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In recent times, the world has witnessed unprecedented challenges, with the COVID-19 pandemic being a major disruptor to various aspects of daily life. This article delves into the profound impact of pandemics on primary care, specifically focussing on changes in antidepressant prescriptions and mental health referrals before, during, and after lockdowns in England, UK. In this retrospective study, we used anonymised individual-level electronic health record data from general practitioner (GP) practices in the North of England, UK. We applied a negative binomial-logit hurdle model and a multinominal logit regression model to assess the impact on antidepressant prescriptions and GP referral types, respectively. The initiation of antidepressant prescriptions showed a notable decrease during and post lockdowns, with a minor uptick in ongoing antidepressant prescriptions during the lockdown periods. Over the course of lockdowns and beyond, there was a growing trend of patients being referred to social prescribing interventions. Notably, individuals from ethnic minorities were more inclined to receive fewer medical treatments and more social prescribing interventions. The increase in antidepressant prescriptions during the pandemic-related lockdowns was expected due to these challenging circumstances. Reduced referrals to secondary mental health services occurred as online counselling services were deemed inappropriate by some doctors, and patients were hesitant to seek face-to-face help. Notably, there was a rise in social prescribing referrals, emerging as a valuable resource for psychological support amid heightened mental health strain. Additionally, ethnic minority patients were less likely to receive medical treatments but more likely to be referred to social prescribing services. Despite the inevitable negative impacts of the COVID-19 pandemic, these findings highlight the active role of non-clinical support in a social model of health, addressing unmet needs and reducing barriers to mental health care for certain groups. [ABSTRACT FROM AUTHOR]

Despite an increased focus on the impact of post-migratory factors on the health of trauma-affected refugees, research on the influence of residence permit is limited. This influence may manifest on the outcome of psychiatric treatment. Accordingly, the aim of this study was to examine the role of temporary residence permit on symptom severity and treatment outcome among trauma-affected refugees in PTSD treatment. The sample consisted of 897 patients, who were allocated into three groups based on their residence permit: temporary residence permit, permanent residence permit, and Danish citizenship. The outcome measures were symptoms of PTSD (Harvard Trauma Questionnaire), depression and anxiety (Hopkins Symptom Checklist-25 and Hamilton Depression and Anxiety Rating Scales), quality of life (WHO-5 Well-being Index), and functioning (The Sheehan Disability Scale), evaluated before and after psychiatric treatment. Temporary residents tended to have less severe symptoms prior to treatment. Overall, no significant differences were observed between the three groups on treatment outcome. However, Danish citizens had a poorer treatment outcome on Hamilton Depression Scale compared with temporary residents. This study is one of the first to investigate treatment implications of residence permit in a clinical setting. The interactions between mental health and individual post-migratory factors are complex. Further research is still needed to understand how residence status affects mental health and treatment outcomes for refugees. • Temporary residents had the least severe symptoms before treatment. • Danish citizens had a poorer HAM-D treatment outcome than temporary residents. • Overall, residence permit was a poor predictor of PTSD treatment outcome. [ABSTRACT FROM AUTHOR]

• Gender-affirming mental health care supports gender diversity and builds resilience. • Effective interventions address individual, interpersonal, and system-level needs. • Barriers and societal stigma affect well-being and access to care for TGD youth. Gender-affirming care is a framework that has developed over the past two decades and has experienced a rapid proliferation of empirical evidence. Given increased attention to transgender and gender diverse (TGD) youth in sociocultural spheres, there is a need to examine the current evidence base for effective gender-affirming mental health treatment. In this State of the Science review, we highlight general treatment frameworks that best support TGD youth and families in a variety of contexts, using gender-affirming psychosocial approaches. We use groupings of presenting concerns for TGD youth and families outlined by Coyne et al. (2020) to highlight differing mental health support needs, emphasizing the need for individual, contextually-based care models that consider aspects of gender-related marginalization and resilience. We further discuss needs for care access and equity and need for further attention in future research and intervention approaches. [ABSTRACT FROM AUTHOR]

Youth experience significant mental health (MH) needs, and gender- and racially/ethnically-diverse youth are less likely than peers to receive care. School-based health centers (SBHCs) are a healthcare delivery model that may decrease disparities. This study examined the role of SBHCs in reducing disparities in MH care receipt among SBHC clients. Data from electronic health records of 5,396 youth ages 12 to 21 years who visited 14 SBHCs in one California county from 2021 to 2023 were analyzed in 2023–2024 using multiple logistic regression to assess disparities in MH care receipt and depression screenings. Receipt of MH care from SBHCs varied significantly by gender but not age, sexual orientation, or race/ethnicity. Compared to female clients, males had reduced odds (AOR: 0.50) and gender-diverse clients had higher odds (AOR: 2.70) of receiving MH care. For receipt of depression screenings, male clients had reduced odds (AOR: 0.86); Latino clients had higher odds than white clients (AOR: 1.80); and older adolescents and young adults had higher odds than younger adolescents (AORs: 1.44 and 1.45, respectively). Receipt of follow-up MH care after a positive depression result varied only by gender, with male clients having reduced odds (AOR: 0.63). SBHCs may reach youth who are traditionally less likely to seek care in other settings, including racially/ethnically- and gender-diverse youth. As in other settings, engaging males in healthcare is an area for improvement. These findings help to demonstrate the potential of SBHCs for decreasing disparities in mental health care. [ABSTRACT FROM AUTHOR]

Children and young people with a social worker (CYPwSW) have particular mental health profiles and needs. Research indicates that despite having higher levels of mental health distress this group tend to experience inequitable access to specialist mental health services. Therefore, much of their mental health support currently falls to generalists including paediatricians. We are currently undertaking a four-year study the CAMHS Referrals and Outcomes for Adolescents and Children with Social Workers (COACHES). Here we present initial insights from an analysis of 20,166 unique case notes which identified 1) High thresholds for entry to CAMHS 2) A requirement that young people must be perceived as stable prior to accessing services 3) that young people often did not feel that their voices were taken seriously 4) the importance of time for trust. Based off these findings and expert-by-experience's insights, we conclude by suggesting ways that paediatricians and health care professionals can best support CYPwSW. These include being the 'connective tissue' around young people's support network, gently and proactively building relationships, redressing power imbalances and supporting transitions to adulthood. [ABSTRACT FROM AUTHOR]

Intermittent Explosive Disorder (IED) is a common, chronic, and impairing psychological condition characterized by recurrent, affective aggressive behavior. IED is associated with a host of cognitive and affective symptoms not included in the diagnostic criteria which may be a valuable indicator of heterogeneity in IED—such information can be useful to enhance understanding and treatment of this disorder in mental health settings. A preliminary investigation conducted on cognitive-affective symptom heterogeneity in individuals with a history of IED demonstrated that level of emotional dysregulation primarily differentiated IED subgroups, however the sample size was limited, and almost half of the individuals did not have current IED (only lifetime IED). The present study addressed these limitations by conducting a latent class analysis of cognitive-affective symptoms among a large (n = 504) sample of individuals diagnosed with current IED. The latent IED classes were then externally validated on several adverse outcomes, historical precursors, and demographic variables. Statistical and clinical indicators supported a four-class model, with classes primarily distinguished by patients' severity of emotion dysregulation. The two moderate emotion-dysregulated classes both endorsed callous-unemotional traits and low empathy relative to other classes, a finding which differs from the initial investigation. An external validation of the four classes revealed that they significantly differed on severity outcomes (e.g., aggression, suicide attempts, antisocial behavior, global functioning, comorbidities) and historical precursors (e.g., aversive parental care, childhood maltreatment). These findings provide further insight into the heterogeneity within IED and the associations of such variability with important precursors and clinical outcomes. • Intermittent Explosive Disorder (IED) involves recurrent and impairing aggression. • It is important to examine heterogeneity among those diagnosed with current IED. • Latent class analysis of cognitive-affective tendencies reveals four IED subgroups. • IED subgroups confer varying risk for adverse outcomes and historical precursors. [ABSTRACT FROM AUTHOR]

Les unités pour malades difficiles (UMD) sont des institutions psychiatriques françaises prenant en charge des patients « présentant pour autrui un danger tel qu'ils nécessitent des protocoles thérapeutiques intensifs adaptés et des mesures de sûreté particulières ». Dans ces unités, la prévalence des intrications neuropsychiatriques apparaît élevée. Pour évaluer, voire valider cette impression, il a été réalisé une revue systématique des dossiers des patients de l'UMD de Plouguernével le 1er mars 2024, au nombre de 34. Il est montré que : la moitié des patients souffrent de psychose sévère, un tiers de ces patients présentent un déficit intellectuel. Dix patients comptent dans leurs antécédents des atteintes neurologiques acquises, plus ou moins graves. De plus, 75 % d'entre eux sont polytoxicomanes. Les causes des atteintes neurologiques de ces patients sont multiples : congénitales, périnatales, traumatiques, toxiques, dues à de graves maltraitances... Ces causes sont ici analysées. Cette analyse permet de réfléchir à des actions de prévention à mettre en place, ainsi qu'à une possible réorganisation des prises en charge de ces patients aux profils si hétéroclites. Psychiatric high security care units are French psychiatric institutions caring for patients "presenting such a danger to others that they require adapted intensive therapeutic protocols and special safety measures". In these units the prevalence of neuropsychiatric complications appears high. To evaluate or even validate this impression, a systematic review of the 34 patients of the unit of Plouguernével was carried out on March 1, 2024. It is shown: that half of the patients suffer from severe psychosis, that a third of these patients have an intellectual deficit. Ten patients have acquired neurological symptoms in their history, more or less serious. In addition, 75 % of them are polydrug addicts. The causes of the neurological damages in these patients are multiple: congenital, perinatal, traumatic, toxic, due to serious abuse, etc. These causes are analyzed here. This analysis allows us to consider preventive actions to be implemented, as well as a possible reorganization of the care of these patients with such heterogeneous profiles. [ABSTRACT FROM AUTHOR]

