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Objectives: Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals. This study aimed to explore the challenges that community health workers (CHWs) encounter while providing mental health services in the community. Methods: Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers (PHCs) among three cites of Indonesia. Focus group discussions were used to collect data. All of data were analyzed using the interpretive phenomenological analysis method. Results: Considering the participants’ voluntary CHW role, the results were organized into five themes. These comprised two themes of challenges—family stigma and limited understanding of mental disorders, and three themes regarding efforts to overcome the challenges—maintaining self-motivation, fostering self-efficacy, and using communication skills when approaching families and patients. Conclusions: Upskilling and empowering CHWs helps to enhance community mental health. Thus, it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.

Salix mucronata is one of the herbal plants offered by the traditional health practitioners in KwaZulu-Natal, South Africa for the treatment of schizophrenia. This study aimed to investigate the effects of repeated administration of ketamine on social interaction, novelty and motivation in adult, male Sprague Dawley rats. It also aimed to investigate the potential of risperidone and the herbal extract of S. mucronata to reverse impairments that are induced by ketamine. Experimental rats (n=45) received a dose of ketamine at 30 mg/kg via intraperitoneal injection for 5 consecutive days. They were then allocated into their respective treatment groups and given risperidone (APD) and the herbal extract of S. mucronata (TM) at doses of 6 mg/kg and 5 mg/kg, respectively, for 7 consecutive days. Social behaviour was tested using the 3-chambered sociability test, and anhedonia was tested using the sucrose preference test. Ketamine induction elicited social withdrawal and reduced social novelty which were later successfully reversed by risperidone and S. mucronata. The rats showed reduced preference to sucrose post-induction and post-treatment. Ketamine and mild stress caused by scruff restraint elicited reduced weight gain for the animals. No differences were noted on brain mass between controls and experimental groups and also between risperidone and S. mucronata groups. However, reduced brain volume was noted in experimental groups. Dopamine and acetylcholine concentration levels were high in groups which received risperidone and S. mucronata. These findings highlight that the antipsychotic potential of S. mucronata is similar to risperidone.

Existing works relied on subjective interviews in clinical settings, which does not detect mental health problems at early stages. With the advancement in learning strategies, research are trying to find a better way for detecting mental disorders and dysfunctions at early stages. EEG signal measurements is one of the prolific ways for identifying mental disorders and dysfunction in a non-invasive and ubiquitous way. However, the label scarcity and multiclass classification concerning EEG signal measurements has been a challenge for the research community that hinders the realization of automated mental dysfunction identification using EEG signals. Data imbalance is another issue that indirectly relates to the data scarcity issue. To tackle this challenge, we propose a novel Transformer-based Self-Contrastive and Multitask Learning (SCAM-Learning) framework for mental dysfunction classification using EEG signals. The SCAM-Learning framework uses Transformer networks, self-supervised contrastive learning paradigm, and multitask learning strategy to improve the classification performance. The multitask learning is accomplished by utilizing simple and complex data augmentation strategies to train the network for pretext task. The self-supervised contrastive learning helps in dealing with data and label scarcity issues. We also propose a novel cross contrastive loss that helps in improving interdependent correlation matrix for improving the classification performance. Our experimental results on a publicly available dataset reveal that the proposed method can achieve up to 11.89% performance gain in comparison to the existing state-of-the-art methods.

Summary: Background: Understanding the disease burden of mental disorders in children and adolescents in China, especially at the sub-national level, is important for effective prevention and intervention. This study aims to assess the prevalence and related health burden of mental disorders in children and adolescents in China. Methods: Following the same approach as the Global Burden of Disease Study 2021, we systematically analyze epidemiological and demographic information for mental disorders, and assess the prevalence, disability-adjusted life-years (DALYs), and years lived with disability (YLDs) in the children and adolescents for mental disorders and their ten subtypes across national and provinces in China from 1990 to 2021. Findings: In 2021, the age-standardized prevalence of mental disorders in children and adolescents was 8.9% (uncertainty intervals [UI]: 8.1, 9.8) in China, accounting for 30.8 million cases (26.0, 36.3) and 2.8 million DALYs (2.0, 3.7). Among mental disorders, attention-deficit/hyperactivity disorder had the highest age-standardized prevalence, at 3.6% (3.0, 4.5). From 1990 to 2021, the age-standardized prevalence increased by 4.8%, but the number of mental disorders cases decreased by 21.9%. DALYs for mental disorders are higher in boys than in girls across all age groups. At the provincial level, the age-standardized prevalence of mental disorders in some provinces was much greater than that in other provinces (e.g., bipolar disorder in Hebei was more than two times greater than that in other provinces). Although disparities in the distribution of mental disorder burden were observed across provinces, there was a reduction in income-related inequality, where the gap in the age-standardized DALY rates between the highest and lowest income provinces decreased by 61.7% between 1990 and 2021. In 2021, among 22 health condition groups in China, mental disorders accounted for the largest proportion of health life lost. Interpretation: Mental disorders are the leading causes of disability in children and adolescents in China, and the disease burden varies geographically. Careful planning of health services, including consideration of the local situation, is needed. Funding: China National Natural Science Foundation (Grant No. 72104113, 72204112), Social Science Fund of Jiangsu Province (Grant No. 21GLD008), ShuangChuang Doctor Program of Jiangsu Province (Grant No. JSSCBS20210359), and the Fundamental Research Funds for the Central Universities (Grant No. 30923011101).

Background: The causal relationship between PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) and common mental disorders, along with its neuropathological mechanisms, remains unclear. Methods: We used genome-wide association study datasets from the UK Biobank and Psychiatric Genomics Consortium to systematically investigate the causal relationship between PM2.5 and nine common psychiatric disorders using two-sample Mendelian randomization (TSMR) methods. Subsequently, we used two-step MR to investigate the mediating effect of 108 potential mediators in the association between PM2.5 and mental disorders. Results: Our findings indicated that PM2.5 was positively associated with major depressive disorder (odds ratio (OR): 1.33, 95 % confidence interval (CI): 1.11–1.55), anxiety disorder (OR: 2.96, 95 % CI: 2.13–3.79), schizophrenia (OR: 1.55, 95 % CI: 1.29–1.81), and attention deficit hyperactivity disorder (ADHD) (OR: 1.95, 95 % CI: 1.66–2.24). Unexpectedly, PM2.5 was inversely associated with bipolar disorder (OR: 0.65, 95 % CI: 0.37–0.93). Additionally, PM2.5 was not significantly associated with autism spectrum disorders (OR: 1.24, 95 % CI: 0.83–1.65), post-traumatic stress disorder (OR: 1.51, 95 % CI: 1.11–1.91), obsessive-compulsive disorder (OR: 0.81, 95 % CI: −0.07–1.69), or anorexia nervosa (OR: 1.42, 95 % CI: 0.86–1.98). Further analysis using two-step MR revealed that Neurotrophin-3 mediated 9.86 % of the PM2.5-ADHD association and 5.88 % of the PM2.5-schizophrenia association. Sensitivity analyses supported these findings. Conclusions: This TSMR analysis provides a comprehensive examination of the causal relationship between PM2.5 exposure and nine common psychiatric disorders, with mediation analysis offering insight into the underlying mechanisms. This study aims to raise public awareness of how air quality affects mental health through empirical evidence.

Background: Emerging research has suggested a link between ambient temperature and mental and neurological conditions such as depression and dementia. This systematic review aims to summarize the epidemiological evidence on the effects of ambient temperature on mental and neurological conditions in older adults, who may be more vulnerable to temperature-related health effects compared to younger individuals. Methods: A systematic search was conducted in PubMed, Ovid/Embase, Web of Science, and Ovid/PsycINFO on July 17, 2023, and updated on July 31, 2024. We included epidemiological studies investigating the association between ambient temperature exposures and numerous mental and neurological conditions in populations aged 60 years and older. Exclusions were made for studies on indoor or controlled exposure, suicide, substance abuse, those not published as peer-reviewed journal articles, or those not written in English. The risk of bias of included studies was assessed using a tool developed by the World Health Organization (WHO). Qualitative synthesis was performed on all eligible studies, and random-effects meta-analyses were conducted on groups of at least four studies sharing similar study design, exposure metric, and health outcome. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework modified by the WHO. Results: From 16,786 screened articles, 76 studies were deemed eligible, primarily from mainland China and North America. There was notable heterogeneity in study variables and methodologies. The most commonly used exposure metrics were daily absolute temperature and heat waves, and time-series and case-crossover analyses were the most frequently employed study designs. Meta-analysis of four studies on the effect of a 1 °C increase in temperature on hospital admissions/visits for mental disorders showed a pooled risk ratio (RR) of 1.014 (95 % Confidence Interval, CI: 1.001, 1.026). Comparing heat wave days to non-heat wave days, pooled effect estimates showed increased risk in hospital admissions/visits (RR: 1.269; 95 % CI: 1.030, 1.564; six studies) and mortality related to mental disorders (RR: 1.266; 95 % CI: 0.956, 1.678; four studies). Despite the limited number of studies on cold exposures, they consistently reported that lower temperatures were associated with an increased risk of various mental and neurological conditions. Conclusions: This review presents epidemiological evidence of the adverse impacts of ambient temperature exposures, such as high temperatures and heat waves, on mental and neurological conditions among the older adult population, with overall moderate certainty. The findings highlight the need for greater attention to the mental and neurological health of older adults in the context of climate change and population aging.Registration number (PROSPERO ID): CRD42023428137.

