex, age, and education.

Objectives This study aimed to identify historical developments, active research areas, and emerging trends within scientific literature on mindfulness published so far, using bibliometric methods. We also aimed to identify prominent journals, authors, organizations, and countries in the field of mindfulness. Methods Articles or reviews which mention mindfulness in the title, abstract, or keywords were identified using the Web of Science. A descriptive summary of the literature was obtained from the Web of Science Analysis tool. Country collaboration, co-authorship, and keyword co-occurrence networks were visualized using VOSviewer. CiteSpace, which uses document co-citation analysis, was used to identify emerging trends and transient patterns in the literature. Results From 1966 to 2021, 16,581 publications on mindfulness were identified. There has been an exponential growth of publications since 2006. Almost half (47%) of the publications were in psychology and about one-fifth (20.8%) in psychiatry. The most prolific journal was Mindfulness (contributing 7% of all publications) and the most prolific author was Eric L. Garland. The vast majority of publications originated from Western countries but representation from Asian countries has increased. The most frequently co-occurring keywords were meditation, depression, stress, and anxiety. Co-citation analysis of the early period (1966–2015) revealed how scholarly work on spiritual themes has inspired early mindfulness research. Recent trends (2016–2021) revealed a rising interest in mechanisms and moderators, long-term meditation, neuroscientific studies, and smartphone/online delivery of interventions. Conclusions This comprehensive bibliometric study summarized and visualized 55 years of mindfulness research, revealing pivotal points, active research areas, and emerging trends.

Background: Symbol Digit Modalities Test (SDMT) is a simple pencil-and-paper substitution task that measures divided attention, visual scanning and processing speed. It is sensitive to cognitive impairment in a wide variety of neuropsychiatric conditions. Extant normative data for the SDMT, mainly based on Western populations, may not be applicable for Sri Lankans. Aims: We aimed to create sex-, age- and education-adjusted regression-based norms for the SDMT for Sri Lankan adults. Methods: Four-hundred and twenty-two community-living adults (220 women, 52.1%), aged 18 to 83 years, with 5 to 23 years of education, completed the study. We conducted multiple linear regression analyses with sex, age and years of education to predict the SDMT score. Results: The SDMT scores of the sample ranged from 5 to 72, with a mean (SD) score of 35.98 (12.87). The regression model [predicted SDMT score = 29.395 - (1.549 × sex) - (0.434 × age in years) + (2.207 × years of education)] explained 56.5% of the variance in SDMT scores (adjusted R2 = 0.565; F=183; p

IntroductionTardive dyskinesia (TD) is a movement disorder caused by long-term treatment with dopamine antagonists such as antipsychotics. As there is no medication universally effective for TD, prevention is important. We propose that non-medical clinicians working in psychiatry can also be trained and involved in a screening programme for TD. To facilitate such a programme, validation of a standard tool translated to Sinhala is a need. AimsTo translate and validate the Abnormal Involuntary Movement Scale (AIMS) into Sinhala. MethodsTranslation and pilot testing followed standard guidelines. The translated version was administered by five raters (two registrars in psychiatry, a medical officer, a community psychiatry nurse (CPN) and a psychiatric social worker) amongst patients treated with antipsychotic medication for a minimum of one year. The goldstandard diagnosis was the Diagnostic and Statistical Manual (DSM)-5 criteria, applied by a psychiatrist. ResultsOf the 137 patients screened (53.3% male; mean age = 49 years), the percentage of patients diagnosed with TD using AIMS and DSM-5 were 33% and 34%, respectively. The sensitivity and specificity of AIMS in detection of TD were 67% and 83.4% respectively. The degree of agreement between the AIMS and DSM- 5 indicated moderate criterion validity (Cohen's kappa= 0.5). For different raters, the agreement with the psychiatrist's diagnosis (kappa) ranged from 0.41 (CPN) to 0.63 (registrar), indicating modest reliability between raters. ConclusionsOur findings provide preliminary evidence for the validity of AIMS in detecting TD among Sinhalaspeaking patients, when administered by a range of mental health professionals.

The aim of this study was to create sex-, age- and education-adjusted norms for the WHO/UCLA version of the Rey Auditory Verbal Learning Test (RAVLT) for Sinhala-speaking Sri Lankan adults.Five-hundred and sixty-one healthy, community-living adults (252 men), aged 19-83 years, and had 0-23 years of education completed the WHO/UCLA RAVLT in Sinhala language. We conducted multiple linear regression analyses with sex, age and years of education to predict RAVLT list A1-A5 individual trial scores; trials A1-A5 total learning; list B score; immediate and delayed recall and recognition trial scores; and retroactive interference.We report regression equations to predict RAVLT norms based on sex, age and years of education; and the test variances accounted by those variables. Accordingly, all measures, except retroactive interference had a significant age-related decline. All measures, except the recognition trial hits, significantly improved with more years of education. Women had significantly higher scores in all measures except in trial B and retroactive interference. Proactive interference, learning rate, learning over trials were not associated with sex, age or education. A confirmatory factor analysis loaded the RAVLT outcome measures into two factors: acquisition and retention.We report sex-, age- and education-adjusted WHO/UCLA RAVLT norms for Sinhala-speaking Sri Lankans aged 19-83 years; and supplement the regression formulae with a calculator that produces predicted and standard scores for given test participant. These norms would help clinicians accurately interpret individual test results, accounting for the variability introduced by sex, age and education.