The authors disclose that this is a fictional case created by the authors. Julian, a 16-year-old adolescent who entered the juvenile justice system facing armed robbery charges, was 8 years old when he entered the child welfare system. He and his younger sister, Jessica, were placed in protective custody after school staff discovered that they were physically abused and witnessed domestic violence. Jessica further disclosed sexual abuse by the mother's boyfriend who was subsequently incarcerated. The siblings were placed together in several foster homes until a biological aunt assumed custody for 2 years. Both children struggled with behavioral problems in school and at home and responded to mental health treatment. The mother participated in substance use treatment, and the children reunified with her by the time Julian was 11 years old. [ABSTRACT FROM AUTHOR]

Measurement-based care (MBC), which collects session-by-session symptom data from patients and provides clinicians with feedback on treatment response, is a highly generalizable evidence-based practice with significant potential to improve the outcomes of mental health treatment in youth when implemented with fidelity; however, it is rarely used in community settings. This study tested whether an implementation strategy targeting organizational leadership and organizational implementation climate could improve MBC fidelity and clinical outcomes for youth in outpatient mental health clinics. In a cluster randomized trial, 21 clinics were assigned to the Leadership and Organizational Change for Implementation strategy plus training and technical assistance in MBC (k = 11, n = 117) or training and technical assistance only (k = 10, n = 117). Primary outcomes of MBC fidelity (assessed via electronic metadata) and youth symptom improvement (assessed via caregiver-reported change on the Shortform Assessment for Children Total Problem Score) were collected for consecutively enrolled youths (ages 4-18 years) who initiated treatment in the 12 months following MBC training. Outcomes of each youth were assessed for 6 months following baseline. A total of 234 youths were enrolled and included in intent-to-treat analyses. At baseline, there were no significant differences by condition in clinic, clinician, or youth characteristics. Youths in clinics using the Leadership and Organizational Change for Implementation strategy experienced significantly higher MBC fidelity compared with youths in control clinics (23.1% vs 3.4%, p =.014), and exhibited significantly greater reductions in symptoms from baseline to 6 months (d = 0.31, 95% CI: 0.04-0.58, p =.023). Implementation strategies targeting organizational leadership and focused implementation climate can improve fidelity to evidence-based practices and clinical outcomes of youth mental health services. Measurement-based care is an evidence-based intervention that has been shown to improve the outcomes of mental health services in dozens of randomized trials; however, it is not widely used in routine practice. In this randomized controlled trial of 21 outpatient mental health clinics and 234 youth, the authors found an organizational intervention which trained clinic leaders in skills to support the use of measurement-based care increased the extent to which patients received measurement-based care compared to control clinics where clinic leaders did not receive this training (23% vs. 3%). Youth receiving services in the clinics that received the organizational intervention also had greater reductions in mental health symptoms. Working to Implement and Sustain Digital Outcome Measures (WISDOM); https://clinicaltrials.gov/ ; NCT04096274. [ABSTRACT FROM AUTHOR]

The urban environment can have a significant impact on mental and physical health. Health impact appraisal of new developments should address these issues. However, transferable economic valuation evidence for urban planners in the United Kingdom is thin, especially around mental health, making it harder to estimate the cost-efficiency of public health interventions to address these conditions. A further complication is that mental health may be perceived differently from physical health. This study examines willingness to pay (WTP) to avoid depression and lower back pain. WTP estimates were obtained by applying contingent valuation tasks in an online survey with a representative sample in the United Kingdom (N = 1553). Interval regression models were used to estimate the effects of disease severity, payment frequency, and respondent characteristics on WTP. Respondents' WTP to avoid both conditions was relatively high (around 5%-6% of stated income to return to current health state). Depression was rated as being twice as burdensome on quality of life than pain, and bids to avoid depression were 20% to 30% more than pain. Analysis of motivation responses suggests mental health treatment is perceived as less easy to access and less effective than the equivalent for pain, and respondents expect a larger burden on their family and relationships as they try to manage their condition themselves. Results suggest that depression bids may be affected by uncertainty around access to effective treatment in the healthcare system. This has implications for how mental illness may be prioritized in resource allocation toward public health interventions. • Mental health suffers from a parity of esteem compared with physical health in resource allocation. A large percentage of sufferers never seek medical treatment, but the disutility of these individuals should be considered in policy appraisal. There is a lack of valuation evidence for application in cost-benefit analysis for the United Kingdom, and those valuation studies which have explored preferences suggest that mental health may be valued inconsistently compared with physical health. • Using a contingent valuation survey in a general population sample, we explore how individuals value depression compared with lower back pain. Measuring ratings for impact on quality of life, and willingness to pay (WTP) to avoid symptoms, we estimate values for varying levels of severity and duration of illness, including values for benefits transfer. Although WTP is relatively high for both conditions, findings indicate disparities in how the 2 conditions are perceived and valued. • Results suggest that even though depression is seen as having a larger burden on quality of life, individual WTP may be affected by uncertainty around access to effective treatment in the healthcare system. This has implications for how mental illness may be prioritized in resource allocation toward public health interventions. Policy makers should consider this effect when applying disutility values derived from stated-preference techniques in health impact appraisal. [ABSTRACT FROM AUTHOR]

Most cancer-associated pain is experienced in low- and middle-income countries (LMICs) due to inequitable access to opioids. To determine opioid access as estimated by both patients and providers and to understand patient and facility-level factors influencing access among patients with advanced cancer in LMICs in Asia using the Behavioral Model of Health Services Use. The APPROACH cross-sectional study was conducted in seven LMICs in Asia, involving in-depth surveys with providers and advanced cancer patients. A hierarchical logistic regression model was used to assess predisposing (i.e. individual factors), enabling (i.e. health care system and facility-level resources) and need (i.e. pain severity) factors predicting opioid access. Among patient participants (n=1,933), approximately 40% reported opioid use. Meanwhile 80% of facilities, as reported by providers, indicated at least half of their advanced cancer patients receive oral morphine prescriptions. Predisposing characteristics factored in the least in the model, with patient education positively associated with access (Odds ratio (OR): 1.01; 95% CI=1.00, 1.03). Facility-level enabling resources, factoring the most, included oral morphine prescription duration >14 days (OR: 1.27; 95% CI=1.05, 1.53) and the extent of physician palliative care training (extensive (>160 hours) OR: 3.95; CI=3.19, 4.88; basic (up to 40 hours) OR: 1.03; CI=1.03, 1.04). Patient need as indicated by greater pain severity predicted access (OR: 1.55; CI=1.47, 1.64). Study findings emphasize the importance of palliative care training—even a minimal amount—in supporting access to opioids for advanced cancer patients. This study also highlights pragmatic site-level policies, such as extended morphine prescription durations, enabling access. [ABSTRACT FROM AUTHOR]

Research suggests that healthcare workers are at greater risk for suicide than other occupations, but most published studies focus on physicians. This study examines the prevalence of suicidal ideation (SI) and associated occupational factors among a broad group of non-physician healthcare staff. An anonymous online survey was sent to a random sample of 30 % of non-physician healthcare staff at a large urban healthcare system between September and November 2022. Weighted multivariable binary logistic regressions were conducted to determine the workplace and mental health factors associated with SI. The 1084 respondents included nurses, administrative staff, research staff, medical assistants, nurse practitioners, physician assistants, and other roles. Of the sample, 8.8 % endorsed having SI over the prior two weeks. Results of the regression indicated that, after adjusting for demographic factors, greater odds of SI were associated with physical violence experienced from a patient or visitor (odds ratio [OR] = 2.15, 95 % confidence interval [CI] = 1.06–4.37), lower perceived leadership support (OR = 0.95, 95 % CI = 0.92–0.98), and positive screening for depression (OR = 4.66, 95 % CI = 2.45–8.86). Exploratory analysis suggests that depression may be a mediating factor between workplace stressors and SI. Limitations include the response rate, the use of a single item to assess SI, and the cross-sectional design. Findings suggest that workplace violence and leadership support are important occupational factors associated with SI among healthcare workers. Reducing and mitigating workplace violence, enhancing leadership support, and improving access to mental health care should be considered targets for interventions to decrease suicide risk in this population. • SI prevalence and correlates were examined in nonphysician healthcare staff. • Physical abuse by a patient or their visitor was associated with SI. • Lower leadership support was associated with SI. • Depression may mediate the relationship between workplace factors and SI. [ABSTRACT FROM AUTHOR]

The use of Smart Screening tools to identify mental health problems has scarce empirical data on their effectiveness. This study aims to explore the response rate of patients to this tool and observe their socio-demographic and healthcare characteristics, and the tool's ability to detect potential mental health diagnoses. The study employed an online survey within patient portal from patients of four teaching hospitals in Madrid. The sample included 8749 patients, comprising 66.77 % females and 31.21 % middle-aged adults. 60.56 % responded to the Smart Screening tool. Respondents were found to be predominantly middle-aged women who had been contacted by mental health services multiple times but had not exhibited suicidal behaviour. These patients demonstrated a higher appointment attendance rate and generated low healthcare costs. The tool identified probable low depression and mild anxiety (72.16 %), and individuals aged 50–65 exhibited higher levels of mental health problems, such as psychosis and suicidality, although these results were not all significant regarding previous mental health diagnoses. The Smart Screening tool collects anonymous online data through short questionnaires to apply sophisticated algorithms and determine probable mental health diagnoses. The response rate to the Smart Screening tool was higher than in previous studies. The respondents' profile was middle-aged and older women with moderate mental health problems, although suicidality was also identified. Future research should focus on those who did not respond to the tool and explore the link between previous psychiatric diagnoses and the accuracy of the Smart Screening tool. • The MEmind Smart Screening tool showed a response rate of 60.56 % among patients. • The profile was largely middle-aged women who had moderate mental health problems. • The profile also had high appointment attendance resulting in lower costs. • Patients aged 50–65 had more serious mental illnesses (e.g., psychosis, suicidality) [ABSTRACT FROM AUTHOR]