Objective: The successful implementation and interpretation of machine learning (ML) models in epidemiological studies can be challenging without an extensive programming background. We provide a didactic example of machine learning for risk prediction in this study by determining whether early life factors could be useful for predicting adolescent psychopathology. Methods: In total, 9643 adolescents ages 9–10 from the Adolescent Brain and Cognitive Development (ABCD) Study were included in ML analysis to predict high Child Behavior Checklist (CBCL) scores (i.e., t-scores ≥ 60). ML models were constructed using a series of predictor combinations (prenatal, family history, sociodemographic) across 5 different algorithms. We assessed ML performance through sensitivity, specificity, F1-score, and area under the curve (AUC) metrics. Results: A total of 1267 adolescents (13.1 %) were found to have high CBCL scores. The best performing algorithms were elastic net and gradient boosted trees. The best performing elastic net models included prenatal and family history factors (Sensitivity 0.654, Specificity 0.713; AUC 0.742, F1-score 0.401) and prenatal, family, history, and sociodemographic factors (Sensitivity 0.668, Specificity 0.704; AUC 0.745, F1-score 0.402). Across all 5 ML algorithms, family history factors (e.g., either parent had nervous breakdowns, trouble holding jobs/fights/police encounters, and counseling for mental issues) and sociodemographic covariates (e.g., maternal age, child's sex, caregiver income and caregiver education) tended to be better predictors of adolescent psychopathology. The most important prenatal predictors were unplanned pregnancy, birth complications, and pregnancy complications. Conclusion: Our results suggest that inclusion of prenatal, family history, and sociodemographic factors in ML models can generate moderately accurate predictions of adolescent psychopathology. Issues associated with model overfitting, hyperparameter tuning, and system seed setting should be considered throughout model training, testing, and validation. Future early risk predictions models may improve with the inclusion of additional relevant covariates.

Introduction: Medical education presents significant challenges for medical students' mental health. Medical students are a vulnerable group, experiencing higher rates of mental health disorders, which can have implications for their well-being and academic performance. Consequently, evaluating Positive mental health (PMH) has become significant in a contemporary and demanding society, particularly among university students. Aim: This study aimed to assess the levels of PMH and identify the association between PMH domains and socio-demographic and health related variables among medical students enrolled at a university in South Africa. Methods: This quantitative, descriptive, and cross-sectional survey was conducted with 144 undergraduate medical students. Data were collected using a multi-dimensional PMH instrument and a sociodemographic and health related questionnaire, from 144 undergraduate medical students. The university's Research and Ethics Committee granted ethical clearance for the study. Results: The data were analysed using IBM SPSS version 29. The majority of the students were older than 20 years (79.2 %, n = 114), had no prior history of psychiatric illness, and had not previously taken any psychiatric medication (94.4 %, n = 136). More than half of the participants were single (66 %, n = 95), identified as Christians (76.4 %, n = 110), received a bursary (78.5 %, n = 113), had families living in rural areas (71.5 %, n = 103) and resided in the university housing (73.6 %, n = 106). Gender (p = 0.01), age (p = 0.02), religious affiliation (p = 0.03), history of psychiatric illness (p = 0.05) and treatment for psychiatric illness (p = 0.05) had a significant influence on the Total PMH score. Male participants reported higher mean scores in most PMH domains, excluding emotional support and spirituality domains. Participants aged between 22 and 23 years reported lower mean scores in Total PMH and most PMH domains. There is a significant difference in mean scores with gender (p = 0.02) and religious affiliation (p = 0.00) in the spirituality domain. Conclusion: The study results emphasised the complex nature of mental health and provided a rationale for assessing the various aspects of PMH in university students. By implementing evidence-based strategies and providing adequate support, medical schools can better support the mental health and well-being of their students, ultimately cultivating a healthier and more resilient future healthcare workforce.

This study aimed to investigate the prevalence and relationships of cyber fraud on dating applications and mental health among emerging adults. An online survey was conducted in Hong Kong (n = 401). Results showed that 32% of the dating application users encountered cyber-fraud in the last 2 weeks. Users encountering cyber-fraud had significantly poorer mental health than non-victim users and non-users. Education levels, being female, financial loss, and the leakage of private information were positively related to mental health problems of cyber-fraud victims. Education programs and supporting services are warranted to enhance youth's awareness and minimize the detrimental effects caused by cyber fraud.

Background: Existing epidemiological studies have indicated a correlation between air pollutants and the occurrence of mental disorders. However, it is difficult to estimate the causal relationship between the two because of the limitations of traditional epidemiological research. In our study, we aimed to extensively explore the causal relationship between five types of air pollutants and four types of mental disorders. Methods: Based on the IEU OPEN GWAS database, we performed a two-sample MR analysis. The primary analysis method utilized was the inverse variance weighted (IVW) method, supplemented by the MR-Egger method and the weighted median method. Additionally, we conducted sensitivity analyses with the Cochran's Q statistic method, the leave-one-out method, and the MR-Egger intercept. We chose at least 4 GWAS datasets for each of the four psychiatric diseases and conducted a meta-analysis of our results of the MR analysis. Results: The meta-analysis's findings demonstrated a causal link between depression and PM2.5 (OR=1.020, 95 %CI: (1.010,1.030), P=0.001). PM10 and schizophrenia are also causally related (OR=1.136, 95 %CI: (1.034,1.248), P=0.008). Nitrogen oxides and bipolar disorder have a causal relationship (OR=1.002, 95 %CI: (1.000,1.003), P=0.022). Nitrogen oxides and schizophrenia have a high causal association (OR=1.439, 95 %CI: (1.183,1.752), P

Summary: Purpose: Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This meta-synthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness. Methods: We systematically searched seven databases [PubMed, CINAHL, Medline (OVID), PsycINFO (OVID), Cochrane, Embase, and ProQuest] in May 2023 and included the studies if they reported the barriers or/and facilitators to seek healthcare in rural patients with mental illness. We conducted hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed. Results: The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007 to 2023. We ultimately identified themes at three levels: navigating the terrain of vulnerability and empowerment (the individual with mental illness), navigating the terrain of external environment (the external environment) and connectivity within the healthcare ecosystem for mental health (the health service system). Conclusions: We must design more effective strategies to improve mental healthcare access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.

Indoor lighting can regulate human mood and sleep, further alleviating mental disorder symptoms. Indoor light intervention (ILI) has been demonstrated as therapeutic for mental disease but lacks standardized guidelines for key parameter settings. This review aims to explore the optimal parameters for widely utilized ILI. We conducted a thorough review of research articles published from 1990 to 2023 in the Web of Science, PubMed, and Scopus databases following the PRISMA guidance. Out of a total of 95728 records, 40 eligible studies were analyzed. We subsequently empirically summarized the ILI’s key parameters (i.e., wavelength, illuminance, and exposure time) into each category and compared the therapeutic effects among different ILI groups within each category. Furthermore, we conducted a multivariate model analysis to identify the optimal parameters further while controlling for confounding factors. Results indicate that ILI was mainly used for treating depressive disorders, accounting for 88% of the included articles. Notably, 450 – 550 nm peak wavelength light exhibited superior therapeutic efficacy compared to other wavelengths. Light illuminance within 2500 – 10000 lux correlated significantly and positively with efficacy. Morning ILI appeared more effective than evening ILI, and the efficacy increased with the number of treatment days. Optimizing light wavelength, illuminance, and exposure time of indoor light intervention can significantly enhance its therapeutic effects on mental illness. Our review provides a fundamental reference for improving the use of indoor light intervention in treating mental disorders and optimizing indoor lighting design for a healthy indoor environment.

