Publications
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King JD, Cheng S, Fok ML-Y, et al., 2024, Interventions to improve the sleep quality of adults with personality disorder: a systematic review, Personality and Mental Health: multidisciplinary studies from personality dysfunction to criminal behaviour, Vol: 18, Pages: 19-31, ISSN: 1932-8621
Poor quality sleep is common for people who have a diagnosis of personality disorder (PD). Core cognitive and behavioral features of PD may cause and perpetuate poor sleep, but to date, no review has collated the evidence on the efficacy of interventions to improve sleep quality for people with PD. Structured searches for interventional studies among adults with PD and reporting validated measures of sleep quality were conducted up to November 2022 in multiple databases. Single-case reports were excluded. Study quality was assessed with standardized risk of bias tools. Unreported data was sought systematically from authors. This review was pre-registered with an international prospective register of systematic reviews (PROSPERO) (CRD42021282105). Of the 3503 identified studies, nine met inclusion criteria, representing a range of psychological, pharmaceutical, and other interventions and outcome measures. Meta-analytic methods were not feasible because of the serious risk of bias in all studies, and results were therefore synthesized narratively. There is limited and low-quality evidence of the effects of a variety of interventions to improve the sleep quality of people living with PD. Further research might consider specifically including people diagnosed with PD in trials of sleep interventions and using sleep outcome measures in trials of established PD treatments.
Pappa S, Shah M, Young S, et al., 2024, Care pathways, prescribing practices and treatment outcomes in major depressive disorder and treatment-resistant depression: retrospective, population-based cohort study., BJPsych Open, Vol: 10, ISSN: 2056-4724
BACKGROUND: Despite the availability of effective therapies, many patients with major depressive disorder (MDD) develop treatment-resistant depression (TRD). AIMS: To evaluate and compare prescribing patterns, contact with specialist services and treatment outcomes in patients with MDD and TRD. METHOD: This was a retrospective analysis of linked primary and secondary care National Health Service data in the north-west London Discover-NOW data-set. Eligible patients were adults who had diagnostic codes for depression and had been prescribed at least one antidepressant between 2015 and 2020. RESULTS: A total of 110 406 patients were included, comprising 101 333 (92%) with MDD and 9073 (8%) with TRD. Patients with TRD had significantly higher risks of suicidal behaviour and comorbidities such as anxiety, asthma, and alcohol or substance misuse (all P < 0.0001). Citalopram, sertraline, fluoxetine and mirtazapine accounted for 83% of MDD and 71% of TRD prescriptions. Use of antidepressant switching (1% MDD, 7% TRD) and combination therapy (1%, 5%) was rare, whereas augmentation occurred more frequently in the TRD group (4%, 35%). Remission was recorded in 42 348 (42%) patients with MDD and 1188 (13%) with TRD (P < 0.0001), whereas relapse was seen in 20 970 (21%) and 4923 (54%), respectively (P < 0.0001). Mean times from diagnosis to first contact with mental health services were 38.9 (s.d. 33.6) months for MDD and 41.5 (s.d. 32.0) months for TRD (P < 0.0001). CONCLUSIONS: There appears to be a considerable difference between treatment guidelines for depression and TRD and the reality of clinical practice. Long-term treatment with single antidepressants, poor remission, and high relapse rates among patients in primary care highlight the need to optimise treatment pathways and access to newer therapies.
Taylor D, Chithiramohan R, Grewal J, et al., 2023, Dopamine partial agonists: a discrete class of antipsychotics, INTERNATIONAL JOURNAL OF PSYCHIATRY IN CLINICAL PRACTICE, Vol: 27, Pages: 272-284, ISSN: 1365-1501
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- Citations: 2
Pappa S, Kalniunas A, Maret J, 2023, Cariprazine for negative symptoms in early psychosis: a pilot study with a 6-month follow-up, Frontiers in Psychiatry, Vol: 14, Pages: 1-5, ISSN: 1664-0640
Background: Cariprazine, a novel antipsychotic drug that is a partial agonist with preferential binding to the D3 receptor, has demonstrated efficacy in clinical trials across all symptom domains, including negative symptoms, which can occur early in the course of psychotic illness. However, evidence, to date regarding its effects in early psychosis patients with primary negative symptoms has been limited.Objectives: To evaluate the efficacy of cariprazine for negative symptoms in early psychosis patients.Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline, 3 and 6 months. Tolerability and discontinuation reasons, where applicable, were also recorded.Results: Ten patients with early psychosis (four men and six women, mean age – 25.5 years) with prominent or predominant negative symptoms were treated with cariprazine (range 1.5 – 3 mg). Three patients discontinued cariprazine within the first 3 months due to patient choice, lack of response and non-compliance, respectively. In the remaining patients, there was a significant reduction in the mean negative PANSS score from baseline to 6 months (from 26.3 to 10.6), mean total PANSS score (from 81.4 to 43.3) and in the mean positive PANSS score (from 14.4 to 9.9) which correspond to a 53.1, 41.5, and 28.5% mean score reduction.Conclusion: This pilot study suggests that cariprazine is a safe and effective treatment in early psychosis, particularly for the alleviation of negative symptoms which remains an area of unmet treatment need.