This purpose of this study is to evaluate the effects of the Mind Space Application on psychological outcomes among Thai-university students with depression. Thai-university students with depression (N = 50) were recruited between November 2021 and January 2022. Participants were randomly assigned to either an 8-week mindfulness-based intervention via the Mind Space Application intervention or a waitlist control group. Stress, anxiety, depression, and mindfulness were assessed at baseline and post-intervention. Post-intervention, compared to waitlist control group, participants using the Mind Space Application reported large effects in the reduction of stress (d = 1.46, p <.001) and depression (d = 1.88 , p <.001), small to moderate effects in reduction of anxiety (d = 0.35, p =.35), but no significant. Also, mindfulness scores were significantly higher (d = 1.90, p <.001) compared to the waitlist control group. Thai-university students with depression who used the Mind Space Application showed lower stress and depression and higher mindfulness compared to the waitlist group among. Similar applications may be useful as an alternative or combined with other treatments to improve psychological outcomes in other university student populations. • Approximately 20% of university students had been diagnosed with mental health disorder, only 16.4% of those students received treatments. • - There are many barriers to receiving treatment including cost, lack of mental health professionals, and personal obstacles (e.g., stigma, and lack of knowledge) • Online mindfulness-based intervention (MBIs) is one of the techniques used for the prevention and treatment of mental health problems in university students in worldwide, but no prior in Thailand. • This study shows that online MBI via Mind Space application improves psychological outcomes in Thai-university students with depression. [ABSTRACT FROM AUTHOR]

Automatic transdiagnostic risk calculators can improve the detection of individuals at risk of psychosis. However, they rely on assessment at a single point in time and can be refined with dynamic modeling techniques that account for changes in risk over time. We included 158,139 patients (5007 events) who received a first index diagnosis of a nonorganic and nonpsychotic mental disorder within electronic health records from the South London and Maudsley National Health Service Foundation Trust between January 1, 2008, and October 8, 2021. A dynamic Cox landmark model was developed to estimate the 2-year risk of developing psychosis according to the TRIPOD (Transparent Reporting of a multivariate prediction model for Individual Prognosis or Diagnosis) statement. The dynamic model included 24 predictors extracted at 9 landmark points (baseline, 0, 6, 12, 24, 30, 36, 42, and 48 months): 3 demographic, 1 clinical, and 20 natural language processing–based symptom and substance use predictors. Performance was compared with a static Cox regression model with all predictors assessed at baseline only and indexed via discrimination (C-index), calibration (calibration plots), and potential clinical utility (decision curves) in internal-external validation. The dynamic model improved discrimination performance from baseline compared with the static model (dynamic: C-index = 0.9; static: C-index = 0.87) and the final landmark point (dynamic: C-index = 0.79; static: C-index = 0.76). The dynamic model was also significantly better calibrated (calibration slope = 0.97–1.1) than the static model at later landmark points (≥24 months). Net benefit was higher for the dynamic than for the static model at later landmark points (≥24 months). These findings suggest that dynamic prediction models can improve the detection of individuals at risk for psychosis in secondary mental health care settings. [ABSTRACT FROM AUTHOR]

Hearing loss affects over 1.5 billion individuals globally, with significant implications for mental health. This study investigates the association between hearing aid use and mental health outcomes, by particularly focusing on depression and unmet mental health needs (UMHN), across a diverse international sample. Utilizing data from the third wave of the European Health Interview Survey (EHIS), this study involved 17,660 participants with hearing impairment from 28 countries. The study examined the association between hearing aid use and mental health outcomes, including the likelihood of moderate and severe depression and UMHN due to lack of contact with general practitioners (GPs) and mental health specialists. Logistic regression models, adjusted for socio-demographic characteristics, health risk behaviours, and other relevant variables, were employed. Inverse probability weights were used to mitigate potential selection bias. Hearing aid usage was associated with significantly lower likelihoods of moderate depression (Odds Ratio [OR] = 0.58, 95%CI = [0.54, 0.63]) and severe depression (OR = 0.61, 95%CI = [0.55, 0.69]), compared to non-usage. Hearing aid usage was also associated with reduced UMHN due to lack of GP contact for moderate (OR = 0.82, 95%CI = [0.75, 0.89]) and severe depression (OR = 0.75, 95%CI = [0.59, 0.95]). The depression risk reductions were greater among females and higher-educated subgroups but lower in individuals aged ≥65 years. Income level and rurality also impacted UMHN due to the lack of GP contact. No associations were found between hearing aids and UMHN due to the lack of mental health specialist contact. Hearing aid adoption showed protective associations against mood disorders and lowered unmet primary mental healthcare needs. Tailoring intervention strategies to vulnerable sociodemographic profiles could optimize mental health benefits among those with hearing loss. Integrating hearing health services within mental healthcare delivery frameworks is vital amidst the rising global burden. • There is little insight into hearing aids' impact on mental health and unmet mental health needs (UMHN). • Hearing aid use was associated with lower rates of depression and UMHN, bases on 17,000 participants from 28 countries. • The findings advocate for integrating hearing health into mental health frameworks. [ABSTRACT FROM AUTHOR]

This study underscores the importance of exploring AI's creative applications in treating depressive disorders to revolutionize mental health care. Through innovative integration of AI technologies, the research confirms their positive effects on preventing, diagnosing, and treating depression. The systematic review establishes an evidence base for AI in depression management, offering directions for effective interventions. This systematic literature review investigates the effectiveness of AI in depression management by analyzing studies from January 1, 2017, to May 31, 2022. Utilizing search engines like IEEE Xplore, PubMed, and Web of Science, the review focused on keywords such as Depression/Mental Health, Machine Learning/Artificial Intelligence, and Prediction/Diagnosis. The analysis of 95 documents involved classification based on use, data type, and algorithm type. The study revealed that AI in depression management excelled in accuracy, particularly in monitoring and prediction. Biomarker-derived data demonstrated the highest accuracy, with the CNN algorithm proving most effective. The findings affirm the therapeutic benefits of AI, including treatment, detection, and disease prediction, highlighting its potential in analyzing monitored data for depression management. This study exclusively examined the application of AI in individuals with depressive disorders. Interpretation should be cautious due to the limited scope of subjects to this specific population. To introduce digital healthcare and therapies for ongoing depression management, it's crucial to present empirical evidence on the medical fee payment system, safety, and efficacy. These findings support enhanced medical accessibility through digital healthcare, offering personalized disease management for patients seeking non-face-to-face treatment. • Many people with depression suffer from physical symptoms such as headaches and insomnia, which often prevent them from receiving timely treatment. • Recently, the use of artificial intelligence (AI) for the treatment and management of depression has been gaining momentum as a potential solution to this problem. • Through these various comparative analyzes such as comparative analysis by prediction, comparative analysis by data, and comparative analysis by algorithm, it is possible to identify the strengths and weaknesses of artificial intelligence technology used in the treatment of depressive disorders in providing accuracy • This baseline data will help create a system essential for advancing digital healthcare and therapeutics to better prevent,diagnose, and treat depressive disorders. [ABSTRACT FROM AUTHOR]

This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems). The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4–5, 8–9, 16–17, and 26–27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4–5, 8–9, and 16–17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26–27 years after the birth of the first child. Complete follow-up data were available for 168 mothers. We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning. Maternal and child measures were based on maternal reports only. The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children. • We present maternal depressive symptom trajectories over 27 years (1989–2017) • The maternal symptom trajectories were Very Low, Low Stable and High Stable • Low Stable trajectory predicted the best and High Stable the least optimal outcome • Child's problems predicted mother's problems but not her adaptive functioning [ABSTRACT FROM AUTHOR]

Improving safe and effective access to ketamine therapy is of high priority given the growing burden of mental illness. Telehealth-supported administration of sublingual ketamine is being explored toward this goal. In this longitudinal study, moderately-to-severely depressed patients received four doses of ketamine at home over four weeks within a supportive digital health context. Treatment was structured to resemble methods of therapeutic psychedelic trials. Patients receiving a second course of treatment were also examined. Symptoms were assessed using the Patient Health Questionnaire (PHQ-9) for depression. We conducted preregistered machine learning and symptom network analyses to investigate outcomes (osf.io/v2rpx). A sample of 11,441 patients was analyzed, demonstrating a modal antidepressant response from both non-severe (n = 6384, 55.8 %) and severe (n = 2070, 18.1 %) baseline depression levels. Adverse events were detected in 3.0–4.8 % of participants and predominantly neurologic or psychiatric in nature. A second course of treatment helped extend improvements in patients who responded favorably to initial treatment. Improvement was most strongly predicted by lower depression scores and age at baseline. Symptoms of Depressed mood and Anhedonia sustained depression despite ongoing treatment. This study was limited by the absence of comparison or control groups and lack of a fixed-dose procedure for ketamine administration. At-home, telehealth-supported ketamine administration was largely safe, well-tolerated, and associated with improvement in patients with depression. Strategies for combining psychedelic-oriented therapies with rigorous telehealth models, as explored here, may uniquely address barriers to mental health treatment. • Telehealth ketamine assisted treatment was safe and effective for 11,000+ patients. • Machine learning identified patient characteristics predicting symptoms improvement. • Temporal network suggested low mood and anhedonia as key in treatment non-response. • Primarily psychiatric adverse events underscored importance of behavioral support. • Telehealth-supported ketamine administration may help address barriers to treatment. [ABSTRACT FROM AUTHOR]

