Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Efficacy of Cognitive Behavioural Therapy for Schizophrenia(QUEEN’S UNIVERSITY, BELFAST, 2025-01-21) Dabsh, Munirah; Ownes, MarkThis dissertation evaluates the efficacy of cognitive behavioural therapy (CBT) in treating schizophrenia, focusing on symptom reduction, social functioning improvement, and cultural adaptations. A systematic review of ten studies was conducted using rigorous inclusion criteria, resulting in a synthesis of evidence spanning diverse settings and methodologies. Findings highlighted CBT's significant impact on positive symptoms, moderate effect on negative symptoms, and the necessity for culturally sensitive approaches. However, barriers such as methodological limitations, cultural barriers, and limited therapist training were evident. Future research is essential to refine interventions and expand access to evidence-based care7 0Item Restricted Breast Cancer Treatment Disparities in Patients with Severe Mental Illness: A Systematic Review and Meta-Analysis(Queensland University of Technology, 2024) Alotiby, Meshary; Protani, Melinda; Kisely, Steve; Siskind, DanBackground Disparities in breast cancer treatment for people with pre-existing severe mental illness (SMI) have not been well studied compared to disparities in cancer screening and stage at diagnosis. Aims To conduct a systematic review of the available evidence and investigate whether female breast cancer patients with pre-existing SMI had equitable access to guideline recommended breast cancer treatment compare to those without SMI. Methods We conducted systematic review and meta-analysis of observational studies that were retrieved from PubMed, EMBASE, CINAHL and PsycINFO databases from 22 February 2021 to 26 March 2021. Female breast cancer patients with SMI were included in the analyses. SMI was defined as Schizophrenia, Bipolar disorder, and major depression. Guideline recommended treatment was defined as surgery, chemotherapy, radiotherapy and adjuvant endocrine therapy. Pooled odds ratios, and other estimates, such as hazard ratios and risk ratios were presented. Risk of bias was assessed using Newcasle-Ottawa scale. DerSimonian-Laird random effects models were used. Results 3,325 citations were identified; 10 studies were included, and 4 studies were meta-analysed. Pooled analyses suggested that people with SMI were less likely to receive guideline recommended breast cancer treatment than those without SMI (OR: 0.83; 95% CI: 0.77 to 0.90). Breast cancer patients with schizophrenia had a reduced likelihood for receiving adjuvant radiotherapy (Crude RR: 0.81, 95% CI: 0.77 to 0.85), while those with major depression and bipolar I disorder had lower likelihood of receiving adjuvant chemotherapy (Crude RR: 0.71, 95% CI: 0.60 to 0.84). Conclusions This review identified disparities in breast cancer care for individuals with pre-existing SMI, which contributed to poorer prognosis and excess mortality. Improving collaboration between psycho-oncology teams is advised to address patients’ needs for treatment. Future research is necessary for identifying disparities in primary and systemic treatments and investigating the reasons for treatment inequity.9 0Item Restricted Regulation of excitation and inhibition in early stages of neuronal differentiation and arborisation(King's College London, 2024) Jelani, Rose; Stolp, HelenNeurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD), schizophrenia (SCZ) and attention deficit hyperactivity disorder (ADHD), have been extensively linked to early-life excitatory/inhibitory (E/I) imbalances. These imbalances are particularly associated with alterations in the GABAergic inhibitory system. Numerous studies in neurodevelopmental research have reported a decreased expression of cortical GABAergic interneurons, which are responsible for releasing gamma-aminobutyric acid (GABA), in patients with NDDs. However, the precise mechanisms underlying this reduction in GABAergic interneurons remain unclear. This study investigated the effects of early-life prolonged GABA-a receptor activation on cortical GABAergic interneuron development in mice. Muscimol, a GABA-a receptor agonist, was injected intraperitoneally (0.5 mg/kg) to mice on post-natal days 3 to 5 (P3-P5). At P10, we employed immunohistochemistry and imaging analyses to assess three distinct GABAergic interneuron populations in the somatosensory cortex: parvalbumin-expressing (PV+), somatostatin-expressing (SST+), and calretinin-expressing (CR+). Our main results revealed a significant increase in PV+ interneuron density (cells/layer) within cortical layer V following muscimol treatment. Additionally, non-significant but consistent trends towards elevation were observed for all interneuron population densities (cells/mm²). These findings suggest that early-life GABA circuit disruption may initially increase GABAergic interneuron expression, potentially offering insight into the trajectory leading to the eventual decrease observed in NDDs. While limited by sample size, this research contributes to understanding the developmental processes that may lead to GABAergic deficits in NDDs. Further research with larger samples and longitudinal designs is needed to elucidate the long-term impacts of early GABAergic perturbations on interneuron populations and their potential relevance to NDD pathology.12 0