Background: Mental disorders (MDs) are becoming a leading burden in non-communicable diseases (NCDs). As per the World Health Organization's 2022 assessment report, there was a steep increase of 25 % in MDs during the COVID-19 pandemic. Early diagnosis of MDs can significantly improve treatment outcome and save disability-adjusted life years (DALYs). In recent times, the application of machine learning (ML) and deep learning (DL)) has shown promising results in the diagnosis of MDs, and the field has witnessed a huge research output in the form of research publications. Therefore, a bibliometric mapping along with a review of recent advancements is required. Methods: This study presents a bibliometric analysis and review of the research, published over the last 10 years. Literature searches were conducted in the Scopus database for the period from January 1, 2012, to June 9, 2023. The data was filtered and screened to include only relevant and reliable publications. A total of 2811 journal articles were found. The data was exported to a comma-separated value (CSV) format for further analysis. Furthermore, a review of 40 selected studies was performed. Results: The popularity of ML techniques in diagnosing MDs has been growing, with an annual research growth rate of 17.05 %. The Journal of Affective Disorders published the most documents (n = 97), while Wang Y. (n = 64) has published the most articles. Lotka's law is observed, with a minority of authors contributing the majority of publications. The top affiliating institutes are the West China Hospital of Sichuan University followed by the University of California, with China and the US dominating the top 10 institutes. While China has more publications, papers affiliated with the US receive more citations. Depression and schizophrenia are the primary focuses of ML and deep learning (DL) in mental disease detection. Co-occurrence network analysis reveals that ML is associated with depression, schizophrenia, autism, anxiety, ADHD, obsessive-compulsive disorder, and PTSD. Popular algorithms include support vector machine (SVM) classifier, decision tree classifier, and random forest classifier. Furthermore, DL is linked to neuroimaging techniques such as MRI, fMRI, and EEG, as well as bipolar disorder. Current research trends encompass DL, LSTM, generalized anxiety disorder, feature fusion, and convolutional neural networks.

Aim: People with severe mental illnesses (SMI) face different occupational challenges than those diagnosed with personality disorders (PD). Supported employment (SE) has been validated for SMI patients but its effectiveness for individuals with PD remains unclear, and the reasons for this potential difference have not been explored. This study aimed to identify differences in SE practice for clients with SMI and those with PD. Methods: Six SE job coaches were interviewed about their experiences. A thematic analysis was run. Results: More difficulties and facilitators were mentioned regarding clients with PD than regarding clients with other SMI. For both, patients’ symptoms were reported to negatively affect their (re)integration into the job market. However, in contrast to that of clients with SMI, the relation between symptoms and SE success for clients with PD involved difficult behaviors and their negative impact on the therapeutic relationship. Conclusion: In summary, SE practice seems to be undermined by PD and could benefit from adaptations, such as specific training for SE teams to help them in managing clients with this disorder.

Methamphetamine (Meth) abuse can cause serious mental disorders, including anxiety and depression. The gut microbiota is a crucial contributor to maintaining host mental health. Here, we aim to investigate if microbiota participate in Meth-induced mental disorders, and the potential mechanisms involved. Here, 15 mg/kg Meth resulted in anxiety- and depression-like behaviors of mice successfully and suppressed the Sigma-1 receptor (SIGMAR1)/BDNF/TRKB pathway in the hippocampus. Meanwhile, Meth impaired gut homeostasis by arousing the Toll-like receptor 4 (TLR4)-related colonic inflammation, disturbing the gut microbiome and reducing the microbiota-derived short-chain fatty acids (SCFAs). Moreover, fecal microbiota from Meth-administrated mice mediated the colonic inflammation and reproduced anxiety- and depression-like behaviors in recipients. Further, SCFAs supplementation optimized Meth-induced microbial dysbiosis, ameliorated colonic inflammation, and repressed anxiety- and depression-like behaviors. Finally, Sigmar1 knockout (Sigmar1−/−) repressed the BDNF/TRKB pathway and produced similar behavioral phenotypes with Meth exposure, and eliminated the anti-anxiety and -depression effects of SCFAs. The activation of SIGMAR1 with fluvoxamine attenuated Meth-induced anxiety- and depression-like behaviors. Our findings indicated that gut microbiota-derived SCFAs could optimize gut homeostasis, and ameliorate Meth-induced mental disorders in a SIGMAR1-dependent manner. This study confirms the crucial role of microbiota in Meth-related mental disorders and provides a potential preemptive therapy.

This paper describes the development and validation of the Autonomy Scale Amsterdam (ASA). We propose that a new measure of autonomy is needed and, as such, we developed and validated an autonomy scale relevant for psychiatry. Based on literature, an expert meeting and three samples of the general population (N = 298, N = 207, N = 309) we provide evidence (a) that supports a 6-factor structure model as a better fit than alternative models with a high reliability to capture the concept of autonomy consisting of: Self-integration, Engagement with life, Goal-directedness, Self-control, External constraints and Social support, (b) for the scale's convergent and discriminant validity with constructs in autonomy's nomological network and (c) for the scale's criterion validity with well-established well-being outcomes, and (d) that the measure is not redundant with a prior measure of autonomy, the autonomy-connectedness scale, and demonstrates incremental validity in the prediction of mental health over and above an existing measure of autonomy. Taken together, the results suggest that the ASA is a useful scale that shows positive evidence of psychometric quality to measure autonomy in a sample of the general population (total N = 856), accounting for a unique predictive value over and above an existing measure of autonomy concerning several mental health outcomes. The ASA can further help our understanding of the role of autonomy in mental disorders.

Summary: Background: Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. Methods: We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45–81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17–78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Findings: Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39–3.23) to 3.37-fold (1.52–7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20–1.79) to 1.83 (1.05–3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07–1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Interpretation: Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Funding: Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.

Background: The publication of South Africa's National Mental Health Policy Framework and Strategic Plan 2023–2030 and the proposed National Health Insurance (NHI) make it timely to review that state of mental health services in the country, and to emphasize the importance of prioritising mental health as a pivotal component of holistic healthcare. Method: We searched the published literature on mental health using Google Scholar, Pubmed, and Bing Chat, focusing on these words: epidemiology of mental health disorders, depression and anxiety disorders, mental health services, mental health facilities, human resources, financing and impact of COVID-19 on mental health in South Africa and beyond. We also searched the grey literature on mental health policy that is publicly available on Google. Results: We provided information on the epidemiology and economic impact of mental health disorders, the availability of mental health services, enabling policies, human resources, financing, and the infrastructure for mental health service delivery in South Africa. We detail the high lifetime prevalence rates of common mental disorders, as well as the profound impact of socioeconomic determinants such as poverty, unemployment, and trauma on mental health disorders. We note the exacerbating effect of the COVID-19 pandemic, and emphasize the pressing need for a robust mental health care system. Conclusion: In addition to outlining the challenges, such as limited mental health service availability, a shortage of mental health professionals, and financial constraints, the review proposes potential solutions, including task-sharing, telehealth, and increasing the production of mental health professionals. The paper underscores the necessity of crafting a comprehensive NHI package of mental health services tailored to the local context. This envisioned package would focus on evidence-based interventions, early identification, and community-based care. By prioritising mental health and addressing its multifaceted challenges, South Africa can aspire to render accessible and equitable mental health services for all its citizens within the framework of the National Health Insurance.

Objective: This study aimed to measure how these parent, friend and teacher relationships could mediate the associations between adverse childhood experiences (ACEs) and mental disorders. Method: A cross-sectional study was implemented on students at an urban multi-level school in Hanoi, Vietnam. A total of 1275 students were included in the study. The Depression-Anxiety-Stress Scale-21 items (DASS-21) and Adverse Childhood Experiences Questionnaire (ACE-Q) scales were used. The present study employed structural equation modelling (SEM) to investigate the potential mediation effects of different relationships on the associations between ACEs and mental health. Results: The rate of depression, anxiety and stress among students were 44.0 %, 35.6 % and 30.6 %, respectively. Overall, 19.7 % experienced one mental disorder, 15.2 % suffered two disorders and 20.0 % experienced three disorders. Parent-child, friend-friend and student-teacher relationships were determined to partly mediate the connections between ACEs and mental disorders among students. The mediating effects of the parent-child, friend-friend and student-teacher relationships accounted for 13 %, 4.4 % and 5.8 % of the total effect, respectively; and 15 %, 4.6 % and 6.1 % of the direct effect, correspondingly. Conclusion: This study highlighted that receiving good parent-child, friend-friend and student-teacher relationships independently affected adolescents’ mental health, as well as buffered the effect of ACEs on mental disorders.