Depression and suicidal ideation often co-occur in children and adolescents, yet they possess distinct characteristics. This study sought to identify the different related factors associated with depression and suicidal ideation. A nationwide cross-sectional survey collected data from Chinese children and adolescents aged 8 to 18 (N = 160,962; 48.91 % girls). The survey included inquiries about demographics, depression, suicidal ideation, anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, bullying, and being bullied. Fifteen machine learning algorithms were conducted to identify the different related factors associated with depression and suicidal ideation. Additionally, we conducted external validation on an independent sample of 1,812,889 children and adolescents. Our findings revealed seven related factors linked to depression and six associated with suicidal ideation, with average accuracy rates of 86.86 % and 85.82 %, respectively. For depression, the most influential factors were anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, experience of bullying, and age. Similarly, anxiety, non-suicidal self-injury, perceived stress, internet addiction, academic burnout, and age emerged as paramount factors for suicidal ideation. Moreover, these related factors showed notable variations in their predictive capacities for depression and suicidal ideation across different subgroups. Anxiety emerged as the predominant shared factor for both depression and suicidal ideation, whereas the other related factors displayed distinct predictive patterns for each condition. These findings highlight the critical need for tailored strategies from public mental health service providers and policymakers to address the pressing concerns of depression and suicidal ideation. • The internal validation sample included 160,962 youths and the external validation sample comprised 1,812,889 youths. • Fifteen algorithms were used to predict depression and suicidal ideation. • Anxiety was the predominant shared factor for both depression and suicidal ideation. • Other related factors were differently associated with depression and suicidal ideation. • Related factors exhibited notable variations in their predictive capacities for predicting depression and suicidal ideation across different subgroups. [ABSTRACT FROM AUTHOR]

Previous research indicates an association of body dysmorphic disorder (BDD) with suicidal thoughts and behaviours, but has largely relied on small cohorts drawn from specialist clinics. Anonymised health-records from the South London and Maudsley NHS Foundation Trust between 2007 and 2019 were systematically searched using the Clinical Record Interactive Search data system. 298 patients diagnosed with BDD between age 12 and 65 years were identified. 206 (69 %) had experienced lifetime suicidal ideation. 149 (50 %) had recorded lifetime acts of self-harm or suicide attempts, most commonly involving cutting and self-poisoning. Rates of self-harm/suicide attempts were similar in those diagnosed before or after 18 years. Comorbid depression was associated with suicidal ideation (OR: 4.26 95% CI 2.07–9.72). Additionally, comorbid depression, OCD and anxiety were all associated with self-harm/suicide attempts (OR: 1.94 95% CI 1.15–3.31, OR: 1.99 95% CI 1.09–3.73, and OR: 1.93 95% CI 1.09–3.45, respectively). The presence of two or more psychiatric comorbidities was associated with a significantly elevated likelihood of suicidal ideation (OR: 7.06 95% CI 2.80–21.7) and self-harm/suicide attempts (OR: 4.62 95% CI 2.32–9.62). It is likely that BDD was under-diagnosed in the cohort, and those identified may not be representative. Additionally, the frequency and detail with which suicidal thoughts and behaviours were assessed varied and may also represent underestimates. Suicidal ideation and self-harm/suicide attempts are common among individuals with BDD accessing mental health services. Psychiatric comorbidity and suicidal ideation should be assessed in all BDD patients. • Suicidal thoughts and behaviours are frequently observed in people with Body Dysmorphic Disorder (BDD). • Co-morbidity significantly increases the risk of suicidality in people with BDD. • Multiple co-morbidities are associated with a particularly high risk of suicidality. • Methods of self-harm in BDD are similar to those seen in other psychiatric conditions. [ABSTRACT FROM AUTHOR]

Anxiety is highly prevalent, but undertreated, in primary care. Brief, non-pharmacological interventions are needed. Modular Anxiety Skills Training (MAST), a cognitive-behavioral anxiety intervention, was developed for primary care and tailored for a Veteran sample (MAST-V). The purpose of this mixed methods pilot study was to evaluate MAST-V's feasibility, acceptability, and implementation potential, and preliminarily examine its effectiveness compared to Primary Care Behavioral Health (PCBH) usual care. This hybrid I randomized controlled trial (conducted 2019–2021) assigned 35 primary care patients (M age = 47, 17 % female, 27 % racial/ethnic minority) with clinically significant anxiety symptoms to receive MAST-V or PCBH usual care. Participants completed validated measures of anxiety symptoms and functional impairment at 0, 4, 8, 12, and 16 weeks. Participants attended more sessions in MAST-V than usual care. After necessary adjustments to reduce session duration, MAST-V will likely fit within PCBH practice parameters. Participants in both conditions valued treatment, but treatment satisfaction, credibility, and therapeutic alliance were higher for MAST-V. Study therapists achieved high treatment fidelity and rated MAST-V as highly feasible, acceptable, and appropriate for PCBH. They identified ways to address potential barriers to implementation. MAST-V was more effective than usual care in reducing anxiety symptoms and impairment. This was a small pilot study at a single site using study therapists. Results should be considered preliminary until replicated in a full-scale clinical trial. This brief modular anxiety intervention, which was designed with implementation in mind, may help to address the anxiety treatment gap in primary care. • Brief nonpharmacological anxiety interventions feasible in primary care are needed. • We conducted a pilot RCT of a modular cognitive-behavioral anxiety intervention. • The intervention was feasible and highly acceptable for patients and therapists. • Clinical outcomes improved more than with usual care (primarily supportive therapy). • The intervention's potential for implementation in routine primary care is high. [ABSTRACT FROM AUTHOR]

Comorbid anxiety and depression predict a poorer prognosis than either disorder occurring alone. It is unclear whether self-reported anxiety symptom scores identify patients with depression in need of more intensive mental health services. This study evaluated how anxiety symptoms predicted treatment receipt and outcomes among patients with new depression diagnoses in the Veterans Health Administration (VHA). Electronic medical record data from 128,917 VHA patients (71.6% assessed for anxiety, n = 92,237) with new diagnoses of depression were analyzed to examine how Generalized Anxiety Disorder-7 (GAD-7) scores predicted psychotropic medication prescriptions, psychotherapy receipt, acute care service utilization, and follow-up depression symptoms. Patients who reported severe symptoms of anxiety were significantly more likely to receive adequate acute phase and continuation phase antidepressant treatment, daytime anxiolytics/sedatives, nighttime sedative/hypnotics, and endorse more severe depression symptoms and suicidal ideation at follow-up. Patients who reported severe symptoms of anxiety at baseline were less likely to initiate psychotherapy. The GAD-7 may help identify depressed patients who have more severe disease burden and require additional mental health services. [ABSTRACT FROM AUTHOR]

Suicidality is a clinically important and multifaceted phenomenon, frequently present in depressed subjects. Religiosity and spirituality (R/S) can have an attenuating as well as a reinforcing effect on suicidality. From two Dutch mental health care settings, a sample of 31 depressed and in- and outpatients with suicidal ideation, self-identifying as being religious or spiritual, was selected by convenience sampling. Using an experience sampling method (ESM) mobile application, during six days (mean of 42 assessments per subject), the association between symptoms of depression, suicidality, and specific positive-supportive affective R/S and positive psychology variables. For 28 participants symptom network plots on a group level, and on an individual level, were analyzed using dynamic time warping (DTW). Participants were on average 35.7 years old, and 65 % were women. In the group-level undirected network, R/S variables were linked to positive psychology variables via a bridge function of inner peace. Changes in the experience of inner peace and enjoying a physical activity preceded changes of several other symptoms. A network dynamic appeared with a dense cluster of 'positive psychology' items. Only a limited number of R/S variables were included. The results of this study suggest that religiosity and spirituality function as meaningful factors in depression and suicidality in religiously or spiritually engaged persons. Experienced inner peace has a positive association with reasons to live. Experience sampling method data can be effectively analyzed using dynamic time warping. Exploring individual religious or spiritual engagement can prove important in treating suicidality and depression. [Display omitted] Significant Outcomes • Affective dimensions of religiosity and spirituality are intricately connected to depression and suicidality, in a complex dynamic system. • The Experience Sampling Method combined with Dynamic Time Warp analysis is a feasible and promising method in exploring dynamics of psychopathology. Limitations • Three selected positive-supportive variables representing clinically interesting aspects of religiosity and spirituality were included in this study. • No subgroup analyses or stratification by gender, symptom severity, or religious affiliation were possible. Most participants identified as Christian. [ABSTRACT FROM AUTHOR]

Individuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment. Participants included 1056 individuals aged 18–69 (M = 32.06, SD = 9.55, male = 696,65.9 %) admitted to three residential treatment facilities in Queensland, Australia from January 1, 2014 to December 31, 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify and analyse suicide-related events. Within 2-years post-discharge, 175 (16.6 %) individuals had a suicide-related event (n = 298 episodes). The highest proportion of episodes (11.1 %) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR = 1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR = 1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR = 0.54 (95%CI:0.35,0.83). The amalgamation of suicidal ideation, attempts, and death into a single outcome oversimplifies their complex nature and interplay. The exclusive focus on one service provider limits generalisability, and data constraints and missingness preclude many analyses. Understanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population. • Suicide-related events were common among individuals seeking substance use treatment. • Suicide-related events were not isolated and often indicated further suicide-related events. • Factors indicating disadvantage were associated with a greater likelihood of suicidal behaviour. • Health service presentations currently represent missed opportunities for suicide prevention. • Continuing care and targeted suicide interventions are needed following substance use treatment. [ABSTRACT FROM AUTHOR]

