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Hawke LD, Bastidas-Bilbao H, Cappe V, van Kesteren MR, Stewart DE, Gupta M, Simpson AIF, Campbell BH, Castle D, Stergiopoulos V. Medical Assistance in Dying for Mental Illness as a Sole Underlying Medical Condition and Its Relationship to Suicide: A Qualitative Lived Experience-Engaged Study: Aide Médicale à Mourir Pour Maladie Mentale Comme Seule Condition Médicale Sous-Jacente et Son Lien Avec le Suicide: Une Etude Qualitative Engagée Dans l'Expérience Vécue. Can J Psychiatry 2024; 69:314-325. [PMID: 37885204 DOI: 10.1177/07067437231209658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVE This lived experience-engaged study aims to understand patient and family perspectives on the relationship between suicidality and medical assistance in dying when the sole underlying medical condition is mental illness (MAiD MI-SUMC). METHOD Thirty individuals with mental illness (age M = 41.8 years, SD = 14.2) and 25 family members (age M = 47.5 years, SD = 16.0) participated in qualitative interviews examining perspectives on MAiD MI-SUMC and its relationship with suicide. Audio recordings were transcribed and analysed using reflexive thematic analysis. People with lived experience were engaged in the research process as team members. RESULTS Four main themes were developed, which were consistent across individuals with mental illness and family members: (a) deciding to die is an individual choice to end the ongoing intolerable suffering of people with mental illness; (b) MAiD MI-SUMC is the same as suicide because the end result is death, although suicide can be more impulsive; (c) MAiD MI-SUMC is a humane, dignified, safe, nonstigmatized alternative to suicide; and (4) suicidality should be considered when MAiD MI-SUMC is requested, but suicidality's role is multifaceted given its diverse manifestations. CONCLUSION For patient-oriented mental health policy and treatment, it is critical that the voices of people with lived experience be heard on the issue of MAiD MI-SUMC. Given the important intersections between MAiD MI-SUMC and suicidality and the context of suicide prevention, the role that suicidality should play in MAiD MI-SUMC is multifaceted. Future research and policy development are required to ensure that patient and family perspectives guide the development and implementation of MAiD MI-SUMC policy and practice.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Vivien Cappe
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Donna E Stewart
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Mona Gupta
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Alexander I F Simpson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - David Castle
- Department of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia
- Statewide Mental Health Service, Hobart, Tasmania, Australia
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Modini M, Baillie A. Measuring the utility of brief psychological intervention in psychiatric hospitals: A call for change. Australas Psychiatry 2024:10398562241246897. [PMID: 38606612 DOI: 10.1177/10398562241246897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Despite the known importance of regularly monitoring progress when delivering psychological interventions, this is not mandated or seemingly even common practice on Australian inpatient psychiatric wards. Barriers for why this might be the case are described, an argument made to rise above them, and a call for research in this area is made. CONCLUSIONS Failure to find ways to collect, analyse and be transparent with data around brief inpatient psychological interventions can diminish treatment outcomes and leaves us open to criticism as a profession.
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Affiliation(s)
- Matthew Modini
- Concord Centre for Mental Health, Sydney Local Health District, NSW Health, Sydney, NSW, Australia
| | - Andrew Baillie
- Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia
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Jay EK, Moxham L, Roberts M, Yousiph T, Robson G, Lewer K, Patterson C. Contributing to 'a sense of purpose' - Evaluating consumer recovery progress after attending a therapeutic-recreation intervention programme: A quantitative analysis. Int J Soc Psychiatry 2024:207640241242024. [PMID: 38605480 DOI: 10.1177/00207640241242024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
INTRODUCTION The recommended objective for mental health plans and policies is the adoption of recovery approaches to mental healthcare. Mental health recovery is no longer defined by symptom resolution but as a journey towards a meaningful life from the consumer's own perspective. Recovery approaches focus on consumers' strengths, feelings of well-being and the achievement of personal goals. Designing recovery-oriented interventions is crucial for supporting people in their personal recovery journey. AIM This study sought to evaluate how attending a recovery-oriented intervention impacts the recovery of attending people living with serious mental illness. METHODS A quasi-experimental approach was utilised to examine changes in self-reported recovery progress in a purposive sample of consumers living with enduring mental illness (N = 105). Recovery progress was evaluated via the Recovery Assessment Scale - Domains and Stages (RAS-DS). Data were collected at entry and exit to a therapeutic recreation programme grounded in principles of recovery-oriented care and social contact theory. Pre-post scores were analysed via a repeated-measures multivariate analysis of variance (RM-MANOVA) per the four RAS-DS recovery domains. RESULTS After attending the therapeutic recreation programme, consumer recovery scores significantly increased in the functional, personal, and social recovery RAS-DS domains as measured by 'Doing Things I Value', 'Looking Forward', and 'Connecting and Belonging' (respectively). No changes were observed to consumers' clinical recovery progress, as assessed via the recovery domain 'Mastering my Illness'. CONCLUSION The results of this study demonstrate that therapeutic recreation camps can provide a recovery-based approach to mental healthcare, with positive effects on the three areas of: a purposeful life; connection and belonging; and optimism and hope. Recovery Camp has been previously identified by the Productivity Commission as having potential person-centred recovery benefits for mental health consumers. The results of this study now establish these benefits as evidence based and can be used to guide mental health practice and policy for the implementation of therapeutic recreation camps for mental health recovery.
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Affiliation(s)
- Elissa-Kate Jay
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Michelle Roberts
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Taylor Yousiph
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Georgia Robson
- Faculty of the Arts, Social Science & Humanities, University of Wollongong, NSW, Australia
| | - Kelly Lewer
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
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Camões-Costa V, Taylor B, Barton C, Chakraborty S, Hewitt A, Lin X, Brijnath B. Mental health outcomes of family carers after admission to aged care: A cross-sectional survey study. Australas J Ageing 2024. [PMID: 38597573 DOI: 10.1111/ajag.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES This study investigated the predictors of poor mental health outcomes among family carers of residents after transitioning into residential aged care. METHODS Using a cross-sectional design, five groups of variables were evaluated as predictors: caregiver demographics; caregiving load; resident-related variables; loneliness and visiting frequency; and the impact of the COVID-19 context. A total of 309 primary family contacts of all residents of two residential aged care organisations in the state of Victoria (Australia) participated in the study (response rate 19%). The K-10 and the Burden Scale for Family Caregivers were used to measure the primary outcomes. We compared psychological distress and burden outcomes between carers whose relative was admitted within the last 12 months, or longer than 12 months ago. RESULTS Time since admission (<12 months or >12 months) did not affect the level of psychological distress (t (238) = -.08, p = .94) or subjective burden (t (245) = -.89, p = .38). Being a woman, a spouse, speaking a language other than English at home, being less satisfied with the support offered by the facility, not feeling supported in the decision to admit their relative, being lonely and providing higher levels of care preadmission were predictors of poor mental health outcomes. CONCLUSIONS Older women with low-English proficiency who were primary carers and are socially isolated, are more likely to experience poor mental health outcomes and need additional support. These findings may inform the development of screening tools and tailored interventions to support this population during and after the transition process.
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Affiliation(s)
- Vera Camões-Costa
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Benjamin Taylor
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Chris Barton
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Samantha Chakraborty
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alana Hewitt
- Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia
| | - Xiaoping Lin
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bianca Brijnath
- National Ageing Research Institute Ltd, Melbourne, Victoria, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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Hadar-Shoval D, Asraf K, Mizrachi Y, Haber Y, Elyoseph Z. Assessing the Alignment of Large Language Models With Human Values for Mental Health Integration: Cross-Sectional Study Using Schwartz's Theory of Basic Values. JMIR Ment Health 2024; 11:e55988. [PMID: 38593424 DOI: 10.2196/55988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Large language models (LLMs) hold potential for mental health applications. However, their opaque alignment processes may embed biases that shape problematic perspectives. Evaluating the values embedded within LLMs that guide their decision-making have ethical importance. Schwartz's theory of basic values (STBV) provides a framework for quantifying cultural value orientations and has shown utility for examining values in mental health contexts, including cultural, diagnostic, and therapist-client dynamics. OBJECTIVE This study aimed to (1) evaluate whether the STBV can measure value-like constructs within leading LLMs and (2) determine whether LLMs exhibit distinct value-like patterns from humans and each other. METHODS In total, 4 LLMs (Bard, Claude 2, Generative Pretrained Transformer [GPT]-3.5, GPT-4) were anthropomorphized and instructed to complete the Portrait Values Questionnaire-Revised (PVQ-RR) to assess value-like constructs. Their responses over 10 trials were analyzed for reliability and validity. To benchmark the LLMs' value profiles, their results were compared to published data from a diverse sample of 53,472 individuals across 49 nations who had completed the PVQ-RR. This allowed us to assess whether the LLMs diverged from established human value patterns across cultural groups. Value profiles were also compared between models via statistical tests. RESULTS The PVQ-RR showed good reliability and validity for quantifying value-like infrastructure within the LLMs. However, substantial divergence emerged between the LLMs' value profiles and population data. The models lacked consensus and exhibited distinct motivational biases, reflecting opaque alignment processes. For example, all models prioritized universalism and self-direction, while de-emphasizing achievement, power, and security relative to humans. Successful discriminant analysis differentiated the 4 LLMs' distinct value profiles. Further examination found the biased value profiles strongly predicted the LLMs' responses when presented with mental health dilemmas requiring choosing between opposing values. This provided further validation for the models embedding distinct motivational value-like constructs that shape their decision-making. CONCLUSIONS This study leveraged the STBV to map the motivational value-like infrastructure underpinning leading LLMs. Although the study demonstrated the STBV can effectively characterize value-like infrastructure within LLMs, substantial divergence from human values raises ethical concerns about aligning these models with mental health applications. The biases toward certain cultural value sets pose risks if integrated without proper safeguards. For example, prioritizing universalism could promote unconditional acceptance even when clinically unwise. Furthermore, the differences between the LLMs underscore the need to standardize alignment processes to capture true cultural diversity. Thus, any responsible integration of LLMs into mental health care must account for their embedded biases and motivation mismatches to ensure equitable delivery across diverse populations. Achieving this will require transparency and refinement of alignment techniques to instill comprehensive human values.
