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Introduction: People with severe mental illness (SMI) are more likely to have obesity and engage in health risk behaviours than the general population. The aims of this study are (1) evaluate the effectiveness of interventions that focus on body weight, smoking cessation, improving sleeping patterns, and alcohol and illicit substance abuse; (2) Compare the number of interventions addressing body weight and health risk behaviours in low- and middle-income countries (LMICs) v. those reported in published systematic reviews focusing on high-income countries (HICs). Methods: Intervention studies published up to December 2020 were identified through a structured search in the following database; OVID MEDLINE (1946–December 2020), EMBASE (1974–December 2020), CINAHL (1975–2020), APA PsychoINFO (1806–2020). Two authors independently selected studies, extracted study characteristics and data and assessed the risk of bias. and risk of bias was assessed using the Cochrane risk of bias tool V2. We conducted a narrative synthesis and, in the studies evaluating the effectiveness of interventions to address body weight, we conducted random-effects meta-analysis of mean differences in weight gain. We did a systematic search of systematic reviews looking at cardiometabolic and health risk behaviours in people with SMI. We compared the number of available studies of LMICs with those of HICs. Results: We assessed 15 657 records, of which 9 met the study inclusion criteria. Six focused on healthy weight management, one on sleeping patterns and two tested a physical activity intervention to improve quality of life. Interventions to reduce weight in people with SMI are effective, with a pooled mean difference of −4.2 kg (95% CI −6.25 to −2.18, 9 studies, 459 participants, I 2 = 37.8%). The quality and sample size of the studies was not optimal, most were small studies, with inadequate power to evaluate the primary outcome. Only two were assessed as high quality (i.e. scored 'low' in the overall risk of bias assessment). We found 5 reviews assessing the effectiveness of interventions to reduce weight, perform physical activity and address smoking in people with SMI. From the five systematic reviews, we identified 84 unique studies, of which only 6 were performed in LMICs. Conclusion: Pharmacological and activity-based interventions are effective to maintain and reduce body weight in people with SMI. There was a very limited number of interventions addressing sleep and physical activity and no interventions addressing smoking, alcohol or harmful drug use. There is a need to test the feasibility and cost-effectiveness of context-appropriate interventions to address health risk behaviours that might help reduce the mortality gap in people with SMI in LMICs. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine change in the attitudes of medical students toward psychiatry as a career choice before and after clinical rotat ion in psychiatry. STUDY DESIGN Cross-sectional design. PLACE AND DURATION OF STUDY 5tudy was conducted at the Institute of Psychiatry & WHO Collaborating Centre (IOP), Benazir Bhutto Hospital Rawalpindi, Pakistan from November 2016 to October 2017. SUBJECTS AND METHODS 212 medical students, who were completing their clinical rotation of psychiatry at IOP, were selected using convenient sampling. Pre and post assessment was conducted using the Attitude Towards Psychiatry (ATP)-30-item scale. RESULTS The ATP- 30 scores were analyzed using a Paired sample ttest and indicated no significant change in attitude towards psychiatry by the end of the study. Cronbach's alpha of the scale was measured twice and was in the acceptable range (0.74- 0.80). Result of the study revealed mi nimum to no impact of psychiatric education and training on students. CONCLUSION The study demonstrated the lack of effect of psychiatric training on the attitudes of medical students regarding psychiatry as a career choice. However, there was a slight trend towards a positive change in the male students regarding their attitude towards psychiatry after their two-week rotation. [ABSTRACT FROM AUTHOR]

OBJECTIVE The purpose of the study was to examine the Early Non-cognitive symptoms of Alzheimer's disease and to determine the duration and frequency of Non-cognitive symptoms of Alzheimers. STUDY & DESIGN It was cross-sectional descriptive study PLACE AND DURATION OF THE STUDY The duration of the study was nine months from May 2008 to February 2009 SUBJECTS AND METHODS Non- probability convenient sampling technique was used to collect the data. Patients were first screened on the scores of Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) and then detailed assessment of those patients was done with Coronell Scale for Depression in Dementia (CSDD). Furthermore, the measurements including, Informant Questionnaire on Cognitive Decline in Elderly (IQCODE), Personality Inventory (PI ), and section H of Cambridge Mental Disorder in Elderly Examination (CAMDEX). Data was analyzed using SPSS version 10. RESULTS The non-cognitive symptoms among the study participants were personality change, every day activity impairment, depressed mood, sleep, persecution, hallucination, and behavioral symptoms. The results also revealed that at least two non-cognitive symptoms were present among all the patients. CONCLUSION Behavioral and psychological symptoms encompass more than half of the presenting features of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Introduction: The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs., Methods: To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS., Registration: https://www.comet-initiative.org/Studies/Details/1580., Results: The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life., Conclusion: Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs., Prospero Registration Number: CRD42020197293., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)