Journal of Mental Health最新文献

Background: During times of war and violent conflict, populations endure profound psychological pressures. These challenging circumstances highlight how personal attributes, particularly one's life orientation and sense of hope, can fundamentally shape an individual's psychological resilience and well-being.

Aims: This cross-sectional quantitative study examined differences in life orientation, agency, pathways, and well-being, and explored their mediating relationships between Jewish and Arab societies in Israel during the first 2 months of the 7/10 war.

Methods: A total of 292 adults residing in Israel, self-identifying as either Arab or Jewish, and having encountered war times participated. Data were collected through an online questionnaire including the Dispositional Hope Scale (DHS), Life Orientation Test, General Well-being Measure, and background characteristics, analyzed using PROCESS.

Results: The Arab minority reported higher levels of pathways, agency, and well-being compared to the Jewish majority. Pathways and agency showed the strongest positive relationship, supporting their complementary roles in forming hope. Life orientation demonstrated moderate positive connections with pathways and agency. While life orientation positively influenced pathways and agency, only agency significantly predicted well-being when controlling for life orientation.

Conclusions: The study reveals psychological strengths building resilience in minority groups during armed conflicts, emphasizing hope agency's critical role in psychological fortitude.

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: Caregivers often report high stress levels, which may be associated with adverse mental health. Less is known about adult sexual and gender minority (SGM) caregivers' experienced stress and/or mental health considering they are likely at increased vulnerability to these outcomes due to social stigma, familial estrangement, and discrimination.

Aims: We tested relationships between caregiving and adverse mental health and if these associations were modified by SGM identity.

Methods: Using 2023 national BRFSS data (n = 32,151) we examined relationships between caregiving and two outcomes: depression and 14+ days with poor mental health, testing effect modification by SGM identity. Regression analyses, using both SGM and caregiving cross-categories and interaction term models were also conducted.

Results: Compared to heterosexual non-caregivers, both caregiving and SGM status were associated with greater depression and having 14+ days of poor mental health, with the highest prevalence of depression among transgender caregivers (aPR = 4.05, CI 3.03-5.00), transgender non-caregivers (aPR = 2.80, CI 2.24-3.25), and cisgender gay caregivers (aPR = 2.52, CI 2.01-2.93). Transgender and cisgender gay and bisexual caregivers also had the highest days with poor mental health. Additionally, interaction term models identified effect modification.

Conclusions: Disproportionate adverse mental health outcomes exist among caregivers, modified by SGM status. Longitudinal research is needed to understand these mechanisms and related outcomes including substance use and suicidality.

Background: Complex PTSD (CPTSD) is often associated with prolonged or repeated trauma exposure and the experience of intimate partner and childhood abuse. CPTSD includes the criteria for PTSD (re-experiencing, avoidance, and sense of threat) in addition to three criteria for self-organization disturbances (affective dysregulation, negative self-concept, and relational disturbance).

Methods: This study aimed to assess profiles of CPTSD symptoms and their association with psychiatric distress among people with co-occurring Serious Mental Illness (SMI; schizophrenia/schizoaffective, bipolar, and treatment-refractory major depression). Treatment-seeking participants (N = 307) with SMI and PTSD diagnoses were drawn from two randomized controlled trials. Distinct symptom profiles were assessed using Latent Profile Analysis (LPA).

Results: A model with three classes best fit the data with the most parsimonious interpretation: 26.7% (n = 82) in the PTSD class, 43.7% (n = 134) in the CPTSD class, and 29.6% (n = 91) in the CPTSD+ Borderline Personality Disorder (BPD) class. The CPTSD+BPD class showed the highest levels of psychiatric symptoms, followed by the CPTSD and PTSD groups, respectively.

Conclusions: The results demonstrate the heterogeneity in symptom presentation across the PTSD classes and that, despite similar diagnoses, individuals may present with varying symptom patterns. This emphasizes the importance of studying CPTSD in subpopulations of persons with SMI.

Objectives: In evaluating the effectiveness of different therapeutic methods aimed at fostering post-traumatic growth (PTG) in individuals who have experienced trauma, a key inquiry arises: Can cognitive-behavioral therapies enhance PTG in those suffering from post-traumatic stress disorder?

Methods: To address this question, comprehensive searches were conducted across the PubMed, Web of Science, and Scopus databases from the inception of these databases through 1 January, 2025. To be included, studies had to consist of clinical trials, randomized controlled trials, quasi-experimental, or experimental methodologies that applied cognitive-behavioral therapy to enhance post-traumatic growth among individuals suffering from PTSD. Each study was qualitatively assessed using the Verhegen quality assessment checklist.

