Clinical Practice and Epidemiology in Mental Health最新文献

Background: Normative data for objective measures in the clinical assessment of Attention Deficit Hyperactivity Disorder (ADHD) are crucial for enhancing the accuracy, reliability, and clinical utility of diagnostic tools. This observational study aimed to establish normative demographic data in a representative population for an investigational version of QbMobile (QbMobile), a software application for the administration of a performance test to provide objective measurements of hyperactivity, inattention, and impulsivity in the clinical assessment of ADHD.

Methods: This study was conducted in the United Kingdom, The Netherlands, Germany, and the United States. Participants between 6-60 years were included. The QbMobile application was pre-installed on the smart device/iPhone. Participants were instructed to sit holding the smartphone with both hands and tap the screen each time a target stimulus appeared on-screen and withhold tapping to all other stimuli. The smartphone tracked the participants' movements with the camera and movements from the smartphone to measure activity.

Results: A total of 2541 participants completed the study, n=326 aged 6-11 years and n=2215 aged 12-60 years. There were more females (55.7%) than males (44.3%). Demographic and characteristics variables had no impact on the data collected. Household income and educational levels were investigated to ensure sufficient spread across countries. The basic parameters of QbMobile were captured and evaluated during the assessment. There was a high degree of acceptance of the test, and 94% reported that the application was easy to use.

Conclusion: Representative normative data for QbMobile was established from a multinational general population and should provide a useful basis as a comparator for other datasets, such as people with ADHD.

Background: The present study aims to evaluate the preliminary content and face validity of the "Perceptions on the Implementation of the CRPD in muniCIpalities Questionnaire (PICI-Q)," a self-report questionnaire built to assess the perceptions on how effectively municipalities implement the CRPD principles concerning social inclusion and participation of persons with disabilities in municipalities.

Methods: A two-step Delphi methodology was used to build the questionnaire and assess its content and face validity. A group including health professionals, academics, experts in psychometrics, persons with disabilities and local policymakers was involved in building the questionnaire according to the CRPD articles regarding social inclusion and active participation of persons with disabilities. Two pools of experts assessed the content and face validity and lay stakeholders, respectively.

Results: An average content validity index of 0.95 was obtained, with no items removed. Regarding face validity, all items achieved high scores, ranging from 17 to 21, with a face validity index of 0.95.

Conclusion: The PICI-Q is a promising tool for assessing perceptions of CRPD implementation in municipalities. Its robust preliminary validation suggests it could support local authorities in designing and improving policies and interventions aligned with the CRPD principles of social inclusion and participation for persons with disabilities.

Background: During wartime, mental health professionals are more prone to mental health problems, such as burnout. Currently, there is less knowledge of the coping strategies employed by Palestinian mental health professionals to manage the consequences of wars and conflicts. In light of the ongoing political violence in Palestine, this study sought to investigate the prevalence of burnout and coping methods among mental health professionals.

Methods: The research design was cross-sectional. We used self-reported questionnaires to gather data, including the abbreviated Maslach Burnout Questionnaire and Brief COPE Scale. Multiple regression, Pearson correlation, and a Chi-square test were used to examine the association between the study variables and burn symptoms.

Results: Out of 514 participants, who were surveyed, there was a prevalence of high burnout (75.4%), emotional exhaustion (24.7%), depersonalization (11.9%), and inadequate personal accomplishment (19.6%). Professionals who reported struggling or being unable to interact with their clients during the political violence and those whose psychological state was negatively impacted by it were more likely to feel emotional exhaustion. Also, self-blame was found to raise the chance of emotional exhaustion, whereas planning decreased it. Depersonalization was more common in 31-40-year-olds. Humor and behavioral disengagement increased depersonalization, but religious coping lowered it. Furthermore, treating patients affected by political conflict, being male, not being single, and using substances decreased personal accomplishment, whereas venting increased it.

Conclusion: The results showed an elevated prevalence of burnout among mental health personnel during conflict and political violence. Therefore, it is critical to immediately provide mental health workers with stress management training and psychological support to enhance their psychological well-being. Additionally, they need help in learning how to effectively organize their time, manage activities, and distribute duties during political conflict.

Background: Obsessive-compulsive disorder is recognized by the World Health Organization as one of the top 10 most disabling disorders globally. Characterized by recurrent and persistent thoughts (obsessions) and/or repetitive behaviors (compulsions), it significantly disrupts an individual's daily life, impacting routine, education, career development, and social relationships. The disorder's prevalence varies worldwide, with studies in Saudi Arabia showing a higher rate of obsessive-compulsive symptoms among medical students.

Objective: This study aimed to determine the prevalence of obsessive-compulsive symptoms among undergraduate medical students in four major universities in Saudi Arabia.

Methods: A cross-sectional, web-based survey was administered between April and June 2023 to medical students from Imam Abdulrahman Bin Faisal University, King Faisal University, King Saud University, and King Abdulaziz University. The survey assessed obsessive-compulsive symptoms using the OCI-R scale.

Results: Out of 886 medical students, 411 (46.4%) scored 21 or more on the OCI-R, indicating probable obsessive-compulsive disorder. Females had significantly higher OCI-R scores compared to males. Younger students, those with a family or personal history of psychiatric disorders, particularly depression, and those with lower academic satisfaction exhibited higher scores.

Conclusion: This study emphasizes the importance of incorporating mental health awareness programs into educational curricula due to the high prevalence of obsessive-compulsive symptoms among medical students. Implementing such programs can help reduce stress and improve both academic performance and overall well-being.

Background: The perception of respect for users' rights is fundamental for organizational well-being in mental health services. This cross-sectional observational study examined the job satisfaction and perception of user rights among nursing staff compared to other health professionals across seven countries in the Mediterranean and Latin American regions. This research measures this perception among nursing staff in different countries, with a particular focus on regional differences and professional roles.

Methods: Data were collected from mental health services in four Mediterranean and three Latin American countries via a structured questionnaire (Well-Being at Work and Respect Rights Questionnaire - WWRR), administered both online and on paper. Using multivariable logistic regression, the study analyzed associations between job satisfaction, respect for rights, and various socio-demographic and professional factors.

Results: Among 408 nurses and 492 other health professionals, findings revealed significant cross-country variability. Nurses in North Macedonia reported higher job satisfaction and perceived respect for user rights than other professionals (p<0.0001 in all items of the questionnaire), while Tunisian nurses showed lower organizational satisfaction but higher respect for user rights (p=0.033 for respect for rights). However, in general, no significant differences were found between nurses and other professionals across all items.

Conclusion: The perception of respect for users' rights is fundamental for organizational well-being in mental health services. The study highlights differences in organizational well-being perceptions across various contexts, emphasizing the need for culturally and economically adapted policies to improve mental health service environments globally. The results indicate the variability in the perception of respect for rights and job satisfaction between different geographical and professional contexts. This indicates the need for policies adapted to specific cultural and economic realities to improve organizational well-being in mental health services.

Background: Many pharmacological treatments are considered effective in the treatment of panic disorder (PD), however, about 20 to 40% of the patients have treatment-resistant PD. Pharmacogenetics could explain why some patients are treatment-resistant.

Objective: Our objective was to gather preliminary data on the clinical usefulness of pharmacogenetic testing in this disorder.

Methods: Twenty patients with treatment-resistant PD were included in this observational study and submitted to commercial pharmacogenetic testing. Testing panel included gene polymorphisms related to CYP, genes EPHX1, UGT1A4, UGT2B15, ABCB1, ADRA2A, ANKK1, COMT, DRD2, FKBP5, GRIK4, GSK3B, HTR1A, HTR2A, HTR2C, MC4R, OPRM1, SCN1A, SLC6A4 and MTHFR. Participants received treatment-as-usual for PD before being enrolled in this study, including first-line and second-line medications for PD.

Results: In 30% of the patients, the tests indicated reduced chance of response to the prescribed drug, while they indicated very low serum levels of the prescribed drug in 20% of the subjects. The pharmacogenetic tests predicted reduction of MTHFR enzyme activity in 74% of the patients. ABCB1 gene alleles associated to drug resistance were found in 90% of the samples.

Conclusion: Commercial pharmacogenetic testing failed to predict negative treatment outcome in most patients with PD. The association between treatment-resistance in PD and the genes CYP2C19, MTHFR and ABCB1 deserves further study.

Background: Mental health well-being is a fundamental human right. However, mental health awareness is not yet considered as a main priority for the government and public in Indonesia. Thus, there is an urgent need for Indonesians to fully comprehend the importance of raising mental health awareness.

Methods: A discussion among 45 experts in September until October 2023 was conducted by the Community Caucus Caring for Mental Health to raise an awareness of the importance of mental health in Indonesia. The results were reported as an expert consensus.

