Discover mental health最新文献

Purpose: The COVID-19 pandemic had a profound negative effect on mental health worldwide. The hospital emergency department plays a pivotal role in responding to mental health crises. Understanding data trends relating to hospital emergency department usage is beneficial for service planning, particularly around preparing for future pandemics. Machine learning has been used to mine large volumes of unstructured data to extract meaningful data in relation to mental health presentations. This study aims to analyse trends in five mental health-related presentations to an emergency department before and during, the COVID-19 pandemic.

Methods: Data from 690,514 presentations to two Australian, public hospital emergency departments between April 2019 to February 2022 were assessed. A machine learning-based framework, Mining Emergency Department Records, Evolutionary Algorithm Data Search (MEDREADS), was used to identify suicidality, psychosis, mania, eating disorder, and substance use.

Results: While the mental health-related presentations to the emergency department increased during the COVID-19 pandemic compared to pre-pandemic levels, the proportion of mental health presentations relative to the total emergency department presentations decreased. Several troughs in presentation frequency were identified across the pandemic period, which occurred consistently during the public health lockdown and restriction periods.

Conclusion: This study implemented novel machine learning techniques to analyse mental health presentations to an emergency department during the COVID-19 pandemic. Results inform understanding of the use of emergency mental health services during the pandemic, and highlight opportunities to further investigate patterns in presentation.

Positive and negative emotional states in rats can be studied by investigating ultrasonic vocalizations (USVs). Positive affect in rats is indexed by 50 kHz hedonic USVs, and negative affect is indexed by 22 kHz aversive calls. We examined the relationship of emotional states in rats using medial prefrontal cortex (MPFC) quantitative electroencephalograms (qEEG) and found that hedonic USVs were associated with active wake qEEG (high alpha/low delta power), and aversive USVs occurred with groggy wake qEEG (low alpha/high delta). Further, alpha frequency electrical stimulation of the MPFC induces hedonic calls and reward-seeking behavior, whereas delta frequency stimulation produces aversive calls and avoidance behavior. The brain region responsible for generating motor output for USVs, the periaqueductal gray (PAG), shows a motor-evoked potential that is temporally locked to the alpha (hedonic) and delta (aversive) motor-evoked potential. Closed-loop alpha frequency electrical stimulation could prevent delta qEEG and aversive USVs. At the neuronal circuit level, the alpha rhythm was associated with synaptic long-term potentiation (LTP) in the cortex, whereas the delta rhythm was associated with synaptic depotentiation (LTD) in the cortex. At the pharmacological level, NMDAR and growth factor modulation regulated these forms of neuroplasticity. At the single neuron level, excitatory neurons show increased activity in response to alpha frequencies and decreased activity during delta frequencies. In humans, the feeling of joy increased alpha and decreased delta power in frontal scalp qEEG, and the opposite response was seen for sadness. Thus, the synchronization of alpha/delta oscillations through the neuronal circuit responsible for emotional expression coordinates emotional behavior, and the switch between active wake/positive affect and groggy wake/negative affect is under the control of an LTP- LTD synaptic plasticity mechanism.

Objective: Mental health problems are a leading and increasing cause of health-related burden in children across the world. Peer support interventions are increasingly used to meet this need using the lived experience of people with a history of mental health problems. However, much of the research underpinning this work has focused on adults, leaving a gap in knowledge about how these complex interventions may work for different children in different circumstances. Realist research may help us to understand how such complex interventions may trigger different mechanisms to produce different outcomes in children. This paper reports on an important first step in realist research, namely the construction of an embryonic initial programme theory to help 'focus' realist evaluation exploring how children's peer support services work in different contexts to produce different outcomes in the West Midlands (UK).

Methods: A survey and preliminary semi-structured realist interviews were conducted with 10 people involved in the delivery of peer support services. Realist analysis was carried out to produce context-mechanism-outcome configurations (CMOC).

Results: Analysis produced an initial programme theory of peer support for children's mental health. This included 12 CMOCs. Important outcomes identified by peer support staff included hope, service engagement, wellbeing, resilience, and confidence; each generated by different mechanisms including contextualisation of psychoeducation, navigating barriers to accessing services, validation, skill development, therapeutic relationship, empowerment, and reducing stigma.

Conclusion: These data lay the groundwork for designing youth mental health realist research to evaluate with nuance the complexities of what components of peer support work for whom in varying circumstances.

The present study aimed to describe adolescents' self-reported emotional and behavioural strengths and difficulties, as well as their insecurity feeling. In addition, the aim was to examine the association with background characteristics, and explore the association between strengths and difficulties and insecurity factors. The study was conducted among 114 secondary school pupils in Finland, using an online questionnaire. Adolescents' emotional and behavioural difficulties and strengths, were mostly classified as normal. Strengths and Difficulties Questionnaire total score as well as internal and external score, were inversely associated with insecurity factors. Girls had significantly higher prosocial behavior compared to boys (P = 0.0007). The age of adolescents was found to be related to their internal difficulties (P = 0.02) and prosocial behavior (P = 0.01). Adolescent's perception of their family relations as poor was associated with external difficulties (P = 0.04). The current results, can be helpful for mental health professionals who work with adolescents in order to implement appropriate and needs specific mental health promotion interventions at individual but also community level. Finally, more research is needed to validate measures for insecurity. This will support mental health professionals in their clinical practice by providing them with all the important factors needed to support adolescents.

