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The Journal of Adolescent Health :... Oct 2023This study evaluated the relationship between sociodemographic factors including family structure and mental health service (MHS) utilization before and during the...
PURPOSE
This study evaluated the relationship between sociodemographic factors including family structure and mental health service (MHS) utilization before and during the COVID-19 pandemic. We also investigated the moderation effects of the COVID-19 pandemic on MHS utilization.
METHODS
Our retrospective cohort study analyzed adolescents aged 12-17 years with a mental health diagnosis as identified in the electronic medical record enrolled in Kaiser Permanente Mid-Atlantic States in Maryland and Virginia, a comprehensive integrated health system. We used logistic regression models with an interaction term for the COVID-19 pandemic year to determine the relationship between family structure and adolescent MHS utilization ≥ one outpatient behavioral health visit within the measurement year, while adjusting for age, chronic medical condition (= physical illness lasting > 12 months), mental health condition, race, sex, and state of residence.
RESULTS
Among 5,420 adolescents, only those in two-parent households significantly increased MHS utilization during COVID-19 compared to the prepandemic year (McNemar's χ = 9.24, p < .01); however, family structure was not a significant predictor. Overall, the odds of adolescents using MHS were associated with a 12% increase during COVID-19 (odds ratio 1.12, 95% confidence interval [CI]: 1.02-1.22, p < .01). Higher odds of using MHS was associated with chronic medical condition (adjusted odds ratio = 1.15; 95% CI: 1.05-1.26, p < .01) and with White adolescents compared to all racial/ethnic minorities. The odds ratio of females using MHS compared to their male counterparts increased by 63% (ratio of adjusted odds ratio = 1.63; 95% CI: 1.39-1.91, p < .01) during the COVID-19 pandemic.
DISCUSSION
Individual-level demographic factors served as predictors of MHS utilization with effects moderated by COVID-19.
Topics: Female; Humans; Male; Adolescent; Infant; Pandemics; Retrospective Studies; COVID-19; Mental Health Services; Mental Disorders
PubMed: 37032208
DOI: 10.1016/j.jadohealth.2023.01.018 -
The Journal of Adolescent Health :... Nov 2023To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships... (Observational Study)
Observational Study
PURPOSE
To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships between gender affirmation and mental health symptoms, and whether associations differed by race/ethnicity subgroup.
METHODS
Baseline data were analyzed from the gender-affirming hormone cohort of the Trans Youth Care United States Study-a 4-clinic site, observational study. Mental health symptoms assessed included depression, suicidality, and anxiety. Gender affirmation measures included the parental acceptance subscale from the perceived Parental Attitudes of Gender Expansiveness Scale-Youth Report; non-affirmation, internalized transphobia, and community connectedness subscales from the Gender Minority Stress and Resilience Measure-Adolescent; and self-reported living full time in affirmed gender. Fisher exact tests and independent sample t tests compared mental health symptoms and gender affirmation between subgroups. Logistic regression analyses evaluated associations between gender affirmation and mental health symptoms. Interaction analyses assessed differences in associations between subgroups.
RESULTS
The sample (mean age 16 years, range 12-20 years) included 92 BLTY (35%) and 170 WTY (65%). Subgroups had comparable prevalence of depression and anxiety symptoms. WTY had higher prevalence of lifetime suicidality (73% vs. 59%; p = .02). There were no differences in gender affirmation. Among the whole sample, higher parental acceptance decreased odds of depression symptoms. Not living in affirmed gender increased odds of depression symptoms. Higher non-affirmation and internalized transphobia increased odds of depression and anxiety symptoms and suicidality. Associations did not vary by subgroup.
DISCUSSION
BLTY and WTY had comparable mental health symptoms. For both subgroups, gender affirmation decreased odds of those symptoms.
