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This paper theoretically examines how the psycho-pathological concept of hysteria has evolved since its emergence in antiquity, what causes contributed to it and how nowadays meaning-making systems of clinical psychology are mirrored through it. As has been shown, the transformation of hysteria is more closely related to the cultural psychology of feminism than any other disease before it. The 20th century in particular marked a significant change in the conceptualization of hysteria. From a highly sexist and paternalistic it became a political diagnose and finally was used, after getting banished from the psychological dictionary as an everyday pejorative personality adjective. It underwent a transformation within its gender classification, which was initially limited exclusively to women. Later, it became a psychiatric diagnosis, which was no longer durable nowadays and has finally changed into the concept of histrionic today. The analysis shows how, on the one hand, medical and biopsychological findings and, on the other hand, especially political movements and their cultural psychological processes of change form the basis of psychopathological concepts. It will be shown to what extent hysteria is exceptionally exemplary for this change in psychological meaning-making. In this context, the close connection between hysteria and the emancipatory development of our society could be emphasized. [ABSTRACT FROM AUTHOR]

Aims: Community treatment orders have been introduced in many jurisdictions with increasing use over time. We conducted a rapid umbrella review to synthesise the quantitative and qualitative evidence from systematic reviews and/or meta-analyses of their potential harms and benefits. Methods: A systematic search of Medline, PubMed, Embase and PsycINFO for relevant systematic reviews and/or meta-analyses. Where available, participants on community treatment orders were compared with controls receiving voluntary psychiatric treatment. This review is registered with PROSPERO (CRD42023398767) and the Open Science Framework (https://osf.io/zeq35). Results: In all, 17 publications from 14 studies met the inclusion criteria. Quantitative synthesis of data from different systematic reviews was not possible. There were mixed findings on the effects of community treatment orders on health service use, and clinical, psychosocial or forensic outcomes. Whereas uncontrolled evidence suggested benefits, results were more equivocal from controlled studies and randomised controlled trials showed no effect. Any changes in health service use took several years to become apparent. There was evidence that better targeting of community treatment order use led to improved outcomes. Although there were other benefits, such as in mortality, findings were mostly rated as suggestive using predetermined and standardised criteria. Qualitative findings suggested that family members and clinicians were generally positive about the effect of community treatment orders but those subjected to them were more ambivalent. Any possible harms were under-researched, particularly in quantitative designs. Conclusions: The evidence for the benefits of community treatment orders remains inconclusive. At the very least, use should be better targeted to people most likely to benefit. More quantitative research on harms is indicated. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a concern in psychiatric patients. We aimed to study the influence of the modifiable lifestyle factors on MetS in adult psychiatric patients along with associated clinical factors and quality of life. Methods: Factors such as diet (Healthy Eating Index), exercise, substance use, cardiovascular risk (QRISK), illness severity (Clinical Global Impression), medications, adverse events (Systematic Monitoring of Adverse Events Related to Treatments), and quality of life (Recovering Quality of Life Scale) were assessed along with clinical components for MetS in 323 psychiatric patients receiving routine care and monitoring in a Community Mental Health Team. Results: MetS was present in 50.5% (95% CI: 45.0–55.9). It was significantly associated with higher age, duration of mental illness, body mass index (BMI), QTc, QRISK, and antipsychotic drugs. In logistic regression, age, QTc, QRISK, and BMI remained significantly linked to MetS. Patients with or without MetS were comparable in their lifestyle factors such as diet, exercise, and substance use, along with the family history of metabolic disorders, age at onset of mental illness, duration of antipsychotic medication, side effects, psychiatric diagnoses, and quality of life. However, many patients with or without MetS had poorer diet and physical inactivity, indicating scope for interventions. Conclusions: Around half of the psychiatric patients had MetS, and modifiable lifestyle factors did not differentiate individuals with or without MetS. The need for further research on the prevention and management of MetS in psychiatric patients is highlighted. [ABSTRACT FROM AUTHOR]

Objective: Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian. Method: We collected parent or self-reported ratings of OCD, ADHD and anxiety traits and diagnoses for 6- to 17-year-olds from a Canadian general population sample (Spit for Science). We examined racial/ethnic differences in trait levels and the odds of reporting a diagnosis using mixed-effects linear models and logistic regression models. Results: East Asian (N = 1301) and South Asian (N = 730) youth reported significantly higher levels of OCD and anxiety traits than White youth (N = 6896). East Asian and South Asian youth had significantly lower odds of reporting a diagnosis for OCD (odds ratio [ OR ]East Asian = 0.08 [0.02, 0.41]; OR South Asian = 0.05 [0.00, 0.81]), ADHD (OR East Asian = 0.27 [0.16, 0.45]; OR South Asian = 0.09 [0.03, 0.30]) and anxiety (OR East Asian = 0.21 [0.11, 0.39]; OR South Asian = 0.12 [0.05, 0.32]) than White youth after accounting for psychiatric trait levels. Conclusions: These results suggest a discrepancy between trait levels of OCD, ADHD and anxiety and rates of diagnoses for East Asian and South Asian youth. This discrepancy may be due to increased barriers for ethnically diverse youth to access mental health care. Efforts to understand and mitigate these barriers in Canada are needed. [ABSTRACT FROM AUTHOR]

Childhood adversity can include traumatic experiences and exposure to other risk factors; consistently predicting poorer psychosocial outcomes in adulthood. Relatively little research has investigated the impact of cumulative risk exposure in childhood. Using data collected in a specialist clinical setting, we investigated the associations between risk exposure, psychopathology and psychosocial functioning. Participants were children attending the Attachment and Trauma service at Great Ormond Street Hospital in London (N = 132, M = 10.25, SD = 3.35). Data was collected via routine clinical practice during multi-disciplinary assessments. Data was collected on developmental and trauma history, psychopathology, and functioning (CGAS), using standardised measures, clinical interviews, and observations. All children had experienced at least one risk factor, with 78% reporting multiple exposures, including witnessing interpersonal violence (52%), neglect (48%), and physical abuse (42%). Other risk exposures included exposure to alcohol (17%) and substances (24%) in-utero, as well as social risk factors such as multiple foster placements in some cases. In this sample, 65% of children met criteria for at least one psychiatric diagnosis (Anxiety = 31%, PTSD = 28%, Depression = 8%). High levels of functional impairment were found, with 52% of children falling into the highest categories of 'obvious' or 'severe' problems. Multiple risk exposure significantly predicted PTSD (OR 9.64 (1.1, 83.7)), but did not predict anxiety, depression, or functional impairment. This study highlights the rates of cumulative risk exposure in this clinical sample. The findings demonstrate the importance of detailed and accurate clinical assessments in ascertaining trauma histories in children with known histories of adversity and maltreatment. There are implications for assessment and treatment, such as the importance of clear guidelines on treating PTSD in children with complex trauma histories. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations between past-year mental illness (MI) diagnoses and e-cigarette use status. Design: Data were obtained from the National College Health Assessment, a nationally recognized cross-sectional survey of university students. Setting: Participants were recruited from 2-year and 4-year public and private universities across the United States from 2017-2019. Subjects: The analytic sample included 277 291 university students. Measures: Self-reported past-year MI diagnosis, binarily coded, served as the primary predictor. The outcome was e-cigarette use status (never, noncurrent, and current user). Analysis: Multinomial logistic regression models were used to estimate relative risk ratios (RRR) of e-cigarette use, as predicted by past-year MI diagnoses, age, race/ethnicity, sex and gender, sexual identity, geographic region, and other combustible tobacco, alcohol, and marijuana use. Results: Compared to those who had never received any MI diagnosis in the past year, those who did had a 16% higher relative risk (RRR = 1.16, 95% CI: 1.11, 1.20) of being a noncurrent e-cigarette user and a 33% higher relative risk (RRR = 1.33, 95% CI: 1.28, 1.38) of being a current e-cigarette user. Schizophrenia, substance use or addiction, bipolar disorder, and attention deficit and hyperactivity disorder (ADHD) diagnoses demonstrated the strongest associations with noncurrent and current e-cigarette use. Conclusion: Results suggest the need to screen young adults for e-cigarette use and mental health indicators to facilitate early detection and timely intervention for at-risk university students. [ABSTRACT FROM AUTHOR]