The objective is to examine how hospital admissions for mental health and eating disorders changed at the beginning of the COVID-19 pandemic and with the return to fully in-person school with increased vaccine availability. Data from a tertiary care children's hospital were examined for admissions to the hospital from March 2018 through March 2022, including children 6–20 years old admitted with ICD-10 codes for mental health and eating disorders. Interrupted time series (ITS) analyses were used to examine for changes at specific time points. In the first year of the pandemic, the ITS analysis showed a significant increase in admissions per month for eating disorders with a slope of 1.2 (95 % CI: 0.2, 2.2) and for other mental health diagnoses, a slope of 1.9 (95 % CI: 1.1, 2.7). In a longer-term ITS analysis, return to fully in-person school was associated with no significant changes. The COVID-19 pandemic had an initial impact on admissions for eating disorders and other mental health that attenuated over time.

Objective: Retrospective exposure to a higher number and prolonged duration of climate-related disasters could be positively associated with adolescent mental distress. Methods: Person-level data came from 38,616 high-school students residing in 22 urban public-school districts in 14 states (U.S. Youth Risk Behavior Survey, 2019). Each district’s federally declared climate-related catastrophes (severe storms, floods, wildfire, etc.) came from the Federal Emergency Management Agency. Logistic regression models estimated the adjusted odds ratios (aOR) of adolescent mental distress (MD, using survey responses feeling prolonged sadness/ hopelessness and short sleep duration) according to disaster events and days during three exposure periods (past 2-, 5-, 10-years); adjusted for age, gender, race/ethnicity, socio-economic disadvantage, feeling unsafe at school, district area size, district poverty, and region. Results: Over 10 years, the median number of disaster events was 3 and total disaster days was 64. Adolescents experiencing the highest number of disaster days (top quartile vs. less) had 25% higher odds of MD when exposed within the past 2-years (aOR 1.25 [95% CI 1.14, 1.38]), and 20% higher odds of MD when exposed within the past 5-years (aOR 1.20 95% CI 1.07, 1.35). The odds of MD were not statistically associated with exposure periods that extended to 10 years, nor disaster events (instead of disaster days, all p-values > 0.1). Conclusions: Severe weather will become more frequent and last longer with human-induced climate warming. More studies like this are needed to understand the broad range of adverse effects and enhance planning and preparedness including preparing for worsening mental health among adolescents.

Limited evidence is available regarding the impact of ambient inhalable particulate matter (PM) on mental disorder (MD) or dementia-related deaths, particularly PM1, PM1–2.5, and coarse particles (PM2.5–10). Moreover, individual confounders have rarely been considered. In addition, evidence from low-pollution areas is needed but is inadequate. Using death records from the Death Registration System during 2015–2021 in Ningde, a coastal city in southeast China, we combined a conditional quasi-Poisson model with a distributed lag nonlinear model to estimate the nonlinear and lagged associations of PM exposure with MD or dementia-related deaths in Ningde, China, comprehensively controlling for individual time-invariant confounders using a time-stratified case-crossover design. The attributable fraction and number were calculated to quantify the burden of MD or dementia-related deaths that were related to PMs. We found J-shaped relationships between MD or dementia-related deaths and PMs, with different thresholds of 13, 9, 19, 33 and 12 μg/m3 for PM1, PM1–2.5, PM2.5, PM10 and PM2.5–10. An inter-quartile range increase for PM1, PM1–2.5, PM2.5, PM10 and PM2.5–10 above the thresholds led to an increase of 31.8% (95% confidence interval, 14.3–51.9%), 53.7% (22.4–93.1%), 32.6% (15.0–53.0%), 35.1% (17.7–55.0%) and 25.9% (13.0–40.3%) in MD-related deaths at lag 0–3 days, respectively. The associations were significant in the cool season rather than in the warm season and were significantly greater among people aged 75–84 years than in others. The fractions of MD-related deaths attributable to PM1, PM1–2.5, PM2.5, PM10 and PM2.5–10 were 5.55%, 6.49%, 7.68%, 10.66%, and 15.11%, respectively; however, only some of them could be protected by the concentrations recommended by the World Health Organisation or China grade I standard. Smaller associations and similar patterns were observed between PMs and dementia-related death. These findings suggest stricter standards, and provide evidence for the development of relevant policies and measures.

Summary: Background: Mental and substance use disorders are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with these. In low- and middle-income countries, such as Kenya, mental health is often given low priority, and resources for the prevention and treatment of mental and substance use disorders are limited. Adolescence and young adulthood are critical periods for the development of mental and substance use disorders, with many disorders emerging during this time. In Kenya, the burden and risk factors of mental and substance use disorders among adolescents and young adults is not well understood. Methods: The data used in this study were obtained from the Global Burden of Disease (GBD) Study 2019. We selected the data on the number of mental and substance use disorders among adolescents and young adults in Kenya from the GBD results tool. The data were extracted by mental health (MH) condition, by age group and by sex. We used descriptive statistical methods to summarise and present the data. Specifically, we calculated the disability-adjusted life-years (DALYs) rates, risk factors of mental and substance use disorders by age group and sex. Findings: In 2019, among 10–24-year-olds in Kenya, mental disorders ranked as the second leading cause of disability, following unintentional injuries, and accounted for 248,936 [95% uncertainty interval 175,033; 341,680] DALYs or 9.4% of 2,656,546 total DALYs. Substance use disorders accounted 15,022 [9948; 20,710] DALYs. Depressive, anxiety, and conduct disorders accounted for the most DALYs of mental disorders accounting for 3.1%, 2.3% and 1.7% of the total DALYs, respectively. The main risk factors for incident DALYs in 10–24-year-olds were bullying and victimization (66.5%). Childhood sexual abuse accounted for 13.7% of the DALYs, lead exposure accounted for 8.5% of the DALYs, intimate partner violence accounted for 11.3% of the DALYs (2%) with all victims being females, and illicit drug use accounted for (52.7%) of DALYs. Interpretation: Improved surveillance of mental health and substance use burden at national and county levels is needed. Focus on timely screening and intervention for idiopathic developmental intellectual disability, conduct disorder, and substance use disorder in young boys and depression, anxiety, and eating disorders in young girls and women is critically needed. Funding: MK is funded by FIC/NIMH K43 TW 010716 and R33MH124149-03. The publication was made possible by funding from the Gates Foundation.

A 51-year-old woman showed structural epilepsy following an atypical, nontraumatic intracranial hemorrhage in the right frontal area. Despite successful seizure control with lamotrigine, she developed severe morning anxiety and panic attacks, leading to agoraphobia, social withdrawal, and psychogenic nonepileptic seizures. Neuropsychiatric and psychological assessments confirmed an anxiety disorder with no significant symptoms of depression. The patient received various psychopharmacological treatments with limited success. This case report illustrates that managing panic disorder in patients with structural epilepsy requires a comprehensive treatment approach that includes pharmacotherapy and psychotherapy. Differential diagnosis and accurate treatment are crucial because of the symptom overlap between panic attacks and peri-ictal fear. Screenings instruments such as the Panic and Agoraphobia Scale (PAS) can aid in assessing anxiety-related symptoms. First-line pharmacotherapy with selective serotonin reuptake inhibitors, especially sertraline, or venlafaxine can effectively reduce panic attacks and can be recommended in patients with epilepsy. Psychotherapy, particularly cognitive-behavioral therapy, is the treatment of choice. Referral to a psychiatrist is indicated when symptoms are severe or refractory to treatment.

