Getting to Precision Psychopharmacology in Child Psychiatry: The Value of Adverse Treatment Effects

Quality of life among residents of Gaza, Palestine: the predictive role of mental distress, fear of COVID-19, and social support

BACKGROUND

Living under siege and deteriorated health, social, educational, and economic conditions and isolation with scarce opportunities to fulfil basic needs and aspirations affect the civil population's mental health and perceived quality of life. In this cross-sectional investigation, we explored the consequences of mental distress, fear of COVID-19, and social support for QoL in the Gaza strip.

METHODS

Nine hundred seventy nine (32.9% males; 67.1% females; mean age was 35.2 years; s.d. = 11.4) adults were recruited in the Gaza strip. We used the Fear for COVID-19 scale (FCS-19), The WHOQOL-BREF Scale, Berlin Social Support Scale (BSSS), Depression Anxiety and Stress Scale (DASS). Pearson correlation coefficient was computed to assess relationships between quality of life, fear of COVID19, mental distress, and social support; a hierarchical regression analysis was used to assess the association between QoL as the dependent variable and demographic variables and fear of COVID19, mental health, and social support as the independent variables.

RESULTS

QoL was positively associated with perceived emotion, instrumental, and support seeking. Depression, anxiety, stress, and fear of COVID19 were negatively associated with quality of life. Gender was significantly associated with lower QoL. The study highlighted that the level of fear of COVID-19 was negatively influencing individuals' quality of life (QoL). This fear was negatively associated to psychological distress, gender, place of residence, and family type. Lower-educated and poorer participants had lower QoL scores. Conversely, female gender was notably linked to a lower QOL. The hierarchical regression confirmed that COVID-19 was an added burden for the Palestinian population. The fear of COVID-19 term added a 6.2% variance in QoL. In the final analysis, all predictors were statistically significant, with the fear of COVID-19 term recording a higher contribution of 22.5%, followed by depression term with 21.5%, perceived emotional 18.5%, income at 15.4%, and perceived instruments at 14.8% towards QoL.

CONCLUSIONS

Practitioners and policymakers must consider the severe violation of human rights when developing psychosocial programs to intervene in the COVID-19 crisis.

How to Mitigate Risk of Premature Cardiovascular Disease Among Children and Adolescents with Mental Health Conditions

PURPOSE OF REVIEW

The goal of this article is to characterize the myriad of ways that children with mental health conditions can be at risk for premature cardiovascular disease (CVD) and various modalities to ameliorate this risk in childhood in order to improve the life course of these children.

REVIEW FINDINGS

Child and adolescent mental health conditions are a common yet underrecognized risk factor for premature CVD. The American Heart Association has recently included psychiatric conditions as a CVD risk factor (CVDRF) and the evidence linking childhood adversity to cardiometabolic disease. There are bidirectional and additive effects from the intrinsic emotional dysregulation and inflammatory changes from the mental health condition, the associations with risky health behaviors, and in some cases, metabolic side effects from pharmacotherapy. These pathways can be potentiated by toxic stress, a physiologic response to stressors from childhood adversity. Toxic stress is also associated with development of mental health conditions with epigenetic effects that can result in transgenerational inheritance of cardiometabolic risk. Exposure to toxic stress and mental health conditions in isolation sometimes compounded by pharmacotherapies used in treatment increase the risk of cardiometabolic diseases in childhood. The multiple pathways, which adversely influence cardiometabolic outcomes, encourage clinicians to consider strategies to mitigate these factors and justify the importance of early screening and treatment for CVDRFs. Mental health, health behaviors, and environmental factors co-occur and intersect in complex pathways that can increase CVD risk over the lifespan. Early detection and response can mitigate the risks associated with premature development of CVD.