Rapid eye movement sleep behavior disorder (RBD) is often underdiagnosed among people living with mental disorders. The present study aimed to investigate the prevalence of probable RBD (pRBD) and its associated factors among middle-aged and older adults in a psychiatric outpatient clinic. We conducted a cross-sectional survey among 2907 people aged 45–80 years who visited the outpatient clinic between March 1 and August 31, 2022 in a psychiatric hospital. A cutoff score ≥5 on the RBD Screening Questionnaire (RBDSQ) was used to indicate the presence of probable RBD (pRBD). Potential factors associated with pRBD were also assessed with a structured checklist. The association between these factors and the presence of pRBD was examined with logistic regression. The response rate was 64.3 %. Among 1868 respondents [age 58.5 ± 9.6 years, male n = 738 (39.5 %), female n = 1130 (60.5 %)], 15.9 % (95 % CI 14.2–17.6 %) screened positive for pRBD. Occupational exposure to chemicals; positive family history of psychotic disorders; a late start of mental health care; a medical history of autonomic dysfunction; mood problems; and use of antidepressants, hypnotics, and acetylcholinesterase inhibitors were associated with an increased likelihood of having pRBD (P < 0.05 for all). pRBD is common among outpatients with mental disorders, especially in mental disorders due to neurological diseases and physical conditions, mood disorders and anxiety or somatoform disorders. The findings highlight the importance of identifying sleep behavior disorders among people living with mental disorders in clinical practice. • Probable REM sleep-related behavioral disorders (pRBD) are common in middle-aged and older adults in psychiatric clinics. • pRBD was particularly common in mental disorders resulting from neurological diseases or physical conditions, and mood disorders. • The use of antidepressants, hypnotics, and acetylcholinesterase inhibitors are associated with increased likelihood of pRBD. • Routine screening for pRBD in psychiatric outpatient settings is important for improving overall patient care and outcomes. [ABSTRACT FROM AUTHOR]

To explore the perspectives of cerebral palsy (CP) experts on access to healthcare and an analysis of socioeconomic and environmental determinants impacting young individuals with CP in Europe. Cross-sectional survey designed by a convenience multi-disciplinary panel of invited experts and completed by clinicians, researchers and opinions leaders in the field of CP. Fifty-eight experts (response rate 85 %) from 39 regions in 26 European countries completed the survey. All countries provide care and financing through public systems. Long waiting lists were reported (mean 3 mo, range 1–12 mo), depending on type of specialist care and place of residence. Although diagnostic and therapeutic services were available, access within countries/regions were unevenly distributed, with children receiving better care than adults. Most experts reported a lack of transition services, although improvement is expected (62 % of responses). Hip and malnutrition surveillance, as well as educational and recreational activities were variably available. Public transportation, accessible roads and pavements, and urban green spaces for persons with disabilities were more available in larger cities. Overall, only 57 % of responders felt that most patients had adequate access to healthcare. The survey of CP experts' perspectives from the majority of European countries indicates discrepancies in the availability and accessibility of healthcare needed by people with CP and nonuniform implementation of policies across Europe. [Display omitted] • Access to specialized CP healthcare services is perceived to be available in most European countries. • Comprehensive work up, early diagnosis and interventions appear to be widely available through Europe. • Long waiting lists and inadequate services in rural areas appear to limit accessibility. • Access to mental health and transition services is thought to remain poor. • Inadequate transportation services and specialized infrastructures are perceived as barriers to healthcare and participation. [ABSTRACT FROM AUTHOR]

Digital mental health interventions (DMHI) may offer scalable treatment for common mental health conditions. However, many commercially available apps have not been subjected to rigorous evaluation of effectiveness, particularly among users experiencing clinically significant symptomatology. We examined depression and anxiety symptom outcomes associated with a top-rated, commercially available self-guided DMHI based on cognitive behavioral therapy ("Sanvello") relative to waitlist control. This preregistered web-based, 2-arm, parallel-group randomized trial enrolled U.S. adults with self-reported elevated symptoms of depression and/or anxiety. Those assigned to the treatment condition were provided 8 weeks of access to Sanvello. Co-primary outcomes of depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]) severity were assessed at baseline and 2, 4, 6, and 8 weeks. Intention-to-treat analyses included 280 participants (mean age 32.47 ± 9.32 years; 86.1 % women). Generalized linear mixed models showed a significant improvement in depression (F (4,779) = 6.51, p <.001) and anxiety (F (4,907) = 3.28, p =.01) associated with the DMHI over time. The intervention was also associated with a greater proportion of participants exhibiting depression response (25 [45.5 %] vs 26 [16.9 %]) and remission (10 [18.2 %] vs 7 [4.5 %]) on the PHQ-9, and anxiety response (31 [44.9 %] vs 39 [22.8 %]) and remission (20 [29.0 %] vs 27 [15.8 %]) on the GAD-7, relative to waitlist. Findings may not represent people with serious mental illness, suicidality, or the broader population of DMHI users. A commercially available, self-guided DMHI was effective at improving symptoms in individuals experiencing depression or anxiety. ClinicalTrials.gov [ NCT05373329 ] • Depression symptoms improved among those assigned to a commercially-available app. • Anxiety symptoms improved among those assigned to a commercially-available app. • App assignment was associated with a treatment response (50 % PHQ-9 reduction) among 45.5 % of those with depression. • App assignment was associated with a treatment response (50 % GAD-7 reduction) among 44.9 % of those with anxiety. [ABSTRACT FROM AUTHOR]

Little is known regarding those who die by suicide without having received help. The aim of this study was to compare those who died by suicide without having attended psychiatric care with controls (a) with a psychiatric diagnosis and (b) from the general population. Cases were all individuals 15+ who lived in Denmark during 2010–2021 and had died by suicide without having attended hospital-based psychiatric care. Cases were matched to controls from the two comparison-groups using a 1:10 ratio and compared using age-and sex-adjusted logistic regression analyses. Geographical variations in psychiatric care utilization were examined. Among 7119 individuals who died by suicide, 3474 (48.8 %) had not attended psychiatric care. Compared to controls with a psychiatric diagnosis, cases were more likely to be male (OR, 3.9, 95% CI, 3.6–4.2), older (80+ years: OR, 10.7, 95 % CI, 9.2–12.5), have lost a close relative (OR, 1.8, 95 % CI, 1.3–2.6) or recently retired (OR, 1.4, 95 % CI, 1.0–1.1.8). Compared to controls from the general population, cases were associated with male sex (OR, 4.6, 95 % CI, 4.2–5.0), living alone (OR, 2.3, 95 % CI, 2.2–2.5), unemployment (OR, 2.1, 95 % CI, 1.8–2.5), as well as having lost a close relative (OR, 5.0, 95 % CI, 3.5–7.2) or divorced within the last 1 year (OR, 3.6, 95 % CI, 2.7–4.9). Characteristics and preceding events were limited to available register data. About half of all who died by suicide had not attended psychiatric care. Being older, male, or exposed to recent stressors were some of the major markers when compared to controls. • Almost half of all people who died by suicide in Denmark between 2011-2021 did not receive psychiatric care prior to suicide. • Compared to psychiatric controls cases were more likely to be male, of older age, recently retired, or recently bereaved. • Compared to general population controls, cases were more likely to be male, living alone, recently ebereaved or divorced. • Almost 53% of cases visited a general practitioner in the 6 months prior, and 34% got a prescription for psychopharmaceuticals. [ABSTRACT FROM AUTHOR]

Psychiatric care following discharge from general hospital treatment of deliberate self-harm (DSH) is important to reduce patients´ risk of relapse. Whether such follow-up is associated with DSH repetition in young adults is not sufficiently understood. This study examined the association between psychiatric service attendance within seven days of discharge and repeated hospital-presented DSH within 3, 6, and 12 months in patients aged 18–35 years. Incident episodes of hospital-presented DSH from 2010 to 2017 were identified from the Norwegian Patient Register. Those already psychiatrically admitted or who died during the general hospital or in the seven days after discharge were excluded. Psychiatric service attendance was categorized as 'no attendance', 'outpatient attendance', and 'inpatient admissions.' The association between psychiatric service attendance and subsequent DSH repetition was examined with an Inverse Probability of Treatment Weighted logistic regression model. Of the 11,308 patients identified, 17.3 % had a psychiatric outpatient attendance, and 19.9 % had an inpatient admission. Outpatient attendance was not associated with a reduced risk of repeated DSH and inpatient admissions were associated with an increased risk in certain subgroups, notably patients: aged 18–24 years; without a recorded mood disorder diagnosis; or no history of hospital-treated DSH. Our data did not contain all relevant confounders. Unmeasured confounding is therefore likely to influence the results. Although no conclusions regarding treatment effectiveness can be drawn from these findings, the study highlights that patients with the most severe psychiatric symptoms and at the highest risk of DSH relapse received follow-up. • Registry data was used to examine psychiatric follow-up after deliberate self-harm. • Patients with the most severe psychiatric conditions received follow-up. • Follow-up was associated with relapse in the youngest age band. • Our results must be interpreted in light of unmeasured confounding. [ABSTRACT FROM AUTHOR]

Politically and economically unstable contexts have been associated with increased prevalence rates of depression. Despite high demand, the availability of mental health experts and care systems is limited in Arabic-speaking countries. Internet-based interventions might provide an opportunity to treat patients independently of location. Therefore, we investigated the efficacy of internet-based cognitive behavioral treatment (iCBT) and interpersonal treatment (iIPT) for depression in Arabic-speaking countries. In total, 743 Arabic-speaking adults with depression were randomly allocated to iCBT (n = 243), iIPT (n = 247), or waitlist (n = 253). Depressive, anxiety, and somatoform symptoms, perceived social support and quality of life (QoL) were assessed at pre-, and post-treatment and at three months follow-up. Multiple imputation was performed for missing data. Changes associated with treatment were analyzed using regression in the completer and intention-to-treat sample. Participants in both treatment groups showed lower depressive and anxiety symptom severity, higher QoL, and perceived social support compared to the waitlist group (p <.001). Somatoform symptom severity was significantly lower in participants receiving iIPT compared to waitlist (p <.001). Differences between the two treatments in all outcomes were non-significant (p >.05). Three-month follow-up treatment effects regarding depressive symptoms were indicated. The sample mainly consists of educated, single, female adults. Three-month follow-up results rely on a small subsample and must be interpreted with caution. This is the first randomized controlled trial to demonstrate the efficacy of iCBT and iIPT for depression in Arabic-speaking countries. It provides first indications that internet-based interventions might help specific individuals in this region. • Internet.based interventions seem to be effective in reducing depressive symptoms for people in Arabic-speaking countries. • Internet-based cognitive behavioral and interpersonal treatment seems to be equally effective in reducing depressive symptoms. • Both internet-based interventions, designed for people with depression, increase QoL and perceived social support from different sources. • Dropout rates in both interventions are similarly high. • Overall treatment satisfaction was high. [ABSTRACT FROM AUTHOR]