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Affiliation(s)
- Dorit Hadar-Shoval
- The Psychology Department, Max Stern Yezreel Valley College, Tel Adashim, Israel
| | - Kfir Asraf
- The Psychology Department, Max Stern Yezreel Valley College, Tel Adashim, Israel
| | - Yonathan Mizrachi
- The Jane Goodall Institute, Max Stern Yezreel Valley College, Tel Adashim, Israel
- The Laboratory for AI, Machine Learning, Business & Data Analytics, Tel-Aviv University, Tel Aviv, Israel
| | - Yuval Haber
- The PhD Program of Hermeneutics and Cultural Studies, Interdisciplinary Studies Unit, Bar-Ilan University, Ramat Gan, Israel
| | - Zohar Elyoseph
- The Psychology Department, Center for Psychobiological Research, Max Stern Yezreel Valley College, Tel Adashim, Israel
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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Parisi M, Raffard S, Slangen P, Kastendieck T, Hess U, Mauersberger H, Fauviaux T, Marin L. Putting a label on someone: impact of schizophrenia stigma on emotional mimicry, liking, and interpersonal closeness. Cogn Emot 2024:1-17. [PMID: 38594881 DOI: 10.1080/02699931.2024.2339531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
Affiliation is both an antecedent and a consequence of emotional mimicry (i.e. imitating a counterpart's emotional expression). Thus, interacting with a disliked partner can decrease emotional mimicry, which in turn can further decrease liking. This perpetuating circle has not been investigated in the context of mental health stigma yet. The present study tested the influence of the label "schizophrenia" on liking, interpersonal closeness, and emotional mimicry. In an online experiment (n = 201), participants recruited from the general population saw several videos of actors displaying emotional expressions. Actors were described with one of four labels: "schizophrenia", "healthy", "diabetes", and a negative adjective (e.g. "hot-tempered"). Emotional mimicry was measured using OpenFace 2.2. Liking and interpersonal closeness were assessed with questionnaires. Overall, compared to other labels, participants reported less liking and interpersonal closeness to the actor with the schizophrenia label. However, no effect on emotional mimicry was found. The decreased liking of the schizophrenia actors was explained by a lack of knowledge about schizophrenia and the explicit stigma of schizophrenia. Our study contributes to the literature by highlighting the need to reduce the stigma of schizophrenia.
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Affiliation(s)
- Mathilde Parisi
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Stéphane Raffard
- Univ Paul Valéry Montpellier 3, Montpellier, France
- University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
| | - Pierre Slangen
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Till Kastendieck
- Humboldt-Universität zu Berlin, Institute of Psychology, Berlin, Germany
| | - Ursula Hess
- Humboldt-Universität zu Berlin, Institute of Psychology, Berlin, Germany
| | - Heidi Mauersberger
- Humboldt-Universität zu Berlin, Institute of Psychology, Berlin, Germany
| | - Tifenn Fauviaux
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Ludovic Marin
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
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Caron MÈ, Maltais N, Corriveau S, Rassy J. The use of information and communication technologies by adolescents living with a mental illness in the past 5 years: Scoping review. Int J Ment Health Nurs 2024. [PMID: 38590128 DOI: 10.1111/inm.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/08/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
The use of information and communication technologies (ICT) is a huge part of adolescents' lives, especially by those living with a mental illness. However, very few studies explore their experience with the use of ICT and how it affects their health. The purpose of this study was to better understand the use of ICT by adolescents living with a mental illness. A scoping review was undertaken using Arksey and O'Malley's method to explore this understudied topic. The following databases were searched: Medline, CINAHL and Psychology and Behavioural Sciences Collection. Studies published between 2017 and 2022 were included. Data were analysed using a data extraction and an analysis grid developed by the research team. Of 1984 articles, only seven met the inclusion criteria. These articles allowed for a better understanding of the type of mental illness these young ICT users had, the type of ICT they use and their overall experience using ICT. The diagnoses most associated with the use of these ICT were suicidal ideation, depression, anxiety and eating illnesss. Types of ICT used were very diverse and adolescents had both positive and negative experiences using these ICT. Very few interventions using ICT were developed according to the needs of adolescents with mental illness. These adolescents often cope with the help of ICT and can have an overall positive experience. Their experience can also be negative as some of them were exposed to suicide-related and violent content. Future research is needed to better understand the best ICT interventions for these young people.
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Affiliation(s)
- Marie-Ève Caron
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Nathalie Maltais
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Quebec, Canada
- Centre de recherche sur le suicide, enjeux éthiques et pratiques de fin de vie (CRISE), Montreal, Quebec, Canada
- Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
| | - Stacy Corriveau
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jessica Rassy
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de recherche sur le suicide, enjeux éthiques et pratiques de fin de vie (CRISE), Montreal, Quebec, Canada
- Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Longueuil, Quebec, Canada
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Patel D, Msosa YJ, Wang T, Williams J, Mustafa OG, Gee S, Arroyo B, Larkin D, Tiedt T, Roberts A, Dobson RJB, Gaughran F. Implementation of an Electronic Clinical Decision Support System for the Early Recognition and Management of Dysglycemia in an Inpatient Mental Health Setting Using CogStack: Protocol for a Pilot Hybrid Type 3 Effectiveness-Implementation Randomized Controlled Cluster Trial. JMIR Res Protoc 2024; 13:e49548. [PMID: 38578666 DOI: 10.2196/49548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/03/2023] [Accepted: 12/17/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Severe mental illnesses (SMIs), including schizophrenia, bipolar affective disorder, and major depressive disorder, are associated with an increased risk of physical health comorbidities and premature mortality from conditions including cardiovascular disease and diabetes. Digital technologies such as electronic clinical decision support systems (eCDSSs) could play a crucial role in improving the clinician-led management of conditions such as dysglycemia (deranged blood sugar levels) and associated conditions such as diabetes in people with a diagnosis of SMI in mental health settings. OBJECTIVE We have developed a real-time eCDSS using CogStack, an information retrieval and extraction platform, to automatically alert clinicians with National Health Service Trust-approved, guideline-based recommendations for dysglycemia monitoring and management in secondary mental health care. This novel system aims to improve the management of dysglycemia and associated conditions, such as diabetes, in SMI. This protocol describes a pilot study to explore the acceptability, feasibility, and evaluation of its implementation in a mental health inpatient setting. METHODS This will be a pilot hybrid type 3 effectiveness-implementation randomized controlled cluster trial in inpatient mental health wards. A ward will be the unit of recruitment, where it will be randomly allocated to receive either access to the eCDSS plus usual care or usual care alone over a 4-month period. We will measure implementation outcomes, including the feasibility and acceptability of the eCDSS to clinicians, as primary outcomes, alongside secondary outcomes relating to the process of care measures such as dysglycemia screening rates. An evaluation of other implementation outcomes relating to the eCDSS will be conducted, identifying facilitators and barriers based on established implementation science frameworks. RESULTS Enrollment of wards began in April 2022, after which clinical staff were recruited to take part in surveys and interviews. The intervention period of the trial began in February 2023, and subsequent data collection was completed in August 2023. Data are currently being analyzed, and results are expected to be available in June 2024. CONCLUSIONS An eCDSS can have the potential to improve clinician-led management of dysglycemia in inpatient mental health settings. If found to be feasible and acceptable, then, in combination with the results of the implementation evaluation, the system can be refined and improved to support future successful implementation. A larger and more definitive effectiveness trial should then be conducted to assess its impact on clinical outcomes and to inform scalability and application to other conditions in wider mental health care settings. TRIAL REGISTRATION ClinicalTrials.gov NCT04792268; https://clinicaltrials.gov/study/NCT04792268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49548.
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Affiliation(s)
- Dipen Patel
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Yamiko Joseph Msosa
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tao Wang
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, Health Service and Population Research Department, King's College London, London, United Kingdom
| | - Omar G Mustafa
- Department of Diabetes, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
- Centre for Education, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Siobhan Gee
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Barbara Arroyo
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Damian Larkin
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Trevor Tiedt
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Angus Roberts
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Richard J B Dobson
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute for Health Informatics, University College London, London, United Kingdom
- Health Data Research UK, University College London, London, United Kingdom
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
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Baheretibeb Y, Wondimagegn D, Law S. "Trust in God, but tie your donkey": Holy water priest healers' views on collaboration with biomedical mental health services in Addis Ababa, Ethiopia. Transcult Psychiatry 2024; 61:246-259. [PMID: 38314780 PMCID: PMC10943614 DOI: 10.1177/13634615241227681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This exploratory qualitative study examines holy water priest healers' explanatory models and general treatment approaches toward mental illness, and their views and reflections on a collaborative project between them and biomedical practitioners. The study took place at two holy water treatment sites in Addis Ababa, Ethiopia. Twelve semi-structured interviews with holy water priest healers found eight notable themes: they held multiple explanatory models of illness, dominated by religious and spiritual understanding; they emphasized spiritual healing and empathic understanding in treatment, and also embraced biomedicine as part of an eclectic healing model; they perceived biomedical practitioners' humility and respect as key to their positive views on the collaboration; they valued recognition of their current role and contribution in providing mental healthcare; they recognized and appreciated the biomedical clinic's effectiveness in treating violent and aggressive patients; they endorsed the collaboration and helped to overcome patient and family reluctance to the use of biomedicine; they lamented the lack of spiritual healing in biomedical treatment; and they had a number of dissatisfactions and concerns, particularly the one-way referral from religious healers to the biomedical clinic. The study results show diversity in the religious healers' etiological understanding, treatment approaches and generally positive attitude and views on the collaboration. We present insights and explorations of factors affecting this rare, but much needed collaboration between traditional healers and biomedical services, and potential ways to improve it are discussed.
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Taylor O, Newbronner E, Cooke H, Walker L, Wadman R. Shaping research for people living with co-existing mental and physical health conditions: A research priority setting initiative from the United Kingdom. Health Expect 2024; 27:e14044. [PMID: 38613770 PMCID: PMC11015889 DOI: 10.1111/hex.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/15/2024] Open
Abstract
INTRODUCTION Those with severe and enduring mental ill health are at greater risk of long-term physical health conditions and have a reduced life expectancy as a result. Multiple factors compound this health inequality, and the need for setting research priorities in this area is highlighted with physical and mental healthcare services being separate, and limited multimorbidity research. METHODS The aim of this exercise was to work in partnership with healthcare professionals and carers, family, friends and individuals with lived experience of both mental and physical health conditions, to set research priorities to help people with mental health conditions to look after their physical health. The exercise was guided by the James Lind Alliance approach. For this, a steering group was set up, two surveys were completed and a final priority workshop was conducted. RESULTS This priority setting exercise guided by people's needs and lived experience has produced a set of well-defined research topics. Initially, 555 research questions were suggested in the first survey, which were refined to 54 questions for the second survey. A priority setting workshop was then conducted to get the final 10 priorities. CONCLUSIONS Taking these topics forward to improve services and treatment for both mental and physical ill health may in turn improve physical health and lessen the reduced life expectancy of those living with mental ill health. PATIENT OR PUBLIC CONTRIBUTION This work was completed in collaboration with people who have lived experience of mental ill health and physical health conditions, as well as carers, family and friends. Their contribution has been significant for this work from piloting surveys, amending language used and educating the researchers and contributing to this paper. The initial work was completed with a steering group and continued with surveys and workshops.
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Affiliation(s)
- Olivia Taylor
- Department of Health SciencesUniversity of YorkYorkUK
| | | | | | - Lauren Walker
- School of Health & Psychological SciencesCity University of LondonLondonUK
| | - Ruth Wadman
- Department of Health SciencesUniversity of YorkYorkUK
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Kernot J, Goh J, Aguilar A, Muller J, Dawson S. Individual placement and support: A qualitative investigation of carers' experiences supporting someone experiencing mental illness into employment. Aust Occup Ther J 2024; 71:240-250. [PMID: 38110830 DOI: 10.1111/1440-1630.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/18/2023] [Accepted: 11/25/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Unemployment rates for people living with mental illness remain persistently high. Individual Placement Support (IPS) is an evidence-based employment model that supports people with severe mental illness to gain employment. Although carers provide emotional and instrumental support for people with mental illness, there is limited research exploring carers' perspectives of IPS. AIMS To explore carers' perspectives of their experience as caregivers of individuals living with mental illness who have participated in IPS. METHODS This qualitative descriptive study gained carers' perspectives through semi-structured interviews. A convenience sample of eight carers was recruited via a community mental health service in Adelaide. Data were analysed thematically. FINDINGS Three main themes were identified: (1) employment benefits, (2) factors that may impact on employment, and (3) knowledge and opinions of IPS. Within each theme, four sub-themes emerged. CONCLUSIONS This study addresses a gap in research and provides insights into carers' experiences of IPS. Increased communication and involvement of carers in IPS may benefit IPS participants and staff as carers provide invaluable additional insight into supporting individuals through their employment journey.