Topics: Humans; Adolescent; United States; Child; Young Adult; Adult; Mental Health; Transgender Persons; White; Gender Identity; Mental Disorders
PubMed: 37610390
DOI: 10.1016/j.jadohealth.2023.06.022 -
Annual Review of Public Health May 2024Several factors motivate the need for innovation to improve the delivery of behavioral health services, including increased rates of mental health and substance use... (Review)
Review
Several factors motivate the need for innovation to improve the delivery of behavioral health services, including increased rates of mental health and substance use disorders, limited access to services, inconsistent use of evidence-based practices, and persistent racial and ethnic disparities. This narrative review identifies promising innovations that address these challenges, assesses empirical evidence for the effectiveness of these innovations and the extent to which they have been adopted and implemented, and suggests next steps for research. We review five categories of innovations: organizational models, including a range of novel locations for providing services and new ways of organizing services within and across sites; information and communication technologies; workforce; treatment technologies; and policy and regulatory changes. We conclude by discussing the need to strengthen and accelerate the contributions of implementation science to close the gap between the launch of innovative behavioral health services and their widespread use.
Topics: Humans; Mental Health Services; Diffusion of Innovation; Models, Organizational; Organizational Innovation; Health Services Accessibility; Substance-Related Disorders; Health Policy; Mental Disorders
PubMed: 37871139
DOI: 10.1146/annurev-publhealth-071521-024027 -
Psychiatria Danubina Oct 2023The pathological entity to which the term "burnout" refers is not clear, although the phenomenon exists. This article aims to clarify the professional and social origins...
BACKGROUND
The pathological entity to which the term "burnout" refers is not clear, although the phenomenon exists. This article aims to clarify the professional and social origins of burnout by confronting the philosophers who have analyzed the concept of work and the modern society to scientific literature.
SUBJECT AND METHOD
The master thesis of Manguelinckx M. served as a starting point for the review of the scientific literature because it tends to understand the concept of burnout based on recent articles from Google Scholar, Discovery-libellule, Pubmed and Mediquality. The philsophers mobilized are: Karl Marx, Hannah Arendt and Bernard Stiegler.
RESULTS
There is heterogeneity in the definition of burnout, its causes and its symptoms. The diagnosis is established in several ways but most of the time, the exhaustion component suffices for diagnosis. Karl Marx describes work as alienating when the person executes repetitively an elementary task imposed on him. Hannah Arendt shows that at work, modern human performs these tasks in a stereotypical way and rarely thinks about their ethical consequences. Modern society transforms humans into consumers and provokes their instrumentalization. Bernard Stiegler shows that at work, the digital dispossesses the human from his know-how. The spread of digitalisation in all fields of life is hampering human autonomy and singularity, the dialogue between generations, friendship and family relationships.
CONCLUSION
The professional and social changes caused by modernity can explain the causes, risk factors and symptoms of burnout. They do not respect the authentically human fulfillment, and seem to "mistreat" humans. It is mandatory to study the links between these mutations and their psychological impact on human. For this, psychiatry must open up to other disciplines. A dialogue between psychiatrists and social and political actors is required.
Topics: Humans; Male; Burnout, Professional; Mental Disorders; Occupations; Psychiatry; Risk Factors
PubMed: 37800210
DOI: No ID Found -
Scientific Reports Oct 2023Mortality is predicted by the sum of behavior-related health risk factors (BRFs: tobacco smoking, alcohol drinking, body overweight, and physical inactivity). We...
Mortality is predicted by the sum of behavior-related health risk factors (BRFs: tobacco smoking, alcohol drinking, body overweight, and physical inactivity). We analyzed degrees and combinations of BRFs in their relation to mortality and adjusted for mental disorders. In a random sample of the general population in northern Germany aged 18-64, BRFs and mental disorders had been assessed in 1996-1997 by the Munich Composite International Diagnostic Interview. A sum score including eight ranks of the behavior-related health risk factors was built. Death and its causes were ascertained 2017-2018 using residents' registration files and death certificates. Relations of the sum score and combinations of the BRFs at baseline with all-cause, cancer, and cardiovascular mortality 20 years later were analyzed. The sum score and combinations predicted all-cause, cardiovascular and cancer mortality. The odds ratio of the sum score was 1.38 (95% confidence interval 1.31-1.46) after adjustment for age, gender, and mental disorder. In addition to the BRFs, mood, anxiety or somatoform disorders were not related to mortality. We concluded that the sum score and combinations of behavior-related health risk factors predicted mortality, even after adjustment for mental disorders.
