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Chai L. Interplay between actual and perceived weight on mental health among Canadian Indigenous post-secondary students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592936 DOI: 10.1080/07448481.2024.2338419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Research increasingly focuses on the mental health implications of both actual and perceived weight, particularly among post-secondary students. Considering their unique socio-cultural context and the frequent oversight in research, this study examines these implications specifically among Canadian Indigenous post-secondary students. Recent evidence indicates that students with normal weight may also experience increased mental health risks due to negative weight perceptions. Therefore, this study explores the independent and combined effects of actual and perceived weight on the mental health of this group. PARTICIPANTS AND METHODS This study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations peoples living off-reserve, Métis, and Inuit. The focus was on Canadian Indigenous post-secondary students aged 19-34 years (n = 1,518). Logistic regression models, stratified by sex, were employed to analyze the data. RESULTS Perceptions of being overweight were linked to a higher risk of mood and anxiety disorders, poor self-rated mental health, and suicidal ideation among female students. This pattern was less evident among male students. Notably, female students who were overweight and perceived themselves as such were more likely to report poor mental health across all four indicators examined. In contrast, male students exhibited a less clear pattern. Diverging from recent studies, the findings indicated less robust mental health disparities among students with normal weight who perceived themselves as overweight, potentially due to the insufficient cell size of this category among Indigenous post-secondary students. CONCLUSIONS The study highlights the complex interplay between actual and perceived weight and its impact on mental health, particularly among female Indigenous post-secondary students.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
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Iorfino F, McHugh C, Richards M, Skinner A, Prodan A, Occhipinti JA, Song YJC, Chiu S, Judkins S, Scott E, Hickie IB. Patterns of emergency department presentations for a youth mental health cohort: data-linkage cohort study. BJPsych Open 2023; 9:e170. [PMID: 37706294 PMCID: PMC10594097 DOI: 10.1192/bjo.2023.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/23/2023] [Accepted: 06/09/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Primary youth mental health services in Australia have increased access to care for young people, yet the longer-term outcomes and utilisation of other health services among these populations is unclear. AIMS To describe the emergency department presentation patterns of a help-seeking youth mental health cohort. METHOD Data linkage was performed to extract Emergency Department Data Collection registry data (i.e. emergency department presentations, pattern of re-presentations) for a transdiagnostic cohort of 7024 youths (aged 12-30 years) who presented to mental health services. Outcome measures were pattern of presentations and reason for presentations (i.e. mental illness; suicidal behaviours and self-harm; alcohol and substance use; accident and injury; physical illness; and other). RESULTS During the follow-up period, 5372 (76.5%) had at least one emergency department presentation. The presentation rate was lower for males (IRR = 0.87, 95% CI 0.86-0.89) and highest among those aged 18 to 24 (IRR = 1.117, 95% CI 1.086-1.148). Almost one-third (31.12%) had an emergency department presentation that was directly associated with mental illness or substance use, and the most common reasons for presentation were for physical illness and accident or injury. Index visits for mental illness or substance use were associated with a higher rate of re-presentation. CONCLUSIONS Most young people presenting to primary mental health services also utilised emergency services. The preventable and repeated nature of many presentations suggests that reducing the ongoing secondary risks of mental disorders (i.e. substance misuse, suicidality, physical illness) could substantially improve the mental and physical health outcomes of young people.
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Affiliation(s)
- Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Catherine McHugh
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Richards
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Adam Skinner
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ante Prodan
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia; and School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Jo-an Occhipinti
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; and Computer Simulation & Advanced Research Technologies, Sydney, New South Wales, Australia
| | | | - Simon Chiu
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | | | - Elizabeth Scott
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; and St Vincent's Private Hospital, Sydney, New South Wales, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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Zerbinati L, Guerzoni F, Napoli N, Preti A, Esposito P, Caruso R, Bulighin F, Storari A, Grassi L, Battaglia Y. Psychosocial determinants of healthcare use costs in kidney transplant recipients. Front Public Health 2023; 11:1158387. [PMID: 37333548 PMCID: PMC10272730 DOI: 10.3389/fpubh.2023.1158387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Psychosocial factors frequently occur in kidney transplant recipients (KTRs), leading to behavioral alterations and reduced therapeutic adherence. However, the burden of psychosocial disorders on costs for KTRs is unknown. The aim of the study is to identify predictors of healthcare costs due to hospital admissions and emergency department access in KTRs. Methods This is a longitudinal observational study conducted on KTRs aged >18 years, excluding patients with an insufficient level of autonomy and cognitive disorder. KTRs underwent psychosocial assessment via two interviews, namely the Mini-International Neuropsychiatric Interview 6.0 (MINI 6.0) and the Diagnostic Criteria for Psychosomatic Research Interview (DCPR) and via the Edmonton Symptom Assessment System Revised (ESAS-R) scale, a self-administrated questionnaire. Sociodemographic data and healthcare costs for hospital admissions and emergency department access were collected in the 2016-2021 period. Psychosocial determinants were as follows: (1) ESAS-R psychological and physical score; (2) symptomatic clusters determined by DCPR (illness behavior cluster, somatization cluster, and personological cluster); and (3) ICD diagnosis of adjustment disorder, anxiety disorder, and mood disorder. A multivariate regression model was used to test the association between psychosocial determinants and total healthcare costs. Results A total of 134 KTRs were enrolled, of whom 90 (67%) were men with a mean age of 56 years. A preliminary analysis of healthcare costs highlighted that higher healthcare costs are correlated with worse outcomes and death (p < 0.001). Somatization clusters (p = 0.020) and mood disorder (p < 0.001) were positively associated with costs due to total healthcare costs. Conclusions This study showed somatization and mood disorders could predict costs for hospital admissions and emergency department access and be possible risk factors for poor outcomes, including death, in KTRs.