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Affiliation(s)
- Jocelyn Kernot
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Jiin Goh
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Alejandra Aguilar
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Jess Muller
- Allied Health & Human Performance Academic Unit, University of South Australia, Adelaide, South Australia
| | - Suzanne Dawson
- Caring Futures Institute, Flinders University, Adelaide, South Australia
- Southern Adelaide Local Health Network, Adelaide, South Australia
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Howes Vallis E, Stephens M, Ross B, Rempel S, Howard C, Liu D, Villars K, Mazurka R, Cumby J, Alda M, Pavlova B, Uher R. Depressive symptoms in youth before and during the COVID-19 pandemic: longitudinal investigation of patterns dependent on age, sex, and family history of mental illness. Psychol Med 2024; 54:895-901. [PMID: 37671680 DOI: 10.1017/s003329172300257x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
BACKGROUND Cross-sectional studies report high levels of depressive symptoms during the COVID-19 pandemic, especially in youth and females. However, longitudinal research comparing depressive symptoms before and during the pandemic is lacking. Little is known about how the pandemic affected individuals with familial history of mental illness. The present study examines the impact of the pandemic on youth depressive symptoms, including offspring of parents with major mood and psychotic disorders. METHODS Between March 2018 and February 2020, we measured depressive symptoms in 412 youth aged 5-25 years. We measured depressive symptoms again in 371 (90%) of these youth between April 2020 and May 2022. Two thirds (249) participants had a biological parent with a major mood or psychotic disorder. We tested the effect of the pandemic by comparing depression symptoms before and after March 2020. We examined age, sex, and family history as potential moderators. RESULTS We found an overall small increase in youth depressive symptoms (b = 0.07, 95% CI -0.01 to 0.15, p = 0.062). This was driven by an increase in female youth without familial history of mental illness (b = 0.35, 95% CI 0.14 to 0.56, p = 0.001). There was no change in depressive symptoms among offspring of parents with mental illness or males. CONCLUSIONS Our results provide reassurance about the wellbeing of children of parents with mental illness during a period of restricted access to resources outside the family. Rather than increasing symptoms in established risk groups, the pandemic led to a redistribution of depression burden towards segments of the youth population that were previously considered to be low-risk.
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Affiliation(s)
- Emily Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Meg Stephens
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Briana Ross
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Sheri Rempel
- Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Dara Liu
- Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Raegan Mazurka
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Jill Cumby
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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Brodie ZP, Shirlaw K, Hand CJ. The Impact of Mental Illness and Intellectual Disability Information on General Public Perceptions of a Person Convicted of a Child Sex Offence. Sex Abuse 2024; 36:292-319. [PMID: 36809111 DOI: 10.1177/10790632231159072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A person convicted of sex offences (PCSO) is confronted with several challenges upon re-entry to the community, often facing difficulties accessing housing and employment, and experiencing stigmatisation, hostility and harassment from community members. Given the importance of community support for successful reintegration, we examined differences in public (N = 117) attitudes toward a PCSO against a child (PCSO-C) with mental illness or intellectual disability compared to a neurotypical PCSO-C in an online survey. At present, differences in attitudes towards these groups has not been explored. Results indicated the PCSO-Cs with intellectual disability or mental illness were seen to pose less risk of sexual reoffending and prompted higher levels of reintegration comfort than the neurotypical PCSO-C. Participants' prior personal exposure to mental illness or intellectual disability was unrelated to attitudes, but those who believed that PCSOs in general have a low capacity for change attributed greater risk of sexual reoffending, greater risk of future harm to children, higher levels of blame and lower reintegration comfort, regardless of MI and ID information. Female participants also perceived greater risk of future harm to adults, and older participants estimated higher risk of sexual reoffending than younger participants. Findings have implications for community acceptance of PCSO-Cs and jury decision-making processes and highlight the importance of public education regarding neurodiverse PCSO-Cs and PCSO capacity for change to encourage knowledge-based judgements.
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Affiliation(s)
- Zara P Brodie
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Kirsty Shirlaw
- Department of Psychology, Glasgow Caledonian University, Glasgow, UK
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Berryhill MB, Culmer N, Smith T, Kopycka-Kedzierawski D, Gurganus R, Curry G. Perceptions of mental health screening and referral to treatment in National Dental-Practice Based Research Network practices: A qualitative study. J Public Health Dent 2024. [PMID: 38561327 DOI: 10.1111/jphd.12607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/27/2023] [Accepted: 01/05/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. METHODS We conducted semi-structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South-Central region of the National Dental Practice-Based Research Network. Transcribed interviews were analyzed using thematic analysis. RESULTS We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. CONCLUSIONS Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns.
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Affiliation(s)
| | | | - Todd Smith
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Ria Gurganus
- The University of Alabama, Tuscaloosa, Alabama, USA
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Moxham L, Tapsell A, Perlman D, Al Mutair A, Al-Sagarat AY, Alsaraireh FA, Chung MH, Jose TT, Kuo SY, Liu MF, Nayak AK, Shamsan A, Sudhakar C, Tsai HT, Velayudhan B, Yang CY, Roberts MM, Yeh PM, Patterson C. Nursing students' attitudes towards mental illness: A multi-national comparison. J Psychiatr Ment Health Nurs 2024. [PMID: 38532682 DOI: 10.1111/jpm.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
Accessible Summary What is known on the subject Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi-national comparisons of nursing students' attitudes towards mental illness. What this paper adds to existing knowledge This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. What are the implications for practice Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. ABSTRACT INTRODUCTION: Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help-seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi-national perspective. AIM To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA. METHOD In a cross-sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one-way analysis of variance was used to compare differences between countries. RESULTS Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest. DISCUSSION Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences. IMPLICATIONS FOR PRACTICE It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution.
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Affiliation(s)
- Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Amy Tapsell
- University of Sydney Business School, University of Sydney, Sydney, New South Wales, Australia
| | - Dana Perlman
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Abbas Al Mutair
- Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- College of Health Sciences, University of Sharjah, University City - Sharjah, Sharjah, United Arab Emirates
| | - Ahmad Yahya Al-Sagarat
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan
| | - Faris A Alsaraireh
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan
| | - Min-Huey Chung
- College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Tessy Treesa Jose
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Megan F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Asha K Nayak
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Abbas Shamsan
- Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Christopher Sudhakar
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Hsiu-Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Binil Velayudhan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Chyn-Yng Yang
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Michelle M Roberts
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pi-Ming Yeh
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Adu MK, Shalaby R, Agyapong B, Dias RDL, Agyapong VIO. Exploring the prevalence and predictors of low resilience and likely PTSD in residents of two provinces in Canada during the 2023 wildfires. Front Public Health 2024; 12:1343399. [PMID: 38590805 PMCID: PMC10999595 DOI: 10.3389/fpubh.2024.1343399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background The recent wildfires in Canada serve as a stark example of the substantial and enduring harm they cause to the health of individuals and communities. Assessing the prevalence and correlates of Post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health. Objectives The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta(AB) during the recent wildfires. Method Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences. Results Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0 and 39.3%, respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis. Conclusion This study established that unemployment and a history of mental health diagnosis predicted likely PTSD, while unemployment was associated with low resilience during the wildfire. These findings offer insights for clinical interventions and the creation of psychosocial support programs for vulnerable populations.
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Affiliation(s)
- Medard K. Adu
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Vincent I. O. Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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Asnakew S, Haile K, Kassa BG, Ayehu GW, Beyene GM, Feleke DG, Endalew DG, Legas G, Munie BM, Tedila A, Shiferaw K, Belete A, Chanie ES, Aytenew TM. Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1361092. [PMID: 38563032 PMCID: PMC10982478 DOI: 10.3389/fpsyt.2024.1361092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
Background Despite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia. Methods All available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: "Pattern of help-seeking behavior'' OR "Pattern of treatment-seeking behavior" OR "Health care-seeking behavior" OR "Help-seeking intention" OR "Help-seeking preferences" OR "Perceived need" OR "Pathways to psychiatric care", AND "Common mental disorders" OR "Mental illness" OR "Mental health problems" OR "Depression", AND "Predictors" OR "Determinate factors" OR "Associated factors", AND "Ethiopia". The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Egger's test (p<0.05). Results The pooled rate of positive help-seeking behavior with respect to modern treatment among people living with mental illness was 42.21% (95% CI: 29.29, 55.12; I2 = 99.37%, P=0.00). Factors significantly associated with a positive pattern of help-seeking behavior were: having a secondary education or above (AOR=5.47, 95% CI: 2.33, 12.86); believing that mental illness requires treatment (AOR=2.76, 95% CI: 2.02, 3.78); having strong social support (AOR=2.00, 95% CI: 1.64, 2.44); having a family history of mental illness (AOR=2.68, 95% CI: 1.38, 3.97); having awareness of the availability of treatment (AOR=2.92, 95% CI: 1.56, 5.46); having previously engaged in positive help-seeking behavior (AOR=3.28, 95% CI: 1.63, 6.60); having comorbid disorders (AOR=4.25, 95% CI: 1.69, 10.66); not using alcohol (AOR=3.29, 95% CI: 1.73, 6.27); and the perceived severity of mental illness (AOR=2.54, 95% CI: 1.490, 4.33). Conclusions The majority of people with mental illness in Ethiopia exhibited a poor pattern of help-seeking behavior with respect to modern treatment. Therefore, mobilization of the community should be encouraged via regular public awareness campaigns regarding mental illness and the availability of evidence-based and effective modern treatment in Ethiopia. Moreover, the design of effective community-based mental health interventions is recommended in order to improve public attitudes and rates of help-seeking behavior in relation to mental health problems.
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Affiliation(s)
- Sintayehu Asnakew
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kalkidan Haile
- Department of Psychiatry, Amhara Public Health Institute, Bahirdar, Ethiopia
| | - Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Wale Ayehu
- Department of Anatomy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dejen Getaneh Feleke
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Getasew Legas
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Birhanu Mengist Munie
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Assasahegn Tedila
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kirubel Shiferaw
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Munye Aytenew
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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McGrath RL, Parnell T, Shephard S, Verdon S, Pope R. Physiotherapists often encounter clients disclosing suicidal thoughts and behaviors: a cross-sectional survey of Australian physiotherapists. Physiother Theory Pract 2024:1-15. [PMID: 38461461 DOI: 10.1080/09593985.2024.2327516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND All health professionals have a role in suicide prevention, although little is known about physiotherapists' contact with clients experiencing suicidal thoughts and behaviors. OBJECTIVE The aims of this study were to investigate physiotherapists' self-reported frequency of contact with clients who disclose suicidal thoughts and behaviors and to identify potential factors associated with frequency of contact. METHODS Three-hundred and thirty-eight Australian physiotherapists were surveyed using an online questionnaire, with an estimated response rate of 6.1%. Data were analyzed using descriptive analysis and logistic regression. RESULTS Over half the respondents (52.1%) reported encountering clients at least once a year who disclosed suicidal thoughts, and nearly half (49.4%) reported having received at least one disclosure of a suicide plan at some point in their career. Among those working in the public sector, 67.5% of respondents reported having received a disclosure of a suicide plan, and almost all physiotherapists working in pain management reported having received such a disclosure (93.8%). The binary logistic regression model explained approximately 39.7% of the variance in whether a physiotherapist had a client disclose a plan for suicide at some point in their career or not. CONCLUSION The results highlight that all physiotherapists should receive training in suicide prevention.