Researchers have been increasingly investigating observer and patient characteristics that may influence the assessment of pain in others. While rates of psychiatric conditions are high in chronic pain populations, surprisingly little attention has been given to if (and why) a comorbid psychiatric diagnosis may influence the estimation of pain in others. Using an experimental vignette paradigm, the current study examined whether a diagnostic label of major depressive disorder (MDD) would impact observer pain estimates of a woman with chronic pain, and whether causal attributions of pain and pain genuineness might help explain these effects. Participants (n = 188) were given a vignette describing a female patient with chronic pain (who either had MDD or no mental health concerns), viewed a brief video clip of the patient, and then were asked to provide a variety of ratings about the woman's pain. Results of a serial multiple mediation analysis revealed that participants in the MDD condition made greater psychological attributions for the woman's pain, which was associated with lower perceptions of pain genuineness, which was then associated with lower estimates of pain intensity. These findings suggest that a diagnosis of depression may indirectly influence observer estimates of another person's pain by heightening psychological attributions of pain, and making their pain seem less genuine. Further research is needed to elucidate the complex processes underlying pain estimation, including patient and observer characteristics, biases, and heuristics, in order to improve quality of care for those living with persistent pain.' [ABSTRACT FROM AUTHOR]

Internalizing and externalizing problems are common targets for school mental health screening. Prior research supports the interpretation of scores from the Youth Internalizing Problems Screener (YIPS) and the Youth Externalizing Problems Screener (YEPS), which were developed separately yet intended as companion measures. We extended previous work by evaluating the psychometric defensibility of integrated measurement models that combined items from the YIPS and YEPS into a unified screener (YIEPS). Specifically, we evaluated (a) a unidimensional model, (b) a correlated-factors model with two latent variables representing internalizing and externalizing problems, and (c) a bifactor model with two specific factors—internalizing and externalizing—and a general factor representing global mental health problems. We then tested the reliabilities of the several factors from these models and the informational value added of the competing models. Results indicated the bifactor YIEPS model had the best data-model fit for representing the unified screener. However, exploratory analyses suggested an alternative bifactor model with three specific factors—parsing attention problems from externalizing and internalizing content—might be an even better fit for the data. Reliability findings suggested the general factor—representing global mental health problems—was the most psychometrically defensible. Future directions for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Background: Resurgent psychedelic research has largely supported the safety and efficacy of psychedelic therapy for the treatment of various psychiatric disorders. As psychedelic use and therapy increase in prevalence, so does the importance of understanding associated risks. Cases of prolonged negative psychological responses to psychedelic therapy seem to be rare; however, studies are limited by biases and small sample sizes. The current analytical approach was motivated by the question of whether rare but significant adverse effects have been under-sampled in psychedelic research studies. Methods: A "bottom margin analysis" approach was taken to focus on negative responders to psychedelic use in a pool of naturalistic, observational prospective studies (N = 807). We define "negative response" by a clinically meaningful decline in a generic index of mental health, that is, one standard error from the mean decrease in psychological well-being 4 weeks post-psychedelic use (vs pre-use baseline). We then assessed whether a history of diagnosed mental illness can predict negative responses. Results: We find that 16% of the cohort falls into the "negative responder" subset. Parsing the sample by self-reported history of psychiatric diagnoses, results revealed a disproportionate prevalence of negative responses among those reporting a prior personality disorder diagnosis (31%). One multivariate regression model indicated a greater than four-fold elevated risk of adverse psychological responses to psychedelics in the personality disorder subsample (b = 1.425, p < 0.05). Conclusion: We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population. [ABSTRACT FROM AUTHOR]

Different forms of maltreatment are thought to incur a cumulative and non-specific toll on mental health. However, few large-scale studies draw on psychiatric diagnoses manifesting in early childhood and adolescence to identify sequelae of differential maltreatment exposures, and emotional maltreatment, in particular. Fine-grained multi-source dimensional maltreatment assessments and validated age-appropriate clinical interviews were conducted in a sample of N = 778 3 to 16-year-olds. We aimed to (a) substantiate known patterns of clinical outcomes following maltreatment and (b) analyse relative effects of emotional maltreatment, abuse (physical and sexual), and neglect (physical, supervisory, and moral-legal/educational) using structural equation modeling. Besides confirming known relationships between maltreatment exposures and psychiatric disorders, emotional maltreatment exerted particularly strong effects on internalizing disorders in older youth and externalizing disorders in younger children, accounting for variance over and above abuse and neglect exposures. Our data highlight the toxicity of pathogenic relational experiences from early childhood onwards, urging researchers and practitioners alike to prioritize future work on emotional maltreatment. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the extent to which people admitted to a private psychiatric inpatient unit access and utilise the gymnasium and individualised coaching with an exercise physiologist (EP). Methods: An audit of the medical record of 100 consecutive discharges and 60 individuals referred to an EP during the audit period was undertaken. Selected demographic information, physical health status, psychiatric diagnosis and routinely collected outcome data were extracted from files. Results: Twenty-four percent of people discharged from the hospital had documentary evidence of having attended the gym. These people were noted to have used the gym regularly and had an exercise prescription documented on discharge. Those with substance use disorder were more likely to use the gym than those diagnosed with an affective disorder. There were no significant differences in outcomes between those who were noted to exercise and those who did not. Conclusion: Those who may most benefit from coaching around exercise in the context of hospital admission are not presently the individuals most likely to be referred to an EP. Standardised procedures for assessment, referral, exercise prescription and ongoing monitoring of activity and outcomes are recommended across the care continuum. [ABSTRACT FROM AUTHOR]

