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Current Psychiatry Reports Jul 2023To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental... (Review)
Review
PURPOSE OF REVIEW
To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice.
RECENT FINDINGS
Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.
Topics: Humans; Mental Health; COVID-19; Pandemics; Mental Disorders; Global Health
PubMed: 37256471
DOI: 10.1007/s11920-023-01426-8 -
Molecular Psychiatry Aug 2023Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of... (Review)
Review
Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.
Topics: Humans; Adolescent; Mental Health; Mental Disorders; Psychopathology
PubMed: 37580524
DOI: 10.1038/s41380-023-02202-z -
The Journal of Headache and Pain Jul 2023The close relationship between pain and mental health problems is well-known, and psychological intervention can provide an effective alternative to medication-based...
BACKGROUND
The close relationship between pain and mental health problems is well-known, and psychological intervention can provide an effective alternative to medication-based pain relief. However, previous studies on the connection between pain and psychological problems, the findings thus far have been inconclusive, limiting the potential for translating psychological interventions into clinical practice. To complement the gap, this study utilized genetic data and Mendelian randomization (MR) to examine the potential relationship between pain in different parts and common mental disorders.
METHODS
Based on the instrumental variables selected from the Genome-wide association study summary statistics of localized pain and mental disorders, we conducted bidirectional two-sample MR analyses to infer bidirectional causal associations between pain and mental disorders. The inverse-variance weighted MR method and MR-Egger were used as the primary statistical method according to the horizontal pleiotropy and heterogeneity level. We reported the odds ratio to infer the causal effect between pain and mental disorders. F statistic was calculated to measure the statistical efficacy of the analyses.
RESULTS
Insomnia is causally related to the genetic susceptibility of multisite pain including head (OR = 1.09, 95% CI: 1.06-1.12), neck/shoulder (OR = 1.12, 95% CI: 1.07-1.16), back (OR = 1.12, 95% CI: 1.07-1.18) and hip (OR = 1.08, 95% CI: 1.05-1.10). Reversely, headache (OR = 1.14, 95% CI: 1.05-1.24), neck/shoulder pain (OR = 1.95, 95% CI: 1.03-3.68), back pain (OR = 1.40, 95% CI: 1.22-1.60), and hip pain (OR = 2.29, 95% CI: 1.18-4.45) promote the genetic liability of insomnia. Depression is strongly associated with the predisposition of multisite pain including headache (OR = 1.28, 95% CI: 1.08-1.52), neck/shoulder pain (OR = 1.32, 95% CI: 1.16-1.50), back pain (OR = 1.35, 95% CI: 1.10-1.66) and stomach/abdominal pain (OR = 1.14, 95% CI: 1.05-1.25), while headache (OR = 1.06, 95% CI: 1.03-1.08), neck/shoulder (OR = 1.09, 95% CI: 1.01-1.17), back (OR = 1.08, 95% CI: 1.03-1.14), and stomach/abdominal pain (OR = 1.19, 95% CI: 1.11-1.26) are predisposing factors for depression. Additionally, insomnia is associated with the predisposition of facial, stomach/abdominal, and knee pain, anxiety was associated with the predisposition of neck/shoulder and back pain, while the susceptibilities of hip and facial pain are influenced by depression, but these associations were unidirectional.
CONCLUSIONS
Our results enhance the understanding of the complex interplay between pain and mental health and highlight the importance of a holistic approach to pain management that addresses both physical and psychological factors.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Genome-Wide Association Study; Mendelian Randomization Analysis; Shoulder Pain; Mental Disorders; Abdominal Pain; Headache; Polymorphism, Single Nucleotide
PubMed: 37415130
DOI: 10.1186/s10194-023-01612-2 -
Journal of Translational Medicine Aug 2023Phosphodiesterases (PDEs) have been associated with psychiatric disorders in observational studies; however, the causality of associations remains unestablished.
BACKGROUND
Phosphodiesterases (PDEs) have been associated with psychiatric disorders in observational studies; however, the causality of associations remains unestablished.
METHODS
Specifically, cyclic nucleotide PDEs were collected from genome-wide association studies (GWASs), including PDEs obtained by hydrolyzing both cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) (PDE1A, PDE2A, and PDE3A), specific to cGMP (PDE5A, PDE6D, and PDE9A) and cAMP (PDE4D and PDE7A). We performed a bidirectional two-sample Mendelian randomization (MR) analysis to investigate the relationship between PDEs and nine psychiatric disorders. The inverse-variance-weighted (IVW) method, MR-Egger, and weighted median were used to estimate causal effects. The Cochran's Q test, MR-Egger intercept test, MR Steiger test, leave-one-out analyses, funnel plot, and MR pleiotropy residual sum and outlier (MR-PRESSO) were used for sensitivity analyses.