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Affiliation(s)
- Ryan L McGrath
- Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, New South Wales, Australia
- Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Victoria, Australia
| | - Tracey Parnell
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, New South Wales, Australia
| | - Sophie Shephard
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, New South Wales, Australia
| | - Sarah Verdon
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, New South Wales, Australia
| | - Rodney Pope
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, New South Wales, Australia
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Moreira MBP, Pereira HP, Torres IN, Marina S, Ricou M. The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC). Front Psychol 2024; 15:1359483. [PMID: 38515965 PMCID: PMC10955081 DOI: 10.3389/fpsyg.2024.1359483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals. Methods A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72). Conclusion The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.
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Affiliation(s)
| | - Helena P. Pereira
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês N. Torres
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sílvia Marina
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel Ricou
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
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20
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Bastidas-Bilbao H, Castle D, Gupta M, Stergiopoulos V, Hawke LD. Medical assistance in dying for mental illness: a complex intervention requiring a correspondingly complex evaluation approach. Br J Psychiatry 2024:1-4. [PMID: 38433599 DOI: 10.1192/bjp.2024.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Medical assistance in dying for mental illness as a sole underlying medical condition (MAiD MI-SUMC) is a controversial and complex policy in terms of psychosocial and ethical medical practice implications. We discuss the status of MAiD MI-SUMC in Canada and argue for the use of the UK Medical Research Council's framework on complex interventions in programme evaluations of MAiD MI-SUMC. It is imperative to carefully and rigorously evaluate the implementation of MAiD MI-SUMC to ensure an understanding of the multiple facets of implementation in contexts permeated by unique social, economic, cultural and historical influences, with a correspondingly diverse array of outcomes. This requires a complexity-informed programme evaluation focused on context-dependent mechanisms and stakeholder experiences, including patients, service providers and other people affected by the policy. It is also important to consider the economic impact on health and social welfare systems. Such evaluations can provide the data needed to guide evidence-informed decision-making that can contribute to safer implementation and refinement of MAiD MI-SUMC.
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Affiliation(s)
- Hamer Bastidas-Bilbao
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mona Gupta
- Département de psychiatrie, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Vicky Stergiopoulos
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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21
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Subramaney U, Minty N, Himlok CM, Adetiba D, Ahmed H, Barnard E, Mahachi YR, Selekana K, Smith JR, Iyaloo S. Prior trauma experiences among state patients charged with murder: A retrospective records review. S Afr J Psychiatr 2024; 30:2190. [PMID: 38628899 PMCID: PMC11019088 DOI: 10.4102/sajpsychiatry.v30i0.2190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/11/2023] [Indexed: 04/19/2024] Open
Abstract
Background Trauma experiences, particularly in childhood, have been associated with criminality and mental illness. There is a paucity of research into the crime of murder, trauma and mental illness. Aim This research study focused on state patients charged with murder and sought to determine associations with prior trauma experiences, and specific types of traumas (sexual, physical and emotional). Setting The study was conducted at a forensic psychiatric hospital in Johannesburg, South Africa. Methods The records of state patients admitted over a 21-year period on a charge of murder were reviewed and analysed with respect to sociodemographic variables, clinical profiles, trauma experience and victim characteristics. Results Experience of trauma in this population, with a much higher number of males compared with females, was lower than previous studies. Neurocognitive disorder was significantly associated with physical trauma. Physical trauma was found to have a significantly negative association with psychotic disorders, compared with other mental disorders. Conclusion Although trauma is common in psychiatric patients, the study's findings are lower than previous studies. Noting the male bias in state patients that commit murder, greater sample sizes are needed to adequately address issues of specific types of traumas, the development of mental illness and murder. Contribution Exploring and managing prior trauma in state patients who commit murder is important while considering rehabilitation efforts, such that reintegration into the community and non-recidivism are encouraged.
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Affiliation(s)
- Ugasvaree Subramaney
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nashia Minty
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chad M. Himlok
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Damilola Adetiba
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hamza Ahmed
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elouise Barnard
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yolanda R. Mahachi
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Koketso Selekana
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jenna R. Smith
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Iyaloo
- Research and Policy Unit, Council for Medical Schemes, Pretoria, South Africa
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22
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De La Rosa JS, Brady BR, Ibrahim MM, Herder KE, Wallace JS, Padilla AR, Vanderah TW. Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities. Pain 2024; 165:666-673. [PMID: 37733475 PMCID: PMC10859853 DOI: 10.1097/j.pain.0000000000003056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/23/2023]
Abstract
ABSTRACT Co-occurrence of chronic pain and clinically significant symptoms of anxiety and/or depression is regularly noted in the literature. Yet, little is known empirically about population prevalence of co-occurring symptoms, nor whether people with co-occurring symptoms constitute a distinct subpopulation within US adults living with chronic pain or US adults living with anxiety and/or depression symptoms (A/D). To address this gap, this study analyzes data from the 2019 National Health Interview Survey, a representative annual survey of self-reported health status and treatment use in the United States (n = 31,997). Approximately 12 million US adults, or 4.9% of the adult population, have co-occurring chronic pain and A/D symptoms. Unremitted A/D symptoms co-occurred in 23.9% of US adults with chronic pain, compared with an A/D prevalence of 4.9% among those without chronic pain. Conversely, chronic pain co-occurred in the majority (55.6%) of US adults with unremitted A/D symptoms, compared with a chronic pain prevalence of 17.1% among those without A/D symptoms. The likelihood of experiencing functional limitations in daily life was highest among those experiencing co-occurring symptoms, compared with those experiencing chronic pain alone or A/D symptoms alone. Among those with co-occurring symptoms, 69.4% reported that work was limited due to a health problem, 43.7% reported difficulty doing errands alone, and 55.7% reported difficulty participating in social activities. These data point to the need for targeted investment in improving functional outcomes for the nearly 1 in 20 US adults living with co-occurring chronic pain and clinically significant A/D symptoms.
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Affiliation(s)
- Jennifer S. De La Rosa
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Benjamin R. Brady
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Arizona Center for Rural Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI, United States
| | - Mohab M. Ibrahim
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Anesthesiology, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Katherine E. Herder
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jessica S. Wallace
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Departments of Family and Community Medicine and
| | - Alyssa R. Padilla
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Todd W. Vanderah
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, United States
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23
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Meadows AL, Strickland JC, Hyder SM, Basconi RC, Stull ME, Wagner FP, Nguyen MN, Rayapati AO, Rush CR. Adverse childhood experiences and early initiation of substance use: A survival analysis. Int J Psychiatry Med 2024; 59:218-231. [PMID: 37594029 PMCID: PMC10843023 DOI: 10.1177/00912174231195751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. METHOD Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. RESULTS A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset ( hazard ratio (HR) = 1.14, 95% CI=1.02-1.28, p = 0.02, and HR=1.19, 95% CI = 1.04-1.37, p = 0.01, respectively. CONCLUSIONS A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood.
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Affiliation(s)
- Amy L. Meadows
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Justin C. Strickland
- Johns Hopkins University School of Medicine, Department of Psychiatry & Behavioral Sciences, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - S. Maela Hyder
- University of Kentucky, College of Medicine, 800 Rose Street, Lexington, KY 40536, USA
| | - Rita C. Basconi
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
| | - Margaret E. Stull
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Frances P. Wagner
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
| | - Mai N. Nguyen
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Abner O. Rayapati
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Craig R. Rush
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
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24
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Dissanayake A, Dupuis A, Burton CL, Soreni N, Peters P, Gajaria A, Arnold PD, Schachar R, Crosbie J. Racial/Ethnic Disparities in Psychiatric Traits and Diagnoses within a Community-based Sample of Children and Youth: Disparités raciales/ethniques dans les traits et diagnostics psychiatriques au sein d'un échantillon communautaire d'enfants et de jeunes. Can J Psychiatry 2024:7067437241233936. [PMID: 38425291 DOI: 10.1177/07067437241233936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian. METHOD We collected parent or self-reported ratings of OCD, ADHD and anxiety traits and diagnoses for 6- to 17-year-olds from a Canadian general population sample (Spit for Science). We examined racial/ethnic differences in trait levels and the odds of reporting a diagnosis using mixed-effects linear models and logistic regression models. RESULTS East Asian (N = 1301) and South Asian (N = 730) youth reported significantly higher levels of OCD and anxiety traits than White youth (N = 6896). East Asian and South Asian youth had significantly lower odds of reporting a diagnosis for OCD (odds ratio [OR]East Asian = 0.08 [0.02, 0.41]; ORSouth Asian = 0.05 [0.00, 0.81]), ADHD (OREast Asian = 0.27 [0.16, 0.45]; ORSouth Asian = 0.09 [0.03, 0.30]) and anxiety (OREast Asian = 0.21 [0.11, 0.39]; ORSouth Asian = 0.12 [0.05, 0.32]) than White youth after accounting for psychiatric trait levels. CONCLUSIONS These results suggest a discrepancy between trait levels of OCD, ADHD and anxiety and rates of diagnoses for East Asian and South Asian youth. This discrepancy may be due to increased barriers for ethnically diverse youth to access mental health care. Efforts to understand and mitigate these barriers in Canada are needed.
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Affiliation(s)
- Andrew Dissanayake
- Department of Psychiatry, Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christie L Burton
- Department of Psychiatry, Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Noam Soreni
- Offord Center for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Pediatric OCD Consultation Clinic, Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Paul Peters
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Amy Gajaria
- The Margaret and Wallace McCain Centre for Child Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Paul D Arnold
- Mathison Centre for Mental Health Research and Education, Departments of Psychiatry and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Russell Schachar
- Department of Psychiatry, Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, School of Graduate Studies, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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25
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Smith M. Psychiatric epidemiology and the Chicago School of Sociology. Hist Psychiatry 2024; 35:11-29. [PMID: 38054442 PMCID: PMC10868140 DOI: 10.1177/0957154x231206510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This article explores the Chicago School of Sociology's influence on psychiatric epidemiology. While the Chicago School text usually associated with psychiatric epidemiology is the 1939 book by Faris and Dunham, it is important to acknowledge the influence of earlier Chicago School projects during the 1920s. These projects, tackling everything from homelessness and delinquency to the ghetto and suicide, provided models not only for Faris and Dunham, but also for numerous methodological and theoretical insights for the social psychiatry projects that would emerge after World War II. The social sciences and the humanities still have important roles to play in informing contemporary approaches to psychiatric epidemiology and deriving ways to tackle the socio-economic problems that contribute to mental illness.