Researchers and clinicians working within the Diagnostic and Statistical Manual of Mental Disorders : Fifth Edition, Text Rev (DSM -5-TR) framework face a difficult question: what does it mean to have an evidence-based assessment of a nonevidence-based diagnostic construct? Alternative nosological approaches conceptualize psychopathology as (a) hierarchical, allowing researchers to move between levels of description and (b) dimensional, eliminating artificial dichotomies between disorders and the dichotomy between mental illness and mental well-being. In this article, we provide an overview of ongoing efforts to develop validated measures of transdiagnostic nosologies (i.e., the Hierarchical Taxonomy of Psychopathology; HiTOP) with applications for measurement-based care. However, descriptive models like HiTOP, which summarize patterns of covariation among psychopathology symptoms, do not address dynamic processes underlying the problems associated with psychopathology. Ambulatory assessment, well-suited to examine such dynamic processes, has also developed rapidly in recent decades. Thus, the goal of the current article is twofold. First, we provide a brief overview of developments in constructing valid measures of the HiTOP model as well as developments in ambulatory assessment practices. Second, we outline how these parallel developments can be integrated to advance measurement-based treatment. We end with a discussion of some major challenges for future research to address to integrate advances more fully in transdiagnostic and ambulatory assessment practices. [ABSTRACT FROM AUTHOR]

The purpose of this article is to provide a description and discussion of the evidence-based assessment of personality disorder. Considered herein is the assessment of the Section II personality disorders included within the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM -5-TR), within Section III of DSM -5-TR, and within the 11th edition of the World Health Organization's International Classification of Diseases (WHO). The recommendation for an evidence-based assessment is for a multimethod approach: first administer a self-report inventory to alert the clinician to maladaptive personality functioning that might not have otherwise been anticipated, followed by a semi-structured interview to verify the personality disorder's presence. The validity of this multimethod strategy can be improved further by considering the impact of other disorders on the assessment, documenting temporal stability, and establishing a compelling, empirical basis for cutoff points. [ABSTRACT FROM AUTHOR]

Background: In the literature on stigma, authors often use self-stigma or internalized stigma interchangeably to refer to this type of stigma. This results in a lack of conceptual clarity with negative repercussions for measurement and intervention. Aims: To identify how internalized stigma and self-stigma are conceptualized in people diagnosed with a mental disorder and establish similarities and differences between both concepts. Method: A scoping review was conducted. Thirty-five studies that conceptualized internalized stigma or self-stigma were selected. Results: It was identified that the concepts are defined from nine components, and there are more conceptualizations that have points in common than those that consider some component of their own. To gain conceptual clarity, the use of the term internalized stigma is recommended, being a process made up of stages: acceptance of stereotypes and prejudices by people with mental disorders and their subsequent internalization. The latter leads to negative consequences for those affected, which can be understood as the personal impact of this process, which has a crucial socio-cultural component. Lines of research are proposed to provide solidity to studies on this type of stigma. Conclusions: The term internalized stigma should be used when referring to the type of stigma that includes acceptance, internalization and personal impact for the subjects of the stigma. In contrast, self-stigma should be reserved to refer to stigma that is directed toward the 'self' and includes subtypes of stigma. [ABSTRACT FROM AUTHOR]

Background: Among refugees residing in countries of first asylum, such as Malaysia, high rates of psychological distress call for creative intervention responses. Aims: This study examines implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model promoting emotional well-being and access to services. Method: The one-session intervention was implemented in community settings by refugee facilitators during 2017 to 2020. 140 Participants including Afghan (n = 43), Rohingya (n = 41), and Somali (n = 56) refugees were randomized to receive either the intervention at baseline, or to a waitlist control group. At 30 days post-intervention, all participants completed a post-assessment. Additionally, after completing the intervention, participants provided feedback on SBIRT content and process. Results: Findings indicate the intervention was feasible to implement. Among the full sample, Refugee Health Screening-15 emotional distress scores reduced significantly among participants in the intervention group when compared to those in the waitlist control group. Examining findings by nationality, only Afghan and Rohingya participants in the intervention condition experienced significant reductions in distress scores compared to their counterparts in the control condition. Examining intervention effects on service access outcomes, only Somali participants in the intervention condition experienced significant increases in service access compared to the control condition. Conclusions: Findings indicate the potential value of this SBIRT intervention, warranting further research. [ABSTRACT FROM AUTHOR]

The Nordic countries are currently attempting to implement prolonged grief disorder as an official psychiatric diagnosis, as enacted by The World Health Organization in 2018. The enactment has been controversial and, especially in Denmark, the forthcoming diagnosis has met resistance from scholars and clinicians alike. In this article we will outline what we believe to be lost considerations during the debate of the so-called "grief diagnosis." We argue that scholars' attention should not focus on the diagnosis itself, but rather on the overall theoretical challenges in conceptualizing and handling mental suffering, which the debate should reflect and address. The article's main purpose is to accentuate why we, as psychologists, must welcome the prolonged grief diagnosis, whilst simultaneously working to more actively politicize mental suffering in general, and criticize the societal function of diagnoses. This should be attained through dialogue and recognition between cultural psychologists and health psychologists. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate whether patients with a non-specific back pain disorder are more likely to be diagnosed with a psychiatric disorder than patients with a specific back pain disorder (such as a herniated disc or inflammatory back disorder). Methods: This was a retrospective cohort study using Danish registries. Results: Our study population included 24,518 patients younger than 61 years and 12,274 patients older than 61 years. In both subpopulations, 60% had a non-specific back pain diagnosis (BPD). In the younger subpopulation, 2.1% of the patients with a non-specific BPD and 1.3% of the patients with a specific BPD had a psychiatric diagnosis within one year of their BPD. In the older subpopulation, 0.6% of patients had a psychiatric diagnosis in both BPD groups. The most frequent psychiatric diagnoses were stress-related disorders. In the younger subpopulation, patients with non-specific back pain had a higher risk of being diagnosed with a psychiatric disorder than patients with specific back pain (adjusted odds ratio 1.56, 95% confidence interval 1.25–1.94). The type of BPD had no effect on the risk of having a psychiatric diagnosis among older patients. Conclusions: Patients with a non-specific back pain disorder younger than 61 years were more likely to be diagnosed with a psychiatric disorder than patients with a specific back pain disorder. We recommend that spine specialists pay special attention to patients younger than 61 years with a back pain disorder to prevent them from developing a psychiatric disorder. [ABSTRACT FROM AUTHOR]

The national shortage of child psychiatrists has resulted in the necessity of primary care providers (PCPs) managing increased mental health concerns of youth. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) is one of several programs throughout the United States which provide PCPs with education, consultation, and resource support related to pediatric mental health. To evaluate initial impact of the program, data from 190 pediatricians and family practitioners from the Wisconsin Health Information Organization (WHIO) were analyzed. Enrollment in the WI CPCP was associated with a significant increase in rates of mental health diagnoses within primary care visits. In addition, the number of providers who made any mental health diagnosis increased from 56% of PCPs pre-enrollment to over 99% post-enrollment. These data provide additional support for pediatric psychiatry consultation programs within primary care. [ABSTRACT FROM AUTHOR]

This study, using semi-structured interviews with a sample of probation officers (N = 151), develops a model that suggests how officers may weigh psychiatric diagnoses when assessing defendants' expressions of remorse and how this may shape their presentencing recommendations for sentencing diversion. Results suggest that probation officers consider psychiatric diagnoses when evaluating remorse in sentencing contexts in three main ways: (a) the extent to which psychiatric symptoms may lead defendants to have difficulties showing conventional expressions of remorse and complicate how officers understand their non-normative remorse displays; (b) how psychiatric symptoms can mitigate defendants' emotional behaviors used to develop and "feel" remorse, particularly their blunted empathy and hindered recognition of their criminal acts; and (c) some officers make stigmatized assumptions about personal qualities of defendants diagnosed with psychiatric diagnoses, which can lead them to be critical of their remorse. Then, drawing from views in the first two areas, officers discussed providing information on defendants' psychiatric illnesses—and the potential impacts on their abilities to show or develop remorse—to support recommendations for sentencing diversion in presentencing reports. Takeaways, as well as how remorse assessments may shape probation recommendations for sentencing diversion for defendants with psychiatric diagnoses, are discussed. [ABSTRACT FROM AUTHOR]

