Search

The author introduces her art project called Marble, which addresses the artistic tradition of the city of Rome, Italy which is famous for its cultural heritage. She refers to themes portrayed by traditional Roman art such as a depressed generation and living in a city characterized by contradiction, youth unemployment, economic crisis and backward mentality of society. She presents examples of her illustrations of Roman people with themes like poverty, depression, homophobia and misogyny.

Major depressive disorder (MDD) is a heritable disease with a heavy personal and socio-economic burden. Antidepressants of different classes are prescribed to treat MDD, but reliable and reproducible markers of efficacy are not available for clinical use. Further complicating treatment, the diagnosis of MDD is not guided by objective criteria, resulting in the risk of under- or overtreatment. A number of markers of MDD and antidepressant response have been investigated at the genetic, epigenetic, gene expression and protein levels. Polymorphisms in genes involved in antidepressant metabolism (cytochrome P450 isoenzymes), antidepressant transport (ABCB1), glucocorticoid signalling (FKBP5) and serotonin neurotransmission (SLC6A4andHTR2A) were among those included in the first pharmacogenetic assays that have been tested for clinical applicability. The results of these investigations were encouraging when examining patient-outcome improvement. Furthermore, a nine-serum biomarker panel (includingBDNF, cortisol and soluble TNF-α receptor type II) showed good sensitivity and specificity in differentiating between MDD and healthy controls. These first diagnostic and response-predictive tests for MDD provided a source of optimism for future clinical applications. However, such findings should be considered very carefully because their benefit/cost ratio and clinical indications were not clearly demonstrated. Future tests may include combinations of different types of biomarkers and be specific for MDD subtypes or pathological dimensions. [ABSTRACT FROM PUBLISHER]

In exploring the problem of thinking in black and white we encounter the difficulty of maintaining our subjectivity as good racialized whites. This commentary follows the journey that Yvette Esprey takes us on to reclaim her thinking mind and reconstruct an authentic racialized self. In addition, this work expands on the concept of racism as a form of abjection in which the hated parts of self that are extruded paradoxically come to construct the self. [ABSTRACT FROM PUBLISHER]

Biological markers for depression are of great interest to aid in elucidating the causes of major depression. We assess currently available biological markers to query their validity for aiding in the diagnosis of major depression. We specifically focus on neurotrophic factors, serotonergic markers, biochemical markers, immunological markers, neuroimaging, neurophysiological findings, and neuropsychological markers. We delineate the most robust biological markers of major depression. These include decreased platelet imipramine binding, decreased 5-HT1A receptor expression, increase of soluble interleukin-2 receptor and interleukin-6 in serum, decreased brain-derived neurotrophic factor in serum, hypocholesterolemia, low blood folate levels, and impaired suppression of the dexamethasone suppression test. To date, however, none of these markers are sufficiently specific to contribute to the diagnosis of major depression. Thus, with regard to new diagnostic manuals such as DSM-V and ICD-11 which are currently assessing whether biological markers may be included in diagnostic criteria, no biological markers for major depression are currently available for inclusion in the diagnostic criteria. [ABSTRACT FROM AUTHOR]

I would like to engage three aspects of Jay's argument: first, I want to suggest that there is an important distinction to be made between melancholia and depression, and that Butler's melancholy gender depends on this distinction, which emphasizes the social and political dimensions of melancholia. Second, Jay diagnoses the theory of melancholy gender witha troubling ambivalence; I contendthat this ambivalence is central to the logic of Butler's argument, and to the processes of melancholia and gendered identification, and that this ambivalence is also purposefully manifest in Freud's text.Third, Jay's piecemakes a call for conceptual disarticulation in the register of foreclosure as it relates to prohibited homosexual object choice. This desire for disarticulation and anxiety about homosexual undecidability leads to the collapse of gender, sex and sexual orientation, and the result of this collapse is an ambiguous subject who emerges as reheterosexualized and normatively gendered. [ABSTRACT FROM AUTHOR]

About 10% of the US population suffers from depression (NIMH, 2000/2001) affecting both the client and his/her family members. This study applies Inconsistent Nurturing as Control Theory (Le Poire, 1994) to romantic relationships with depressed individuals (N=68 couples) and examines types and patterns of attempts to curtail depression. Results from in-depth interviews of depressed individuals and their partners suggest partners change their communication strategies over time such that they use more negative strategies before they label depression problematic, actively help and encourage depressed individuals more after the labeling, and revert to a less consistent sequence of positive and negative strategies after the initial control strategies have proven unsuccessful. Implications for health challenges in romantic relationships are discussed. [ABSTRACT FROM AUTHOR]