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26
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Hecht LM, Joseph-Mofford G, Iacobelli R, Ahmed M, Haley E, Loree AM, Miller-Matero LR. Anxiety, depression, and infertility-specific distress among women with female factor infertility. J Health Psychol 2024:13591053241235092. [PMID: 38413845 DOI: 10.1177/13591053241235092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This study aimed to evaluate whether anxiety, depression, and infertility-specific distress differ among women with female infertility who are trying to conceive and/or seeking infertility treatment. Women with diagnosed female factor infertility in the past 2 years (N = 188) completed demographic questions, and measures of infertility-specific distress, anxiety, and depression. The majority of the sample were actively trying to conceive (78.7%, n = 148) and approximately one third (33.5%, n = 63) were undergoing fertility treatment. Anxiety and depression scores did not differ based on trying to conceive or treatment-seeking, although these subgroups reported higher levels of need for parenthood and rejection of a childfree lifestyle. High levels of mood and anxiety are experienced by women with female infertility. Although infertility-specific distress is experienced more so by women with anxiety and depression, a substantial proportion of those without mental health conditions had high levels of distress, underscoring the need for screening and treatment.
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27
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Wong JCM, Chua JYX, Chan PY, Shorey S. Effectiveness of educational interventions in reducing the stigma of healthcare professionals and healthcare students towards mental illness: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38402635 DOI: 10.1111/jan.16127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
AIM To examine the effectiveness of educational interventions in reducing stigma among healthcare professionals and students towards people with mental illness. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster RCTs. DATA SOURCES Articles published from database inception to October 2023 were systematically searched from seven databases (CINAHL, Embase, ProQuest Dissertations and Theses Global, PsycINFO, PubMed, Scopus, Web of Science), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Random-effect meta-analyses were conducted. Heterogeneity was evaluated using the I2 statistics and Cochran's Q chi-squared test. A quality appraisal conducted at the study level used the Cochrane risk of bias tool and an outcome-level quality assessment utilized the Grades of Recommendation, Assessment, Development and Evaluation Approach. Publication bias was assessed using the funnel plot. RESULTS Twenty-five articles were included in this review. Meta-analysis reported statistically significant medium and small effect sizes for attitudes towards mental illness and attitudes towards people with mental illness respectively, showing the association between educational interventions and improved attitudes among healthcare professionals and students. However, a statistically non-significant effect was reported for knowledge of mental illness. Subgroup analyses indicated that face-to-face and contact-based interventions were particularly effective at reducing stigma. Notably, single-session interventions were just as effective as multiple sessions, suggesting a potential for resource-efficient approaches. CONCLUSION Educational interventions demonstrate promise in fostering more positive attitudes towards mental health issues. Future research should aim to determine the long-term effects of these interventions and include patient feedback on the stigmatizing behaviours of healthcare professionals and students, to holistically evaluate the effect of interventions. NO PATIENT OR PUBLIC CONTRIBUTION This study is a secondary review and does not require relevant contributions from patients or the public. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Face-to-face contact-based educational sessions have proven to be the most effective. Reinforcing learning may be achieved through a series of repeated single-session interventions.
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Affiliation(s)
- John Chee Meng Wong
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pao Yi Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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28
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Haysom L. Forensic mental health issues for women in contact with the criminal justice system. Australas Psychiatry 2024:10398562241232523. [PMID: 38332690 DOI: 10.1177/10398562241232523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE This review demonstrates that women who encounter the Australian criminal justice system include some of the most disadvantaged and mentally unwell people in society, particularly Aboriginal women. Women in custody are a heterogeneous group and have different psychosocial needs when compared to male prisoners. CONCLUSION The approaches to female offending must address their significant psychosocial and mental health issues at every point of contact with the criminal justice system, be culturally informed and specifically address Indigenous overrepresentation.
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Affiliation(s)
- Leigh Haysom
- Adolescent Health and Medical Administration, Justice Health and Forensic Mental Health Network, Malabar, NSW, Australia
- School of Medicine, Western Sydney University, Penrith, NSW, Australia; and
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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Elyoseph Z, Refoua E, Asraf K, Lvovsky M, Shimoni Y, Hadar-Shoval D. Capacity of Generative AI to Interpret Human Emotions From Visual and Textual Data: Pilot Evaluation Study. JMIR Ment Health 2024; 11:e54369. [PMID: 38319707 PMCID: PMC10879976 DOI: 10.2196/54369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/09/2023] [Accepted: 12/25/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Mentalization, which is integral to human cognitive processes, pertains to the interpretation of one's own and others' mental states, including emotions, beliefs, and intentions. With the advent of artificial intelligence (AI) and the prominence of large language models in mental health applications, questions persist about their aptitude in emotional comprehension. The prior iteration of the large language model from OpenAI, ChatGPT-3.5, demonstrated an advanced capacity to interpret emotions from textual data, surpassing human benchmarks. Given the introduction of ChatGPT-4, with its enhanced visual processing capabilities, and considering Google Bard's existing visual functionalities, a rigorous assessment of their proficiency in visual mentalizing is warranted. OBJECTIVE The aim of the research was to critically evaluate the capabilities of ChatGPT-4 and Google Bard with regard to their competence in discerning visual mentalizing indicators as contrasted with their textual-based mentalizing abilities. METHODS The Reading the Mind in the Eyes Test developed by Baron-Cohen and colleagues was used to assess the models' proficiency in interpreting visual emotional indicators. Simultaneously, the Levels of Emotional Awareness Scale was used to evaluate the large language models' aptitude in textual mentalizing. Collating data from both tests provided a holistic view of the mentalizing capabilities of ChatGPT-4 and Bard. RESULTS ChatGPT-4, displaying a pronounced ability in emotion recognition, secured scores of 26 and 27 in 2 distinct evaluations, significantly deviating from a random response paradigm (P<.001). These scores align with established benchmarks from the broader human demographic. Notably, ChatGPT-4 exhibited consistent responses, with no discernible biases pertaining to the sex of the model or the nature of the emotion. In contrast, Google Bard's performance aligned with random response patterns, securing scores of 10 and 12 and rendering further detailed analysis redundant. In the domain of textual analysis, both ChatGPT and Bard surpassed established benchmarks from the general population, with their performances being remarkably congruent. CONCLUSIONS ChatGPT-4 proved its efficacy in the domain of visual mentalizing, aligning closely with human performance standards. Although both models displayed commendable acumen in textual emotion interpretation, Bard's capabilities in visual emotion interpretation necessitate further scrutiny and potential refinement. This study stresses the criticality of ethical AI development for emotional recognition, highlighting the need for inclusive data, collaboration with patients and mental health experts, and stringent governmental oversight to ensure transparency and protect patient privacy.
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Affiliation(s)
- Zohar Elyoseph
- Department of Educational Psychology, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
- Imperial College London, London, United Kingdom
| | - Elad Refoua
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Kfir Asraf
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Maya Lvovsky
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Yoav Shimoni
- Boston Children's Hospital, Boston, MA, United States
| | - Dorit Hadar-Shoval
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
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Girma AZ, Brathwaite R, Karamagi Y, Nakabuye F, Nakasujja N, Byansi W, Nabunya P, Sensoy Bahar O, Ssewamala FM. The impact of COVID-19 changes and disruptions on generalized anxiety disorder among young adults living with HIV (YLHIV) in Uganda. J Health Psychol 2024:13591053241228205. [PMID: 38321709 DOI: 10.1177/13591053241228205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
In the context of the COVID-19 pandemic, we investigated associations between specific COVID-19-related changes and its impact on generalized anxiety disorder (GAD) levels among vulnerable young adults living with HIV (YALHIV) in a low-resource setting in Southern Uganda. This research utilized data from 500 YALHIV aged 19 to 25 from the Suubi+Adherence-R2 COVID-19 Supplement study. Disruptions were assessed using an 8-item modified Coronavirus Impact Scale, while anxiety was measured with the GAD-7 questionnaire. Hierarchical logistic regression analysis and multivariate linear regression were employed, guided by the Social Determinants of Health framework. Key findings highlighted changes in routines, family income, stress from the pandemic, changes in family stress and discord, and reduced access to mental health services heightened levels of probable GAD for YALHIV during the pandemic. Additionally, female young adults showed greater levels than males. These results underscore the urgency to develop tailored support mechanisms for YALHIV, especially during challenging and unprecedented times.
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31
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Cummins I. Psychiatry, racism and crime: the case of Christopher Clunis reconsidered. Front Psychiatry 2024; 15:1334020. [PMID: 38384593 PMCID: PMC10880558 DOI: 10.3389/fpsyt.2024.1334020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/10/2024] [Indexed: 02/23/2024] Open
Abstract
In December 2022, the death of Christopher Clunis was made public. He had actually died in February 2021. Christopher Clunis was convicted of the manslaughter of a stranger, Jonathan Zito. He attacked Mr Zito at a train station. This paper will argue that this terrible event became a totemic symbol of the wider failings of the policy of community care. The image of Clunis being driven away from Court was repeatedly used in newspaper and other media reports as a reference point. The image reflects a number of long-standing traits in the representation of the "mentally ill." These are combined with a racial stereotype of Black men. The paper examines historical representations of the mentally ill as a context for a discussion of the Clunis case. The paper uses the work of Stuart Hall as an analytical tool to examine the questions of race and representation, and the moral panic following failings of community care.
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Affiliation(s)
- Ian Cummins
- School of Health & Society, University of Salford, Salford, United Kingdom
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Schwarz J, Meier-Diedrich E, Neumann K, Heinze M, Eisenmann Y, Thoma S. Reasons for Acceptance or Rejection of Online Record Access Among Patients Affected by a Severe Mental Illness: Mixed Methods Study. JMIR Ment Health 2024; 11:e51126. [PMID: 38315523 PMCID: PMC10877495 DOI: 10.2196/51126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Over the past few years, online record access (ORA) has been established through secure patient portals in various countries, allowing patients to access their health data, including clinical notes ("open notes"). Previous research indicates that ORA in mental health, particularly among patients with severe mental illness (SMI), has been rarely offered. Little is known about the expectations and motivations of patients with SMI when reading what their clinicians share via ORA. OBJECTIVE The aim of this study is to explore the reasons why patients with SMI consider or reject ORA and whether sociodemographic characteristics may influence patient decisions. METHODS ORA was offered to randomly selected patients at 3 university outpatient clinics in Brandenburg, Germany, which exclusively treat patients with SMI. Within the framework of a mixed methods evaluation, qualitative interviews were conducted with patients who chose to participate in ORA and those who declined, aiming to explore the underlying reasons for their decisions. The interviews were transcribed and analyzed using thematic analysis. Sociodemographic characteristics of patients were examined using descriptive statistics to identify predictors of acceptance or rejection of ORA. RESULTS Out of 103 included patients, 58% (n=60) wished to read their clinical notes. The reasons varied, ranging from a desire to engage more actively in their treatment to critically monitoring it and using the accessible data for third-party purposes. Conversely, 42% (n=43) chose not to use ORA, voicing concerns about possibly harming the trustful relationship with their clinicians as well as potential personal distress or uncertainty arising from reading the notes. Practical barriers such as a lack of digital literacy or suspected difficult-to-understand medical language were also named as contributing factors. Correlation analysis revealed that the majority of patients with depressive disorder desired to read the clinical notes (P<.001), while individuals with psychotic disorders showed a higher tendency to decline ORA (P<.05). No significant group differences were observed for other patient groups or characteristics. CONCLUSIONS The adoption of ORA is influenced by a wide range of motivational factors, while patients also present a similar variety of reasons for declining its use. The results emphasize the urgent need for knowledge and patient education regarding factors that may hinder the decision to use ORA, including its practical usage, its application possibilities, and concerns related to data privacy. Further research is needed to explore approaches for adequately preparing individuals with SMI to transition from their inherent interest to active engagement with ORA. TRIAL REGISTRATION German Clinical Trial Register DRKS00030188; https://drks.de/search/en/trial/DRKS00030188.