There are multiple risk factors for preterm birth (PTB), one of the most important of which is mood disorders during pregnancy. We aimed to comprehensively investigate the association of both total mental health concerns and ten specific psychiatric symptoms with PTB risk. A cohort study was performed consisting of 25,175 pregnant women who participated in Women and Children's Hospital of Chongqing Medical University between 2020 and 2022. The Symptom Checklist 90 (SCL-90) was utilized to assess the psychiatric symptoms. Multivariable or multinomial logistic regression was applied to investigate mental health concerns associated with risk of PTB or its different clinical sub-categories, respectively. Sensitivity analyses were further performed to validate the results. 8336 women who met the inclusion criteria were included; of these, 547 (6.6 %) had preterm deliveries, and 2542 (30.5 %) had mental health concerns. Compared with women with healthy minds, women with total mental health concerns had a 29.0 % higher risk of overall PTB (OR = 1.28, 95%CI = 1.07–1.54), medical-induced PTB (OR = 1.49, 95%CI = 1.05–2.13) and spontaneous PTB with premature rupture of membranes (OR = 1.33, 95%CI = 1.01–1.74). As to the specific psychological symptoms, hostility pregnant women had a 55.0 % higher risk of PTB (OR = 1.55, 95%CI = 1.14–2.11). Similar results were observed in most of the sensitivity analyses. This is a single-center study, thus the extrapolation of the results may be limited. Pregnant women with mental health symptoms, especially hostility, have an increased risk of PTB. The findings underscore that integrating mental health services into routine maternal care may be a strategy to prevent PTB. • Few studies have comprehensively evaluated psychiatric symptoms with preterm birth risk • We investigated both total mental health concerns and ten specific symptoms with risk of preterm birth and its different clinical sub-categories • Women with total mental health concerns had a 29 % higher risk of preterm birth • For the specific symptoms, hostility pregnant women had a 55 % higher risk of preterm birth • The results highlight that integrating mental health services into routine maternal care may be a strategy to prevent preterm birth [ABSTRACT FROM AUTHOR]

Many studies have shown that the COVID-19 pandemic has increased the risk of suicidal tendencies among the public. However, there is limited research reporting on the changing trends in suicidal ideation after 2020 in the context of the long-term normalization of COVID-19 prevention and control measures in China. The self-administered online questionnaire was adopted to collect 12-month suicidal ideation, depressive symptoms, anxiety symptoms, stress, and some demographic information from university students by convenient cluster sampling in Shandong, Shaanxi, and Jilin Provinces, China. Multivariate logistic regressions were performed to assess the association between different factors and suicidal ideation. The prevalence of 12-month suicidal ideation from 2021 to 2023 among university students was 3.89 %, 5.81 %, and 4.33 %, respectively, showing a trend of first increasing and then decreasing. The trends presented a similar tendency in the subgroups according to gender, majors, and grades, except among urban freshman-year students. The associated factors of suicidal ideation were different among university students in different surveys. However, female gender, poor mental health, and depressive symptoms were linked to a higher risk of suicidal ideation. More representative large-scale longitudinal studies should be used to monitor the suicidal behavior of university students. The prevalence of 12-month suicidal ideation among Chinese university students exhibited a pattern of initial increase followed by a subsequent decrease from 2021 to 2023. Despite the complete lifting of COVID-19 prevention and control measures in China, the prolonged three-year epidemic may have enduring adverse effects on university students, underscoring the ongoing importance of providing continuous mental health services to this population. • The prevalence of 12-month suicidal ideation from 2021 to 2023 among Chinese university students showed a trend of first increasing and then decreasing. • Each survey showed a higher prevalence of 12-month suicidal ideation among female university students than among males. • Female gender, poor mental health status, and depressive symptoms were associated with an increased risk of suicidal ideation. [ABSTRACT FROM AUTHOR]

Innovative technology-based solutions in mental healthcare promise significant improvements in care quality and clinical outcomes. However, their successful implementation is profoundly influenced by the levels of trust patients hold toward their treatment providers, organizations, and the technology itself. This paper delves into the complexities of building and assessing patient trust within the intensive mental health care context, focusing on inpatient settings. We explore the multifaceted nature of trust, including interpersonal , institutional , and technological trust. We highlight the crucial role of therapeutic trust, which comprises both interpersonal trust between patients and providers, and institutional trust in treatment organizations. The manuscript identifies potential key barriers to trust, from sociocultural background to a patient's psychopathology. Furthermore, it examines the concept of technological trust, emphasizing the influence of digital literacy, socio-economic status, and user experience on patients' acceptance of digital health innovations. By emphasizing the importance of assessing and addressing the state of trust among patients, the overarching goal is to leverage digital innovations to enhance mental healthcare outcomes within intensive mental health settings. • Successful implementation of technology within mental healthcare settings emphasizing its impact on the quality of care and clinical outcomes. • Multidimensional framework of trust essential for technology adoption in mental health hospitals. • Mediators of trust highlighting their influence on patient-provider relationships and technology acceptance. • Participatory design principles in developing digital mental health solutions to enhance therapeutic trust and technological trust. • Bridge the gap between technological innovation and mental healthcare practices by fostering an environment of trust, thereby improving patient engagement and clinical outcomes. [ABSTRACT FROM AUTHOR]

Parents have reported increased symptoms of depression and anxiety during the COVID-19 pandemic. This study evaluated changes in mental health and addiction (MHA)-related health service use among mothers and other birthing parents during the COVID-19 pandemic. We conducted a repeated cross-sectional study using health administrative data in Ontario, Canada. The population included all mothers and birthing parents (≥1 child aged 1–18, no children <1 to exclude postpartum parents) between January 2016 and December 2021. We compared rates of MHA-related outpatient physician visits, hospitalizations, and emergency department (ED) visits during COVID-19 (March 2020–December 2021) to pre-COVID-19 (pre-March 2020). MHA-related outpatient visit rates increased by 17 % (rate ratio (RR) 1.17, 95 % CI 1.16–1.18) during COVID-19. Monthly utilization rates remained higher than expected across the COVID-19 period. MHA-related ED visit rates remained lower than expected during COVID-19, while MHA-related hospitalization rates returned to expected levels by August 2020. The largest relative increases in MHA-related outpatient visits during COVID-19 were in mothers and other birthing parents living in higher income (RR 1.20, 95 % CI 1.19–1.22) or urban areas (RR 1.20, 95 % CI 1.18–1.21), with children aged 1–3 years (RR 1.23, 95 % CI 1.20–1.25) and with no history of MHA-related health service use (RR 1.20, 95 % CI 1.19–1.21). This study only captured physician-delivered MHA-related health service use. The COVID-19 pandemic was associated with an increase in MHA-related outpatient visits among mothers and other birthing parents. These findings point to the need for improvements in mental health service access. • Mental health outpatient visits increased for mothers and birthing parents during COVID-19. • This increase was more notable in certain subgroups of mothers and birthing parents. • Mental health acute care use was lower than expected. • This was consistent with more broadly observed reduced acute care use during COVID-19. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic had a particularly negative impact on mental wellbeing of vulnerable individuals, such as sexual minority men (SMM) living in Eastern Europe and Central Asia (EECA), where the social-political climate may be restrictive for SMM. Alcohol, tobacco, and other drugs (ATOD) use may be another factor contributing to exacerbated mental health among SMM in this region. Secondary analyses were conducted using data collected as part of the COVID-19 disparities survey from active users of Hornet, a popular geo-social networking app for SMM in late 2020. Using a subset of SMM living in EECA (n = 3209) and pre-validated scales (AUDIT-C and PHQ-4), we used multivariable logistic regression models to examine the relationship between changes in participants' use of ATOD and their mental wellbeing. Based on AUDIT-C, 35.1 % SMM screened for alcohol use disorder (AUD), 18.6 % reported an increase in alcohol use since the pandemic began. Over 30 % screened for depressive symptoms and anxiety based on PHQ-4 (30.4 % and 30.7 %, respectively). In multivariable models, AUD was significantly associated with screening positive for depressive symptoms and anxiety. Other factors associated with mental distress included lower socioeconomic status, unemployment, ethnic minority identity, IPV victimization, and financial and economic vulnerability. Cross-sectional data cannot be used to infer causality. Our results support the needs for integrated substance use reduction and mental health services tailored for SMM in EECA. Programs aimed at promoting mental wellbeing among SMM in EECA must consider both interpersonal and structural barriers. • Sexual minority men (SMM) reported increase in alcohol and tobacco (ATOD) use since the COVID-19 pandemic began. • SMM in Eastern Europe and Central Asia (EECA) reported high rate of mental distress, especially compared with other regions. • COVID-19 pandemic vulnerability contribute to worsening mental health of SMM when mental health service utilization was low. [ABSTRACT FROM AUTHOR]

In the United States, an estimated 1.9 million youth 13 to 17 years of age (9.5%) identify as sexual and/or gender diverse (SGD), identifying as nonheterosexual and/or having a gender identity other than the assigned sex at birth.1 Up to 7% of SGD adolescents may have at least one parent currently or previously serving in the US military, an estimated 133,000 youth nationwide.1,2 SGD adolescents are highly exposed to acute and chronic stressors, including minority stress and discrimination, resulting in elevated rates of depression, anxiety, and suicidal ideation.3,4 SGD military-connected youth (ie, SGD youth with a parent or caregiver with military service experience) were found to be at even higher risk for these negative outcomes in one published report.2 While both military connection and SGD identity may foster strengths, these youth also face well-studied stressors,2,5 and the convergence of these identities and experiences is likely to produce greater challenges. Nearly half of military-connected youth are seen by civilian clinicians in local communities for primary care, and even more are seen for specialty care.6 As a result, all clinicians, both within and outside the military health system, and especially clinicians providing mental health care, must be familiar with these unique converging stressors facing SGD military-connected youth. [ABSTRACT FROM AUTHOR]