A study was conducted to test the effects of adding emotion-focused interventions to the empathic relationship. The authors compared client-centered therapy, which provides an empathic relationship based on the relational attitudes of empathy, positive regard, and congruence, and emotion-focused therapy (EFT), which integrates process-guiding emotion-focused interventions that focus on depressogenic affective–cognitive problems with a client-centered supportive relationship. Thirty-eight patients meeting DSM–IV criteria for major depressive disorder were randomly assigned to 16 to 20 sessions of 1 of the 2 treatments. Clients’ level of depressive symptoms, general symptom distress, interpersonal distress, and self-esteem improved in each condition, but improvement on symptomatology was superior in the EFT condition. An empathic relationship appears to be enhanced by the addition of specific emotion-focused interventions.ZusammenfassungDie Effekte zusätzlicher emotions-fokussierter Interventionen auf die Bedingungen klientenzentrierter Beziehung bei der Behandlung von DepressionEs wurde eine Studie dazu durchgeführt, welche Effekte zusätzliche emotions-fokussierte Interventionen auf die empathische Beziehung haben. Die Autoren verglichen klientenzentrierte Therapie, die eine empathische Beziehung auf Grund von Beziehungseinstellungen von Empathie, positiver Zuwendung und persönlicher Kongruenz beinhaltet mit emotions-fokussierter Therapie (EFT), die prozessbegleitende emotions-fokussierte Interventionen umfasst, die auf depressionsgenetische Probleme affektiv-kognitiver Art mit einer klientenzentrierten unterstützenden Beziehung gerichtet sind. 38 Patienten, die nach den DSM-IV Kriterien an einer schweren Depressionsstörung litten, wurden dem Zufall nach 16 bis 20 Sitzungen in einer der Behandlungen zugewiesen. Das Niveau der depressiven Symptome, die allgemeine Belastung durch die Symptome, wie sowohl die interpersonale Belastung und der Selbstwert verbesserten sich in beiden Behandlungen, aber die Verbesserung der Symptomatologie war höher in der EFT Bedingung. Eine empathische Beziehung scheint durch zusätzliche spezifische emotions-fokussierte Interventionen verstärkt zu werden.RésuméLes effets de l'intégration d'interventions focalisées sur les émotions dans les conditions relationnelles centrées sur le patient dans le traitement de la dépressionNous avons conduit une étude pour tester les effets de l'intégration d'interventions focalisées sur les émotions dans la relation empathique. Les auteurs ont comparé la thérapie centrée sur le client qui crée une relation empathique sur la base des attitudes relationnelles de l'empathie, du regard positif et de la congruence, et la thérapie focalisée sur les émotions (EFT) qui intègre des interventions focalisées sur les émotions, guidant le processus, et qui focalisent sur des problèmes affectifs – cognitifs dépressiogènes par une relation de soutien, centrée sur le client. 38 patients suffisant aux critères DSM-IV pour la dépression majeure étaient attribués au hasard à 16-20 séances avec l'un des deux traitements. Le niveau de symptômes dépressifs, la détresse symptomatique générale, la souffrance interpersonnelle et l'estime de soi s'amélioraient dans les deux conditions, mais l'amélioration symptomatique était supérieure en condition EFT. Une relation empathique semble être favorisée par le rajout d'interventions spécifiques, focalisées sur les émotions.ResumenSe realizó un estudio para testear los efectos de agregar, a la relación empática, intervenciones focalizadas en la emoción. Los autores compararon la terapia centrada en el cliente, que provee una relación empática basada en las actitudes relacionales de la empatía, mirada positiva y congruencia, con la terapia focalizada en la emoción (EFT), que integra intervenciones focalizadas en la emoción que guía el proceso (process-guiding emotion-focused interventions) que se centran en problemas depresógenos afectivo-cognitivos en una relación de apoyo centrada en el cliente. Se asignaron al azar, para 16 a 20 sesiones de 1 de los 2 tratamientos, a treinta y ocho pacientes que reunían los criterios del DSM-IV para el desorden depresivo mayor. En cada condición, el nivel de síntomas depresivos, el distrés general de síntomas, el distrés interpersonal y la autoestima mejoraron, pero la mejoría fue superior en la condición EFT. La relación empática parece aumentar por la adición de intervenciones específicas focalizadas en la emoción.ResumoOs efeitos de adicionar intervenções focadas nas emoções às condições de relação centrada no cliente no tratamento da depressãoEste estudo foi conduzido para testar os efeitos de adicionar intervenções focadas nas emoções à relação empática. Os autores compararam a terapia centrada no cliente, que fornece uma relação empática baseada nas atitudes relacionais de empatia, aceitação positiva e congruência, e a terapia focada nas emoções (EFT), que integra intervenções focadas nas emoções e guiadas pelo processo, centradas nos problemas afectivo-cognitivo depressogénicos com uma relação de suporte centrada no cliente. Trinta e oito pacientes com critérios de diagnóstico do DSM-IV para perturbação depressiva major foram aleatoriamente distribuídos por um dos dois tratamentos, de duração de 16 a 20 semanas. O nível de sintomas depressivos do cliente, disfuncionamento sintomático geral, disfuncionamento interpessoal e auto-estima melhoraram em cada condição, mas a melhoria da sintomatologia foi superior na condição EFT. Uma relação empática parece ser melhorada pela adição de intervenções específicas focadas nas emoções.SommarioGli effetti degli interventi aggiuntivi focalizzati sulle emozioni nella relazione centrata sul cliente, nel trattamento della depressione.E’ stato condotto uno studio per valutare gli effetti degli interventi aggiuntivi focalizzati sulle emozioni nella relazione empatica.Gli autori hanno confrontato la terapia centrata sul cliente, che offre una relazione empatica basata sulle attitudini relazionali dell'empatia, sulla stima positiva e sulla coerenza, con la terapia focalizzata sulle emozioni (EFT), che integra i processi che guidano gli interventi focalizzati sulle emozioni, che si focalizzano sui problemi depressogeni affettivo-cognitivi, con una relazione supportiva centrata sul cliente.Trentotto pazienti con i criteri del DSM-IV del disturbo depressivo maggiore sono stati assegnati casualmente da 16 a 20 sedute di uno dei due trattamenti. I livelli dei clienti di sintomi depressivi, di sintomi generali di sofferenza, della sofferenza interpersonale e dell'autostima sono migliorati in ogni condizione, ma il miglioramento nella sintomatologia è stato superiore nella condizione EFT. Una relazione empatica sembra essere cresciuta attraverso l'aggiunta di interventi specifici focalizzati sulle emozioni.Abstract [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including mental health nursing, mental health wellness and biofield therapies.