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Affiliation(s)
- Julian Schwarz
- Department of Psychiatry and Psychotherapy, Center for Mental Health, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Center for Health Service Research Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Eva Meier-Diedrich
- Department of Psychiatry and Psychotherapy, Center for Mental Health, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Katharina Neumann
- Department of Psychiatry and Psychotherapy, Center for Mental Health, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Martin Heinze
- Department of Psychiatry and Psychotherapy, Center for Mental Health, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Center for Health Service Research Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Yvonne Eisenmann
- Center for Health Service Research Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Samuel Thoma
- Department of Psychiatry and Psychotherapy, Center for Mental Health, Immanuel Hospital Rüdersdorf, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Vanzetto S, Quarenghi A, Varinelli A, Dragoni C, Conti D, Boscacci M, Carrà G, Percudani M, Morganti C, Gambini O, Barbieri V, Brambilla P, Lazzaretti M, Rubelli P, Mencacci C, Fusi A, Viganò C, Dell'Osso B. Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan. Int J Soc Psychiatry 2024:207640231217177. [PMID: 38312065 DOI: 10.1177/00207640231217177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. AIMS The objective of this study is to evaluate its outcomes over 8 years of observation. METHOD We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on 'positive', 'negative', and 'other' outcomes. RESULTS We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%).Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p < .001), while the dismissals diminished from 26.7% to 13.3% (p < .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p < .005). CONCLUSIONS PIR-TR106 represents a territorial employment inclusion program with progressively increasing effectiveness and specificity, as suggested by changes in outcomes during the 8-year observation. The adaptive capacity and sustainability of the intervention are worth further investigation.
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Affiliation(s)
- Simone Vanzetto
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Andrea Quarenghi
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Alberto Varinelli
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Chiara Dragoni
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Dario Conti
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Maria Boscacci
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Giuseppe Carrà
- Department of Mental Health and Addiction Services, ASST Nord Milano, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Mauro Percudani
- Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carla Morganti
- Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Orsola Gambini
- Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
- CRC 'Aldo Ravelli' for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Lombardy, Italy
- Department of Health Sciences, University of Milan, Italy
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Paola Rubelli
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Claudio Mencacci
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Antonio Fusi
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
- CRC 'Aldo Ravelli' for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Lombardy, Italy
- Department of Psychiatry and Behavioural Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Italy
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Jiang C, Shi J. The Long Arm of Childhood Bullying Victimization: Associations with Social Isolation, Gender Differences and Depression in Later Life. J Interpers Violence 2024:8862605241227980. [PMID: 38312080 DOI: 10.1177/08862605241227980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
The association between childhood bullying victimization and depression has been well-explored among young adults, but little is known about whether this relationship persists into later life stages, specifically during middle-aged and older phases. Moreover, the intricate mechanisms underpinning this association and the potential existence of gender differences within this context remain inadequately elucidated. To address this gap in knowledge, this study aims to investigate the association between childhood bullying victimization and depression in later life, with a focus on exploring the mediating role of social isolation and the moderating roles of gender. A nationally representative sample of 5,070 individuals (mean age = 61.02, SD = 9.48; male = 55%) was drawn from the China Health and Retirement Longitudinal Study. By employing the bootstrapping analysis method, the mediating role of social isolation was examined, and the moderating role of gender was tested through the generation of interaction items. The results reveal a significant association between childhood bullying victimization and severe depression in later life. Additionally, social isolation plays a mediating role in this association between childhood bullying victimization and social isolation, and the association between social isolation and depression, as well as the relationship between social isolation and depression, are both moderated by gender, presenting stronger effects for female groups than for male groups. However, no moderating role of gender is found in terms of the direct association between childhood bullying victimization and depression. These findings highlight the fact that childhood bullying is not only a problem in the immediate term but also a concern that affects individuals across entire life course. This study has implications for healthcare in proactively investigating, diagnosing, and treating depression by inquiring about childhood bullying victimization experiences. Furthermore, intervention policies that aim to reduce social isolation may be particularly beneficial in mitigating the negative associations, especially for female individuals.
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Affiliation(s)
- Chaoxin Jiang
- School of Social Development,East China Normal University, Shanghai, China
| | - Jiaming Shi
- School of Public Administration,Southwestern University of Finance and Economics, Chengdu, Sichuan, China
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Uzzan S, Rostevanov IS, Rubin E, Benguigui O, Marazka S, Kaplanski J, Agbaria R, Azab AN. Chronic Treatment with Nigella sativa Oil Exerts Antimanic Properties and Reduces Brain Inflammation in Rats. Int J Mol Sci 2024; 25:1823. [PMID: 38339101 PMCID: PMC10855852 DOI: 10.3390/ijms25031823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Nigella sativa (NS) is a native herb consumed habitually in several countries worldwide, possessing manifold therapeutic properties. Among them, anti-inflammatory features have been reported, presumably relating to mechanisms involved in the nuclear factor kappa-B pathway, among others. Given the observed association between neuroimmune factors and mental illness, the primary aim of the present study was to examine the effects of chronic NS use on manic-like behavior in rats, as well as analyze levels of brain inflammatory mediators following NS intake. Using male and female rats, baseline tests were performed; thereafter, rats were fed either regular food (control) or NS-containing food (treatment) for four weeks. Following intervention, behavioral tests were induced (an open field test, sucrose consumption test, three-chamber sociality test, and amphetamine-induced hyperactivity test). Subsequently, brain samples were extracted, and inflammatory mediators were evaluated, including interleukin-6, leukotriene B4, prostaglandin E2, tumor necrosis factor-α, and nuclear phosphorylated-p65. Our findings show NS to result in a marked antimanic-like effect, in tandem with a positive modulation of select inflammatory mediators among male and female rats. The findings reinforce the proposed therapeutic advantages relating to NS ingestion.
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Affiliation(s)
- Sarit Uzzan
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
| | - Ira-Sivan Rostevanov
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
| | - Elina Rubin
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
| | - Olivia Benguigui
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W1S4, Canada
| | - Said Marazka
- Department of Cognitive and Brain Sciences, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Jacob Kaplanski
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
| | - Riad Agbaria
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
| | - Abed N. Azab
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel (R.A.)
- Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
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Kuo YH. [Theory and Practice of Empowerment for Family Members of Patients Under Custodial Protection Sentence]. Hu Li Za Zhi 2024; 71:99-104. [PMID: 38253858 DOI: 10.6224/jn.202402_71(1).12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Empowerment not only benefits patients but also provides support and assistance to their family members, especially in cases when patients are subject to custodial protection sentences. The positive effects of empowerment on patients' family members may be summarized into three main aspects, including: enhancing their engagement in healthcare, alleviating their anxiety, and enhancing their caregiving skills. With regard to enhancing engagement in healthcare, family members receive health education that provides an overview of the illness, treatment options, prognosis, and key nursing points and allows them to better understand the patient's condition and actively participate in decision-making. With regard to alleviating anxiety, patients under custodial protection sentences are involved in legal problems, which results in higher levels of stress for family members compared to their peers caring for general patients. Through emotional support and active listening, nurses provide opportunities for family members to express their concerns and offer comfort and encouragement, helping them cope with difficulties and pressures. With regard to enhancing caregiving skills, the purpose of custodial protection sentences is to prevent recidivism, and family members bear significant responsibility for caregiving after discharge. Nurses can share similar caregiving experiences from their ward, educate family members about observing symptoms, and provide guidance, thereby strengthening their caregiving capabilities. In addition, with regard to the disposition of patients, nurses assist family members to understand the medical process and provide necessary guidance, ensuring family members have a clear understanding and are respected during the preparations for discharge. Based on related theoretical frameworks and practical experiences, this research highlights the positive role of empowerment in enhancing the caregiving abilities and satisfaction of the family members of patients, particularly those subject to custodial protection sentences.
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Affiliation(s)
- Yu-Heng Kuo
- MD, Visiting Staff, Department of Addictive and Forensic Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Taiwan, ROC.
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de Oliveira C, Matias MA, Jacobs R. Microsimulation Models on Mental Health: A Critical Review of the Literature. Value Health 2024; 27:226-246. [PMID: 37949353 DOI: 10.1016/j.jval.2023.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/20/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To retrieve and synthesize the literature on existing mental health-specific microsimulation models or generic microsimulation models used to examine mental health, and to critically appraise them. METHODS All studies on microsimulation and mental health published in English in MEDLINE, Embase, PsycINFO, and EconLit between January 1, 2010, and September 30, 2022, were considered. Snowballing, Google searches, and searches on specific journal websites were also undertaken. Data extraction was done on all studies retrieved and the reporting quality of each model was assessed using the Quality Assessment Reporting for Microsimulation Models checklist, a checklist developed by the research team. A narrative synthesis approach was used to synthesize the evidence. RESULTS Among 227 potential hits, 19 studies were found to be relevant. Some studies covered existing economic-demographic models, which included a component on mental health and were used to answer mental-health-related research questions. Other studies were focused solely on mental health and included models that were developed to examine the impact of specific policies or interventions on specific mental disorders or both. Most models examined were of medium quality. The main limitations included the use of model inputs based on self-reported and/or cross-sectional data, small and/or nonrepresentative samples and simplifying assumptions, and lack of model validation. CONCLUSIONS This review found few high-quality microsimulation models on mental health. Microsimulation models developed specifically to examine mental health are important to guide healthcare delivery and service planning. Future research should focus on developing high-quality mental health-specific microsimulation models with wide applicability and multiple functionalities.
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Affiliation(s)
- Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Maria Ana Matias
- Centre for Health Economics, University of York, York, England, UK
| | - Rowena Jacobs
- Centre for Health Economics, University of York, York, England, UK
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Lee SH, Jung EM. Adverse effects of early-life stress: focus on the rodent neuroendocrine system. Neural Regen Res 2024; 19:336-341. [PMID: 37488887 PMCID: PMC10503627 DOI: 10.4103/1673-5374.377587] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 07/26/2023] Open
Abstract
Early-life stress is associated with a high prevalence of mental illnesses such as post-traumatic stress disorders, attention-deficit/hyperactivity disorder, schizophrenia, and anxiety or depressive behavior, which constitute major public health problems. In the early stages of brain development after birth, events such as synaptogenesis, neuron maturation, and glial differentiation occur in a highly orchestrated manner, and external stress can cause adverse long-term effects throughout life. Our body utilizes multifaceted mechanisms, including neuroendocrine and neurotransmitter signaling pathways, to appropriately process external stress. Newborn individuals first exposed to early-life stress deploy neurogenesis as a stress-defense mechanism; however, in adulthood, early-life stress induces apoptosis of mature neurons, activation of immune responses, and reduction of neurotrophic factors, leading to anxiety, depression, and cognitive and memory dysfunction. This process involves the hypothalamus-pituitary-adrenal axis and neurotransmitters secreted by the central nervous system, including norepinephrine, dopamine, and serotonin. The rodent early-life stress model is generally used to experimentally assess the effects of stress during neurodevelopment. This paper reviews the use of the early-life stress model and stress response mechanisms of the body and discusses the experimental results regarding how early-life stress mediates stress-related pathways at a high vulnerability of psychiatric disorder in adulthood.