Introduction: Childhood trauma plays a central role in the long-term outcomes and quality of life of adults with mental disorders. Its burden among patients receiving mental health care in rural health facilities has not been established formally. This study determined the prevalence of childhood trauma among individuals receiving treatment at two mental health facilities in southwestern Uganda. Methods: Two hundred forty-nine adult psychiatric patients were screened for childhood trauma using the Adverse Childhood Experience International Questionnaire. Descriptive analyses were performed to determine the information on prevalence rates, cumulative traumas and types of trauma experienced by individuals receiving treatment at Ugandan mental health facilities. Results: Nine in ten mentally ill patients had experienced childhood adversities which were more significant greater among participants diagnosed with depression and substance use disorder compared to those with bipolar disorder and schizophrenia. 99.6% of participants with childhood trauma experienced multiple forms of adverse childhood adversities. The commonest adverse childhood experiences in our sample were witnessing violence against household members, physical neglect, bullying and emotional violence. Conclusion: Our results highlight the extremely high rate of childhood trauma among patients with mental disorders and raise the global health policy issue revealing the need for a primary health level intervention to address its effects along the mainstream mental health care.

Evidence suggests that adopting a healthy diet, such as the Mediterranean Diet (MD), can positively affect mental health. To further explore this, a study was conducted to determine the impact of MD instruction over 12 weeks on depression, anxiety, stress, and anthropometric indices. The study is a randomized, double-blind, controlled clinical trial with sixty participants who reported stress, anxiety, and depression conducted in Tabriz, Iran (2022–2023). They were randomly assigned to either the intervention group (n = 30), which received MD instruction, or the control group (n = 30), which received standard healthy nutrition education. Both groups were asked to follow their respective nutrition education plans for 12 weeks. After 12 weeks, depression, anxiety, and stress levels were measured using the DASS-21 questionnaire, and anthropometric indices were assessed. Initially, the unadjusted DASS-21 scores for depression, anxiety, and stress did not show significant differences between the two groups. However, after adjusting for baseline variables (model 2), all scores decreased significantly (the P-value for all scores was

Background: Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens. However, the lifestyles of children with mental, behavioral, and developmental disorders (MBDDs) remains under-described within the literature of public health field. This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics. Methods: Data were from the 2016–2020 National Survey of Children's Health—A national, population-based, cross-sectional study. We used the data of 119,406 children aged 6–17 years, which included 38,571 participants with at least 1 MBDD and 80,835 without. Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity, screen time, and sleep duration. Results: Among children with MBDDs, 20.3%, 37.0%, 60.7%, and 77.3% met the physical activity, screen time, sleep, and at least 1 of the 24-hour movement guidelines. These rates were lower than those in children without MBDDs (22.8%, 46.2%, 66.7%, and 83.4%, respectively; all p < 0.001). Children with MBDDs were less likely to meet these guidelines (odds ratio (OR) = 1.21, 95% confidence interval (95%CI): 1.13–1.30; OR = 1.37, 95%CI: 1.29–1.45; OR = 1.29, 95%CI: 1.21–1.37; OR = 1.45, 95%CI: 1.35–1.56) than children without MBDDs. Children with emotional disorders had the highest odds of not meeting these guidelines (OR = 1.43, 95%CI: 1.29–1.57; OR = 1.48, 95%CI: 1.37–1.60; OR = 1.49, 95%CI: 1.39–1.61; OR = 1.72, 95%CI: 1.57–1.88) in comparison to children with other MBDDs. Among children aged 12–17 years, the difference in proportion of meeting physical activity and screen time guidelines for children with vs. children without MBDD was larger than that among children aged 6–11 years. Furthermore, the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children. Conclusion: Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs. In educational and clinical settings, the primary focus should be on increasing physical activity and limiting screen time in children aged 12–17 years who have MBDDs; and specifically for white children who have MBDDs, increasing physical activity may help.

Background: Prior research suggests that psychiatric disorders could be linked to increased mortality among patients with COVID-19. However, whether all or specific psychiatric disorders are intrinsic risk factors of death in COVID-19 or whether these associations reflect the greater prevalence of medical risk factors in people with psychiatric disorders has yet to be evaluated. Methods: We performed an observational, multicenter, retrospective cohort study to examine the association between psychiatric disorders and mortality among patients hospitalized for laboratory-confirmed COVID-19 at 36 Greater Paris University hospitals. Results: Of 15,168 adult patients, 857 (5.7%) had an ICD-10 diagnosis of psychiatric disorder. Over a mean follow-up period of 14.6 days (SD = 17.9), 326 of 857 (38.0%) patients with a diagnosis of psychiatric disorder died compared with 1276 of 14,311 (8.9%) patients without such a diagnosis (odds ratio 6.27, 95% CI 5.40–7.28, p < .01). When adjusting for age, sex, hospital, current smoking status, and medications according to compassionate use or as part of a clinical trial, this association remained significant (adjusted odds ratio 3.27, 95% CI 2.78–3.85, p < .01). However, additional adjustments for obesity and number of medical conditions resulted in a nonsignificant association (adjusted odds ratio 1.02, 95% CI 0.84–1.23, p = .86). Exploratory analyses after the same adjustments suggested that a diagnosis of mood disorders was significantly associated with reduced mortality, which might be explained by the use of antidepressants. Conclusions: These findings suggest that the increased risk of COVID-19–related mortality in individuals with psychiatric disorders hospitalized for COVID-19 might be explained by the greater number of medical conditions and the higher prevalence of obesity in this population and not by the underlying psychiatric disease.

Background: Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the ‘triply troubled’. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. Methods: A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. Results: A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. Conclusions: The present study helps disentangle the heterogeneity of the ‘triply troubled’ patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.

This study aimed to evaluate the prevalence and risk factors of mental disorders in patients with chronic urticaria (CU) in a cohort of adult outpatients. Mental disorders occurred in almost one-sixth of the patients with CU, depression (9.7%), and anxiety (5.0%) being the most prevalent conditions. Furthermore, a significant difference in impairment of quality of life was seen between patients with mental disorders compared to patients without. Although, the prevalence of mental disorders in patients with CU is high, larger clinical studies are needed to investigate and understand the association and risk factors of mental disorders in patients with CU.

Background: Mental disorders can significantly impact children's lives and affect their emotional, cognitive, and behavioral development. Family support and care is critical to the well-being of children, particularly children with mental disorders. However, given the “gap” between research and practice“,” there have been very few studies in the Arab region that focus on the role of the family in supporting children with mental disorders. The study also examines how families cope with caring for a person with mental disorders and what behaviors may influence the patient's distress. In addition, the study will examine the importance of family rehabilitation and integration of people with mental disorders into society. Methods: The study adopts the descriptive-analytical method and uses a questionnaire to gather data from the participants. The 350-parents sample (with 113 boys, 237 girls) was selected from the Shafallah Center for Integrating People with Disability. Morgan's law is used to determine the sample size. Results: The results show that there are statistically significant differences in the role of family members in supporting people with mental disorders due to two variables: Gender and Work. Age has no statistically significant effect on the role of family members in supporting people with mental disorders. Conclusion: This study is the first study conducted to investigate the role of family in supporting children with mental disorders in the Gulf Cooperation Council (GCC) in general and Qatar in particular. The results show that families should cope with the needs of a person with a mental disorder. Family rehabilitation is important in the care of people with mental disorders. There are certain behaviors of family members that can increase or decrease stress for the person. The results suggest that the family plays an essential role in supporting and promoting the lives of people with mental disorders and recommending effective ways to cope with them.

Resumen: The autistic spectrum has gained special relevance in today's society, with an increase in its prevalence, greater concern for early diagnosis, therapeutic interventions and the observation of different evolutions. In this article, three evolutionary trajectories are presented, and analyses are made on issues concerning the different psychopathological developments in a mental health framework. The importance of early diagnosis, early individual therapeutic strategies, different evolutionary trajectories and the implications of psychiatric and physical comorbidities are highlighted. Abstract: El espectro autista ha cobrado especial relevancia en la sociedad actual, observándose un aumento de su prevalencia, mayor preocupación por el diagnóstico temprano, las intervenciones terapéuticas y la observación de distintas evoluciones. En el presente artículo se presentan 3 trayectorias evolutivas y se reflexiona en temas concernientes a los distintos desarrollos psicopatológicos en un marco de salud mental; se destaca la importancia del diagnóstico precoz, las estrategias terapéuticas individuales precoces, las distintas trayectorias evolutivas, la implicancia de las comorbilidades psiquiátricas y físicas.

