Discover mental health最新文献

Background: Data are needed on differences in community-dwelling populations with bipolar disorder (BP) regarding trust in research and access to care. We characterized community members by lifetime history of bipolar disorder. We hypothesized that those with BP would have less trust in research, visit a health provider less, and participate less in research than those without BP. We also hypothesized that those with BP would be more likely to have a history of marijuana (MJ) use.

Methods: A cross-sectional design was used for this analysis. The study population consisted of 12,489 members (78.0%) from the HealthStreet community engagement program who were interviewed by a Community Health Worker about health history and demographics.

Results: Among the sample, the rate of BP was 10.6% (n = 1326). Those reporting BP were more likely than those who did not (n = 11,163), to report muscle, bone, and mental health problems, to be younger, female, to have visited the doctor in the past 12 months, to be interested in participating in research, and be current MJ users. Trust did not differ between BP groups.

Conclusions: Our analysis found that persons with BP had higher access to care and more interest in research, thus our primary hypothesis was rejected. Our secondary hypothesis, that persons with BP were more likely to have a history of MJ use was upheld. These findings are important because they address a crucial gap in the literature surrounding BP and lay the groundwork for future community-level research.

Background: This case report describes an infrequent instance of risperidone-induced hyperprolactinemia in a 23-year-old nonverbal male with cri du chat syndrome.

Case presentation: Risperidone, initially prescribed to manage aggressive behaviors, resulted in bilateral gynecomastia and hyperprolactinemia. Tapering of risperidone led to resolution of these symptoms but exposed a resurgence of excessive masturbation, a behavior previously suppressed by the medication. Reintroduction of risperidone controlled this behavior, suggesting its potential role in managing compulsive behaviors in this population.

Conclusion: This case underscores the complex interaction between pharmacological treatment and behavioral symptoms in neurodevelopmental disorders. It highlights the necessity for meticulous monitoring and individualized treatment approaches in managing such cases.

Case presentation: Initially prescribed for managing aggressive behaviors, Risperidone led to bilateral gynecomastia and hyperprolactinemia in the patient. Gradual tapering of Risperidone alleviated these symptoms but unveiled a resurgence of excessive masturbation, a behavior previously suppressed by the medication. Reintroduction of Risperidone mitigated this behavior, suggesting its potential efficacy in managing compulsive tendencies in this demographic.

Conclusion: This case highlights the intricate interplay between pharmacological interventions and the complex behavioral manifestations of neurodevelopmental disorders. It underscores the importance of vigilant monitoring and personalized treatment strategies in such cases.

Over the years, the use of Electroconvulsive therapy (ECT) has gained increasing acceptance as a viable treatment for managing treatment-resistant mental health conditions, and it is known to deliver more rapid therapeutic benefits than most treatment modalities in psychiatry. However, the practice of ECT exhibits significant variability both within and between countries. This review aimed to shed light on the status of ECT in the African context and its implications for mental health care in the region. In July 2023, databases (Ovid, PubMed, Web of Science, etc.) were searched for articles about ECT in Africa, following the PRISMA guidelines. Eligible studies reporting ECT practices in Africa and those about knowledge, attitudes, and perceptions were excluded. A total of 25 articles met the study criteria. The reviewed studies revealed that unmodified ECT continues to be used in some African countries due to resource limitations, while bilateral ECT is widely practiced across the continent. The primary diagnostic indications for ECT in Africa included severe depression and affective disorders. ECT usage and regulation vary significantly throughout Africa. The studies, primarily observational, detailed numerous challenges in employing the method, particularly concerning resource utilization in healthcare facilities. The review highlights the necessity for adaptable standards and local protocols to enhance ECT practices throughout Africa. It emphasizes the importance of conducting more evidence-based research to develop region-specific guidelines that ensure the safe and effective use of ECT. Policymakers and healthcare practitioners should prioritize resource allocation, training, and standardization to improve ECT delivery and outcomes on the continent.

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.

Background: The COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework.

Methods: The study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services.

Results: Overall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services.

Conclusions: While remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services.

Violence, poor mental health, and harmful substance use are commonly experienced by female sex workers (FSWs) in sub-Saharan Africa, all of which are associated with increased HIV susceptibility. We aimed to investigate the associations between violence, poor mental health and harmful alcohol/substance use with hair cortisol concentration (HCC) levels as a potential biological pathway linking the experiences of these stressors and HIV vulnerability. We used the baseline data of the Maisha Fiti study of FSWs in Nairobi, Kenya. Participants reported recent violence, poor mental health, and harmful alcohol/substance use. Hair samples proximal to the scalp were collected to measure cortisol levels determined by ELISA. We analysed the data of 425 HIV-negative respondents who provided at least 2 cm of hair sample. The prevalence of recent violence was 89.3% (physical 54.6%; sexual 49.4%; emotional 77.0% and financial 66.5%), and 29.1% had been arrested due to sex work. 23.7% of participants reported moderate/severe depression, 11.6% moderate/severe anxiety, 13.5% PTSD and 10.8% recent suicidal thoughts and/or attempts. About half of the participants (48.8%) reported recent harmful alcohol and/or other substance use. In multivariable linear regression analyses, both physical and/or sexual violence (adjusted geometric mean ratio (aGMR) = 1.28; 95% CI 1.01-1.62) and harmful alcohol and/or other substance use (aGMR = 1.31; 95% CI 1.03-1.65) were positively and independently associated with increased HCC levels. Findings suggest a role of violence and substance use in elevated HCC levels, which could increase HIV risk due to cortisol-related T cell activation. However, longitudinal and mechanistic studies are needed to confirm this hypothesis.