Purpose: To assess differences in mental health screening based on patient's preferred language. Methods: For this retrospective cohort study, data for 85 725 unique patients from 10 primary care clinics in West Michigan were analyzed if patients received at least 1 mental health screening with the Patient Health Questionnaire 4 (PHQ-4) within a 12-month period (10/15/2021-10/14/2022). A general linear regression model was used to assess the adjusted odds ratios (aOR) of being screened. Results: Patients having a preferred language other than English (n = 2755) had an 87.0% chance of receiving the recommended mental health screening, compared to 76.7% of English-speaking patients (P <.001). A multivariable model revealed decreased screening odds for Kinyarwanda (aOR 0.29, 95% CI 0.19-0.45) and Persian/Dari/Pashto (aOR 0.46, 95% CI 0.23-0.91) speaking patients and higher screening odds for Spanish (aOR 1.45, 95% CI 1.19-1.77), Bosnian (aOR 2.13, 95% CI 1.11-4.11), and Vietnamese (aOR 2.25 95% CI 1.64-3.08) speaking patients compared to English speaking patients. Conclusions: Results highlight the inequities between the language groups that are probably the result of the challenges to access multilingual depression and anxiety screening instruments. Furthermore, providers may be prone to bias about who they think "needs" a mental health screening. We suggest that measures are implemented to ensure consistency in mental health screening regardless of a patients' preferred language. [ABSTRACT FROM AUTHOR]

Rapid Response Systems (RRS) improve patient outcomes at large medical centers. Little is known about how RRS are used in other medical settings. The purpose of this exploratory study was to describe RRS events at a long-term acute care hospital (LTACH). We conducted a retrospective review of 71 RRS event records at an urban 50-bed Midwestern LTACH. Measures included demographic data, triggering mechanisms, contextual factors, mechanism factors, and clinical outcomes. Of patients who experienced a RRS event, median age was 71 (62, 80) years; 52.1% were female; most (n = 49, 69%) were "full code." Most (n = 41, 58%) events occurred during the daytime. The most common trigger was "mental status changes/unresponsiveness." Registered nurses were the most frequent activator (n = 19, 26.8%) and responders (n = 63, 60.6%). Median duration of RRS events was 14 (6, 25) minutes. Most patients stabilized and their condition improved (n = 54, 76.1%). RRS can be expanded and modified to the LTACH population. [ABSTRACT FROM AUTHOR]

Objectives: (1) To calculate the proportions of people who sought mental health and addiction (MHA) specialty services in Nova Scotia, overall and by sex and age. (2) To describe the health and psychosocial profiles of the MHA Intake clients. (3) To identify factors associated with acceptance for MHA services. Methods: The data of the Nova Scotia MHA Intake clients aged 19 to 64 years old in 2020 (N = 10,178) and in 2021 (N = 12,322) were used. The proportions of unique clients in the general population were calculated based on 2021 census data. The percentages of primary presenting concerns, the presence and frequency of psychiatric symptoms in the past month, suicide risk levels, current or past provisional psychiatric diagnosis, medical problems, and psychosocial stressors were calculated. Logistic regression was conducted to identify factors associated with the acceptance of MHA services after the assessment. Results: It was found that 1.48% and 2.33% of Nova Scotians aged 19 to 64 contacted the MHA Intake in 2020 and 2021. Over 66% were self-referrals, followed by physician referrals (28.34%). Mood (28.3%), anxiety (25.17%), and substance use (19.81%) were the top three presenting concerns for the contact. Many clients had a current or past provisional psychiatric diagnosis (58.7% in 2020, 61.8% in 2021). Among the clients, 74.67% and 68.29% reported at least 1 psychosocial stressor in 2020 and 2021, respectively. The clients with a current or past psychiatric diagnosis, suicide risk, and 2 or more psychosocial stressors, those who lived outside of Central Zone, and who had employee assistance program benefits/private insurance, were more likely to be qualified and accepted for MHA services than others. Conclusions: The Intake clients have complex health and psychosocial profiles. Future studies are needed to monitor the trajectories of the clients to reduce inequities in receiving MHA services and improve client outcomes. [ABSTRACT FROM AUTHOR]

Those of us with embodied experiences of gender diversity and sexually assault have and continue to be subject to psychiatric diagnosis and categorization that pathologize our acts of dissociation within a medical framework. In this paper we adopt Barad, Karen. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham and London: Duke University Press new materialist ontology of agential realism to argue that agentially cutting psychiatric discourse on dissociative symptoms could materialize new realities for embodied people which have been excluded to the psychiatric realm of abjection via gender diversity and sexual assault. Specifically, we explore how approaching dissociative symptoms not as dysfunction but as forms of agential dislocation from hegemonic norms of race and gender could open new political horizons by naming relations of dominance. [ABSTRACT FROM AUTHOR]

Dopamine agonists are the first-line treatment of prolactinomas. The risk of developing de novo psychiatric symptoms during dopamine agonist therapy is low. Herein, we report the case of a 42-year-old woman with a giant prolactinoma who developed a psychiatric disorder after 1 day of cabergoline therapy initiation. She presented with amenorrhea, galactorrhea, headaches, and disturbed vision. Biological investigations revealed hyperprolactinemia (2975 ng/ml) with gonadotropin deficiency. Pituitary MRI showed a giant pituitary adenoma. The patient was treated with cabergoline at the dose of 1 mg twice weekly. One day after the treatment initiation, she developed acute delirium with temporospatial disorientation and compulsive medication use. These symptoms disappeared 1 week after the reduction of the dose of cabergoline. Patients with hyperprolactinemia receiving an initial high dose of cabergoline may develop changes in mood and behavior regardless of prior psychiatric history. [ABSTRACT FROM AUTHOR]

When scales or tests are used to make decisions about individuals (e.g., to identify which adults should be assessed for psychiatric disorders), it is crucial that these decisions be accurate and consistent. However, it is not obvious how to assess accuracy and consistency when the scale was administered only once to a given sample and the true condition based on the latent variable is unknown. This article describes a method based on the linear factor model for evaluating the accuracy and consistency of scale-based decisions using data from a single administration of the scale. We illustrate the procedure and provide R code that investigators can use to apply the method in their own data. Finally, in a simulation study, we evaluate how the method performs when applied to discrete (vs. continuous) items, a practice that is common in published literature. The results suggest that the method is generally robust when applied to discrete items. [ABSTRACT FROM AUTHOR]