Persistent pain (PP) is a complex mechanism affecting 35% to 51.3% of adults in the United Kingdom and is associated with significant reductions in quality of life. Understanding of PP and how best to treat it has developed over the past 50 years, but there is still a vacuum of research to inform novel applications for self-management. Mindfulness techniques and nature exposure have separately been found to have beneficial effects on general well-being and health. The integration of the two could produce much needed self-management strategies, improving quality of life in this patient group. To determine if nature-based mindfulness (NBM) interventions improve pain and quality of life in adults with PP. Systematic literature review. Seven electronic databases were searched to identify quantitative papers investigating nature-based mindfulness and persistent pain. Included articles were appraised using the PEDro tool. A total of 362 studies were identified. Of these, three were included in the final review. All studies reported statistically significant improvements in self-reported scores for pain (p ≤ 0.001–0.006) and depression (p ≤ 0.001–0.000). Other outcomes, such as stress and fatigue produced mixed results. Despite showing statistical significance in multiple outcomes, the minimal clinically important difference was not reached across all measures. Heterogeneity of interventions and outcomes, as well as methodological issues of internal and external validity, preclude definitive conclusions. Further research is required, employing explicit mindfulness interventions and outcome measures with greater relevance and specificity, as well as further investigation of theoretical mechanisms. [ABSTRACT FROM AUTHOR]

The resurgence of interest in psychedelic substances for psychiatric treatment has sparked both excitement and scepticism within the scientific community. This paper addresses the moralisation and hype surrounding psychedelic therapies. Through a systematic review of the literature and a detailed case study, we illustrate that the therapeutic effect of psychedelics is not solely pharmacological but is instead facilitated by their ability to enhance psychotherapy. The paper explores the historical context of psychedelics in psychiatry, their mechanism of action, and evidence of their efficacy in treating depression. We highlight the necessity of integrating psychedelics with psychotherapeutic interventions and emphasise the importance of methodological rigour and ethical standards in psychedelic research and practice. By presenting an informed understanding of psychedelic treatments, we advocate for their consideration as legitimate alternatives alongside traditional therapies, offering a potential paradigm shift in psychiatric care. [ABSTRACT FROM AUTHOR]

This paper interrogates two different perspectives on music and wellbeing. The first positions musical practice as being beneficial for emotional wellbeing and mental health, whilst the second positions musical work – building a career as a musician – as potentially detrimental. This apparent paradox matters because the clinical findings which establish a causal link between music and wellbeing are being disembedded from the contexts in which those links are manifesting by charities, social enterprises, advocacy organisations, educational institutions, governments and international bodies, and fuelling normative sociological prescriptions which encourage participation in music making. For those who go on to develop career ambitions, wellbeing outcomes are far less clear. Therefore, a more sophisticated appreciation of the uses of music and its impact on wellbeing is required. This paper provides a more balanced view of the connections between music, wellbeing and health and reflects on how this paradox might be resolved. [ABSTRACT FROM AUTHOR]

In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020. Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods. The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data. Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria. [ABSTRACT FROM AUTHOR]

Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the outside world. This review aims to examine the prevalence of DDD amongst different populations. A systematic review protocol was developed before literature searching. Original articles were drawn from three electronic databases and included only studies where prevalence rates of DDD were assessed by standardized diagnostic tools. A narrative synthesis was conducted. Twenty-three papers were identified and categorized into three groups of participants: general population, mixed in/outpatient samples, and patients with specific disorders. The prevalence rates ranged from 0% to 1.9% amongst the general population, 5–20% in outpatients and 17.5–41.9% in inpatients. In studies of patients with specific disorders, prevalence rates varied: 1.8–5.9% (substance abuse), 3.3–20.2% (anxiety), 3.7–20.4% (other dissociative disorders), 16.3% (schizophrenia), 17% (borderline personality disorder), ~50% (depression). The highest rates were found in people who experienced interpersonal abuse (25–53.8%). The prevalence rate of DDD is around 1% in the general population, consistent with previous findings. DDD is more prevalent amongst adolescents and young adults as well as in patients with mental disorders. There is also a possible relationship between interpersonal abuse and DDD, which merits further research. [ABSTRACT FROM AUTHOR]