Puntis S, Pappa S, Lennox B, 2023, What happens after early intervention? Mapping early intervention in psychosis care pathways in the 12 months after discharge, EARLY INTERVENTION IN PSYCHIATRY, ISSN: 1751-7885
Barnett J, Pappa S, 2023, Patients' perspectives on switching from one to three monthly Paliperidone Palmitate a cross-sectional patient satisfaction survey, Publisher: CAMBRIDGE UNIV PRESS, Pages: S489-S490, ISSN: 0924-9338
Winter-van Rossum I, Weiser M, Galderisi S, et al., 2023, Efficacy of oral versus long-acting antipsychotic treatment in patients with early-phase schizophrenia in Europe and Israel: a large-scale, open-label, randomised trial (EULAST)., Lancet Psychiatry, Vol: 10, Pages: 197-208
BACKGROUND: Schizophrenia is a severe psychiatric disorder with periods of remission and relapse. As discontinuation of antipsychotic medication is the most important reason for relapse, long-term maintenance treatment is key. Whether intramuscular long-acting (depot) antipsychotics are more efficacious than oral medication in preventing medication discontinuation is still unresolved. We aimed to compare time to all-cause discontinuation in patients randomly allocated to long-acting injectable (LAI) versus oral medication. METHODS: EULAST was a pragmatic, randomised, open-label trial conducted at 50 general hospitals and psychiatric specialty clinics in 15 European countries and Israel. Patients aged 18 years and older, with DSM-IV schizophrenia (as confirmed by the Mini International Neuropsychiatric Interview 5 plus) and having experienced their first psychotic episode from 6 months to 7 years before screening, were randomly allocated (1:1:1:1) using block randomisation to LAI paliperidone, LAI aripiprazole, or the respective oral formulations of these antipsychotics. Randomisation was stratified by country and duration of illness (6 months up to 3 years vs 4 to 7 years). Patients were followed up for up to 19 months. The primary endpoint was discontinuation, regardless of the reason, during 19 months of treatment. We used survival analysis to assess the time until all-cause discontinuation in the intention-to-treat (ITT) group, and per protocol analyses were also done. This trial is registered with ClinicalTrials.gov, NCT02146547, and is complete. FINDINGS: Between Feb 24, 2015, and Dec 15, 2018, 533 individuals were recruited and assessed for eligibility. The ITT population included 511 participants, with 171 (33%) women and 340 (67%) men, and a mean age of 30·5 (SD 9·6) years. 410 (80%) of 511 participants were White, 35 (7%) were Black, 20 (4%) were Asian, and 46 (9%) were other ethnicity. In the combined oral antipsychotics treatment group of 24
Pappa S, Barnett J, Mason K, 2023, A 10-year observational study of the use, acceptability and effectiveness of long-acting paliperidone Palmitate: implications for clinical decision making, CNS Drugs, Vol: 37, Pages: 107-116, ISSN: 1172-7047
Background:Long-acting injectable antipsychotics (LAIs) have been shown to improve adherence and prevent relapse in the treatment of schizophrenia and psychotic disorders, though longitudinal data on treatment outcomes are limited.Objectives:To establish the long-term acceptability and effectiveness of paliperidone palmitate once monthly (PP1M).Methods:This independent 10-year mirror image study was carried out in a large urban mental health provider. The study evaluated the retention and hospitalization rates 5 years following initiation of PP1M in a naturalistic patient cohort of all adult patients who were newly initiated on PP1M between 2011 and 2015. Electronic records were used to compare the frequency and length of hospital admissions in the 5 years before and after introduction of PP1M. Switching and discontinuation rates and reasons were also recorded with a separate analysis of patients who continued and discontinued PP1M during the study period.Results:A total of 167 patients were included in the study (70% with schizophrenia, 30% with other diagnoses). Discontinuation rates were 24%, 15%, 17%, 5% and 8% in years 1–5, respectively; poor tolerability was the most common cause for stopping PP1M. Demographic and clinical factors such as age, sex, diagnosis and care setting did not discriminate between continuers and discontinuers. The group that completed 5 years on PP1M (46%) showed an overall reduction of 72% in the mean number and 68% in the mean length of admissions compared to the 5-year period before initiation, with more than half of the patients requiring no admission at all during this period of time (median = 0). On the contrary, discontinuers demonstrated worse outcomes in overall bed occupancy than continuers. Findings were overall similar across the total cohort and schizophrenia-only group.Conclusions:Our study has one of the longest durations of follow up of a naturalistic cohort treated with LAIs confirming sustained improvements for pa