Although single items can save time and burden in psychology research, concerns about their reliability have made the use of multiple-item measures the default standard practice. Although single items cannot demonstrate internal reliability, their criterion validity can be compared with multiple-item measures. Using ecological momentary assessment data, we evaluated repeated measures correlations and constructed multilevel cross-lagged models to assess concurrent and predictive validity of single- and multiple-item measures. Correlations between the single- and multiple-item measures ranged from.24 to.61. In 27 of 29 unique single-item predictor models, single items demonstrated significant predictive validity, and in one of eight sets of comparisons, a single-item predictor exhibited a larger effect size than its multiple-item counterpart. Although multiple-item measures generally performed better than single items, the added benefit of multiple items was modest in most cases. The present data provide support for the use of single-item measures in intensive longitudinal designs. [ABSTRACT FROM AUTHOR]

Background: Medical students tend to experience high levels of stress during their studies, that can result in mental health disorders and burnout, further affecting academic performance and later ability to practice. Aims: To investigate previous and current mental health issues, significant sources of stress, burnout, and substance use among medical students in the United Arab Emirates (UAE). Method: We conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 385 medical students from the UAE University. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire. Results: Our results indicated that 5.7% of participants had been diagnosed with a mental health condition prior to joining medical school, and that 21.6% of participants were diagnosed with a mental illness while in medical school. On the OLBI, 77.4% screened positive for burnout (81.3% for disengagement and 95.1% for exhaustion), with 74.5% screening positive for mental health difficulties on the GHQ-12 and <1% screening positive on the CAGE for problem drinking. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12. Conclusions: Our study indicated that high levels of stress, burnout and mental illness are experienced among medical students in the UAE. [ABSTRACT FROM AUTHOR]

Amid extensive press coverage, George Stephen Penny (1885–1964) was tried for murder in 1923. He was found 'guilty but insane' due to 'confusional insanity' associated with malaria which he suffered during World War I. Penny was admitted to Broadmoor Criminal Lunatic Asylum at a time of great public concern about inadequate and cruel care in mental institutions, but he was treated with humanity and respect. Penny's story also reveals much about challenges of psychiatric diagnosis and the relationships between crime, insanity, the public, lawyers and the medical profession. Following discharge from Broadmoor, Penny built himself a life in the community. His pseudonymous memoir, with masterly concealment of his identity and crime, tells his story up to 1925. [ABSTRACT FROM AUTHOR]

Introduction: Mental illness is a non-communicable disease that is increasingly contributing to the global burden of diseases and disability. It affects a person's feelings, thinking, behavior, and daily life functioning. Objectives: The purpose of this study was to explore perceived causes of mental illness, techniques for identifying mental illness, and treatment methods used by traditional healers in the Berta community. Methods: The study employed a qualitative research method. Data were collected using semi-structured in-depth interviews with seven traditional healers who were selected purposefully. We used thematic analysis to present and analyze the data. Results: The findings of this study indicated that witchcraft, supernatural power, hereditary, substance use, and food poising as the main perceived causes of mental illness among traditional healers in the Berta community. The traditional healers identify mental illness using different techniques such as patient observation, interviews with a patient's family, use of religious books, and use of herbals. The traditional healers in the Berta community identify mental illness based on behavioral symptoms like talking about things that don't make sense, laughing alone, taking off clothes in public places, collecting and carrying dirty materials, eating dirty foods, and harming or intention to harm others. Conclusions: The traditional healers in the Berta community use herbals, religious books, and bone divination to guide their treatment of persons with mental illnesses. Some of these traditional healing practices options are peculiar to the Berta Community that are used to diagnosize and treat mental illnesses. Recommendations: The traditional healing practices of the Berta community should be recognized, licensed, and supported by the Ministry of Health and the Ethiopian Food and Drug Administration and Control Authority. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to measure frequency and correlates of initial idiopathic psychiatric diagnosis in a cohort of 147 patients with Frontotemporal Dementia (FTD)-spectrum disorders. Methods: Participants were evaluated at the National Institutes of Health in Bethesda, Maryland. Initial participant diagnoses were determined by chart review and patient and informant interviews. Logistic regression was used to assess the relationships between diagnosis and age of symptom onset, gender, education, family history of psychiatric illness, and family history of dementia. Additional exploratory analyses investigated patients' first symptom type. Results: 25% (n=43) of all the patients reviewed were initially misdiagnosed with an idiopathic psychiatric illness, which is less than half the commonly cited 50% rate.3 Depression was the most common misdiagnosis (46.5%). Family history of dementia, family history of mental illness and an exploratory analysis of behavioral first symptoms suggested significant association with a greater likelihood of initial idiopathic psychiatric diagnosis in FTD patients. Discussion: This data confirms patterns of initial idiopathic psychiatric diagnosis in FTD and elucidates potential factors underlying misdiagnosis. Potential implications for patient outcomes, caregiver burden and healthcare costs are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Many behavioral health providers (BHPs) in primary care practices spend a majority of their time addressing mental health rather than behavior change. We wanted to better understand the practice of BHPs in integrated primary care. Methods: Survey of BHPs from practices participating in the Colorado State Innovation Model (SIM) initiative. The survey measured what diagnoses BHPs receive referrals to treat, what they treat regardless of referral reason, which techniques they use, and think are most effective for mental health diagnoses and behavior change/weight management support, and their interest in providing support for weight management. Results were analyzed using descriptive statistics and Spearman correlations. Results: We received 79 surveys representing 64 out of 248 SIM practices (practice response rate of 26%). BHPs reported addressing health-related behaviors with patients referred to them for mental health diagnoses. They expressed interest in health behavior and believed the techniques they use for traditional mental health diagnoses also support behavior change. Most reported using cognitive behavioral therapy (89%), mindfulness (94%), and relaxation/stress management (94%). Time in practice was associated with receiving more referrals for weight management (rho(76) =.271, P =.018) and with addressing diet (rho(75) =.339, P =.003) and weight management (rho(75) =.323, P =.005). BHPs in practices that had care managers were more likely to report receiving referrals for weight management than BHPs in practices that did not employ a case manager ( r τ (76) =.222, P =.038); practices employing a health coach were more likely to receive referrals for physical activity than practices without a health coach ( r τ (76) =.257, P =.015). Conclusions: BHPs are interested in and frequently address health related behavior. Formalizing health behavior services from BHPs in primary care may provide opportunities to better support patients with behavior change and subsequently improve health outcomes. [ABSTRACT FROM AUTHOR]

Background: We report emergency department and inpatient amphetamine-related trends focusing on co-occurring substance use and psychiatric diagnoses at the Centre for Addiction and Mental Health, the largest mental health teaching hospital in Canada. Methods: We describe yearly trends in amphetamine-related Centre for Addiction and Mental Health emergency department visits and inpatient admissions out of all emergency department visits and inpatient admissions between 2014 and 2021, along with proportions of concurrent substance-related admissions and mental/psychotic disorders emergency department visits and inpatient admissions among amphetamine-related contacts; joinpoint regression analyses assessed changes in amphetamine-related emergency department visits and inpatient admissions. Results: Amphetamine-related emergency department visits rose from 1.5% in 2014 to 8.3% in 2021, with a peak of 9.9% in 2020. Amphetamine-related inpatient admissions rose from 2.0% to 8.8% in 2021, with a peak of 8.9% in 2020. Significant increasing trends in the percentage of amphetamine-related emergency department visits happened especially between the second and the fourth quarter of 2014 (quarterly percent change = + 71.4, P <0.01). Similarly, the percentage of amphetamine-related inpatient admissions increased mostly between the second quarter of 2014 and the third quarter of 2015 (quarterly percent change = + 32.6, P <0.01). The proportion of concurrent opioid-related contacts among amphetamine-related emergency department visits and inpatient admission increased markedly between 2014 and 2021; psychotic disorders in amphetamine-related inpatient admissions more than doubled from 2015 to 2021. Discussion: Prevalence of amphetamine use, mostly from methamphetamine, has been increasing in Toronto as have co-occurring psychiatric disorders and opioid use. Our findings highlight the need for increases in accessible efficacious treatments for complex populations with polysubstance use and co-occurring disorders. [ABSTRACT FROM AUTHOR]