The goal of this study was to review the economic evaluations of health technologies in multiple myeloma (MM) and provide guidance and recommendations for future health economic analyses. A systemic literature review (SLR) was conducted on original economic assessment studies and structured review papers focusing on the studies in MM. The search was limited to English language papers published from 1 January 2000 onwards. Publications not applying any type of modelling methodology to describe disease progression and patient pathways over a specific time horizon were excluded. A total of 2,643 publications were initially identified, of which 148 were eligible to be included in the full-text review phase. From these, 49 publications were included in the final analysis. Most published health economic analyses supported by models came from high-income countries. Evaluations from middle-income countries were rarely published. Diagnostic technologies were rarely modelled and integrated care had not been modelled. Very few models investigated MM treatments from a societal perspective and there was a relative lack of evaluations regarding minimal residual disease (MRD). Limitations of the publications included differences between trial populations and modelled populations, justification of methods, lack of confounder analyses, and small trial populations. Limitations of our study included the infeasibility of comparing MM economic evaluations due to the significant variance in modelled therapeutic lines and indications, and the relative scarcity of published economic evaluations from non-high-income countries. As published economic models lacked many of the elements of the complex and heterogeneous patient pathways in MM and they focused on single decision problems, a thorough, open-source economic whole disease modelling framework is needed to assess the economic value of a wide range of technologies across countries with various income levels with a more detailed view on MM, by including patient-centric and societal aspects. [ABSTRACT FROM AUTHOR]

SARS-CoV-2, commonly known as COVID-19, continues to have a profound affect ON adolescents and their families. Mental health professionals have seen an alarming increase in anxiety, depression, and suicidality during the COVID-19 pandemic. Adolescents face the challenge of differentiating from their families, and often place increased focus and importance on their peer group. Given the increased isolation, this paper illustrates how Satir's therapy model can be used by therapists who treat adolescents and their families related to COVID-19 specific stressors. Specifically, this paper will examine how Satir's focus on how self-worth, communication, and holistic approaches, are uniquely beneficial to treatment. [ABSTRACT FROM AUTHOR]

Objective: Depression is associated with increased morbidity, mortality and hospital readmission in patients with heart failure (HF). This systematic review aimed to compile studies examining whether the use of antidepressants could improve outcome in patients with HF and concomitant depression. Methods: The electronic libraries Embase, OVID MEDLINE(R) and PsychInfo were used to search the following terms 'heart failure' AND 'anti-depressants'; 'heart failure' AND 'TCA' OR 'SSRI' OR 'SNRI'. The result of this database search was analysed to select papers that satisfied our inclusion criteria. Results: Of the 180 papers found in the original database search, only three met the inclusion criteria. A further two papers were added from hand-searching through the references. Three of these papers are randomised controlled trials (RCT); the other two, cohort studies. All studies show that antidepressants are well tolerated in this group. There was no significant difference in depressive symptoms between the test and placebo. The cardiac outcomes of patients with HF are not improved by the use of antidepressants relative to placebo. Conclusions: Antidepressants are not associated with increased mortality rate as established in previous papers. However, there is inadequate evidence that the use of antidepressants effects significant improvement in depression or cardiac outcomes. [ABSTRACT FROM AUTHOR]

Derek Hook’s (this issue) excellent paper provides illustrations of complex Lacanian concepts through the relatively rare presentation of Lacanian case material. His paper lends itself to reading Freud with Lacan. This reply to his paper engages such a reading to show that the idea of the over present object emphasised by Lacan is prefigured in Freud in his 1917 paper on Mourning and Melancholia. My reply to Hook affirms the additional clinical themes he introduces and indicates that these themes would be anticipated if, as Lacan argues, melancholia is seen to be underpinned by a psychotic structure. Finally, the reply argues for a resurrection of the Lacanian notion of Das Ding, as it connotes differently to objet a despite overlaps in meaning and the fact that in later Lacan the term Das Ding was dropped. [ABSTRACT FROM AUTHOR]

Green Care therapies are defined as the engagement of a patient with the nature, exposing patients to a nature based therapeutic setting that may facilitate their recovery. Such therapies became popular at the end of the twentieth century. This therapeutic approach may include therapeutic horticulture, nature therapies, care farming, facilitated exercise, and animal-assisted therapies with farm animals (AATF). This paper describes the processes of planning and creating an AATF-based clinical intervention wherein persons with TBI interacted with ducks (in twice weekly, 1-hour groups) for 12 wk at a TBI rehabilitation facility. The discussion includes site identification, stakeholder engagement, intervention design and human and animal safety procedures. The research methods, theoretical framework, ethical consideration, and risk reduction strategies for human participants and ducks are discussed. Also, description of challenges and blueprints of possible solutions for other researchers interested in developing similar initiatives. This program will serve as a study site for examining effects of AATF-based interventions on self-efficacy, depression, and anxiety in persons with TBI. If the study suggests that AATF interventions with ducks may lead to positive changes, the proposed study will be followed with studies that include larger samples at multiple sites. Findings in this paper may contribute to the implementation science body of knowledge. Because of that, the information in this paper may benefit the researchers outside of the healthcare arena. From that perspective methods described in this paper may help to develop studies that focus on policy development, program expansion, or individual project implementation. [ABSTRACT FROM AUTHOR]