Bartoli F, Cavaleri D, Nasti C, et al., 2023, Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies, THERAPEUTIC ADVANCES IN PSYCHOPHARMACOLOGY, Vol: 13, ISSN: 2045-1253
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- Citations: 2
Garcia-Carmona JA, Pappa S, 2023, Cumulative Clinical Experience of the Use of Paliperidone Palmitate 3-Monthly Long-Acting Injection in the Treatment of Schizophrenia : A Critical Appraisal, DRUG HEALTHCARE AND PATIENT SAFETY, Vol: 15, Pages: 113-123, ISSN: 1179-1365
Barnett J, Pappa S, 2023, Switching from monthly to three-monthly Long-Acting Injectable 1 Paliperidone: a survey on subjective satisfaction and safety, Patient Preference and Adherence, Vol: 17, Pages: 1603-1610, ISSN: 1177-889X
Introduction: Poor adherence to antipsychotic medication is common in the treatment of schizophrenia and other psychotic disorders. Paliperidone palmitate 3-monthly (PP3M) is the first long-acting injectable (LAI) antipsychotic to allow for only four medication administrations per year, and although there is sufficient information available about the clinical effects, there is relatively limited insight into the subjective experience of people with lived experience.Methods: This descriptive, cross-sectional survey explored patient’s satisfaction and perspectives on the advantages and disadvantages of switching from monthly to 3-monthly paliperidone while also reporting on perceived levels of safety with regard to the reducing dose regimen during the Covid-19 pandemic. Information on discontinuation and hospitalisation rates at one year was also collected from the electronic records.Results: Of the 46 patients included in the study, the vast majority reported feeling satisfied (89.2%) and safer (93.5%) after switching to the three-monthly formulation. Participants highlighted several advantages of changing to PP3M, most notably convenience (93.5%), improved quality of life (58.7%), decreased stigma (39.1%) and better adherence (28.3%). Furthermore, 93.5% of respondents experienced no disadvantages, while 6.5% described worsening side effects or symptoms. In fact, only one patient discontinued PP3M at one year with the overall number of hospitalisations also reducing in the same period compared to the year before switching.Discussion: Our findings add to the small, but growing, body of evidence supporting patient satisfaction and acceptance with the use of PP3M and may reinforce the use of less frequent LAIs in clinical practice to enhance individual experience and treatment persistence and decrease levels of stigmatisation.
García-Carmona JA, García-Pérez A, Isidro García G, et al., 2023, Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study., Ther Adv Psychopharmacol, Vol: 13, ISSN: 2045-1253
BACKGROUND: Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. OBJECTIVES: To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. METHODS: The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). RESULTS: At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. CONCLUSION: Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future dat
Chapman N, Browning M, Baghurst D, et al., 2022, Setting national research priorities for difficult-to-treat depression in the UK between 2021-2026., J Glob Health, Vol: 12
BACKGROUND: Difficult-to-treat depression (DTD) presents a substantial health care challenge, with around one-third of people diagnosed with a depressive episode in the UK finding that their symptoms persist following treatment. This study aimed to identify priority research questions (RQs) that could inform the development of new and improved treatments, interventions, and support for people with DTD. METHODS: Using an adapted Child Health and Nutrition Research Initiative (CHNRI) method, this national prioritisation exercise engaged 60 leading researchers and health care professionals in the UK, as well as 25 wider stakeholders with relevant lived experience to produce a ranked list of priority RQs in DTD. The final list of 99 distinct RQs was independently scored by 42 individuals against a list of five criteria: answerability, effectiveness, impact on health, deliverability, and equity. RESULTS: Highly ranked RQs covered a range of novel and existing treatments. The three highest scoring RQs included evaluation of psychological and pharmacological therapies (eg, behavioural activation, and augmentation therapies), as well as social interventions to reduce loneliness or increase support for people with DTD. CONCLUSIONS: This exercise identified and prioritised 99 RQs that could inform future research and funding decisions over the next five years. The results of this research could improve treatment and support for people affected by DTD. It also serves as an example of ways in which the CHNRI method can be adapted in a collaborative manner to provide a more active role for patients, carers, and health care professionals.