Background: The prevalence of mental disorders is increased among people of low socioeconomic status or educational level, but it remains unclear whether their access to treatment matches their increased need. Aims: Our objective was to examine whether educational level as an indicator of socioeconomic status is associated with use of mental health services, psychotropic medication and psychotherapy in Finland. Method: Cross-sectional data from a follow-up survey of a longitudinal, population-based cohort study were used to form a sample of 3,053 men and women aged 24 to 68 with a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, mental health service use and educational level were assessed with self-report questionnaire. Educational level was determined by the highest educational attainment and grouped into three levels: high, intermediate and low. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates in the fully adjusted model were age, gender and number of somatic diseases. Results: Compared to high educational level, low educational level was associated with higher odds of using antidepressants (OR 1.35, 95% CI [1.09, 1.66]), hypnotics (OR 1.33, 95% CI [1.07, 1.66]) and sedatives (OR 2.17, 95% CI [1.69, 2.78]), and lower odds of using mental health services (OR 0.80, 95% CI [0.65, 0.98]). No associations were found between educational level and use of psychotherapy. Conclusions: The results do not suggest a general socioeconomic status related mismatch. A pharmacological emphasis was observed in the treatment of low educational background participants, whereas overall mental health service use was emphasized among high educational background participants. [ABSTRACT FROM AUTHOR]

Background: Cannabis use disorder (CUD) is one of the main reasons for seeking substance use treatment. It is thus important to monitor and increase knowledge of individuals with CUD utilizing healthcare. We aimed to examine the number of CUD diagnoses over time, compare individuals with CUD with those without and identify subgroups based on CUD diagnosis, sex, birth year, socioeconomic factors and psychiatric comorbidity. Methods: A Swedish, population-based study with 3,307,759 individuals, born in 1970–2000, with register data extending to 2016. K-mode cluster analysis was used to identify potential subgroups. Results: The number of individuals with a CUD diagnosis was 14,046 (0.42%). CUD diagnoses increased over time (born 1990–1994: 61 per 100,000, born 1995–2000: 107 per 100,000, by 2016). A majority of those with a CUD had another psychiatric diagnosis (80%, compared with 19% for those without CUD). Four clusters were identified. Cluster 1 comprised mainly men with low income and substance use disorders, clusters 2, 3 and 4 comprised mainly women with higher proportions of mood-related, neurotic and stress-related and behavioural disorders. Conclusions: There was an increase in CUD diagnoses in Sweden over time, especially among younger birth cohorts. Individuals with CUD were more often male, from younger birth cohorts, with lower education and income than those without CUD. Men and women with CUD exhibited differences in education, income and psychiatric comorbidity. Our results demonstrate the importance of monitoring the impact of socioeconomic factors and psychiatric comorbidity in relation to CUD. [ABSTRACT FROM AUTHOR]

Purpose: The most common form of social work (SW) practice in Canada is clinical which requires specialized knowledge and advanced clinical skills. The SW profession is more than 100 years old, but regulation is new to Canada and presently most jurisdictions have regulatory bodies to advance safe, competent, and ethical practices. Regulatory bodies establish admission requirements, standards of practice, ethical guidelines, supervision, continuing education requirements, and measures for complaints and discipline. Methods: This article examines regulation of SW practice in Canada with a focus on registration requirements, clinical SW designation, use of controlled acts such as psychotherapy and diagnosis, supervision, continuing education, technology, private practice, and how regulatory bodies address diversity, equity, reconciliation, racism, and discrimination. Results: This critical examination of clinical SW practice found inconsistent standards across the country. Conclusions: It is important to harmonize the three pillars including education, association, and regulation to strengthen clinical SW practice in Canada. [ABSTRACT FROM AUTHOR]

There are cases in forensic psychiatric evaluations with inconclusive information or with important information missing. In such situations, when new information becomes available the judge may ask an expert to supplement his/her report in the light of new information. For the purpose of this study, we collected 42 supplemental evaluations written in the University Psychiatric Hospital Vrapče to determine possible factors which were associated with changes in supplemental evaluations. The following data were gathered: demographic data, types of criminal offenses, reasons for the supplement evaluation, court questions, and diagnoses. Changes in supplemental evaluations occured more often when the defendants were diagnosed with a personality disorder (PD) only, compared to those who had a PD with a comorbidity, especially substance use disorders. Defendants with the diagnosis of a substance use disorder were 63.7% less likely to have changed experts' evaluations. The evaluations remained the same when the reason for supplemental evaluations were new witnesses' testimonies. Considering the principle of economy of actions in a judiciary system, a more critical approach should be taken when the judge requests a supplemental report. [ABSTRACT FROM AUTHOR]

At the very least, an adequate diagnosis of the mental patient's suffering ought to differentiate between the dogmatism that is paranoiac and the dogmatism that does not cause suffering. We here differed from the classic theory of the diagnosis of mental illness that Emil Kraeplin (1856 -1926) has suggested when he inaugurated the modern theory of mental illness - as persistent delusion, namely, as a dogma. Paranoia, dogmatism, rationalism, critical rationalism Keywords: paranoia; dogmatism; rationalism; critical rationalism EN paranoia dogmatism rationalism critical rationalism 72 78 7 12/06/22 20230101 NES 230101 Reply to Nathaniel Laor Nathaniel Laor discusses the work of the late Yehuda Fried and myself on mental illness. [Extracted from the article]

ICU readmission is associated with increased mortality. The primary goal of our investigation was to determine the impact of early ICU readmission on mortality and to identify clinical factors which contribute to early ICU readmission in the trauma population. We retrospectively reviewed 175 patients admitted to ICU in a single, academic Level I Trauma Center from January 2019 to December 2021. Early readmission was defined as readmission within 72 hours of discharge and late readmission as after 72 hours. Early readmission mortality rate was 2.8 times higher than late readmission. Statistically significant variables in early readmission were more operations >2 hours, shorter initial length of stay in ICU, lower hematocrit and paCO2 on ICU discharge, and presence of a psychiatric diagnosis. Additional prospective research is needed to guide the development of practice guidelines that reduce frequency, morbidity, and mortality associated with ICU readmission in the trauma population. [ABSTRACT FROM AUTHOR]

Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade. Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models. Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)). Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females. [ABSTRACT FROM AUTHOR]