Narrative review of the processes of goal setting and goal attainment scaling, as practical approaches to operationalizing and implementing the principles of shared decision making (SDM) in the routine care of people living with major depressive disorder (MDD). We searched electronic databases for clinical studies published in English using key terms related to MDD and goal setting or goal attainment scaling. Two clinical studies of goal setting in MDD are considered in detail to exemplify the practicalities of the goal setting approach. While SDM is widely recommended for people living with mental health problems, there is general agreement that it has thus far been implemented variably. In other areas of medicine, the process of goal setting is an established way to engage the patient, facilitate motivation, and assist the recovery process. For people living with MDD, the concept of goal setting is in its infancy, and only few studies have evaluated its clinical utility. Two clinical studies of vortioxetine for MDD demonstrate the utility of goal attainment scaling as an appropriate outcome for assessing functional improvement in ways that matter to the patient. Goal setting is a pragmatic approach to turning the principles of SDM into realities of clinical practice and aligns with the principles of recovery that encompasses the notions of self-determination, self-management, personal growth, empowerment, and choice. Accumulating evidence supports the use of goal attainment scaling as an appropriate personalized outcome measure for use in clinical trials. Shared decision making is a structured approach in which a doctor assists their patient in making informed choices about treatment that consider the patient's own preferences. However, while acknowledged as the ideal approach, many doctors working in the mental health area say it can be difficult to apply in their daily clinical practice. In other areas of medicine, such as physical rehabilitation, the structured process of patients setting treatment goals in dialogue with their doctor has been recommended as a practical way to put the principles of shared decision making into practice. In this paper, we reviewed the medical literature to better understand how goal setting can be used to improve the care of people with major depressive disorder. The available evidence supports goal setting as a powerful way to engage patients in healthcare decisions, and ultimately improve health-related outcomes. The goal setting process provides patients the opportunity to verbalize their own, tangible goals for treatment; and following some negotiation, receive endorsement of their goals from their doctor. Patients feel supported and are better motivated to continue with their treatment. While still in its infancy, the growing evidence base supporting goal setting for people with major depressive disorder is encouraging. For example, the Goal Attainment Scaling (GAS) method of evaluating treatment success has been suitably adapted for use in people living with depression (GAS-D) and provides an easy, structured format for discussing personal treatment goals, as well as a method for tracking success, both in clinical practice and research studies. [ABSTRACT FROM AUTHOR]

Dysfunctional mental imagery is integral to the maintenance of many psychological disorders and is typically associated with stronger affective and behavioural responses than verbal cognitions. This finding extends itself to the high prevalence of suicidal mental imagery in disorders such as depression and bipolar disorder. Imagery Rescripting is a therapy approach which has been found to effectively reduce dysfunctional mental images across various mental health conditions. Thus, Imagery Rescripting of suicidal mental imagery may be effective at reducing such cognitions and ultimately associated risk. However, this remains an unexplored area within the treatment literature. This paper puts out an urgent call for clinical research to evaluate the effectiveness of such a treatment intervention, and to assist, we propose and describe a clinical approach to this to stimulate further thought and research. There are also many research questions of clinical relevance that must be explored in this field of work, which we put forward and consider in this commentary piece. What is already known about this topic: Mental imagery is a form of cognition that generates stronger emotional responses compared to verbal-linguistic thinking and is integral to the maintenance of most psychological disorders. Cognitive Behavioural Therapy (CBT) approaches are typically more effective when mental imagery techniques – such as Imagery Rescripting (ImRs) – are incorporated to target intrusive, distressing mental imagery. Mental images of suicide (comprised of both flash-back and/or flash-forward mental images) are more distressing, realistic and promote suicidal behaviours more than verbal thoughts, and are common in disorders such as depression and bipolar disorder. What this topic adds: Urgent clinical research is needed to evaluate the effectiveness of ImRs at reducing intrusive suicidal mental images, and thus related risk, and this paper proposes and describes an approach for researchers to use as a framework. There are several clinical research considerations to be made when examining ImRs of suicidal mental images, including around the delivery and safety of the intervention. More research is needed to clarify the above clinical considerations, and to further understand change mechanisms, to learn the most safe and effective ImRs approach. If ImRs is found to be effective at reducing suicidal images in upcoming clinical trials, it is strongly recommended clinicians receive adequate training and ongoing clinical supervision from an experienced practitioner given the complexities around this approach. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic and subsequently increased time spent at home signified the importance of understanding on the link between housing and mental health. This paper examines how housing qualities affect depression and suicide ideation for each age group (i.e. young adults, middle-aged and older adults) and gender. With South Korea population-based panel data, fixed-effect models and a partial least squares structural equation model were used. A functional problem was a major risk factor for depression in women, whereas a structural problem was a key risk factor for men's depression. For older adults, living in basement and vulnerability to natural disaster were detrimental to mental health. Functional problems increased the likelihood of suicide ideation in the middle-aged. The mechanisms of the housing qualities-mental health nexus were varied by age and gender. This paper proposed policy suggestions including a tailored housing policy and provision, a housing rating system for health and a support system for noise control. [ABSTRACT FROM AUTHOR]