Resumen: A nivel mundial, los problemas de salud mental constituyen una carga de enfermedad importante. En Chile, la depresión ocupa el primer lugar en la carga de enfermedad debida a trastornos mentales; según datos de la Encuesta Nacional de Salud 2016-2017 realizada por el Ministerio de Salud, un 15,8% de la población mayores de 18 años presentan depresión según la definición que emplea el CIDI (Composite International Diagnostic Interview) desarrollado por la OMS para estudios de salud mental. Uno de los principales desafíos que enfrenta la psiquiatría actualmente, es poder mejorar el enfoque de prueba y error para el tratamiento farmacológico de la enfermedad mental, puesto que uno de los problemas más importantes es la falta de respuesta al tratamiento (20-30% de los pacientes), sumado a la falta de adherencia al tratamiento y la presencia de reacciones adversas a las drogas.Dados los avances en la secuenciación del genoma humano, se ha podido establecer que uno de los factores que influyen en el metabolismo de las drogas usadas en pacientes psiquiátricos es la presencia de polimorfismos que afectan distintos genes que modulan la farmacocinética o la farmacodinamia de los fármacos. De ahí que en los últimos años los centros de salud más importantes del mundo realizan estudios de farmacogenética a sus pacientes con el fin de entregarles la mejor terapia de acuerdo con sus características individualesEn este trabajo se presenta una actualización de este tema y, conjuntamente, se comenta la experiencia en Clínica Las Condes de la caracterización realizada en un estudio previo en pacientes que consultan principalmente por trastornos psiquiátricos como cuadros ansiosos y depresivos. Dicho estudio incluyó las variantes genómicas de un grupo de 6 genes pertenecientes a la familia del Citocromo P450 (CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4 y CYP3A5), responsables en gran medida del metabolismo de la mayoría de las drogas usadas en psiquiatría. Con esta información se ha podido implementar una terapia farmacológica dirigida a cada paciente con el fin de lograr una mejor respuesta terapéutica Summary: Globally, mental health problems constitute a significant disease burden. In Chile, depression ranks first in the burden of disease due to mental disorders, according to data from the 2016-2017 National HealthSurvey conducted by the Ministry of Health, 15,8% of the population over 18 years old present depression according to the definition used by CIDI (Composite International Diagnostic Interview) developed by the WHO for mental health studies. One of the main challenges facing psychiatry today is to improve the trial-and-error approach for the pharmacological treatment of mental illness since one of the most important problems is the lack of response to treatment (20-30% of patients), in addition to the lack of treatment adherence and the presence of adverse drug reactions.Given the advances in the sequencing of the human genome, it has been established that one of the factors that influence the metabolism of drugs used in psychiatric patients is the presence of polymorphisms that affect different genes that modulate the pharmacokinetics or pharmacodynamics of drugs. Hence, in recent years the most important health centers in the world carry out pharmacogenetic studies on their patients to deliver the best therapy according to their individual characteristics.In this review, we present an update on this topic and also comment Clínica Las Condes’ experience in the implementation of a pharmacogenetic study for patients consulting for psychiatric disorders, mainly anxiety and depression, which analyzed the genomic variants of a group of 6 genes belonging to the cytochrome P450 family (CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5), largely responsible for the metabolism of most drugs used in psychiatry. With this information, it has been possible to implement a pharmacological therapy directed at each patient to achieve a better therapeutic response.

The primary aims of this study are to examine associations between obesity-related eating behaviors (OEB) and chronic and infectious diseases, and mental disorders. A representative nationwide survey was used to collect information among 11,659 medical students from 31 universities in China. Multiple variable logistic regression analysis was conducted to examine the associations between OEB and the diseases. The multiple variable logistic regression model found that OEB was significantly associated with chronic disease (OR (Odds Ratio): 1.74 ), infectious disease (OR: 3.37 ), and mental disorder (OR: 1.87( ). These findings underscore the importance of addressing OEB in programs and policies to promote health and prevent disease among university students.

Summary: Myiasis refers to infestation of living animals or humans by maggots or fly larvae. Urogenital myiasis is a rare condition that is linked to poor sanitary conditions and limited access to healthcare and with few published case reports. Here, we describe the case of a 67-year-old homeless woman with multiple comorbidities, who presented with extensive vaginal myiasis requiring inpatient management with ivermectin, ceftriaxone, and metronidazole and daily larvae extraction and debridement. The relevance of this case is providing a report of a successful management with ivermectin of a case of severe vaginal myiasis. Severe cases of vaginal myiasis can require repeated debridement of necrotic tissue and systemic antibiotics in addition to antiparasitic medication. People living under poor sanitary conditions and with poor hygienic practices are at increased risk for severe vaginal myiasis.

Purpose: Adolescents with psychiatric disorders face increased risks for unintended pregnancy. This study examines adolescents hospitalized with psychiatric disorders' interest in contraceptive information and initiation and associated factors., Methods: We enrolled 451 adolescents assigned female at birth, ages 14-17, hospitalized with psychiatric disorders at a Midwestern quaternary children's hospital from November 19, 2021, to March 22, 2023. Participants completed a questionnaire that assessed interest in contraceptive information and contraceptive initiation and explanatory factors. Survey data were linked to data from health records. We examined factors associated with interest in contraceptive information and initiation during hospitalization using logistic and multinomial logistic regression., Results: Participants' mean age was 16.1 (95% CI: 14.1-18.1). Over half (51.3%) of participants were interested in contraceptive information during hospitalization and 21.4% were interested in contraceptive initiation. The strongest predictors for interest in information about contraceptives and contraceptive initiation were not knowing where to get contraceptives (adjusted odds ratio (aOR) 2.96; 95% CI 1.6-5.5 and aOR 2.85; 95% CI 1.43-5.68, respectively), difficulty getting to contraceptive access (aOR 3.33: 95% CI 1.49-7.4 and aOR 4.72; 95% CI 2.03-10.95, respectively), and ever having sex (aOR 2.91; 95% CI 1.86-4.57 and aOR 2.12; 95% CI 1.22-3.68 respectively)., Discussion: Interest in contraceptive information and initiation is high among adolescents hospitalized with psychiatric disorders. Sexually active adolescents and adolescents with access barriers were more likely to indicate interest in contraceptive care. Hospitalizations represent opportunities for important reproductive health services for adolescents with psychiatric disorders., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine the implementation and effectiveness of a contraception care intervention for adolescents hospitalized with psychiatric disorders., Methods: This prospective, observational, hybrid type 2 effectiveness-implementation study examined the effectiveness of the Contraception Care at the Behavioral Health Pavilion (CC@BHP) intervention in 4 inpatient psychiatric units at a quaternary children's hospital. A multifaceted implementation blueprint guided implementation. CC@BHP is a clinical pathway intervention designed to increase access to contraceptive counseling and initiation during hospitalization. Eligible patients were assigned female at birth, at least 14 years old, and admitted to one of four units between December 2021 and February 2023. Implementation outcomes were provider adoption (documentation of assessing interest in contraception care) and intervention reach (order placed for contraception consultation). Intervention effectiveness outcomes assessed downstream health service access, including patient receipt of contraception consultation and contraceptive prescription/initiation., Results: Across 1,461 visits, the mean patient age was 15.9 years and 63.4% were White. Forty percent (n = 586) of visits included at least one intervention component. Overall, healthcare providers adopted CC@BHP in 29.0% (n = 424) of visits and ordered contraception consultations in 19.1% (n = 279) of visits (reach). Adolescents received contraception consultations in 16.7% (n = 244) of visits and 116 patients (7.9%) initiated a contraceptive (effectiveness). Later study waves demonstrated greater adoption and reach., Discussion: Implementation improved over time and CC@BHP delivered contraceptive counseling and initiation, including implants and intrauterine devices, in a large quaternary hospital to interested adolescents. Inpatient psychiatry admissions offer a timely opportunity to address reproductive health needs of adolescents., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To describe the mental health experiences of Muslim American women in the perinatal period., Design: Qualitative descriptive., Setting: Telephone interviews., Participants: Eighteen Muslim American women who gave birth in the last 12 months., Methods: We used a semistructured guide to conduct individual interviews and thematic network analysis to identify key themes across the interviews., Results: Participants had a mean age of 32.5 years, 83% were White, and 17% were Asian. Educational attainment ranged from high school diploma to doctorate degree (83% completed a bachelor's degree or higher), and 83% reported U.S. citizenship. We identified four organizing themes: Need for Tailored Mental Health Support; Challenging Screening Experiences; Mental Health Experiences That Affect Maternal-Infant Bonding; and Faith, Culture, and Mental Health., Conclusion: Findings underscore the need for culturally responsive mental health screening and enhanced support tailored to Muslim American women during the perinatal period. Health care providers should use culturally sensitive care approaches to build trust and enhance mental health outcomes., Competing Interests: Conflict of Interest The authors report no conflicts of interest or relevant financial relationships., (Copyright © 2024 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