Topics: Humans; Mental Disorders; Risk Factors; Anxiety Disorders; Somatoform Disorders; Neoplasms
PubMed: 37798350
DOI: 10.1038/s41598-023-43669-8 -
BMJ Open Dec 2023To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence...
OBJECTIVES
To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020.
DESIGN
Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants).
SETTING
National databases of the National Institute of Public Health in Slovenia.
PARTICIPANTS
All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020.
RESULTS
The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses.
CONCLUSION
The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.
Topics: Pregnancy; Humans; Male; Female; Adult; Retrospective Studies; Absenteeism; Prevalence; Slovenia; Pandemics; Mental Disorders; Health Personnel; Sick Leave; Delivery of Health Care
PubMed: 38070887
DOI: 10.1136/bmjopen-2023-075718 -
PloS One 2023Western literature has long explored help-seeking behaviours related to mental health issues. However, this has been relatively neglected in the Middle East despite an...
BACKGROUND
Western literature has long explored help-seeking behaviours related to mental health issues. However, this has been relatively neglected in the Middle East despite an increase in mental health needs in the region. The purpose of this review was to conduct a systematic review and qualitative meta-synthesis exploring help-seeking behaviours related to mental health issues in the Middle East.
METHODS
We conducted a systematic review and meta-synthesis to gain a comprehensive overview of what is known about mental health and help-seeking behaviours in the Middle East from published qualitative research in the Middle Eastern region. A search of electronic databases (MEDLINE, Embase, CINAHL, PsycINFO and QScience) was carried out from inception to July 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool, and the review protocol was pre-registered with PROSPERO (Ref: CRD42022311494).
RESULTS
We identified 16 qualitative studies exploring mental health-seeking behaviours in Middle East countries. Facilitators and barriers to help-seeking were captured under six overarching themes. Across all studies, we identified negative attitudes towards seeking help for mental health issues, economic and structural barriers to accessing mental healthcare, and misconceptions surrounding religious beliefs, all of which had a critical role in impacting decisions to seek mental healthcare services. Many sought help from alternative sources, such as traditional healers or family members before consulting a healthcare professional. The role of the family and cultural norms was also identified as key contributors to people's help-seeking behaviours.
CONCLUSIONS
This meta-synthesis indicates the existence of many challenges surrounding mental health-seeking in the Middle East, including public and internalizing stigmas. This suggests an urgent need for an increase in psychoeducation and mental health awareness in the region.
Topics: Humans; Health Services Accessibility; Help-Seeking Behavior; Mental Disorders; Mental Health; Mental Health Services; Qualitative Research; Middle Eastern People
PubMed: 37883515
DOI: 10.1371/journal.pone.0293525 -
BMJ Open Jul 2023Mental health disorders (MHDs) are considered a serious public health concern globally. The burden of mental health conditions is estimated to be higher in low-income...
BACKGROUND
Mental health disorders (MHDs) are considered a serious public health concern globally. The burden of mental health conditions is estimated to be higher in low-income and middle-income countries, including Cameroon, where reliable estimates are lacking. This review aims to synthesise evidence on the prevalence of MHDs, the effectiveness of mental health management interventions and identify risk factors for MHDs in Cameroon.
METHOD
This review will systematically search electronic databases for studies focusing on one or more MHDs of interest within the context of Cameroon. We will include cohort, case-control and cross-sectional studies which assessed the prevalence or risk factors for MHDs in Cameroon and intervention studies to provide evidence on the effectiveness of interventions for managing MHDs. Two reviewers will independently perform all screening stages, data extraction and synthesis. We will provide a narrative synthesis and, if we identify enough articles that are homogeneous, we will perform a meta-analysis using a random effect model. The strength of the evidence will be assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach.
CONCLUSION
This review will contribute to the current body of knowledge by providing a synthesis of current evidence on the prevalence of common MHDs, risk factors for different MHDs and the effectiveness of interventions for managing different mental health conditions in Cameroon.