Suicidal behaviors including ideations and attempts may ultimately lead to suicide especially among intravenous drug users (IVDUs). The present study assessed the prevalence, sociodemographic characteristics, risky behaviors, mental health conditions, and type of drug use associated with suicidal behaviors among IVDUs. Studies in English published from January 1, 1995 to February 1, 2022 were searched on PubMed, Scopus, Cochrane, and Web of Science to identify papers on variables associated with suicidal behaviors (ideation and attempts) among IVDUs. Out of 10,795 papers, 21 studies met the eligibility criteria. Among IVDUs, the findings indicated a past-year pooled prevalence rate of 35% for suicide ideations (95% CI, 22%–48%) and 25% for suicide attempts (95% CI, 13%–36%). Generally, suicide ideations were associated with being homeless, having a previous history of physical and sexual abuse, and depression. Suicide attempts were associated with being female, having a previous history of physical and sexual abuse, having depression or other mental health disorders (e.g., anxiety, stress, and serious mental health disorders), and having cocaine, methamphetamine, sedative-hypnotic, and polysubstance use disorders. Integrated treatment and assertive community treatment approaches may be promoted to prevent suicidal behaviors. Such programs can be implemented for referring individuals to receive suicide attempt-concerned interventions and motivational therapy. [ABSTRACT FROM AUTHOR]

This paper reads contemporary South Africa through the lens of melancholia and situates the experience of loss at the heart of social entanglements in the country. It argues that the purchase of melancholia lies partly in the fact that the problem of disarticulated and disenfranchised loss is common to post-apartheid modernity in general. It suggests that post-apartheid melancholia is a resultant effect of the country's fraught engagement with loss and (be)longing. It also notes that post-apartheid melancholia is a result of structural traumas and moral anguish that have not been worked through. This paper shows how melancholia manifests in the different modes of attachments to, and identifications with victimhood; it explains why each identity group lays il/legitimate claims to victimhood in South Africa. In addition, this paper conceptualises post-apartheid melancholia along racial and generational lines. That is, it examines the ways in which personal testimonies and meditations shed light on the prospects of white, black and intergenerational melancholia in post-apartheid South Africa. In all, this paper argues that melancholia is an affective structure of the everyday life in post-apartheid South Africa which – if we are not quick to pathologise it – may help combat hurried attempts at closing the door on the past. [ABSTRACT FROM AUTHOR]

The relationship between pediatric Traumatic Brain Injury (TBI) and long-term mental health and substance use disorders is not well known, resulting in inadequate prevention and management strategies. The aim of this scoping review is to review the evidence on pediatric TBI and the development of mental health disorders and substance use later in life and to identify gaps in the literature to inform future research. We searched multiple databases for original articles published between September 2002 and September 2022 on TBI-related mental health and/or substance use disorders in children and youth. Two independent reviewers performed the screening using Arksey and O'Malley and Levac et al.'s scoping review framework. A total of six papers are included in this scoping review. Studies included are comprised of cross-sectional and prospective longitudinal cohort studies. A correlation between pediatric TBI and development of certain mental health disorders and substance use is suggested, although much of the current evidence is mixed and does not account for confounding variables. Future studies should aim to closely examine these links and identify modifiers that can influence these relationships. [ABSTRACT FROM AUTHOR]

Primary Objective: Survey TBI literature to identify evidence of risk for post-injury suicide. Literature Selection: Search terms ((traumatic brain injury OR TBI) AND (suicidality OR suicidal behaviour OR suicidal ideation)) entered in PubMed, OVID Medline, PsychInfo, and Web of Science for papers published in print 01/01/1997 to 06/30/2019. Analysis of Literature: Authors screened abstracts, excluding duplicates and articles not meeting inclusion/exclusion criteria. Full papers were reviewed to make final exclusions. Data were extracted from 40 papers included co- and premorbid disorders, demographics, injury-related and psychological factors. Results: Persons with TBI have a higher risk for suicide than the general population. Reviewed articles reported comorbid depression and/or PTSD as risk factors for post-TBI suicide. Co- or premorbid substance misuse, sex, and sleep disturbance moderate risk. Quality of the literature was limited by sample size, the predominance of male participants, and inconsistency in reporting of findings. Conclusions: Comorbid depression and PTSD are significant post-TBI risk factors for suicide. Several variables combine to moderate or mediate TBI's connection with suicide. Civilian and military clinician cross-talk and consistent reporting of results from reproducible studies of post-TBI suicide risk factors could improve prevention and treatment efforts in veterans and civilians. [ABSTRACT FROM AUTHOR]