We read with great interest the article by Srinivasan et al., 1 and we are heartened to see a renewed focus on irritability as an important phenomenon that necessitates better understanding. In particular, the hypothesis that irritability in childhood may signal the development of psychiatric problems later in life is a persuasive concept that aligns with our thinking., (Copyright © 2024 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

The deleterious health impacts of polycyclic aromatic hydrocarbons (PAHs) on the population have been extensively substantiated and acknowledged. Mounting evidence underscores that PAH exposure is closely linked to an elevated risk of mental disorders, particularly in populations experiencing occupational and high-level exposure. In this study, we aimed to investigate the mechanisms underlying anxiety-like behaviors induced by different dosages of PAHs, with a concentrated focus on brain region-specific metabolic alterations in mice using various metabolomics approaches. Male C57BL/6 mice were exposed to benzo[a]pyrene (B[a]P), a typical PAH, through gavage at occupational exposure and EPA toxicologically relevant dosages (2.0 and 20.0 mg/kg/day) for 21 days, respectively. Behavioral assessments revealed that occupational exposure to B[a]P induced anxiety-like behaviors in C57BL/6 mice. Meanwhile, elevated serum norepinephrine and corticotropin-releasing hormone further confirmed the anxiety-inducing effects of B[a]P exposure. Metabolomics analysis uncovered dysregulation across various metabolic pathways following B[a]P exposure, encompassing brain neurotransmitter, organic acid, amino acid, lipid, fatty acid, and cholesterol. Anxiety levels and lipid metabolic abnormalities were notably exacerbated at the higher dosage, despite being only a 10-fold increase. Of particular significance, a decrease in lysophosphatidic acid (LPA) and lysophosphatidylserine (LPS) emerged as pivotal indicators of B[a]P neurotoxicity. Spatial-resolved metabolomics further demonstrated distinctive lipid and metabolite profiles across different brain subregions after exposure to B[a]P. Remarkably, alterations were specifically observed in the anxiety-related brain regions, such as the hippocampus, cortex, white matter, and thalamus, varying with exposure dosages. These findings underscore the significance of brain metabolic abnormalities in the development of mental disorders triggered by B[a]P exposure and highlight the need for establishing precise exposure limits of B[a]P to safeguard public mental health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Resumen: Antecedentes: : Los trastornos psiquiátricos forman parte de las enfermedades más frecuentes en la población chilena y, a pesar de que la mayoría de estos cuadros son tratables farmacológicamente de manera eficaz, hay un porcentaje de pacientes que no responden adecuadamente, o presentan severos efectos adversos que obligan a la discontinuidad de su tratamiento. En la actualidad, no existe ningún método fiable para predecir qué tratamiento farmacológico será el mejor para un determinado pacienteEl metabolismo de los psicofármacos está mediado, principalmente, por el complejo enzimático Citocromo P450 (CYP450), que incluye las isoformas 1A2, 2C9, 2C19, 2D6, 3A4 y 3A5. Los genes que codifican para estas enzimas, presentan variantes polimórficas que influyen en la actividad enzimática. La identificación de estos polimorfismos del CYP450, nos permite clasificar a los pacientes como metabolizadores lentos, intermedios, normales o ultrarrápidos, facilitando el diseño de una estrategia farmacológica personalizada predeciblemente eficaz para el paciente Objetivo: : Genotipificar las variantes alélicas más relevantes del CYP450 1A2, 2C9, 2C19, 2D6, 3A4 y 3A5 en pacientes chilenos que consultan por trastornos psiquiátricos Resultados: : En este estudio observacional, descriptivo y exploratorio se evaluaron las variantes genéticas de 6 enzimas del CYP450 mediante RFLP y secuenciación en 158 pacientes chilenos, consultantes por trastornos psiquiátricos, cuyo rango etario es de 6-74 años (mediana de 35 años), siendo 66 hombres y 92 mujeres. Las frecuencias alélicas obtenidas mostradas como alelo silvestre/alelo polimórfico fueron las siguientes: 1A2 (1A/1F 0,290/0,710); 2C9 (1A/2A 0,880/0,120); 2C19 (1A/2A 0,885/0,115); 2D6*2 (1/2 0,590/0,410); 2D6*3 (1/30,985/0,0015); 2D6*4 (1/4 0,910/0,090); 3A4 (1A/1B 0,935/0,065); y 3A5 (1A/3A 0,115/0,885). En nuestro estudio, las frecuencias genotípicas para todos los polimorfismos estudiados en la población estaban en equilibrio de Hardy-Weinberg Conclusiones: : Las frecuencias alélicas obtenidas para el grupo de estudio son similares a las descritas por otros autores tanto para población chilena como de otros países del mundo y por tanto permite ajustar las dosis de los medicamentos de acuerdo a las pautas internacionales en concordancia con el uso de una medicina personalizada. En psiquiatría, contar con un examen que nos permita implementar, desde el comienzo, una terapia predeciblemente eficaz para el paciente, puede hacer una gran diferencia en la práctica clínica Summary: Introduction: : Psychiatric disorders are one of the most frequent illnesses in the Chilean population and, even though most of these conditions are effectively pharmacologically treatable, there is a percentage of patients who do not respond adequately or have severe adverse effects that require patients to discontinue their treatment. At present, there is no reliable method to predict which drug treatment will be the best for a given patient.The metabolism of psychotropic drugs is mainly mediated by the enzyme complex Cytochrome P450 (CYP450), which includes the isoforms 1A2, 2C9, 2C19, 2D6, 3A4, and 3A5. The genes that code for these enzymes have polymorphic variants that influence enzyme activity. Identification of these CYP450 polymorphisms allows us to classify patients as poor, intermediate, normal, or ultra-rapid metabolizers, facilitating the design of a personalized drug strategy that is predictably effective for the patient. Objective: : Genotyping the most relevant allelic variants of CYP450 1A2, 2C9, 2C19, 2D6, 3A4, and 3A5 in Chilean patients consulting for psychiatric disorders. Results: : In this observational, descriptive and exploratory study, the genetic variants of 6 CYP450 enzymes were evaluated by RFLP and sequencing in 158 Chilean patients, consulting for psychiatric disorders whose age range was 6-74 years (median of 35 years), being 66 men and 92 women. The allele frequencies obtained shown as wild allele/polymorphic allele were the following: 1A2 (1A/1F 0.290/0.710); 2C9 (1A/2A 0.880/0.120); 2C19 (1A/2A 0.885/0.115); 2D6 * 2 (1/2 0.590/0.410); 2D6 * 3 (1/3 0.985/0.0015); 2D6 * 4 (1/4 0.910/0.090); 3A4 (1A/1B 0.935/0.065); and 3A5 (1A/3A 0.115/0.885). In our study, the genotype frequencies for all the polymorphisms studied in the population were in Hardy-Weinberg equilibrium. Conclusions: : The allelic frequencies obtained for the study group are similar to those described by other authors for both the Chilean population and those of other countries in the world and therefore allow adjusting the drugs doses according to international guidelines on personalized medicine. In psychiatry, having a test that allows us to implement a predictably effective therapy for the patient right from the start can make a big difference in clinical practice.

Background: Treatments for mental health problems in childhood and adolescence have advanced in the last 15 years. Despite advances in research, most of the evidence on effective interventions comes from high-income countries, while evidence is scarce in low- and middle-income countries (LMICs), where 90% of world's children and adolescents live. The aim of this review was to identify evidence-based interventions tested in LMICs to treat or prevent child and adolescent mental health problems. Methods: We conducted a systematic review of seven major electronic databases, from January 2007 to July 2019. We included randomised or non-randomised clinical trials that evaluated interventions for children or adolescents aged 6 to 18 years living in LMICs and who had, or were at risk of developing, one or more mental health problems. Results were grouped according to the studied conditions. Due to the heterogeneity of conditions, interventions and outcomes, we performed a narrative synthesis. The review was registered at PROSPERO under the number CRD42019129376. Findings: Of 127,466 references found through our search strategy, 107 studies were included in narrative synthesis after the eligibility verification processes. Nineteen different conditions and nine types of interventions were addressed by studies included in the review. Over 1/3 of studied interventions were superior to comparators, with psychoeducation and psychotherapy having the highest proportion of positive results. One-third of studies were classified as presenting low risk of bias. Interpretation: This review shows that different interventions have been effective in LMICs and have the potential to close the mental health care gap among children and adolescents in low-resource settings.