RESULTS
The PDEs specific to cAMP were associated with higher-odds psychiatric disorders. For example, PDE4D and schizophrenia (SCZ) (odds ratios (OR) = 1.0531, P = 0.0414), as well as major depressive disorder (MDD) (OR = 1.0329, P = 0.0011). Similarly, PDE7A was associated with higher odds of attention-deficit/hyperactivity disorder (ADHD) (OR = 1.0861, P = 0.0038). Exploring specific PDE subtypes and increase intracellular cAMP levels can inform the development of targeted interventions. We also observed PDEs (which hydrolyzes both cAMP and cGMP) was associated with psychiatric disorders [OR of PDE1A was 1.0836 for autism spectrum disorder; OR of PDE2A was 0.8968 for Tourette syndrome (TS) and 0.9449 for SCZ; and OR of PDE3A was 0.9796 for MDD; P < 0.05]. Furthermore, psychiatric disorders also had some causal effects on PDEs [obsessive-compulsive disorder on increased PDE6D and decreased PDE2A and PDE4D; anorexia nervosa on decreased PDE9A]. The results of MR were found to be robust using multiple sensitivity analysis.
CONCLUSIONS
In this study, potential causal relationships between plasma PDE proteins and psychiatric disorders were established. Exploring other PDE subtypes not included in this study could provide a more comprehensive understanding of the role of PDEs in psychiatric disorders. The development of specific medications targeting PDE subtypes may be a promising therapeutic approach for treating psychiatric disorders.
Topics: Humans; Depressive Disorder, Major; Autism Spectrum Disorder; Genome-Wide Association Study; Mendelian Randomization Analysis; Mental Disorders; 3',5'-Cyclic-AMP Phosphodiesterases
PubMed: 37605207
DOI: 10.1186/s12967-023-04368-0 -
Ugeskrift For Laeger Oct 2023This review investigates the mortality gap that exists between people with or people without mental illness. Poor physical health is the leading cause of excess... (Review)
Review
This review investigates the mortality gap that exists between people with or people without mental illness. Poor physical health is the leading cause of excess mortality among people with mental illness. Mental disorders increase the risk of developing a broad range of physical diseases and the risk of death caused by somatic diseases is increased. Also, mental disorder is associated with less optimal treatment in the somatic healthcare system, which is also evident within a broad spectrum of somatic diseases. The role of structural factors such as the design of the healthcare system and stigma are developing.
Topics: Humans; Mental Disorders; Psychotic Disorders; Morbidity
PubMed: 37897384
DOI: No ID Found -
Clinical Psychology Review Dec 2023Coherence in the science and practice of mental health assessment depends upon a tight connection between psychopathology concepts that are used and the way those... (Review)
Review
Coherence in the science and practice of mental health assessment depends upon a tight connection between psychopathology concepts that are used and the way those concepts are operationalized and defined. In contrast, the use of the same word to mean more than one thing contributes to incoherence, inefficiency, and confusion. In this paper, we review three possible meanings of the word "dimension" as it relates to the assessment of psychopathology and describe how the indiscriminate use of this word has caused confusion in the general context of the transition to a more evidence-based approach to mental health diagnosis. We attempt to disambiguate the term "dimension" by demarcating three concepts that can be distinguished based on different empirical standards: continuous variables, unidimensional dimensions, and distinct dimensions.
Topics: Humans; Psychopathology; Mental Disorders
PubMed: 37926058
DOI: 10.1016/j.cpr.2023.102356 -
Zeitschrift Fur Kinder- Und... 2024
Topics: Humans; Adolescent; Child; Europe; Mental Disorders; Stress, Psychological; Mental Health Services; Cross-Sectional Studies; Health Services Needs and Demand
PubMed: 38725366
DOI: 10.1024/1422-4917/a000977 -
BMC Psychiatry Sep 2023About a year and a half after publishing ICD-11, we aim to gather initial feedback, comments, opinions, and even recent study results from experts in the relevant fields...