Few studies have explored the mental health status of parents of children with burns and the moderating effect of social support on them. A survey was performed with parents of 112 burn-injured children at a burn center in China. Their perceived stress, anxiety, depression, sleep quality, and social support were measured by the Chinese Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale. ➀ The prevalence of anxiety (46.43%), depression (52.67%) and poor sleep quality (43.75%) of parents indicated that they experienced emotional and sleep disorders;➁ The perceived stress was positively correlated with sleep quality, anxiety and depression（P＜0.01), and negatively correlated with perceived social support (p＜0.05); ➂ Social support had a significant moderating effect on their perceived stress and anxiety, depression, but not on their sleep quality. With high social support, parental perceived stress had a significant positive association on anxiety and depression, while with low perceived social support, parental perceived stress had no significant association on anxiety and depression. Parents of burned children had increased stress, obvious symptoms of anxiety and depression, and poor sleep quality. Social support had a significant buffering effect on them under low pressure, and high pressure will hinder the buffering effect of social support on stress. Therefore, the ideal services to improve mental health should be provided for them to face different levels of stress. • Parents of children with burns have high levels of anxiety, depression and poor sleep quality; • Parental perceived stress was positively correlated with their anxiety, depression and sleep quality; • The benefits of increasing social support for parents with low stress in practical life may be higher after the burn event. [ABSTRACT FROM AUTHOR]

Over the past decades dozens of randomized trials have shown that psychological treatments are more effective than care-as-usual (CAU). It could be expected that these treatments are implemented in routine care and that the response rates in usual care improve over time. The aim of the current meta-analysis is to examine if response and remission rates in usual care have improved over time. We used an existing meta-analytic database of randomized controlled trials examining the effects of psychological treatments of depression and selected CAU control groups from these trials. We only included CAU conditions in primary care, specialized mental health care, perinatal care and general medical care. The response rate (50 % symptom reduction) was the primary outcome. We included 125 CAU control groups (8542 participants). The response rate for all CAU control groups was 0.22 (95 % CI: 0.19; 0.24) with high heterogeneity (I 2 = 83; 95 % CI: 80; 85), with somewhat higher rates in primary care (0.27; 95 % CI: 0.23; 0.31). We found hardly any indications that the outcomes have improved over the years. The meta-regression analysis with publication year as predictor in the full dataset resulted in a coefficient of 0.1 (SE = 0.01; p = 0.0.35). A series of sensitivity analyses supported the main findings. Remission rates and pre-post effect sizes also did not significantly improve over time. Response and remission rates in usual care are low, with the large majority of patients not responding or remitting, and the outcomes have probably not improved over time. • Response rates in usual mental health care have not improved over time. • Only about one in five patients in usual care respond. • Response rates are low in specialized mental health care, perinatal and general medical care. • Response rates are somewhat higher in primary care. [ABSTRACT FROM AUTHOR]

From 2004 to 2019, suicide rates among Black youth increased by 122 % for females and 65 % for males. Guided by the interpersonal theory of suicide, this study explored how perceptions of social support and parental involvement may contribute to suicidal behavior among Black youth aged 12–17 years. Data are from the 2004–2019 National Survey on Drug Use and Health (NSDUH). Multivariable logistic regression with backwards elimination was conducted to determine if characteristics associated with outcomes of interest (i.e., suicidal ideation, made a suicide plan, and made a suicide attempt) differed by sex. The characteristics examined included: age, poverty level, health insurance coverage, currently receiving mental health treatment, grades for last completed semester, parental involvement, frequency of arguments or fights with parents, frequency of fights at school or work, parental attitudes, and availability of emotional support. Over 400,000 Black youth with depression symptoms reported suicidal thoughts and behaviors (80 % female). Females had increased odds of suicidal ideation and making a plan if they had no one to talk to about serious problems. Males had increased odds of attempting suicide if they reported academic struggles. Limitations. This is a cross-sectional study and potential biases may affect generalizability of results. Risk and protective factors identified in this study aligned with the interpersonal theory of suicide. Evidence-based interventions that focus on increasing connectedness and self-esteem may be effective for Black youth struggling with suicidal ideation. Preventing suicide requires a comprehensive approach including prevention strategies for individuals, families, and communities. • This study explores factors associated with suicidal behavior among Black youth. • Lack of social support and parental involvement may increase suicide risk. • Improved parental relationships may protect against suicidal behavior. • Evidence-based interventions that focus on protective factors may be effective. [ABSTRACT FROM AUTHOR]

• Access to mental health providers alone does not sufficiently address the mental health crisis. • Standardized practices for hiring and training therapists are key. • Consistent application of effective mental health treatments contributes to better outcomes. • Financial viability in a fee for service integrated behavioral health model is possible. Integrated behavioral health (IBH) in primary care is growing as an approach to decrease barriers and provide earlier intervention for youth experiencing behavioral and mental health symptoms. However, increasing access to mental health providers alone without ensuring evidence-based treatment (EBT) is provided will not sufficiently address the current mental health crisis. To spread to scale, IBH needs to be implemented and tested in community-based practices with integrity to EBT. This paper provides a model for implementing cognitive behavioral therapy (CBT) in community pediatric primary care via master's prepared therapists through an academic-community partnership. This paper describes the hiring practices, training in CBT, ongoing supervision and consultation, and use of data to inform the evolution of the model. Using a retrospective review of the rate of emergency department (ED) admissions per 1,000 patients with a diagnosis of depression, we compared practices enrolled in our academic-community partnership IBH model to practices who implemented their own IBH and practices with no IBH. Across a four-year period, we found that practices enrolled in the academic-community partnership IBH model had a lower number of patients per 1,000 patients with a diagnosis of depression admitted to the ED with behavioral health concerns compared to practices that did not incorporate an IBH therapist. There was no difference in ED admission rates per 1,000 between practices that hired their own IBH and those without IBH. Analysis of costs of the program against generated revenue from billed services demonstrated that the academic-community partnership model shows promise of sustainability. [ABSTRACT FROM AUTHOR]

Conflict-affected youth are at risk for poor psychological and social outcomes, yet few receive mental health services. Strategies to expand access and sustain evidence-based interventions (EBIs) across novel delivery platforms must be tested. The present study was a hybrid type II implementation-effectiveness trial using a cluster randomized design. The primary goal was to evaluate feasibility and impact of using the collaborative team approach to deliver the Youth Readiness Intervention (YRI), an EBI, integrated into a youth entrepreneurship program (ENTR) with quality control in post-conflict Sierra Leone. Youth were screened and randomly assigned to control, ENTR, or combined YRI and ENTR (YRI+ENTR). Implementation outcomes were dissemination and implementation indicators, competence, and fidelity. Effectiveness outcomes were emotion regulation, psychological distress, and interpersonal functioning. Secondary outcomes were third-party reporter assessments of youth functioning and behavior. Data were collected and analyzed from 1,151 youth participants and 528 third-party reporters. Scores on implementation constructs, competence, and fidelity demonstrated acceptable intervention response and quality. YRI+ENTR participants showed overall improvements in depression (β = −.081, 95% CI −0.124 to −0.038, d = −0.154) and anxiety (β = −.043, 95% CI −0.091 to −0.005, d = 0.082) symptoms compared with control participants. Community leaders indicated that YRI+ENTR participants demonstrated improvements in overall work or training performance compared with control participants (β = −.114, 95% CI 0.004 to 0.232, d = 0.374). Integration of EBIs such as the YRI into youth employment programs has the potential to address limited reach of EBIs in conflict and post-conflict settings. A collaborative team implementation approach can facilitate integration and fidelity. In a Hybrid Type-II Implementation-Effectiveness trial conducted in Sierra Leone, researchers tested a Collaborative Team Approach (CTA) for delivering an evidence-based mental health intervention, the Youth Readiness Intervention (YRI), within a youth entrepreneurship program. A total of 1,151 youth participated in the study, with outcomes measured on youth mental health indicators of emotional regulation, psychological distress, and interpersonal functioning, as well as implementation indicators, competence, and fidelity. Results demonstrated that the integrated YRI and entrepreneurship program led to significant improvements in depression and anxiety symptoms compared to the control group. Community leaders also noted enhanced overall performance in YRI participants, suggesting that integrating evidence-based interventions into youth employment programs can effectively address mental health challenges in low-resource regions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science. Youth FORWARD Phase 2 YRI and EPP Study; https://clinicaltrials.gov/ ; NCT03542500. Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol; https://doi.org/10.1176/appi.ps.202000009. [ABSTRACT FROM AUTHOR]

• Youth treated in acute psychiatric settings are diagnostically heterogeneous. • Transdiagnostic CBT is acceptable to families in acute psychiatric settings. • Transdiagnostic CBT is associated with clinically meaningful symptom improvements. • Transdiagnostic CBT is associated with improvements in functioning and regulation. Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom inpatient psychiatric hospitalization is not recommended or desired. Very few interventions have been developed, adapted for, or evaluated in these fundamentally different delivery contexts. Transdiagnostic treatments may be ideal for addressing the comorbidity, complexity, and heterogeneity typical of acute mental health settings. Our aim was to examine initial acceptability and effectiveness of an adaptation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May, Kennedy, et al., 2017), delivered as part of comprehensive therapeutic programming in a general psychiatric PHP. We recruited 152 youths (M age = 13.1 years, 62.5% female) and caregivers, who participated in an average of 11 days of intensive UP-C/A intervention. Participants rated symptoms and functioning at baseline, weekly, posttreatment, and 1-month follow-up. Latent growth curve modeling was used to examine patterns of change and evaluate the impact of potential demographic and treatment-related covariates. For all outcomes, a quadratic model best fit the data, with symptoms and emotional reactivity decreasing significantly during treatment and then leveling off during follow-up. There was a medium-sized change in functional impairment from baseline to the 1-month follow-up, and ≥90% of participants reported treatment as acceptable and helpful. Results provide initial support for use of a transdiagnostic, cognitive-behavioral intervention in acute mental health settings and suggest important future directions, including controlled trials and investigation of implementation supports. [ABSTRACT FROM AUTHOR]