Pappa S, Kalniunas A, Sharma H, et al., 2022, Efficacy and safety of cariprazine augmentation in patients treated with clozapine: a pilot study, Therapeutic Advances in Psychopharmacology, Vol: 12, Pages: 1-7, ISSN: 2045-1253
Background: Cariprazine, a novel antipsychotic drug is a partial agonist of dopamine D2/D3 receptors with preferential binding to the D3 receptor. There has been an increasing interest in cariprazine augmentation to clozapine, however the evidence thus far has been only limited to case reports and case series. Aim: To evaluate the efficacy and safety of the augmentation of clozapine with cariprazine in patients with sub-optimal treatment response.Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline and three months. Tolerability and discontinuation reasons where applicable were also recorded. Results: Ten patients (4 men and 6 women) with a mean age of 36.5 years (range 26-45) were included. Reasons for cariprazine initiation included inadequate treatment response, persistent negative symptoms and/or tolerability issues with clozapine or previous augmentation options. Two patients discontinued cariprazine within the first 6 weeks due to restlessness and poor response, respectively. There was a significant reduction in the median total PANSS score from baseline to 3 months (from 59 to 22.5, p<0.05), median positive PANSS score (11.5 to 5.5, p<0.05) and in the median negative PANSS score (from 15.5 to 3, p<0.05) which correspond to a 48%, 33.8% and 65.8% mean score reduction respectively.Conclusion: This is the first pilot study evaluating the effectiveness of clozapine augmentation. The preliminary evidence suggests that this may be a safe and effective practice in patients failing to adequately respond to or tolerate clozapine and/or previous augmentation strategies.
Asimakos A, Spetsioti S, Vogiatzis I, et al., 2022, Rehabilitation facilitates the natural recovery of symptoms, mental health and quality of life outcomes post COVID-19, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Korkontzelou A, Driva S, Schoretsaniti S, et al., 2022, Smoking cessation program for patients with diabetes-success factors, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Dewa L, Pappa S, Mitchell L, et al., 2022, Reflections, impact and recommendations of a co-produced ecological momentary assessment (EMA) study with young people who have experience of suicidality and psychiatric inpatient care, European Psychiatry, Vol: 65, Pages: S252-S252, ISSN: 0924-9338
IntroductionPatient and public involvement (PPI) in suicide research is ethical, moral and can deliver impact. However, inconsistent reporting of meaningful PPI, and hesitancy in sharing power with people with experience of suicidality (i.e.co-researchers) in research makes it difficult to understand the full potential impact of PPI on the research, researchers and co-researchers.ObjectivesTo describe how our ecological momentary assessment (EMA) study, examining the sleep-suicide relationship in young psychiatric inpatients (aged 18-35) transitioning to the community, has been co-produced, whilst reflecting on impact, challenges, and recommendations.MethodsWe built on our experience of co-produced mental health research to conduct meaningful PPI in our study. Young adults with experience of psychiatric inpatient care and suicidality were appointed November 2020 to work across all research stages. Reflections on challenges, recommendations and impact have been collected throughout.ResultsThree young people became co-researchers. Researcher and co-researcher reflections indicated establishing and maintaining safe environments for open discussion, and continued communication (e.g.WhatsApp group) were vital to effectively share power and decision making. Safeguarding and support requirements for both co-researchers (e.g.individualised strategy) and researcher (e.g.clinical supervision) were particularly evident. To date, the co-produced recruitment poster, research documentation, and research article have demonstrated significant impact.ConclusionsThis is the first EMA study focused on suicide-sleep during transitions to be co-produced with young people with experience of suicidality. Co-producing suicide research is intensive, time-consuming, and challenging but makes a significant impact to the research, researchers, and co-researchers. We expect our learning will directly influence, and help others produce, meaningful co-produced suicide research.