This paper uncovers the complexity of the term "Jian kang/health 健康" and "Fu/wellbeing (福)" by analysing their etymological origins and cultural connotations in the context of China. The paper introduces a Taoist philosophy of tradition to understand health and wellbeing. This paper argues that in Chinese cultural connotations, "Jian kang" (health) and "Fu" (wellbeing) entail the integration of human beings' physical and mental status and beyond. Notwithstanding the contextual and culturally specific philosophy and traditions of understanding health and wellbeing, this paper initiates intercultural epistemological dialogue, engages with contemporary psychotherapy, and argues that health and wellbeing is regarded and understood as a concept across cultural boundaries, while emphasising its pivotal features of being holistic, comprised of multifaceted and interrelated components of body, mind, and spirit, focusing on lifestyle behaviours, and recognising the interweaving relationship between human and the environment. [ABSTRACT FROM AUTHOR]

This paper returns to a seminal case in the historical of phenomenological psychopathology, Ludwig Binswanger's discussion of "Ellen West A woman with a long history of melancholia and disordered eating, Ellen West was treated at Binswanger's Bellevue sanatorium in 1921, a two-and-a-half month-long stay that resulted in a diagnosis of schizophrenia and Ellen West's suicide. Binswanger relied on West's personal writings and clinical history to develop and apply an original approach to case analysis, Daseinsanalyse or "existential analysis." This paper takes up this case and Binswanger's analysis to explore the origins of contemporary phenomenological psychopathology, the recent progress in this field, and areas for continued growth. The paper argues that new approaches to exploring the embedded or situated quality of psychopathology are needed for advancing clinical phenomenology, and that feminist and critical phenomenology are among the disciplines that can provide important methodological and theoretical foundations for this work. Without this, the field risks repeating Binswanger's original mistakes and viewing psychiatric illness solely as the expression of a disturbed individual. [ABSTRACT FROM AUTHOR]

Adolescent depression is a serious and debilitating disorder associated with lifelong negative outcomes, including heightened risk for recurrence into adulthood, psychiatric comorbidities, and suicide. Among evidence-based treatments for adolescents, psychotherapies for depression have the smallest effect sizes of all psychiatric conditions studied. Advancing care for depression in adolescents is complex due to the heterogeneity in etiology and co-occurring difficulties among youth presenting with depression symptoms. This and a companion paper (Lewandowski et al., 2022) draw on a recent multisite collaboration that focused on implementing depression treatment for adolescents within clinical and research contexts. Specifically, this paper will review our work adapting behavioral activation (BA) as a principle-based framework to improve effectiveness and efficiency of depression treatment used within clinical and research settings in academic medical centers. Piloted adaptations include the use of BA principles to address idiographic drivers of depression and in-session BA "exposures" to illustrate BA principles. Case vignettes illustrate these adaptations of BA to address adolescent depression in the context of co-occurring difficulties. [ABSTRACT FROM AUTHOR]

We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method. [ABSTRACT FROM AUTHOR]

Objective: To emphasize the necessity for increased research in this field, incorporating depression into the preventative, diagnostic, and therapeutic considerations for asthma. Additionally, we seek to highlight upcoming advancements that can be applied to simultaneously address these comorbidities, ultimately improving the overall well-being and quality of life for individuals coping with these conditions. Methods: A rigorous search in PubMed using the MeSH terms "asthma" and "depression" was performed, and papers were screened by the authors in view of their eligibility to contribute to the study. Results: There exists a correlation between these two conditions, with specific biological mechanisms and genetic factors playing a crucial role in their concurrent occurrence. In this review, we present preclinical and clinical research data, shed light on the possible mechanisms contributing to the co-occurrence of symptoms associated with both asthma and depression, and explore the intricate relationship between both conditions. Conclusion: The evidence presented here supports the existence of a correlation between asthma and depression. By acknowledging these shared biological mechanisms, genetic factors, and epidemiological trends, we can formulate more efficacious strategies for addressing the dual impact of asthma and depression. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents with Autism Spectrum Disorder (ASD) often experience symptoms of various mental disorders along with the characteristics that define ASD. High rates of several psychiatric disorders have been reported in people with ASD such as anxiety, depression, cognitive problems, emotional regulation difficulties and related behavioral problems can occur in children of all ages with ASD. There are many treatment programs that can help autistic persons cope with these symptoms. Cognitive and Behavioral Therapy (CBT), Information and Communication Technology (ICT) and more are treatment programs that can help people with autism recognize and manage their symptoms. Aim: This paper examines through bibliographic sources of the last 15 years the possible mental disorders that a child or adolescent with ASD may experience, as well as the therapeutic interventions that can help to manage them. Methodology: For the present bibliographic research, 15 scientific articles from English journals were used. The databases from which the scientific articles were found were PubMed, PsycINFO, MEDLINE, and Google Scholar. Results: According to the results of various studies, children and adolescents with autism show various symptoms of psychological disorders such as Anxiety Disorders, Depression and Obsessive-Compulsive Disorder. The combination of CBT and ICT can help people with autism recognize and manage their symptoms. Discussion: The various symptoms of disorders that children and adolescents with autism experience can have a major impact on their family, their daily life, their schooling, and their future work. It is of the utmost importance that these children enter into a treatment program in order to better manage and treat their symptoms. The support of the school is also very important. [ABSTRACT FROM AUTHOR]