Background: Tiredness, poor concentration, disturbed sleep and poor appetite can all be caused by depression, which is a common mental disorder and a leading cause of disability worldwide. This study aimed to assess the prevalence of major depressive disorder, suicidal ideation, and risk factors in Sudanese children and adolescents during the Sudanese army conflict.

Methods: A descriptive cross-sectional community-based study was carried out among Sudanese children between 11 and 17 years old who living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Patients Health Questionnaire-9 (PHQ-9) checklist for the assessment of major depression disorder symptoms according to the Diagnostic and Statistical Manual Edition 5th Edition (DSM-5). The questionnaire was translated into Arabic by two expert translators, and its validity and reliability were confirmed. Data analysis was performed using Statistical Package for the Social Sciences version 25 software, and descriptive analysis and any appropriate statistical tests were performed.

Results: Among the 963 participants, the mean age was 15.18 ± 2.1 years, 65.5% were female, and 67.7% had major depressive disorder. There was a significant relationship between MDD score, age, sex, current residency status, and traumatic event exposure, with P values less than 0.001 for all variables.

Conclusion: Major depressive disorder was highly prevalent among Sudanese children and adolescents included in the present study. Additionally, suicidal ideation, which requires immediate intervention, was reported to be very high. The findings will help the government to provide proper mental health interventions for affected people.

Background: There is a growing recognition that staff attitudes toward coercion in mental health care may influence its application. This study presents the psychometric properties of the Portuguese version of the Staff Attitudes towards Coercion Scale (SACS) and describes mental health professionals' attitudes towards coercion in Portugal.

Methods: Mental health professionals working in five Portuguese mental health services in urban and rural regions of Portugal were invited to complete a questionnaire comprising the SACS and a socio-demographic form. Psychometric analyses including construct validity and internal consistency were carried out using R software.

Results: A total of 91 out of 119 questionnaires completed were valid for analysis. Fifty-seven (62.64%) respondents were female, with an age range of 24 to 69 years (M = 39.33; SD = 11.09). More than half of them were nurses (52.75%, n = 48), and a third were psychiatrists (36.26%, n = 33). A three-factor structure was confirmed and showed the best fit compared to previously proposed models with a cumulative explained variance of 59%. The Portuguese SACS exhibited adequate internal consistency for both the full-scale and subscales. The highest mean score was in the pragmatic attitude domain (20.60; SD = 3.37). A negative correlation was observed between the critical attitude domain and both age and years of experience (p < 0.05).

Conclusion: A three-factor structure was confirmed and showed the best fit compared to previously proposed models. The Portuguese SACS showed excellent psychometric properties and is acceptable for assessing staff attitudes towards coercion.

Background: Anxiety, depression, and Type D personality are strongly correlated with the prognosis of IHD and the effectiveness of therapy. The main purpose of this study was to assess the proportions and associations of anxiety, depression, and Type D personality among clinically stable IHD patients (aged 18-60) treated at an outpatient clinic operated by a government hospital in Sri Lanka, who were diagnosed with IHD within the preceding three months.

Methods: A cross-sectional study design was analysed using SPSS® version 23.0. The validated Sinhalese version of the Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression, while the DS-14 was used to determine Type D personality traits.

Results: Among the 399 patients, 29.8% (n = 119) had anxiety, 24.8% (n = 99) had depression, and 24.6% (n = 24.6) had Type D personality. The level of anxiety had a significant association with depression (p = 0.002) and Type D personality (p = 0.003). Furthermore, depression was significantly associated with ethnicity (p = 0.014), occupation (p = 0.010), and type D personality (p = 0.009). Type D personality was the strongest predictor of anxiety, with patients being 1.902 times more likely to experience anxiety (95% CI 1.149-3.148; p = 0.012). Anxiety was a significant predictor of depression, with patients being 1.997 times more likely to experience depression (95% CI 1.210-3.296; p = 0.007). Non-Sinhalese ethnic background was also a significant predictor of depression (OR: 0.240; 95% CI 0.073-0.785; p = 0.018). Anxiety increased the likelihood of having Type D personality traits by 1.899 times (95% CI 1.148-3.143; p = 0.013).

Conclusion: The current study recommends the importance of screening and treating the psychological risk factors of IHD patients parallel to their IHD treatment to improve their prognosis. These insights highlight the need for targeted interventions that address depression, anxiety and the impact of Type D personality traits in enhancing the overall management and prognosis of IHD.