Thana L, O'Connell L, Carne-Watson A, et al., 2022, Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial, BMC Psychiatry, Vol: 22, ISSN: 1471-244X
Background: More than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial.Methods: We developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis. Results : Nine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients’ mental stability, mutual discomfort and embarrassment about discussing a “taboo” subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these “hidden” side effects. Conclusion: The identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of
Katsarou M-S, Iasonidou E, Osarogue A, et al., 2022, The Greek Collaborative Long COVID Study: Non-Hospitalized and Hospitalized Patients Share Similar Symptom Patterns, JOURNAL OF PERSONALIZED MEDICINE, Vol: 12
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- Citations: 5
Dewa LH, Pappa S, Greene T, et al., 2022, The Association Between Sleep Disturbance and Suicidality in Psychiatric Inpatients Transitioning to the Community: Protocol for an Ecological Momentary Assessment Study, JMIR RESEARCH PROTOCOLS, Vol: 11, ISSN: 1929-0748
Pappa S, Sakkas N, Sakka E, 2022, A year in review: sleep dysfunction and psychological distress in healthcare workers during the COVID-19 pandemic, SLEEP MEDICINE, Vol: 91, Pages: 237-245, ISSN: 1389-9457
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- Citations: 22
Pappa S, Barmparessou Z, Athanasiou N, et al., 2022, Depression, Insomnia and Post-Traumatic Stress Disorder in COVID-19 Survivors: Role of Gender and Impact on Quality of Life, JOURNAL OF PERSONALIZED MEDICINE, Vol: 12
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- Citations: 11
Pappa S, Chen J, Barnett J, et al., 2022, A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia, PSYCHIATRY AND CLINICAL NEUROSCIENCES, Vol: 76, Pages: 41-50, ISSN: 1323-1316
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- Citations: 29
García-Carmona JA, Barnett J, Campos-Navarro MP, et al., 2022, Comparative effectiveness of long-acting injectable antipsychotics in a large naturalistic cohort across two European centers: Findings from the long-acting injectable antipsychotics collaborative (LAICO) study., Neuroscience Applied, Vol: 1, Pages: 100111-100111, ISSN: 2772-4085
Kalniunas A, Chakrabarti I, Mandalia R, et al., 2021, The relationship between antipsychotic-induced akathisia and suicidal behaviour: a systematic review, Neuropsychiatric Disease and Treatment, Vol: 2021, Pages: 3489-3497, ISSN: 1176-6328
Objective: We aim to systematically review evidence for an association between antipsychotic-induced akathisia and suicidal behaviour, in order to guide further clinical decision making in this area. Methods: Several electronic databases (Embase, Medline, Cochrane and PsychINFO) were systemically searched for articles published up to February 2021, using search terms related to akathisia, antipsychotics and suicidal behaviour. Two reviewers independently evaluated all the relevant studies using pre-determined criteria and assessed the risk of bias for each included study. The systematic review was conducted in line with PRISMA methodology and reporting.Results: Following de-duplication, screening and application of exclusion criteria, four eligible studies were identified. All of the available studies were in English and included adult patients. Nevertheless, there was significant variability regarding methodology and overall quality was deemed low due to small sample sizes. There was insufficient data to perform statistical analyses of the results. Of the four studies, two found a weak correlation between antipsychotic-related akathisia and suicidal behaviour, a finding that was not supported by the remaining two studies. Conclusion: The search yielded very few studies for inclusion. On the basis of the existing evidence, akathisia cannot be reliably linked to the presence of suicidal behaviour in patients treated with antipsychotic medication. However, proactive screening for emerging suicidal behaviour in this vulnerable patient group is advisable. Our findings highlight the pressing need for further research in this area.
Barnett J, Mason K, Pappa S, 2021, The relationship between level of compliance with aripiprazole long-acting injectable and risk of hospitalisation, 34th European-College-of-Neuropsychopharmacology (ECNP) Congress on Early Career Scientists in Europe, Publisher: ELSEVIER, Pages: S354-S355, ISSN: 0924-977X
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- Citations: 2
Pappa S, Barmparessou Z, Sakka E, et al., 2021, Effects on mental health, sleep and quality of life in hospitalized patients with COVID-19 infection, 34th European-College-of-Neuropsychopharmacology (ECNP) Congress on Early Career Scientists in Europe, Publisher: ELSEVIER, Pages: S581-S582, ISSN: 0924-977X
O'Driscoll C, Shaikh M, Finamore C, et al., 2021, Profiles and trajectories of mental health service utilisation during early intervention in psychosis, SCHIZOPHRENIA RESEARCH, Vol: 237, Pages: 47-53, ISSN: 0920-9964
Pataka A, Kotoulas S, Sakka E, et al., 2021, Sleep Dysfunction in COVID-19 Patients: Prevalence, Risk Factors, Mechanisms, and Management, JOURNAL OF PERSONALIZED MEDICINE, Vol: 11
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- Citations: 16
Pappa S, Barnett J, Gomme S, et al., 2021, Shared and Supported Decision Making in Medication in a Mental Health Setting: How Far Have We Come?, COMMUNITY MENTAL HEALTH JOURNAL, Vol: 57, Pages: 1566-1578, ISSN: 0010-3853
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- Citations: 8
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