Introduction: Injectable drug use is a cause of disease burden and a contributor to blood-borne virus transmission and health-related problems. It is one of the serious problems of our country. The best suitable strategy of treatment for opioid dependence is 'opioid substitution therapy' (OST). It is beneficial for the injectable drug users (IDUs) in reduction in the behaviour of injecting and opioid use, which helps in reducing criminal activities, domestic violence, enhancing ties within the family and improving productivity. Objective: To assess the mental health problems, quality of life, work ability and social adjustability among OST and non-OST IDUs. Materials and Methods: The descriptive study was conducted among 100 male IDUs (50 in the OST group and 50 in the non-OST group), registered with the two selected non-governmental organizations (NGOs) of Chandigarh selected by using the consecutive sampling technique. The OST group was contacted during their visit to the centre for receiving the daily dose of OST, while the non-OST group was contacted during their visit to the NGO centres for getting fresh syringes in exchange with used syringes under the syringe exchange programme. The data were collected by interviewing the study subjects by using the interview schedule comprising of the (a) socio-demographic profile, (b) health problems, (c) substance-use-related problems scale, (d) work ability and social adjustability scale, (e) the depression, anxiety and stress scale-21 and (f) World Health Organization Quality-of-Life BREF (WHOQOL BREF) Scale. All the tools were standardized and available in the open domain. Results: The study subjects were in the age group of 18–58 years with the mean age of 27.52 ± 6.67 years. Significantly lesser problems in the OST group study participants related to health, occupation, finance, legal, family, marital and social status were reported than those in the non-OST group participants (t -test, p < 0.01). A significantly higher percentage of the study participants in the non-OST group had depression, anxiety and stress than that in the OST group. Quality of life of IDUs in the OST group was significantly better than that of IDUs in the non-OST group, as per the WHOQOL BREF Scale (Mann–Whitney U test, p < 0.05). Conclusion: IDUs on OST therapy (OST group) were having lesser problems in the area of health (physical and mental), occupational, financial, legal, family, marital, social and better quality of life than those in the non-OST group. [ABSTRACT FROM AUTHOR]

This paper provides insights from experiences in data gathering and recruitment from two research projects on disability/mental health in Ghana. The focus of the study explores stigma amongst individuals diagnosed with mental illness and their caregivers. The study investigates the positioning of the researcher in a superior light by participants which often wrests power from those who should be considered the true experts of their own circumstances. Inequality in the interview process thus carried the risk of impacting the quality of the data, as some participants did not consider themselves as 'experts' of their condition. The paper explores strategies for addressing these challenges of hierarchy and inequality in the research process in the Global South. Based on the study, we report on our experiences as follows: (1) ensuring that participants are empowered to engage with researchers; and (2) training local researchers to engage in culturally sensitive research processes. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a total upending of our daily lives. While anxiety and depression were frequently reported among the general population, the pandemic's impact on patients with mental health problems remains unknown. Methods: A cross-sectional questionnaire survey involving 1,166 patients was conducted at one psychiatric hospital and one mental health clinic. Results: Symptom deterioration was reported in 23% to 34% of the patients and 9% to 20% reported increase in drug dosage. No significant differences were reported in these items among diagnostic categories. Patients with F 3 (mood disorders) reported more psychological stress during the pandemic's beginning and during the emergency. Patients with F 2 (schizophrenia, schizotypal, and delusional disorders) did online shopping and meetings less frequently, and reported poorer adherence of 3C's, while mask management was stricter in patients with F 4 (neurotic, stress-related, and somatoform disorders). Symptom deterioration was significantly associated with increase in drug dosage, new physical symptoms, anxiety unrelated to COVID-19, stress at the beginning of pandemic, stress during the 'state of emergency', poor adaptability to environmental change, daily life changes, decrease in sleeping time, and decrease in time spent outside. Conclusion: One third of patients reported symptom deterioration during the pandemic, which was associated with stress and daily life changes. Patients with good adaptability to environmental changes might resilient against symptom deterioration. Providing continuous support to help patients manage their daily life in this COVID-19 era may minimize the risk of symptom deterioration. [ABSTRACT FROM AUTHOR]

Increasing attention has detailed negative outcomes among interactions between autistic individuals and criminal justice system officers, including police, across the US. The purpose of this study is to identify the experiences of autistic individuals and their caregivers across their interactions with the criminal justice system through quantitative and qualitative analyses of responses from a statewide survey in one large, northeastern state. Qualitative findings show a diverse array of experiences between autistic individuals and the justice system as victims, offenders, and witnesses with both positive and negative experiences reported. Quantitative findings show increased risk for justice interaction with a co-occurring psychiatric diagnoses, gender, age, and other factors. The findings from this study present important future directions for research, policy, and practice. [ABSTRACT FROM AUTHOR]

Exposure to interpersonal violence (EIV) is a prevalent risk-factor for aggressive behavior; however, it is unclear whether the effect of EIV on clinically significant aggressive behavior is similar across gender. We examined whether gender moderates the association between experiencing and witnessing interpersonal violence and the diagnosis of intermittent explosive disorder (IED). We also examined potential pathways that might differentially account for the association between EIV and IED in men and women, including emotion regulation and social information processing (SIP). Adult men and women (N = 582), who completed a semistructured clinical interview for syndromal and personality disorders, were classified as healthy controls (HC; n = 118), psychiatric controls (PC; n = 146) or participants with an IED diagnosis (n = 318). Participants also completed the life history of experienced aggression (LHEA) and life history of witnessed aggression (Lhwa) structured interview and self-report measures of emotion regulation and SIP. Men reported more EIV over the lifetime. In multiple logistic regression analysis, experiencing and witnessing aggression within the family and experiencing aggression outside the family were associated with lifetime IED diagnosis. We found that the relationship between EIV and IED was stronger in women than in men. Affective dysregulation mediated certain forms of EIV, and this relation was observed in both men and women. SIP biases did not mediate the relation between EIV and IED. EIV across the lifespan is a robust risk factor for recurrent, clinically significant aggressive behavior (i.e., IED). However, the relationship between EIV and IED appears to be stronger in women. Further, this relation appears partially mediated by affective dysregulation. [ABSTRACT FROM AUTHOR]

Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents' initial reactions after receiving a clinical diagnosis of Major Depressive Disorder in the context of a neurobiological study of depression in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and neuroimaging study, in which they were given a diagnosis of depression, and in a follow-up visit 2 weeks later. Interviews were designed to explore the subjective experience of receiving the diagnosis and the impacts of depression on adolescents' lives. Framework Analysis was used to analyze the accounts. Diagnosis was perceived as a reification of an abnormal status, highlighting the role of stigma and the process of disclosing the diagnosis to others. Adolescents reported the multiple sensemaking processes that occurred when they received a diagnosis of depression, and most struggled with the idea that negative emotions would equate their experience with a disorder. The results show that future efforts could enhance clinical assessment processes with adolescents by exploring adolescents' reactions to diagnosis, as well as the support networks available to them, resulting in increased help-seeking behaviors, and diminished social and personal stigma. [ABSTRACT FROM AUTHOR]