Results: The results showed that seven articles fulfilled the inclusion criteria, representing a total of 249 individuals and 46 couples, with a gender distribution of 47 males and 164 females. The findings of the study indicated that cognitive behavioral therapies lead to a notable enhancement in post-traumatic growth signs within the intervention group (SMD=-0.81, 95% CI=-1.19, -0.43, p=0.027). Furthermore, as the sample size in the studies increased, the impact of CBT on PTG improvement also grew (P=0.056).

Conclusions: It can be concluded that CBT-related interventions can assist individuals in achieving growth by engaging with and addressing crises.

Background: Family/informal carers play important roles in supporting or monitoring medicine-taking for people with recurrent psychosis, but their views on antipsychotic medication are under-researched.

Aim: To explore family/informal carers' views and experiences of antipsychotic reduction and discontinuation within a medication reduction research trial (Research into Antipsychotic Discontinuation And Reduction [RADAR]).

Method: Semi-structured interviews with 15 family/informal carers of participants in the antipsychotic reduction/discontinuation arm of RADAR who had completed the trial up to one year previously. Data were analysed using thematic analysis.

Results: Most carers observed improvements in social engagement, daily functioning or identity, and challenges related to mental health over the 24-month reduction period. Carers described a general state of vigilance that was heightened during the trial, and often felt they were better at detecting warning signs of deterioration than clinicians. Carers' views did not necessarily reflect their loved ones' relapse status. Many wished they had been more involved in the trial. Some expressed cautious optimism for future reductions, although complete discontinuation was generally deemed less viable.

Conclusions: Carers' perspectives on antipsychotic reductions within the RADAR trial complement main trial findings and explorations of service users' experiences. Clinicians should endeavour to include carers in decisions about, monitoring and support of changes or reductions to antipsychotics.

Background: Criminalization of people experiencing mental illness is systemic, but the conditions surrounding police use-of-force in such encounters are under-examined.

Aims: To describe mental or behavioral health (MBH) involvement in injurious shootings by U.S. police compared with MBH-uninvolved shootings.

Methods: Using a 2015-2020 dataset developed from manual review of injurious shootings by police compiled from the Gun Violence Archive (GVA) (n = 10,615), we identified 2454 people shot in MBH-involved encounters. Through further review, we classified the MBH conditions and behaviors involved. Using descriptive statistics and logistic regression models, we compared characteristics of injured people, presenting conditions, and responses.

Results: Twenty-three percent of injurious shootings by police involved MBH symptoms (n = 2336) or substance use (n = 921). Eighty-one percent of injured people threatened violence against others; 10% presented only self-harming symptoms, and 5% presented no symptoms. MBH involvement was associated with 1.5-times higher odds of fatality than MBH-uninvolved shootings and 31% higher odds of injuring an unarmed person vs. person with a gun. Clinician presence was identified in 1% of MBH-involved shootings.

Conclusions: Police are de facto mental health system responders. Associated harms may be reduced through triage systems to facilitate clinician involvement, extreme risk protection order statutes, and better police training and protocols.

Background: Systematic reviews have identified variation and inequity in care provision for people with pre-existing severe mental illnesses who have palliative or end-of-life care needs.

Aim: To analyse service use and variation for people with severe mental illness in the last year of life in Wales.

Methods: This is an observational retrospective cohort study between 2018 - 2023 using anonymised linked routinely collected health datasets within a data dashboard.

Results: We identified n = 4722 (2.3%) deaths with ICD-10 codes for severe mental illness for the period 2018-2023. As a group, people with severe mental illness die younger, are in receipt of specialist palliative care at lower rates, die more often in institutional settings rather than their own homes and comorbidity indicates more unscheduled care use in the last year of life.

Conclusions: Unscheduled care use in the last year of life is associated with comorbidity, indicating opportunities for upstream intervention to improve treatment, experience, and quality of life for people with severe mental illness. Further investigation, such as mixed methods approaches to examine experiences of those with severe mental illness in the last year of life, and the human and systems factors influencing the nature and effectiveness of unscheduled delivery, is needed.

Background: Limited evidence exists regarding how sex differences in mental health are changing over time, especially in the context of recent health and economic adversities.

Aims: To examine the temporal shifts in mental health issues among males and females, and explore the influence of education and loneliness on these trends.

Methods: Data were utilized from the 2020 to 2023 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The study employed a Qualtrics-based web panel survey (n = 5,317). Mental health was assessed using Kessler-6 questionnaire, and analyses were performed using Generalized Linear Model (GLM) with gamma distribution.

Results: The results showed that there was a significant three-way interaction effect between sex, time and education with psychological distress (p = 0.014), suggesting that psychological distress increased between 2020 and 2023 among males who had less than college education. However, it remained stable among males with college/university degrees and females overall. Interaction between sex and feeling lonely on psychological distress was also evident (p = 0.004).

Conclusions: Mental health issues remained a significant public health challenge among adults, especially psychological distress increasing among males with less than a college education. This underscores the importance of targeted interventions addressing males' mental health.