About a year and a half after publishing ICD-11, we aim to gather initial feedback, comments, opinions, and even recent study results from experts in the relevant fields through this collection. We hope to facilitate a preliminary summary of whether the new classification truly represents progress, and how it has changed treatment, and research of mental illnesses.
Topics: Humans; International Classification of Diseases; Mental Disorders
PubMed: 37749513
DOI: 10.1186/s12888-023-05186-w -
Ugeskrift For Laeger Jun 2023Children and adolescents with psychiatric or neurologic disorders often suffer from sleep problems. Disrupted sleep might lead to different comorbidities in the... (Review)
Review
Children and adolescents with psychiatric or neurologic disorders often suffer from sleep problems. Disrupted sleep might lead to different comorbidities in the child/adolescent. These symptoms often mimic other psychiatric symptoms, which makes the diagnostic process challenging. Sleep problems can lead to aggravation of existing symptoms, exacerbation into psychiatric problems, or arise as a response to pharmacological treatment. In order to provide an efficient and well-qualified treatment, it is important to understand the pathogenesis of sleep problems to be able to distinguish between the cause and consequence, as argued in this review.
Topics: Adolescent; Child; Humans; Mental Disorders; Sleep Wake Disorders
PubMed: 37381875
DOI: No ID Found -
JAMA Network Open Oct 2023Mental disorders among children and adolescents are global health concerns. Published studies have provided discordant results regarding treatment rates for mental... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Mental disorders among children and adolescents are global health concerns. Published studies have provided discordant results regarding treatment rates for mental disorders among youths.
OBJECTIVE
To estimate combined treatment rates for several common psychiatric disorders among children and adolescents.
DATA SOURCES
PubMed, Web of Science, PsycINFO, Scopus, and Embase were searched from database inception until September 23, 2022, and supplemented with hand-searching of reference lists.
STUDY SELECTION
Included studies were those that used validated methods to report treatment rates for any mental disorder, depressive disorders, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and behavior disorders among children and adolescents.
DATA EXTRACTION AND SYNTHESIS
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two reviewers independently assessed study eligibility, extracted data, and scored quality. Studies with a Joanna Briggs Institute score of 5 or more were included in the meta-analysis. Treatment rates were pooled using random-effects models. Subgroup analyses were performed to investigate the association with treatment rates of factors, such as year of data collection, World Health Organization region, age, income level, timeframe of diagnosis, informant source, service type, sample origin, and internalizing or externalizing disorder.
MAIN OUTCOMES AND MEASURES
Treatment rates for mental disorders among children and adolescents were the main outcomes, measured as percentage estimates.
RESULTS
Forty studies were included in the analysis, comprising 310 584 children and adolescents, with boys accounting for 39% of participants (sex was not reported in 10 studies). The pooled treatment rate was 38% (95% CI, 30%-45%) for any mental disorder, 36% (95% CI, 29%-43%) for depressive disorders, 31% (95% CI, 21%-42%) for anxiety disorders, 58% (95% CI, 42%-73%) for ADHD, and 49% (95% CI, 35%-64%) for behavior disorders. Age, income level, and region were significantly associated with the combined treatment rates of mental disorders in children and adolescents. The treatment rate for depressive disorders was higher among adolescents than children (36% [95% CI, 25%-46%] vs 11% [95% CI, 0%-25%]), whereas the treatment rate for anxiety disorders was higher among children than adolescents (64% [95% CI, 52%-75%] vs 20% [95% CI, 9%-30%]). The treatment rate for any mental disorder in lower-middle income countries was 6% (95% CI, 2%-14%), in upper-middle income countries was 24% (95% CI, 2%-47%), and in high-income countries was 43% (95% CI, 35%-52%). For depressive disorders, treatment rates were higher in the Americas (40% [95% CI, 30%-51%]) than in Europe (28% [95% CI, 13%-43%]) and the Western Pacific region (6% [95% CI, 1%-16%]).
CONCLUSIONS AND RELEVANCE
This study suggests that, in general, the treatment rates for mental disorders among children and adolescents were low, especially for depression and anxiety. Targeted intervention policies and effective measures should be designed and implemented to improve treatment rates of psychiatric disorders among youths.
Topics: Male; Adolescent; Child; Humans; Anxiety Disorders; Anxiety; Attention Deficit Disorder with Hyperactivity; Conduct Disorder; Combined Modality Therapy
PubMed: 37851443
DOI: 10.1001/jamanetworkopen.2023.38174