AbstractMajor Depressive Disorder (MDD) is a common condition with complex psychological and biological background. While its aetiology is still unclear, chronic stress stands amongst major risk factors to MDD pathogenesis. When researching on MDD, it is necessary to be familiar with the neurobiological effects of several prominent contributors to the chronic stress factor experienced across hypothalamic-pituitary-adrenal (HPA) axis, neurotransmission, immune system reflexivity, and genetic alterations. Bi-directional flow of MDD pathogenesis suggests that psychological factors produce biological effects. Here, a summary of how the MDD expresses its mechanisms of action across an overactive HPA axis, the negative impacts of reduced neurotransmitter functions, the inflammatory responses and their gene x environment interactions. This paper builds on these conceptual factors and their input towards the MDD symptomatology with a purpose of synthesising the current findings and create an integrated view of the MDD pathogenesis. Finally, relevant treatment implications will be summarised, along with recommendations to a multimodal clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: To examine experiences of care home staff to better understand how to support them during the ongoing pandemic and in the future. Method: A systematic review examining experiences of care staff over the last year (March 2020-2021). Results: Fourteen papers related to experiences of staff and one was an intervention study. Quantitatively there was evidence of anxiety, PTSD and depression amongst the staff. Qualitatively, seven themes were identified: Poor working conditions; Lack of skills and knowledge; Psychological/Mental health concerns; Feeling undervalued and abandoned; Fears of contagion; Support and the positive impacts of COVID. The intervention study recommended employing needs-based approaches, including educational and wellbeing components. Conclusion: Recommendations are made in terms of how to work with staff, both practically and clinically. There are also suggestions about how to deal with similar situations if they were to reoccur. It is evident that lessons need to be learned because errors were made. Indeed, from a UK perspective, discharging thousands back to care homes, without testing, cost lives. This may have been done to protect the NHS, but it unwittingly 'lockdown' the virus within the care sector. [ABSTRACT FROM AUTHOR]

Therapist art making in individual sessions with adult service users has received little attention in the art therapy literature. Similarly, art therapy's efficacy with anxiety problems has not been established. NHS Criminal Justice Community Mental Health Team, long term weekly individual art therapy. Service User reported marked reduction in anxiety, CJCMHT observed significant reduction in anxiety and increased social functioning leading to discharge from forensic services. Therapist art making helped reduce anxiety by increasing trust. The ambiguity of the artwork challenged black and white ways of relating to self and others. Therapist artmaking functioned as a non-verbal form of psychoeducation. Three styles of therapist art making can be described, all of which are characterised by improvisation: Alongside the Service User; Jointly with the Service User; Under the gaze of the Service User. Art making can be helpful in 1:1 therapy with adult service users because it magnifies the art therapist's ostensive (i.e. non-verbal) communications and increases trust. Making art alongside service users provides a unique way to engage with complex psychological and interpersonal material. It is the ambiguity of therapist artwork that seems particularly helpful, and it should be considered as a promising way to address black and white thinking in common mental health problems like anxiety and depression. This paper describes the benefits of therapist art making in individual sessions with an adult user of mental health services. Lived Experience feedback is used to show how therapist art making helped reduce severe anxiety and improve social functioning. The paper describes the clinical reasoning for three art-based interventions; how they built and maintained trust, meaning and hope for both therapist and Lived Experience Author. The paper suggests that the ambiguity of therapist artwork can be thought about in terms of the presenting problem, particularly to reframe black and white ways of relating to self and others. [ABSTRACT FROM AUTHOR]

This paper examines the longitudinal effects of the COVID-19 pandemic on older adults (65+) with multimorbidity on levels of depression, anxiety, and perceived global impact on their lives. Baseline (2011–2015) and Follow-up 1 (2015–2018) data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit waves of the CLSA COVID-19 study (April–December, 2020) (n = 18,099). Multimorbidity was measured using: a) an additive scale of chronic conditions; and b) six chronic disease clusters. Linear Mixed Models were employed to test hypotheses. Number of chronic conditions pre-pandemic was associated with pandemic levels of depression (estimate = 0.40, 95% CI: [0.37,0.44]); anxiety (estimate = 0.20, 95% CI: [0.18, 0.23]); and perceived negative impact of the pandemic (OR = 1.04, 95% CI: [1.02, 1.06]). The associations between multimorbidity and anxiety decreased during the period of the COVID-19 surveys (estimate = −0.02, 95% CI: [−0.05, −0.01]); whereas the multimorbidity association with perceived impact increased (OR = 1.03, 95% CI: [1.01, 1.05]). This study demonstrates that pre-pandemic multimorbidity conditions are associated with worsening mental health. Clinicians treating mental health of older adults need to consider the joint effects of multimorbidity conditions and pandemic experiences to tailor counseling and other treatment protocols. [ABSTRACT FROM AUTHOR]

Despite few studies assessing the effectiveness of phase-based interventions for treating complex trauma symptoms, such approaches have been endorsed by experts as a first-line intervention. The aim of this study was to evaluate Phase 1 of the Women's Trauma Recovery Program, a phase-based intervention for women who have experienced complex trauma. Quantitative assessments of posttraumatic stress, depression, anxiety and stress (baseline and Week 10) are reported for 11 participants. