Journal of Mental Health最新文献

Background: Priority setting in mental health research is arguably lost in translation. Decades of effort has led to persistent repetition in what the research priorities of people with lived-experience of mental ill-health are.

Aim: This was a narrative review and synthesis of published literature reporting mental health research priorities (2011-2023).

Methods: A narrative framework was established with the questions: (1) who has been involved in priority setting? With whom have priorities been set? Which priorities have been established and for whom? What progress has been made? And, whose priorities are being progressed?

Results: Seven papers were identified. Two were Australian, one Welsh, one English, one was from Chile and another Brazilian and one reported on a European exercise across 28 countries (ROAMER). Hundreds of priorities were listed in all exercises. Prioritisation mostly occured from survey rankings and/or workshops (using dots, or post-it note voting). Most were dominated by clinicians, academics and government rather than people with lived-experience of mental ill-health and carer, family and kinship group members.

Conclusion: One lived-experience research led survey was identified. Few studies reported lived-experience design and development involvement. Five of the seven papers reported responses, but no further progress on priorities being met was reported.

Background: Substance use amongst young people poses developmental and clinical challenges, necessitating early detection and treatment. Considering the widespread use of technology in young people, delivering interventions digitally may help to reduce and monitor their substance use.

Aims: We conducted a systematic review and two meta-analyses to assess the effectiveness of digital interventions for reducing substance use (alcohol, smoking, and other substances) among young people aged 10 to 24 years old.

Method: Embase, Global Health, Medline, PsychINFO, Web of Science and reference lists of relevant papers were searched in November 2020. Studies were included if they quantitatively evaluated the effectiveness of digital health technologies for treating substance use. A narrative synthesis and meta-analysis were conducted.

Results: Forty-two studies were included in the systematic review and 18 in the meta-analyses. Digital interventions showed small, but statistically significant reductions in weekly alcohol consumption compared to controls (SMD= -0.12, 95% CI= -0.17 to -0.06, I²=0%), but no overall effect was seen on 30-day smoking abstinence (OR = 1.12, 95% CI = 0.70 to 1.80, I²=81%). The effectiveness of digital interventions for reducing substance use is generally weak, however, promising results such as reducing alcohol use were seen. Large-scale studies should investigate the viability of digital interventions, collect user feedback, and determine cost-effectiveness.

Prisma/prospero: This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in November 2020 (CRD42020218442).

Introduction: While there are several web-based mental health interventions, few target higher education (HE) students. Importantly, more research is needed to establish their effectiveness. Here, we provide a pragmatic evaluation of an online intervention (MePlusMe) specifically designed to improve the mental health, well-being, and study skills of HE students.

Methods: In accordance with the published protocol for a feasibility study, we recruited a convenience sample of 137 HE students to participate in an eight-week intervention, with 26 participants retained at week 8. Validated measures of mood (depression and anxiety), well-being, and self-efficacy were collected at baseline, 2, 4, and 8 weeks, alongside two feedback forms assessing design and functionality (baseline) and engagement (week 4 and 8).

Results: We observed significant reductions in levels of anxiety and depression as well as increases in well-being, but no changes in self-efficacy. Participants rated the system design and functionality positively and qualitative findings indicated high levels of satisfaction with MePlusMe.

Discussion: Findings support both the acceptability and the effectiveness of MePlusMe. Nonetheless, modest retention rates limit the precision and generalisability of these findings. Further investigation should ascertain optimal duration of engagement, most acceptable means of outcome assessment, and further detail about obstacles to utilisation.

Background: Borderline personality disorder (BPD) affects 0.7 to 2.7% of the adult population and higher rates are reported in inpatient care. Hospitalizations of BPD patients are a complex and controversial challenge for mental health professionals. Recurrent hospitalizations are common and it is essential to identify risk factors that characterize patients who benefit from their hospitalization and those who return to the ward shortly after discharge. Aim: To investigate the potential link between BPD patients' socio-demographic factors and the expected time interval between their successive hospitalizations. Methods: A retrospective analysis of 1051 hospitalization records from 174 BPD patients. Through univariate, bivariate, and multivariate analyses, we investigated the possible relationship between patients' primary socio-demographic factors and the time between their successive hospitalizations. Results: Patients' age, marital status, and living arrangement were found to be statistically connected with the time interval between successive hospitalizations. Specifically, being older, married and/or patients to live with one's spouse/partner seem to be linked with a longer time interval between successive hospitalizations compared to patients who are young, single/divorced and/or those who live with their parents. Conclusions: The expected time interval between successive hospitalization of BPD patients can be partly explained by their socio-demographic characteristics.

Background: Anxiety symptoms and disorders are common in the UK. Whilst waiting for, or alongside, treatments such as anxiolytics or psychological therapies, people often self-manage anxiety symptoms with products purchased over-the-counter (OTC), such as herbal medicines or dietary supplements. However, the evidence for these products is often presented across different reviews and is not easy for patients or healthcare professionals to compare and understand.

Aims: To determine the nature and size of the evidence base available for these products.

Methods: A scoping review. CENTRAL, MEDLINE, EMBASE, PsycInfo, and AMED (inception-Dec 2022) were searched for RCTs assessing OTC products in people aged 18-60 with symptoms or a diagnosis of anxiety.

Results: In total 69 papers assessing a range of products were found, which mostly focussed on kava, lavender, saffron, probiotics, Galphimia glauca and valerian. Studies used varying dosages. Compared to herbal medicine studies, there were much fewer dietary supplement studies and homeopathic remedy studies, despite some of use of these by the general public.

Conclusion: Future research needs to investigate commonly used but less evaluated products (e.g. chamomile, St John's Wort) and to evaluate products against or alongside conventional treatments to better reflect patient decision making.

Background: Psychosis is often associated with loneliness, the absence of a confidant and a perceived lack of social support. In addition, the social isolation and solitude experienced can aggravate internalised stigma, depressive symptoms and/or suicidal tendencies, and worsen the course of the disorder.

Aim: This study explores the experiences and perceptions of persons with psychosis concerning how their interpersonal relationships have evolved from the earliest symptoms of the disorder to its subsequent clinical stabilisation.

Method: A qualitative content analysis was performed of the findings from five focus groups and six in-depth interviews (36 participants).

Results: In the prodrome and initial symptoms stage, five themes were coded: social withdrawal, loss of friends, loss of personal skills, communication difficulties and breakdown of life project. During the recovery phase, four themes were coded: family support, partner support, loneliness and the desire for more close relationships. Finally, during the clinical stabilisation phase, three themes were coded: the recovery of interpersonal relationships, including with peers; reconstruction of the life project and increased interpersonal sensitivity.

Conclusions: These findings highlight the impact that psychosis can have on social life and show that recovery is also related to the development of maeningful interpersonal relationships.

Background: Work-related mental health problems impose significant economic and personal burdens. eHealth interventions may offer low-cost, practical solutions, but guidance on their cost-effectiveness in workplace mental health is limited.

Objective: The objective of this study was to systematically review economic evaluations of workplace eHealth interventions for mental health, offering insights into methodologies and cost-effectiveness outcomes.

Methods: Adhering to PRISMA guidelines, searches were conducted in Embase, MEDLINE, Web of Science, Google Scholar, Cochrane library, PsycInfo and EconLit databases in May 2022, selecting peer-reviewed papers that performed economic evaluations on workplace eHealth interventions for adult mental health. Quality was assessed using the Drummond checklist.

Results: From 3213 references, eight met the inclusion criteria. These studies varied in economic perspective, types of economic analysis type, primary outcome measures, intervention focus (e.g. stress, alcohol, insomnia & return-to-work) and direct non-medical costs. Five eHealth interventions were found to be cost-effective and/or have a positive return on investment, with seven studies rated as high quality according to the Drummond checklist.

Conclusions: The study outcomes unveiled the potential cost-effectiveness of eHealth interventions targeting mental health issues, particularly these focusing on workplace stress. However, generalization is challenging due to variations in the methodologies across studies.

Background: Black men are one of the most disadvantaged groups when accessing mental health services in the UK. There is extensive guidance from qualitative research on how to bring equity, but it is unclear how this evidence is being implemented.

Aim: To systematically review interventions that help Black men access timely and appropriate mental health care and to explore their nature and effectiveness.

Method: We registered on PROSPERO (CRD42022345323). We searched electronic databases up to September 2023 for studies with at least 50% of Black male participants receiving an intervention to improve access to mental health support in community settings. We conducted a narrative synthesis of eligible studies.

Results: Five studies met our inclusion criteria. An important characteristic was discussing thoughts and feelings through peer support, leading to a normalization of experiences.

Conclusions: There is a paucity of research into interventions that support Black men accessing community mental health support. Proactively testing interventions, not just seeking qualitative feedback, is required. Evidence-based strategies to support recruitment of Black men into research is necessary. Commissioners could consider evidence typically seen as less robust to mitigate against an underlying racial bias within research and stimulate the growth of an evidence base.

Background: Survivors of Child Sexual Abuse (CSA) are reported to have difficulties in trusting. Yet no previous study investigating CSA survivors' subjective experiences of trust exists and there is a paucity of clinical research into constructs and definitions of "trust."

Aims: To use a phenomenological lens to investigate CSA survivors' descriptions of trust relationships and trustworthy others by privileging their subjective experience. To better understand how trust can be built within therapeutic relationships.

Methods: A qualitative methodology using Interpretative Phenomenological Analysis was conducted within the survivor-research paradigm. The researcher was a person with lived experience of CSA who co-produced the study with CSA survivor advisors and co-constructed interviews with 17 adult CSA survivors.

Results: Findings present a "Survivor Trust Enactment Model" that delineates the process of building/repairing relational trust and advancing "transactional trust." Trust is portrayed as nuanced and formed across and according to context, including the demarcation of generalised and relational trust. The findings emphasise that trustees' trustworthiness is key to building trust which challenges assumptions that survivors are deficient in trust.

Conclusion: The foregrounding of subjective trust experiences challenges diagnostic and clinical views on trust deficiency in adult CSA survivors. The study develops clinical constructs of trust, considers implications for clinical practice, and indicates areas for further research into trust dynamics in therapeutic relationships.