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Affiliation(s)
- Seung Hyun Lee
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Busan, Republic of Korea
| | - Eui-Man Jung
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Busan, Republic of Korea
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Lawal SA, Adedeji IA, Ogunniyi A, Henderson D. Social domains of poor mental health: A qualitative pilot study of community stakeholders' understanding and demarcation of mental illness and its interpretations in rural Nigeria. Health Sci Rep 2024; 7:e1922. [PMID: 38420202 PMCID: PMC10899201 DOI: 10.1002/hsr2.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Background and Aims Although previous studies on mental health/illness in Nigeria have explored knowledge and attitude of community members using quantitative approaches, few studies have engaged stakeholders within rural communities on the issue of mental illness using qualitative approaches. Community stakeholders play a critical role in influencing health behaviors. The objective of this pilot study was to explore community stakeholders' understanding and demarcation of mental illness, and its interpretations in a rural Nigerian town. This is with the aim of shaping stakeholders understanding of people when they experience mental distress within the community. Methods The study was conducted in Ijebu-Igbo town of Ogun State in south-west Nigeria. In-depth interviews were conducted among two religious' leaders: a Pastor and an Imam, a traditional healer, a medical doctor, and a registered nurse, and a focus group discussion was held in a church with members of its advisory committee. Results The findings showed that community stakeholders gave multiple interpretations of mental illness and many attribute mental illness to spiritual attack, ancestral curse, anger of the gods, and personal affliction (Ogun-Afowofa). This has been categorized as familial and individual attributes in this study which is part of the main themes derived. The study findings also show that the understanding of community members regarding the root causes of mental illness is somewhat vague based on their poor knowledge of mental illness. This is because of the various interpretations they gave to explain mental health is based on their cultural orientation, socialization, and belief system, and not based on any medical knowledge. Conclusion This pilot study was conducted to justify the main study. There is therefore a need for health education interventions to enlighten and educate community stakeholders with requisite knowledge for better understanding and interpretation of mental illness. Also, through mental health education interventions, community members will gain clarity on what mental health is and what it is not.
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Affiliation(s)
- Saheed A. Lawal
- Department of Public Health, School of Public and Allied HealthBabcock UniversityIlishan‐RemoOgun StateNigeria
| | - Isaac A. Adedeji
- Department of GerontologySimon Fraser UniversityBritish ColumbiaCanada
| | - Adesola Ogunniyi
- Department of Medicine, College of MedicineUniversity of IbadanIbadanNigeria
| | - David Henderson
- Department of Psychiatry, Boston University Medical CenterBoston UniversityBostonMassachusettsUSA
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Jørgensen SW, Petersen EN, Harnow S, Lee K, Nørgaard B. The meaning that people with severe mental illnesses ascribe to e-health in encounters with healthcare professionals - A repeat interview study. Int J Ment Health Nurs 2024; 33:62-72. [PMID: 37658655 DOI: 10.1111/inm.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
This study sought to explore the meaning that people with severe mental illnesses attribute to e-health solutions regarding user involvement and encounters with healthcare professionals. A qualitative design with a social phenomenological approach was applied, and data were collected via repeat interviews. Using a purposive sampling strategy, eight people with severe mental illness were interviewed two times between August 2021 to May 2022, at three different treatment sites in southern Denmark. To be included, participants needed to be 18-65 years of age, diagnosed with severe mental illness (schizophrenia, bipolar disorder, or depression), and using an e-health solution in collaboration with a health professional. The interviews lasted between 20 and 70 min and were audio recorded and then transcribed. The data were analysed with Braun and Clarke's 6-step thematic analysis. Participants experienced the use of an e-health solution as helpful for structuring their everyday lives, and e-health used together with healthcare professionals was considered to have a positive impact on the collaboration. The participants experienced feeling involved and in control when e-health solutions were used, which engaged them in their treatment. Furthermore, the participants found it important to have had some in-person meetings with healthcare professionals to build trust before the e-health solutions could be implemented successfully. E-health solutions used in collaboration with a trusted healthcare professional whom the participants had met in person tended to affect treatment engagement positively.
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Affiliation(s)
| | - Esben Nedenskov Petersen
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Søren Harnow
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- University College South Denmark, Esbjerg, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Thekkumkara S, Rawat VS, Jagannathan A, Muliyala KP. Vocational rehabilitation in persons with mental illness in India: A scoping review. Int J Soc Psychiatry 2024; 70:13-22. [PMID: 37387462 DOI: 10.1177/00207640231183920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND Employment has a therapeutic impact, enhances community integration and improves the quality of life of persons with mental illness (PwMI). Vocational rehabilitation (VR) models must be sensitive to existing needs and resources. Several VR models have been tested in high income countries. Mapping different VR models in India would help both practitioners and policymakers. AIM The study aimed to comprehensively review VR models tested among PwMI in India. METHODS We adhered to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews. We included interventional studies, case studies and grey literature carried out for the VR of PwMI in India. The search was done in PubMed, PsychInfo, worldwide science and Web of Science. Google Scholar was used to supplement the search. A Boolean search using MeSH terms was carried out for the period January 2000 to December 2022. RESULTS A total of twelve studies (one feasibility study, four case studies, four institute-based intervention studies and two studies reporting NGOs' role) were included in the final synthesis. The studies included in the review were either quasi-experimental studies or case based. Types of VR included supported employment or place and train or train and place models, case management and prevocational skills training. CONCLUSION Limited studies exist on VR in PwMI from India. Most studies assessed a restricted set of outcomes. The experiences of NGOs should be published so that practical challenges can be understood. There is a need for public-private partnerships in designing and testing services and should involve all the stakeholders.
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Affiliation(s)
| | - Vikram Singh Rawat
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, India
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Vijayalakshmi S, Rajagopal K, Govindan R, Ganjekar S, Chacko LK, Prathyusha PV. Sexual and reproductive health (SRH) of women with mental illness (WMI) - An integrative mixed-method study. Indian J Psychiatry 2024; 66:171-178. [PMID: 38523762 PMCID: PMC10956590 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_524_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/02/2023] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Background Women with mental illness (WMI) are more likely to experience unreported sexual and reproductive health (SRH) problems. Mixed-method research studies with the strengths of quantitative and qualitative approaches provide deeper insight into SRH issues of WMI. Methods A sequential explanatory mixed-method design was used to understand better the SRH problems of WMI attending tertiary care psychiatry hospital. In phase 1, a survey was conducted to identify if they have SRH problems. Women who were identified to have SRH problems were part of Phase II. In this phase, in-depth interview was conducted to explore their lived-in experiences. Integration at the method level was adopted by connection through sampling. Using a narrative approach, integration was accomplished at the level of interpretation and reporting. Results Among the users, 261 (64.6%) female sterilization, 244 (93%) was the most common, and the other methods like coitus interruptus, male condoms, and intrauterine devices were reported less. Of the non-users, 137 (33.9%) WMI 100 (73%) were unaware of the best family planning approach. Most of them, 377 (93.3%), were ignorant about sexually transmitted infection (STI) symptoms. WMI reported 62 (15.3%) unusual foul-smelling vaginal discharge and 58 (14.4%) genital ulcers, with poor treatment-seeking behavior. Sexual dysfunction in desire, arousal, lubrication, orgasm, satisfaction, and pain were also reported. The findings were described in a single report based on the quantitative data followed by themes obtained from qualitative interviews using weaving techniques under the headings of contraceptive use and its awareness, prevalence of STI symptoms and its treatment, and sexual health experiences. Conclusion Data integration demonstrated that one-fourth of WMI had inadequate awareness of contraceptive use, were ignorant of STI symptoms, and experienced sexual dysfunction.
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Affiliation(s)
- Sundaram Vijayalakshmi
- College of Nursing, National Institute of Mental Health and Neurosciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Kaipangala Rajagopal
- Department of OBG, Yenepoya Medical College, Yenepoya (Deemed to be) University, Mangaluru, Karnataka, India
| | - Radhakrishnan Govindan
- Department of Nursing, National Institute of Mental Health and Neurosciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Leena K. Chacko
- Department of Community Health Nursing, Yenepoya Nursing College, Yenepoya (Deemed to be) University, Mangaluru, Karnataka, India
| | - P. V. Prathyusha
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, (Institute of National Importance), Bengaluru, Karnataka, India
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Chaukos D, Genus S, Wiesenfeld L, Maunder R, Mylopoulos M. Improving patient-centered care for HIV and mental illness: exploring hospital and community integration through education. AIDS Care 2024; 36:181-187. [PMID: 37856839 DOI: 10.1080/09540121.2023.2269408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023]
Abstract
Current models of care delivery are failing patients with complexity, like those living with HIV, mental illness and other psychosocial challenges. These patients often require resource-intensive personalized care across hospital and community settings, but available supports can be fragmented and challenging to access and navigate. To improve this, the authors created a program to enhance integrated, trauma-informed care through an innovative educational role for a HIV community caseworker embedded in an academic HIV Psychiatry clinic, called the Mental Health Clinical Fellowship. Through qualitative interviews with 21 participants (patients, physicians, clinicians and Mental Health Clinical Fellows) from October 2020-March 2023, the authors explore how implementation of this program affects patient experiences and satisfaction with care. Patients described their care experiences as less stigmatizing, more accessible, holistic and coordinated. They often attributed this to the integration between fellow and psychiatrist, and specifically the accessible stance of community organizations embedded within a hospital, which helped build trust. Interchangeable and integrated support by caseworker and psychiatrist improved patient engagement in psychiatric management and patient satisfaction with their care. Cross-context and cross-disciplinary care provision that includes providers from community and hospital working directly together to deliver care can improve care for patients with significant complexity.
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Affiliation(s)
- Deanna Chaukos
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sinai Health System, Toronto, Canada
| | - Sandalia Genus
- Department of Psychiatry, Sinai Health System, Toronto, Canada
- Department of Anthropology, University of Toronto, Toronto, Canada
| | - Lesley Wiesenfeld
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sinai Health System, Toronto, Canada
| | - Robert Maunder
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sinai Health System, Toronto, Canada
| | - Maria Mylopoulos
- Department of Pediatrics, University of Toronto, Temerty Faculty of Medicine, Toronto, Canada
- The Wilson Centre, University of Toronto, Toronto, Canada
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San L, Arranz B. The Night and Day Challenge of Sleep Disorders and Insomnia: A Narrative Review. Actas Esp Psiquiatr 2024; 52:45-56. [PMID: 38454895 PMCID: PMC10926017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This is a narrative review of sleep disorders, especially chronic insomnia, as a primary diagnosis or as a comorbid diagnosis associated with different psychiatric and organic diseases. The epidemiological evidence is reviewed, the diagnostic criteria most frequently used in clinical practice are examined, and a series of therapeutic recommendations for the correct treatment of this pathology is presented. Sleep disorders are very prevalent in the general population (one-third experiences difficulty with sleep initiation/maintenance at least once a week, and about 6-15% meet the criteria for insomnia disorders), but remain relatively poorly understood and frequently overlooked by healthcare professionals. Prevalence estimates of insomnia disorder vary between 5% and 20%. Sleep disorders co-exist with psychiatric and medical conditions with an interactive and bidirectional relationship. About 70-80% of psychiatric patients show some sleep disturbance and there is a correlation between the severity of the sleep disturbance and the severity of the psychopathology. Untreated sleep disorders increase the risk of cardiovascular events, cognitive impairment, motor vehicle accidents, obesity, diabetes, and efficiency and safety at work, leading to increased all-cause healthcare utilization and being a strong predictor of sick leave or disability pension and poor quality of life. Sleep disorders can cause drowsiness or excessive daytime sleepiness, which can lead to functional impairment in 15% of the general adult population. Sleep quality should be a routine target in the evaluation of patients with psychiatric and non-psychiatric diseases to ensure sleep health based on early diagnosis and adequate therapeutic approaches.