Having a serious mental illness (SMI) is often associated with significant adversities, and people respond differently to adversities. The existing research supports the idea that people with SMI can achieve and maintain positive life outcomes despite experiencing adversities. Resilience, the ability to cope with (or bounce back quickly from) crisis, can help buffer the negative effects of various types of adversities, including chronic illness and disability, and facilitate the psychosocial adaptation process to SMI. Kumpfer's resilience model, a person–process–context framework, has been widely used to conceptualize, and assess for, resilience in various populations, including people with chronic illnesses and disabilities. However, the research in resilience among people with SMI is very limited. The purpose of this study was to empirically assess the utility of Kumpfer's resilience model and its proposed predictive components for conceptualizing the adaptation process to SMI. One hundred forty-four participants completed a Qualtrics survey containing demographic questions and a series of validated instruments representing the major components of Kumpfer's resilience model. Hierarchical regression analysis was used to analyze the data, and the final model explained 71% of the variance of the dependent variable—adaptation to disability. Avoidance coping, internalized stigma, and optimism were significant independent predictors of adaptation to disability. This study supports the utilization of Kumpfer's resilience model to conceptualize the adaptation to disability process among people with SMI. Implications for rehabilitation counseling practices are discussed. [ABSTRACT FROM AUTHOR]

Introduction: People with pre-existing mental health conditions may have been disproportionally impacted by the COVID-19 pandemic and associated public health restrictions. In this study, we compared psychological outcomes, experiences and sources of stress over the pandemic lockdown in New Zealanders with and without a previous diagnosis of mental illness. Methods: Two online surveys were conducted in New Zealand over the level 4 lockdown in April 2020 measuring psychological distress, anxiety, well-being, suicidality, alcohol use and subjective experiences. They included 3389 participants, of whom 18.4% reported having been previously diagnosed with a mental illness. Results: During the lockdown, people previously diagnosed with a mental illness had about twice the risk of reporting moderate-high levels of psychological distress (K10 ⩾ 12), at least moderate levels of anxiety (GAD-7 ⩾ 10) and poor well-being (WHO-5 ⩽ 12). They reported increased alcohol use and were about four times as likely to have experienced suicidal thoughts with 3% reporting having made a suicide attempt over the lockdown period. They reported less satisfaction with, and poorer relationships with people in their 'bubble', reduced social contacts and greater loneliness. They also reported higher levels of health and financial concerns. Conclusion: During the COVID-19 lockdown in New Zealand, people with a previous diagnosis of a mental illness were at increased risk of detrimental psychological outcomes. This highlights the importance of recognising this and the challenges people face in pandemics. [ABSTRACT FROM AUTHOR]

This is a cross-sectional study carried out on 34 individuals hospitalized for a long period in the Federal District, in Brazil. To evaluate factors related to prolonged institutionalization in mental patients with history of violence and criminal records. Individuals found were assorted into two groups: with and without criminal records. We analyzed 56 items by reviewing medical records and health records. Demographic and social data, history of violence, criminal involvement, medical history, substance use, and other aspects related to long hospitalizations, by reviewing medical and health records. We found a profile of male individuals: single, male, with an average age of 47.6 years, low education, and little professional qualification from correctional facilities or long-term psychiatric clinics and hospitals. Most men had a history of aggressive behavior, a leading psychiatric diagnosis of psychosis, and an issue with polypharmacy. Two factors showed statistical significance and were highly related to longer institutionalizations: polypharmacy and records of hospitalization for violent behavior. Further studies with these populations are needed to increase knowledge on the subject. They can help health care systems to improve and provide broad, humanized and quality assistance with multi-professional teams, aiming to reduce prolonged hospitalizations. [ABSTRACT FROM AUTHOR]

Background: Mental Health Literacy (MHL) is the ability to recognize mental disorders, along with knowledge of professional help available, effective self-help strategies, skills to give support to others, and knowledge of how to prevent mental disorders. Adequate MHL is linked to better health-seeking behavior and management of mental illness. Aim: To assess the MHL related to depression and anxiety among adolescents of age 15 to 19 years residing in Delhi Methods: A survey was conducted among adolescents in southeast Delhi. MHL was assessed using sex-matched vignettes of Common Mental Disorders (CMDs) like depression and anxiety. MHL was assessed under domains of identifications of disorders, help-seeking behavior, knowledge about prevention, and stigmatizing attitude toward the respective illness. Statistical analysis was done in STATA and percentage of participants with adequate MHL in various domains was calculated, and difference between various groups was examined using chi-square test. Results: A total of 491 adolescents participated (response rate of 87.2%) of whom a 50.3% were girls and 57.8% were 15 to 17 years of age. Only 50 (10.2%) participants identified depression vignette as that of depression and 51 (10.4%) identified vignette of anxiety disorder as the same. No statistically significant gender differential in MHL was seen (p value =.8). The stigmatizing attitude, assessed by asking a series of questions suggesting stigma toward the particular illness, was observed among almost all participants (depression -99.4%, and anxiety disorders -96.1%). 18.3% and 18.7% of participants reported correct knowledge about the prevention of depression and anxiety respectively. Four hundred and twenty-two (86%) identified the need to seek help for symptoms reported in vignettes. Of these, 234 (55%) preferred parents, and 62 (14.7%) look after friends for any help. Conclusion: Adolescents residing in Delhi reported poor MHL for Common Mental Disorders. High stigma and poor help-seeking behavior was also observed among the participants toward CMDs [ABSTRACT FROM AUTHOR]

Objective: The effectiveness of ECT under naturalistic conditions has not been well-studied. The current study aimed to 1) characterize a naturalistic sample of ECT patients; and 2) examine the long-term outcomes of ECT on depressive symptoms (Beck Depression Inventory-II; BDI-II) and functional disability symptoms (WHO Disability Assessment Schedule 2.0) in this sample. Methods: Participants were adults who received ECT for a major depressive episode at an ambulatory ECT clinic between September 2010 and November 2020. Clinical and cognitive assessments were completed at baseline (n = 100), mid-ECT (n = 94), 2–4 weeks post-ECT (n = 64), 6-months post-ECT (n = 34), and 12-months post-ECT (n = 19). Results: At baseline, participants had severe levels of depressive symptoms (BDI-II: M = 41.0, SD = 9.4), and 62.9% screened positive for multiple psychiatric diagnoses on the MINI International Neuropsychiatric Interview. Depressive symptoms (F (4,49.1) = 49.92, P < 0.001) and disability symptoms (F (3,40.72) = 12.30, P < 0.001) improved significantly following ECT, and this was maintained at 12-months follow-up. Improvement in depressive symptoms trended towards significantly predicting reduction in disability symptoms from baseline to post-ECT, (F (1,56) = 3.67, P = 0.061). Although our clinical remission rate of 27% (BDI-II score ≤ 13 and ≥ 50% improvement) and overall response rate of 41.3% (≥ 50% improvement in BDI-II score) were lower than the rates reported in the extant RCT and community ECT literature, 36% of those treated with ECT were lost to follow-up and did not complete post-ECT rating scales. At baseline, remitters had significantly fewer psychiatric comorbidities, lower BDI-II scores, and lower disability symptoms than non-responders (P < 0.05). Conclusions: Participants were severely symptomatic and clinically complex. ECT was effective at reducing depressive symptoms and functional disability in this heterogeneous sample. Although a large amount of missing data may have distorted our calculated response/remission rates, it is also likely that clinical heterogeneity and severity contribute to lower-than-expected remission and response rates to ECT. [ABSTRACT FROM AUTHOR]