ETHICS AND DISSEMINATION
This study will involve synthesis of published literature and does not warrant ethical approval. The findings will be disseminated through internationally peer-reviewed journals related to mental health.
PROSPERO REGISTRATION NUMBER
CRD42022348427.
Topics: Humans; Mental Health; Prevalence; Cameroon; Cross-Sectional Studies; Mental Disorders; Risk Factors; Meta-Analysis as Topic; Review Literature as Topic; Systematic Reviews as Topic
PubMed: 37423625
DOI: 10.1136/bmjopen-2022-068139 -
European Child & Adolescent Psychiatry Oct 2023Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common... (Review)
Review
Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common treatment for behavioural disorders, and these medications may have intended or unintended positive or negative bladder sequelae. This review identifies the literature regarding the effects of behavioural pharmacotherapy on bladder functioning and possible bladder management strategies in children with concomitant behaviour and bladder disorders to enable clinicians to better manage both conditions. A PROSPERO registered PRISMA-guided review of three major databases was performed. After an initial scoping study revealed significant heterogeneity, a narrative approach was undertaken to discuss the results of all relevant cases relating to children being treated with pharmacotherapy for behaviour disorders and outcomes related to bladder function. Studies were screened to identify those that described effects of commonly prescribed medications in children with behavioural disorders such as stimulants, alpha 2 agonists, tricyclic antidepressants (TCA), serotonin and noradrenergic reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI) and antipsychotics, and the findings and implications were summarised. The review identified 46 studies relevant to behavioural pharmacotherapy and bladder function (stimulants (n = 9), alpha 2 agonists (n = 2), TCAs (n = 7), SNRIs (n = 8), SSRIs (n = 8) and antipsychotics (n = 6). Six studies focused specifically on bladder management in children with behavioural disorders with concurrent behavioural pharmacotherapy. This review identifies useful factors that may assist clinicians with predicting unintended bladder effects following initiation of behavioural pharmacotherapy to facilitate the best approach to the treatment of bladder dysfunction in children with behavioural disorders. With this evidence, we have provided a useful decision-making algorithm to aide clinicians in the management of these dual pathologies.
Topics: Humans; Child; Antidepressive Agents; Urinary Bladder; Central Nervous System Stimulants; Mental Disorders; Antipsychotic Agents; Selective Serotonin Reuptake Inhibitors
PubMed: 35767104
DOI: 10.1007/s00787-022-02016-4 -
International Journal of Methods in... Dec 2023To investigate the associations between low education and risk of mental disorders, substance use disorders and self-harm in different age-groups.
Educational level and the risk of mental disorders, substance use disorders and self-harm in different age-groups: A cohort study covering 1,6 million subjects in the Stockholm region.
OBJECTIVE
To investigate the associations between low education and risk of mental disorders, substance use disorders and self-harm in different age-groups.
METHODS
All subjects in Stockholm born between 1931 and 1990 were linked to their own or their parent's highest education in 2000 and followed-up for these disorders in health care registers 2001-2016. Subjects were stratified into four age-groups: 10-18, 19-27, 28-50, and 51-70 years. Hazard Ratios with 95% Confidence Intervals (CIs) were estimated with Cox proportional hazard models.
RESULTS
Low education increased the risk of substance use disorders and self-harm in all age-groups. Males aged 10-18 with low education had increased risks of ADHD and conduct disorders, and females a decreased risk of anorexia, bulimia and autism. Those aged 19-27 years had increased risks of anxiety and depression, and those aged 28-50 had increased risks of all mental disorders except anorexia and bulimia in males with Hazard Ratios ranging from 1.2 (95% CIs 1.0-1.3) for bipolar disorder to 5.4 (95% CIs 5.1-5.7) for drug use disorder. Females aged 51-70 years had increased risks of schizophrenia and autism.
CONCLUSION
Low education is associated with risk of most mental disorders, substance use disorders and self-harm in all age-groups, but especially among those aged 28-50 years.
Topics: Male; Female; Humans; Cohort Studies; Anorexia; Bulimia; Risk Factors; Self-Injurious Behavior; Substance-Related Disorders; Educational Status; Mental Disorders
PubMed: 36802082
DOI: 10.1002/mpr.1964