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Affiliation(s)
- Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Franco Guerzoni
- Programming and Management Control Service, Unit of Controls, St. Anna University-Hospital, Ferrara, Italy
| | - Nicola Napoli
- Programming and Management Control Service, Statistics Service, St. Anna University-Hospital, Ferrara, Italy
| | - Antonio Preti
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Pasquale Esposito
- Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | | | - Alda Storari
- Nephrology and Dialysis Unit, St. Anna University-Hospital, Ferrara, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Yuri Battaglia
- Department of Medicine, University of Verona, Verona, Italy
- Nephrology and Dialysis Unit, Pederzoli Hospital, Verona, Italy
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Schick B, Mayer B, Jäger M, Jungwirth B, Barth E, Eble M, Sponholz C, Muth CM, Schönfeldt-Lecuona C. Emergency medical care of patients with psychiatric disorders - challenges and opportunities: Results of a multicenter survey. BMC Emerg Med 2022; 22:173. [PMID: 36303120 PMCID: PMC9615220 DOI: 10.1186/s12873-022-00722-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background Pre-clinical psychiatric emergencies are generally treated by emergency medical staff. The subsequent clinical treatment is often conditioned by interaction problems between emergency medical staff and psychiatric clinical staff. Objectives To identify problems affecting interaction between emergency medical and psychiatric care of mentally ill patients and pinpoint aspects of optimized emergency care. Methods To shed light on the interaction problems an anonymous, questionnaire-based, nonrepresentative survey of 98 emergency physicians (EM) and 104 psychiatrists (PS) practicing in acute psychiatry was conducted between March 1, 2021 and October 1, 2021. Results The chi-square test for multiple response sets revealed consistently significant differences (p < 0.001) between EM and PS with respect to the questions analyzed. Approximately 36% of EM reported not to be adequately qualified to handle psychiatric emergencies (p = 0.0001), while around 50% of respondents were neutral in their assessment in how to deal with psychiatric emergencies. 80% of EM reported a negative interaction (rejection of patients) with PS when referring a psychiatric emergency patient to the acute psychiatric unit. The most common reasons for refusal were intoxication (EM: 78.8%, PS: 88.2%), emergency physician therapy (EM: 53.8%, PS: 63.5%), and not resident in the catchment area of the hospital (EM 68.8%, PS: 48.2%). In the casuistry presented, most respondents would choose “talk down” for de-escalation (EM: 92.1%, PS: 91.3%). With respect to drug therapy, benzodiazepine is the drug of choice (EM: 70.4%, PS: 78.8%). More EM would choose an intravenously (i.v.) or a Mucosal Atomization Device (MAD) administration as an alternative to oral medication (i.v.: EM: 38.8%, PS: 3.8%, p = 0.001, MAD: EM: 36.7%, PS: 10.6%, p = 0.006). Significantly more EM would seek phone contact with the acute psychiatric hospital (EM: 84.7%, PS: 52.9%, p = 0.0107). A psychiatric emergency plan was considered useful in this context by more than 90% of respondents. The need for further training for EM with regard to treating psychiatric clinical syndromes was considered important by all respondents. In particular, the topics of “psychogenic seizure,“ “intoxication,“ and “legal aspects of psychiatric emergencies” were considered important (Mann-Whitney U test, p < 0.001). Conclusion The interaction-related problems identified in the emergency medical care of pre-clinical psychiatric patients relate to non-modifiable, structural problems, such as insufficient admission capacity and non-existent or inadequate monitoring capabilities in acute psychiatric hospitals. However, factors such as the education and training of EM and communication between EM and PS can be improved. Developing personalized emergency care plans for psychiatric patients could help to optimize their care. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00722-5.
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Affiliation(s)
- Benedikt Schick
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstraße 13, 89075, Ulm, Germany
| | - Markus Jäger
- Department of Psychiatry, Psychotherapy and Psychosomatic, District Hospital Kempten, Kempten, Germany
| | - Bettina Jungwirth
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Eberhard Barth
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Martin Eble
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine & Pain Therapy, Klinikum Friedrichshafen GmbH, Röntgenstraße 2, 88048, Friedrichshafen, Germany
| | - Christoph Sponholz
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Claus-Martin Muth
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Carlos Schönfeldt-Lecuona
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Leimgrubenweg 12-14, 89075, Ulm, Germany
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Doan Q, Barbic D. Are mood disorders associated with frequent emergency department visits? Question answered, or a dialogue just beginning? CAN J EMERG MED 2022; 24:3-4. [PMID: 35038154 PMCID: PMC8762438 DOI: 10.1007/s43678-021-00238-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Quynh Doan
- Department of Pediatrics, UBC; BC Children's Hospital, Vancouver, BC, Canada
| | - David Barbic
- Department of Emergency Medicine, UBC, Centre for Health Evaluation and Outcomes Sciences, Vancouver, BC, Canada.
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