The growing global burden of mental illness has prompted calls for innovative research strategies. Theoretical models of mental health include complex contributions of biological, psychosocial, experiential, and other environmental influences. Accordingly, neuropsychiatric research has self-organized into largely isolated disciplines working to decode each individual contribution. However, research directly modeling objective biological measurements in combination with cognitive, psychological, demographic, or other environmental measurements is only now beginning to proliferate. This review aims to (1) to describe the landscape of modern mental health research and current movement towards integrative study, (2) to provide a concrete framework for quantitative integrative research, which we call Whole Person Modeling, (3) to explore existing and emerging techniques and methods used in Whole Person Modeling, and (4) to discuss our observations about the scarcity, potential value, and untested aspects of highly transdisciplinary research in general. Whole Person Modeling studies have the potential to provide a better understanding of multilevel phenomena, deliver more accurate diagnostic and prognostic tests to aid in clinical decision making, and test long standing theoretical models of mental illness. Some current barriers to progress include challenges with interdisciplinary communication and collaboration, systemic cultural barriers to transdisciplinary career paths, technical challenges in model specification, bias, and data harmonization, and gaps in transdisciplinary educational programs. We hope to ease anxiety in the field surrounding the often mysterious and intimidating world of transdisciplinary, data-driven mental health research and provide a useful orientation for students or highly specialized researchers who are new to this area.

Adverse influences during pregnancy are associated with a range of unfavorable outcomes for the developing offspring. Maternal psychosocial stress, exposure to infections and nutritional imbalances are known risk factors for neurodevelopmental derangements and according psychiatric and neurological manifestations later in offspring life. In this context, the maternal immune activation (MIA) model has been extensively used in preclinical research to study how stimulation of the maternal immune system during gestation derails the tightly coordinated sequence of fetal neurodevelopment. The ensuing consequence of MIA for offspring brain structure and function are majorly manifested in behavioral and cognitive abnormalities, phenotypically presenting during the periods of adolescence and adulthood. These observations have been interpreted within the framework of the "double-hit-hypothesis" suggesting that an elevated risk for neurodevelopmental disorders results from an individual being subjected to two adverse environmental influences at distinct periods of life, jointly leading to the emergence of pathology. The early postnatal period, during which the caregiving parent is the major determinant of the newborn´s environment, constitutes a window of vulnerability to external stimuli. Considering that MIA not only affects the developing fetus, but also impinges on the mother´s brain, which is in a state of heightened malleability during pregnancy, the impact of MIA on maternal brain function and behavior postpartum may importantly contribute to the detrimental consequences for her progeny. Here we review current information on the interaction between the prenatal and postnatal maternal environments in the modulation of offspring development and their relevance for the pathophysiology of the MIA model.

Background: Questions of equitable access to primary mental healthcare (PMHC) for older persons in India have been examined mostly in terms of the coverage of services, although perceptions of mental health and old age and social norms at the community level should be considered in the shaping of PMHC approaches. The present qualitative study, therefore, examined how social perceptions and norms of mental health in old age are and should be considered in the design and implementation of primary healthcare approaches in India.

Methods: A secondary thematic analysis of semi-structured interviews with key stakeholders (n = 14) of PMHC in India was conducted.

Results: Four key themes emerged from the analysis, in which social perceptions and norms were discussed: (1) family participation and low threshold access to mental healthcare, (2) the position of community health workers as an important pillar of old age and mental health-sensitive community-based care, (3) the role of social cohesion and traditional values in fostering a positive and supportive community environment for old age mental health, and (4) the empowerment of communities, families and older persons through mental health education.

Conclusions: PMHC, with its focus on mental health promotion, could be an important anchor for combatting negative attitudes about mental health and old age. The findings presented in this study can inform age-sensitive policies and programmes for mental health in India and could inform future research on the subject.

Health care coverage is an important factor in receipt of behavioral healthcare. This study uses data from the New York City Community Health Survey to examine how sexual minority status impacts the relationship between depression status and having health care coverage. Approximately 10% of the sample (n = 9571; 47% 45+ years old; 35% White Non-Hispanic; 7% sexual minority) reported probable depression and low health care coverage. Compared to heterosexual participants, a greater proportion of sexual minority participants had low health care coverage (17% vs. 9%) and probable depression (19% vs. 9%). Logistic regression examining the association between probable depression status and health care coverage showed that those with probable depression have odds of low health care coverage that are were 3.08 times those who did not have probable depression; this relationship was not modified by sexual orientation. Continued research to understand the interplay of health care coverage, mental health, and sexual orientation is needed.