Varying patterns in eating disorder (ED) classification are evident and may impact ED treatment and prevention. However, investigations of patterns of heterogeneity in ED presentations have been limited to civilian samples, despite the high prevalence of EDs in military personnel and veterans. The present study aimed to explore ED-related symptom patterns, including emotional overeating, in women veterans. Participants were 407 women veterans using health care services at a large Veterans Affairs health care system who completed mental health measures via surveys. Latent profile analyses were used to explore distinct ED symptom patterns (binge eating, purging, heavy exercise, positive and negative emotional overeating, dietary restraint, and shape/weight concerns). Subsequent auxiliary models explored associations with mental health concerns (depressive symptoms, posttraumatic stress disorder, anxiety, alcohol misuse, substance misuse), adjusting for age, race and ethnicity, and service branch. A four-class solution demonstrated the best model fit, characterized as follows: 1) Low ED Concerns, 2) Moderate Dietary Restraint/Negative Emotional Eating, 3) High Binge/Emotional Eating, and 4) High ED Concerns. Although all profiles had moderate or higher levels of negative emotional overeating, the High Binge/Emotional Eating and High ED Concerns profiles were distinct in levels of dietary restraint and had the highest probabilities of positive emotional overeating. The High ED Concerns profile also had the most severe mental health concerns relative to the other profiles. The identification of unique ED symptom patterns in women veterans can inform prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Mass violence incidents (MVIs) involving firearms, commonly referred to as "mass shootings" have become increasingly frequent in the United States. These shootings often result in immediate casualties and have far-reaching psychological impacts on survivors, witnesses, and the broader community. This study aimed to assess the prevalence and risk factors of depression within affected communities. Population-based cross-sectional study. Data were collected from six communities affected by MVIs involving firearms that occurred between 2015 and 2020. Participants were randomly selected through address-based sampling, and depression was assessed using Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic-level major depressive episode (MDE). Overall, the MDE prevalence was 17·2% since the MVI, 15·4% in the past year, and 8·2% in the past month. Significant risk factors for MDE since MVIs include high exposure to the incident (adjusted relative risk [aRR] = 1·32, 95% confidence interval [CI]: 19–1·60), being aged 18–29 years (aRR = 2·52, 95% CI: 1·61–3·95), being a woman (aRR = 1·58, 95% CI: 1·27–1·96), having low social support (aRR = 1·80, 95% CI: 1·46–2·22), and experiencing past sexual or physical trauma (aRR = 2·20, 1·52–3·19). Our study reveals a high burden of depression within communities affected by MVIs involving firearm use. Persons with high exposure to the MVIs and certain demographic groups had greater risks for MDE. These findings highlight the long-term mental health burden in communities affected by MVIs and underscore the necessity of providing mental health services in its aftermath. [ABSTRACT FROM AUTHOR]

Although effective treatments for common mental health problems are available, individual responses to treatments are difficult to predict. Treatment efficacy could be optimized by targeting interventions using individual predictions of treatment outcomes. The aim of this study was to develop a prediction algorithm using data from one of the largest randomized controlled trials on psychological interventions for common mental health problems. This is a secondary analysis of the Enhancing Recovery in Coronary Heart Disease study investigating the effectiveness of cognitive behavioral therapy (CBT) and care as usual (CAU) for depression and low perceived social support following acute myocardial infarction. 2481 participants were randomly assigned to CBT and CAU. Baseline social-demographics, depression characteristics, comorbid symptoms, and stress and adversity measures were used to build an algorithm predicting post-treatment depression severity using elastic net regularization. Performance and generalizability of this algorithm were determined in a hold-out sample (n = 1203). Treatment matching based on predictions in the hold-out sample resulted in inconsistent and small effects (d = 0.15), that were more pronounced for individuals matched to CBT (d = 0.22). We identified a small subgroup of individuals for which CBT did not appear more efficacious than CAU. Limitations are a poorly defined CAU condition, a low-severity sample, specific exclusion criteria and unavailability of certain baseline variables. Small matching effects are likely a realistic representation of the performance and generalizability of multivariable prediction algorithms based on clinical measures. Results indicate that future work and new approaches are needed. • Machine learning predictions were made for targeted psychological interventions. • Predictions relied on self-report and clinical observation. • Predictions were developed and tested in a large dataset. • Predictions resulted in small matching effects. • Improvements are needed to guarantee clinical relevance of these prediction models. [ABSTRACT FROM AUTHOR]

Within the perioperative period, depression-related diagnoses are associated with postoperative complications. We developed a perioperative depression screening programme to assess disease prevalence and feasibility for intervention. Adult patients in multiple surgical departments at a single academic centre were screened for depression via the electronic health record patient portal or preoperative anaesthesia clinic before surgery, using the Patient Health Questionnaire (PHQ)-2 and -8. We utilised a broad method, screening all patients, and a focused method, only screening patients with a history of depression. Logistic regression was used to identify characteristics associated with clinically significant depression (PHQ-8 ≥10). Symptomatic patients were administered a brief psychoeducational intervention and referred for mental health services. A total of 3735 patients were identified by the broad and focused screens, of whom 2940 (79%) returned PHQ-2 data and were included in analysis. The broad screen (N =1216) found 46 (4%) patients who reported symptoms of moderate or greater severity. The focused screen (N =1724) found 242 (14%) patients with symptoms of moderate or greater severity and over all higher rates of depression across the symptom severity scale. Using the total screened pool, logistic regression identified a history of depression as the strongest associated patient characteristic variable but this did not capture most cases. Finally, we found that 66% of patients who were contacted about mental health services accepted referrals or sought outside care. At least 4% of preoperative patients have clinically significant symptoms of depression, most of whom do not have a chart history of depression. [ABSTRACT FROM AUTHOR]

Rates of hospitalizations and emergency department (ED) visits due to self-harm are important indicators for understanding the impact of the COVID-19 pandemic on mental health. The objective of this study was to assess changes in self-harm hospitalizations and ED visits in Canada during the first two years of the pandemic. Rates of self-harm hospitalizations and ED visits during the pandemic were predicted based on regression analyses that modeled trends over a 5-year pre-pandemic period from fiscal year 2015 to 2019. The ratios of observed and model predicted (expected) rates in 2020 and 2021 were estimated separately to assess changes during the pandemic. Overall, rates of self-harm hospitalizations and ED visits were lower than expected during the pandemic, especially in 2020. In 2021, rates for females returned to near-expected levels; but they remained lower than expected for males. Females aged 10–14 years had higher than expected rates. The rate ratio of observed rate over expected rate was 1.2 in 2020 but further increased to 1.8 in 2021 for both hospitalizations and ED visits. Higher than expected rates were also observed among females aged 15–19 years in 2021 only. Suicide attempts and non-suicidal self-harm cases could not be distinguished. We observed lower than or close to expected rates of self-harm hospitalizations and ED visits during the pandemic for most population groups. The increased rates for young females highlights the importance of continued surveillance post-pandemic and targeted mental health services and suicide prevention programs. • This study assessed changes in self-harm hospitalizations and ED visits in Canada during the COVID-19 pandemic. • In 2020, overall rates of self-harm hospitalizations and ED visits were lower than expected. • In 2021, rates for females returned to near-expected levels; but they remained lower than expected for males. • Females aged 10–19 years had increased rates during the pandemic, especially for females aged 10–14 years in 2021. • The findings highlight the importance of continuing surveillance post-pandemic and targeted mental health services. [ABSTRACT FROM AUTHOR]

In the era of digital communication, detecting emotions has become crucial for applications ranging from customer service to mental health assessment. This study examines emotion recognition in text through various machine learning techniques, from traditional machine learning techniques, to advanced large language models (LLMs) such as BERT, Falcon 7B, and Mistral 7B. The results reveal that the fine-tuned Mistral 7B model is the most precise, achieving an accuracy of 76%. Furthermore, Support Vector Machine attained an accuracy of 64%. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth, individuals whose gender identity is different from the sex that was assigned at birth, report higher rates of mental health and emotional challenges and are approximately twice as likely to access psychiatric inpatient services compared with cisgender peers. 1 Existing research has suggested that the minority stress that TGD youth face from having to navigate transphobic cultural contexts and systems (eg, unsupportive parents/caregivers, school staff, peers) may play a key factor in mental health disparities, such as increased risk of depression, anxiety, suicidal ideation, suicide attempts, and nonsuicidal self-harm. 1,2 These higher rates of mental health challenges among TGD youth offer an explanation as to why these youth access inpatient services significantly more frequently than cisgender peers. Research has found that TGD youth often experience discrimination during psychiatric inpatient admissions (eg, being misgendered during admission intake, facing stigmatization for an evolving gender identity, and receiving care from staff who have not been trained to provide gender-affirming care), 3 despite professional organizations, such as the American Academy of Child and Adolescent Psychiatry, underscoring the importance of TGD youth receiving psychiatric care that is inclusive and affirming. 4 Given that the inpatient setting offers a unique opportunity to facilitate positive and affirming changes for TGD youth, it is essential for providers to have a strong understanding of what affirmative care looks like within this context to best support this vulnerable patient population and reduce experiences of discrimination. [ABSTRACT FROM AUTHOR]