Mental health conditions have the potential to be worsened by air pollution or other climate-sensitive factors. Few studies have empirically examined those associations when we faced to co-exposures, as well as interaction effects. There would be an urgent need to use deep learning to handle complex co-exposures that might interact in multiple ways, and the model performance reinforced by SHapely Additive exPlanations (SHAP) enabled our predictions interpretable and hence actionable. Here, to evaluate the mixed effect of short-term co-exposure, we conducted a time-series analysis using approximately 1.47 million hospital outpatient visits of mental disorders (i.e., depressive disorder-DD, Schizophrenia-SP, Anxiety Disorder-AD, Bipolar Disorder-BD, Attention Deficit and Hyperactivity Disorder-ADHD, Autism Spectrum Disorder-ASD), with matched meteorological observations from 2015 through 2019 in Nanjing, China. The global insights of gated recurrent unit model revealed that most of input features with similar effect size caused the illness risk of SP and ASD increase, and most markedly, 73% of relative humidity, 44.6 µg/m3 of NO2, and 14.1 µg/m3 of SO2 at 5-year average level associated with 2.27, 1.14, and 1.29 visits increase for DD, SP, and AD, respectively. Both synergic and antagonistic effect among informative paired-features were distinguished from local feature dependence. Interestingly, variation tendencies of excessive visits of bipolar disorder when atmospheric pressure, PM2.5, and O3 interacted with one another were inconsistent. Our results provided added qualitative and quantitative support for the conclusion that short-term co-exposure to ambient air pollutants and meteorological conditions posed threats to human mental health.

Background: WHO reported that mental disorders is rising all over the world and its burden is significantly impact the individuals’ health, even the social and economic status of countries. Mental illness continues to be stigmatized in Arab countries because people in these countries hold negative attitudes toward mental illnesses. Stigma stress is one of the most stressful factors facing patients with mental illness and their families. Perceived stigma by patients with mental illness is associated with different consequences such as feeling of shame, being non-compliant to medications, being socially withdrawn. This study aims to assess perceived stress and internalized stigma among patients with mental disorders in Al-Ahsa governorate – Saudi Arabia. The total number of the subject was 125 patients with mental disorders. The study revealed that there is a significant positive relationship between patients’ perceived stress and their feelings of internalized stigma. Understanding how stigma develops and how it interacts with other psychological processes is very important so, it is recommended to develop interventions to reduce internalized stigma to improve the well-being of patients with mental disorders.

Introduction: Mental disorders are the main cause of mortality and morbidity worldwide. Deep learning offers a considerable promise for mental health diagnosis and risk assessment. The current study considered the potential application of deep learning methods in mental disorders. Method: Four databases were reviewed between 2000 and February 2023, based on the PRISMA methodology. A total of 1339 papers was recognized and screened for their relevance to the use of deep learning algorithms in mental disease; 85 pertinent studies were identified and categorized based on several dimensions, such as subspecialty, deep learning methods, data sources, study limitations, and future directions. Result: The obtained result revealed that deep learning in mental health is vastly used for depression and mood recognition analysis. The Convolutional Neural Network (CNN) is a prominent method applied in selected studies. Conclusion: The results of this study may motivate further research on the use of deep learning in mental disorders and future directions for this promising technology.

Resumen: Objetivo: Conocer la extensión y las características de las experiencias adversas y de victimización en una muestra de personas adultas con un trastorno mental grave residentes en la ciudad de Barcelona. Método: Estudio descriptivo, cuantitativo y transversal. Las experiencias adversas y de victimización se evaluaron a partir de 26 ítems del Adverse Childhood Experiences Questionnaire (ACE-IQ), el cual se amplió para incluir experiencias acontecidas en la edad adulta. Se entrevistó a 74 personas con trastorno mental grave (edad media: 42,03 años; desviación estándar: 9,60). Resultados: Todas las personas entrevistadas reportaron haber vivido como mínimo dos victimizaciones a lo largo de su vida. Las más frecuentes fueron los delitos comunes (87,8%) y la victimización por parte de los cuidadores principales (86,5%). Las mujeres presentaban casi 13 veces más probabilidades de sufrir victimización sexual que los hombres a lo largo de la vida (odds ratio: 12,75; intervalo de confianza del 95%: 4,19-38,71). Antes de los 18 años destaca la alta prevalencia de violencia física por parte de los cuidadores principales (52,7%) y el abuso sexual infantil (32,4%). Conclusiones: La victimización sufrida por las personas con un trastorno mental grave es un problema extendido que ha recibido muy poca atención. Los resultados de este estudio son coherentes con los obtenidos en investigaciones previas y ponen de manifiesto la necesidad de trasladar estos conocimientos a la práctica médica, teniéndolos en cuenta para desarrollar tratamientos con un abordaje integral de la salud mental. Abstract: Objective: To describe the extension of the adverse experiences, including victimization, lived in childhood and adulthood in a sample of people with severe mental illness residing in Barcelona, Spain. Method: Descriptive, quantitative and cross-sectional study. Adverse and victimization experiences were assessed using 26 items from the Adverse Childhood Experiences Questionnaire (ACE-IQ). Items were included obtain information regarding victimization during adulthood. Seventy-four people with severe mental illness were interviewed (median age: 42.03 years; standard deviation: 9.60). Results: All participants reported at least two victimization experiences throughout their lifetime. The most frequent experiences were conventional crimes (87.8%) and victimization by caregivers (86.5%). Before age 18, half of the participants reported having experienced physical violence by their caregivers (52.7%) and almost one out of three reported to have been victim of sexual abuse (32.4%). Women were almost 13 times more likely to experience sexual victimization than men throughout their lifetime (odds ratio: 12.75; 95% confidence interval: 4.19–38.71). Conclusions: Victimization experienced by people with severe mental illness is a widespread problem that has received little attention. The results of this study are consistent with those obtained in previous investigations and underscore the need to translate this knowledge into medical practice into medical practice, considering them in order to develop treatments with a comprehensive approach to mental health.

Introduction: In Norway, general practitioners (GPs) are the gatekeepers who provide written assessment of patients' functional ability to provide documentation for the Norwegian Labor and Welfare Administration for decisions about welfare benefits. This article investigates the description of functioning in sickness certificates according to the bio-psycho-social model described in WHO's International Classification of Functioning, Disability and Health (ICF). In particular, the study focuses on medical sick notes for young patients with common mental disorders. Methods: This study utilized directed content analysis, where codes were defined a priori. A simplified bio-psycho-social model with ICF as a framework was used to categorize functional assessment. 393 sick notes were analyzed in Norway between January 2018–January 2020. Results: The results show that more than half (50.4%) of the certificates contain no information about function on any level, and that the diagnosis was the only indication of a patient's function. The biological perspective was the most common description in 39,9% of the certificates, 13,5% had a description of the patient's functioning from an individual perspective. The social perspective was only adopted in 12.0% of certificates. Only 4 certificates (1.0%) described all three perspectives (biological, individual, and social) and mentioned what the individual could do despite the illness (resources). Conclusions: We find that information on functional ability is limited on sickness certificates in Norway. The descriptions given were mainly from the biological perspective and without social context, which is consistent with prior research.

Problems in mental health and socioeconomic health inequalities during childhood and adolescence are receiving important scientific and political attention. This in mind, we study how current family income and parental education are associated with psychiatric disorders among children in a well-developed welfare state, Finland. To gain a deeper understanding of how these disparities develop through early life course, we study the differences between genders, age groups, types of mental disorders, and also take into account the role of parental mental disorders. We exploit high-quality Finnish register data containing the whole population aged 4–17 with information on their families and parents. Our results of linear probability models show that lower parental education is consistently associated with higher probability of mental disorders throughout childhood, although some gender and disorder-specific differences are also identified. Interestingly, household income is related to mental health in more complex ways, having both negative and positive associations with psychiatric disorders. Inequalities are stronger among boys than girls, and the strongest associations are found among boys aged 7–12 and girls aged 13–17. Parental mental disorders increase the risk of children's psychiatric disorders but do not explain socioeconomic disparities. Considering the negative effects of mental problems on socioeconomic outcomes, inequalities in childhood mental health can be expected to reinforce other social inequalities in later life and should therefore be a focus of interventions.