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Affiliation(s)
- Luis San
- Parc Sanitari Sant Joan de Déu, Camí Veil de la Colonia 25, E-08830 Sant Boi de Llobregat, Barcelona, Spain
- CIBERSAM, Centro de Investigación Biomédica en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Arranz
- Parc Sanitari Sant Joan de Déu, Camí Veil de la Colonia 25, E-08830 Sant Boi de Llobregat, Barcelona, Spain
- CIBERSAM, Centro de Investigación Biomédica en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Khan J, Khan JA, Kumari S, Charan D. Treatment Non-adherence Patterns Among Patients With Mental Illness: A Study From the District Mental Health Care Center in India. Cureus 2024; 16:e54495. [PMID: 38516451 PMCID: PMC10955436 DOI: 10.7759/cureus.54495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION The success of any medical intervention, including mental health treatment, depends largely on patient adherence to the prescribed regimen. In psychiatric illnesses, one of the biggest problems is getting people to adhere to their treatment schedule, representing a treatment gap that increases the burdens of patients, families, communities, and countries. Globally, it has become necessary for community health organizations to actively work towards reducing this gap and treatment non-adherence. Therefore, in this study, we aimed to examine treatment non-adherence patterns among patients with mental illness. MATERIALS AND METHODS This work used a retrospective study design and consecutive sampling. The data source was secondary data obtained from the healthcare records of patients registered in the outpatient department of the District Mental Health Care Center, India, from January 2022 to December 2022. RESULTS Out of a total of 883 patients recruited for the study, 35.7% (n=315) were on regular follow-up over a duration of more than one year. Among patients with severe mental illness, 46% (n=46) had regular follow-ups and were compliant with therapy. About 49% of patients (n=433) discontinued their treatment after the initial contact with the therapist, with the highest rate among those with substance use disorders (77.0%; n=57). The remaining 15.3% (n=135) of recruited patients discontinued their follow-up appointments over a duration of 1 week to 12 months. Overall, 64.3% (n=568) of the recruited patients discontinued their treatment within one year. CONCLUSION There was considerable early treatment dropout among patients with mental illness. However, this treatment discontinuation can be avoided because the individual identities of these patients are well-known to the therapist or facility, as they have had at least one interaction with the therapist. In order to improve treatment adherence, patients with mental illnesses must receive consistent support through community outreach programs, home visits, and new strategies to promote treatment compliance.
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Affiliation(s)
- Jahangir Khan
- Department of Healthcare and Pharmaceutical Management, School of Management and Business Studies, Jamia Hamdard, New Delhi, IND
| | - Jwaad A Khan
- Department of Healthcare and Pharmaceutical Management, School of Management and Business Studies, Jamia Hamdard, New Delhi, IND
| | - Subhra Kumari
- Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND
| | - Deepak Charan
- Department of Psychiatry, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND
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Lankford A. Studying mental disorders among perpetrators of mass murder-suicide: Methodological challenges and promising avenues for new research. Crim Behav Ment Health 2024; 34:1-6. [PMID: 38293895 DOI: 10.1002/cbm.2323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
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Doroud N, King A, Zirnsak TM, Brasier C, Hall T, Jordan H, Brophy L. Creating "an oasis of hope, inclusion and connection": students and stakeholders' experiences of a pilot Recovery College. J Ment Health 2024; 33:92-100. [PMID: 37641410 DOI: 10.1080/09638237.2023.2245881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/28/2023] [Accepted: 05/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Recovery Colleges are an innovative approach to promoting personal recovery for people experiencing mental illness. AIMS This study was to explore experiences of students, supporters, staff, educators and external stakeholders (i.e. partner organisations) of a pilot Recovery College in the Australian Capital Territory (ACTRC), and the impact of participation in the College for students and supporters. METHODS ACTRC students, supporters, staff and educators, and external stakeholders were invited to participate in a mixed-method evaluation via an online survey, interviews and/or focus groups. The survey included questions regarding experiences and recovery-orientation of the College environment, and for students and supporters only, satisfaction with the College. Qualitative data from interviews and focus groups was inductively coded, thematically analysed and triangulated with survey responses. RESULTS The findings suggest that the ACTRC provides a safe space, promotes meaningful connections within and beyond the college, and offers steppingstones supporting recovery and growth. Participants spoke positively about cross institutional partnerships and collaboration with several organisations within the ACT. CONCLUSIONS This evaluation reiterates the role of Recovery Colleges as an innovative approach to promoting personal recovery for people living with mental illness. Adequate resourcing and collaboration are essential in realising the value of co-production whilst ensuring sustainability.
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Affiliation(s)
- Nastaran Doroud
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Alicia King
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Tessa-May Zirnsak
- Department of Community and Clinical Health, La Trobe University, Melbourne, VIC, Australia
| | - Catherine Brasier
- Department of Community and Clinical Health, La Trobe University, Melbourne, VIC, Australia
| | - Teresa Hall
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Helen Jordan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Brophy
- Department of Community and Clinical Health, La Trobe University, Melbourne, VIC, Australia
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Mohamed AA, Alomair SM, Alnijadi AA, Abd Aziz F, Almulhim AS, Hammad MA, Emeka PM. Barriers to Mental Illness Treatment in Saudi Arabia: A Population-Based Cross-Sectional Study. Cureus 2024; 16:e53797. [PMID: 38465168 PMCID: PMC10924077 DOI: 10.7759/cureus.53797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Mental illness is a disorder that can cause impairment and disability, affecting mood, thinking, and behavior; therefore, early intervention will reduce morbidity. This study aims to evaluate all the personal, family, societal, and medical barriers that prevent mental health patients from seeking consultation and treatment. METHODS In Saudi Arabia, a cross-sectional study was conducted on 463 individuals aged 18 and above. Data were collected by face-to-face interviews using a validated questionnaire, which consisted of two parts. The first part included sociodemographic data, while the second part contained subsections of society/family, personal, and medical barriers. RESULTS The results showed that 379 (81.9%) indicated that society and family barriers impacted them, whereas 325 (70.3%) believed that personal barriers hindered seeking help. However, 294 (63.5%) opted for medical barriers as a hindrance. Regarding the highest barriers, 120 of the total respondents (25.9%) saw psychiatric illness as a source of shame and stigma, 166 respondents (35.9%) said that the psychiatric patient is seen as crazy, 159 of them (34.3%) believed it is tough for anyone to talk about their feelings and emotions and 183 respondent (39.5%) feared that psychiatric illness would decrease the chance of marriage to the appropriate person. Our findings also indicated a low trust in hospital treatment, hence a loss of confidence in using medications. CONCLUSION The findings of this study indicate that societal stigma is the most common barrier preventing people from seeking mental health consultation. Many barriers differ significantly between males and females.
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Affiliation(s)
- Ahmed A Mohamed
- Clinical Pharmacy, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Sufyan M Alomair
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Fatimatuzzahra Abd Aziz
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Abdulaziz S Almulhim
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Promise M Emeka
- Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
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Zhang X, Ren H, Wang C, Zhang Y, Zhou Q, Fan J. The effect of mindfulness-based interventions on mental health outcomes and wellbeing of informal caregivers of people with mental illness: A systematic review and meta-analysis. Int J Ment Health Nurs 2024. [PMID: 38291626 DOI: 10.1111/inm.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
The increasing prevalence of mental illness has resulted in a growing burden on informal caregivers. Mindfulness-based interventions, as a form of psychotherapy, have shown efficacy in alleviating psychological stress and enhancing emotional and physical well-being. However, the utilisation of mindfulness-based interventions for informal caregivers of individuals with mental illness remains limited. The aim of the meta-analysis is to evaluate the impact of mindfulness-based interventions on the mental health and well-being among informal caregivers of people with mental illness. A comprehensive literature search was conducted across seven electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, Embase, APA PsycINFO and CINAHL Ultimate) from the inception of these databases until 20 July 2023. Two authors independently screened the studies and extracted the relevant data. The meta-analysis was performed by using Stata 12.0 software, and the effect sizes were calculated utilising standardised mean difference (SMD) along with their corresponding 95% confidence intervals (CI). The meta-analysis included 13 studies with 1007 participants, and the results demonstrated that mindfulness-based interventions were efficacious in reducing stress (SMD = -0.80, 95% CI [-1.33, -0.28], p = 0.003), depression (SMD = -0.43, 95% CI [-0.62, -0.24], p < 0.001) and caregiver burden (SMD = -0.21, 95% CI [-0.40, -0.01], p = 0.038), and enhancing the mindfulness level (SMD = 0.37, 95% CI [0.09, 0.65], P = 0.010) and quality of life (SMD = 0.22, 95% CI [0.04, 0.39], p = 0.015) among informal caregivers of people with mental illness, but not on anxiety reduction (SMD = -0.19, 95% CI [-0.49, 0.10], p = 0.198). Furthermore, future research should aim to employ more rigorous methodologies to confirm the effectiveness.
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Affiliation(s)
- Xiaofeng Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Huilin Ren
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Caixia Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yongping Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Qilun Zhou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jianming Fan
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Galvin LJ, Nel YM. Contraceptive use in women with mental illness in Soweto, South Africa. S Afr J Psychiatr 2024; 30:2153. [PMID: 38322177 PMCID: PMC10839196 DOI: 10.4102/sajpsychiatry.v30i0.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/28/2023] [Indexed: 02/08/2024] Open
Abstract
Background The psychosocial and medical implications of unplanned pregnancy in women with mental illness (MI) are vast. International guidelines make clear recommendations about family planning for women with MI, particularly those exposed to known human teratogens; however, there is limited research related to contraceptive usage among women with MI. Aim The aim of this study was to investigate the prevalence of consistent contraceptive use and family planning education (FPE) among a population of women of childbearing age with MI. Setting This quantitative cross-sectional study was conducted at Chris Hani Baragwanath psychiatric unit in Soweto, South Africa. Methods A convenience sample comprising 190 eligible women of childbearing age with MI was employed for the study. The women were invited to participate by means of a structured questionnaire which was administered by the researcher. Clinical information was obtained from the patients' medical records. Results Consistent contraceptive usage occurred in 44.7% of participants. Family planning education was low (26.8%). Relationship status was associated with using contraception consistently (p = 0.0229). Teratogen exposure was not associated with either contraceptive use or FPE. Family planning education was not associated with contraceptive use. Conclusion Women with MI may have increased risk for unplanned pregnancy if they are not in a relationship because of perceived lack of need for contraception. Contribution Family planning education must be prioritised in women with MI, especially among women prescribed teratogenic medication, highlighting the risks associated with unplanned pregnancy.
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Affiliation(s)
- Lisa J Galvin
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Perinatal HIV Research Unit, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Yvette M Nel
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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