Results: The discussion acknowledged the urgency of managing mental health issue along with its five key drivers and three essences. It identified nine specific themes of mental health issues in Indonesia by focusing on four high-risk population groups. The consensus proposed multi-pronged recommendations, i.e., developing personalized mental health-related campaigns and movements, conducting mental health-relevant studies at clinical and community settings, incorporating of mental health awareness in teaching curriculum and family's discussion, innovating technology for screening and diagnosing mental health issues, as well as an providing mental health first-aid with wide access to all population.

Conclusion: The expert consensus concluded that Indonesians must start to prioritize mental health awareness and to provide sufficient resources to screen, diagnose and treat individuals with mental health disorders. The expert consensus identified nine specific themes of mental health issues in Indonesia and subsequently proposed multi-pronged recommendations with an aim to improve mental health awareness in Indonesia.

Background: The coronavirus disease (COVID-19) has affected people psychologically worldwide, particularly healthcare personnel. Even though the COVID-19 pandemic situation has eased, healthcare personnel must still perform their duties, which has resulted in psychological impacts, particularly stress.

Objectives: This study aimed to examine the risk factors associated with stress among healthcare personnel post-COVID-19 pandemic in northeast Thailand.

Methods: A cross-sectional analytic design was conducted from January to April 2023. One thousand and three hundred healthcare workers were selected from primary, secondary, and tertiary hospitals across 16 districts within Chaiyaphum province. The questionnaires were used to collect data, and the stress test 5 (ST-5) questionnaire was used to investigate stress among healthcare personnel.

Results: The overall stress rate for healthcare workers was 15.47%, including very severe (8.85%) and severe (6.62%). The factors associated with stress consisted of work position, environment of work, personal life such as education level and income, and responsibility for taking care of family members, in addition to experiencing quarantine from COVID-19 were more likely to have a high risk of stress problems among healthcare workers.

Conclusion: This result highlighted that the mental health of personnel should be in critical situations, and those found severely afflicted should undergo professional care. To prevent psychological issues, particularly stress, health organizations should be concerned with strong organizational management, which includes supporting bonuses and providing high-quality personal protective equipment (PPE) to healthcare staff.

Background: Despite the increased interest from researchers in Postpartum depression (PPD) globally, related studies are limited in Palestine and do not provide a comprehensive understanding of PPD.

Objective: We examined the factors that determine post-partum depression among Palestinian mothers in Hebron governorate.

Methods: A cross-sectional study was conducted in 122 governmental primary healthcare clinics in Hebron Governorate. A convenient sampling method was used to collect data from 435 using a self-administered questionnaire using the Edinburg Postnatal Depression Scale.

Results: The mean EPDS scale score was 10.56 (SD 5.273), and 36.1% had a score of ≥13, indicating moderate to severe depression symptoms. The study results revealed that psychosocial factors were significantly associated with PPDS and play a crucial role in the development of PPD, such as the history of depression, being exposed to domestic violence before and during pregnancy, poor husband support, unplanned pregnancy, fear of infant's gender, and in addition to anemia than other factors.

Conclusion: A high prevalence of PPD was found among Palestinian women in this study. The study proposes screening women for trauma or domestic violence and assessing their social support, inquiring about pregnancy intention, and discussing family planning. Delivering iron supplements to pregnant or postpartum anemic women is important. Women who have a history of depression, domestic abuse, or lack social support should receive psychological and medical treatment. Mental health services must be included in the after-birth care protocol to train primary health clinic staff to recognize and treat PPD.

Background: The correlation between sleep disturbance and depression is widely recognized in developed countries but relevant evidence is lacking in developing countries.

Objective: This study aims to assess the correlation between sleep disturbance and depression levels among the general Indonesian population.

Methods: This national cross-sectional survey was conducted using the Indonesian Family Life Survey. Sleep disturbance was assessed based on the questions related to sleeping experience. Depression levels were assessed with a modified Center for Epidemiologic Studies-Depression scale. Sociodemographic factors as confounders were obtained from the self-reported data. Logistic regression was performed after adjusting for confounders.

Results: A total of 22,024 respondents were included. Respondents with severe, moderate, and mild sleep disturbance were associated with depression compared to those with none or slight sleep disturbance.

Conclusions: Respondents with sleep disturbance had a higher possibility of experiencing depression. Screening of sleep quality among the general population is important to reduce the risk of depression.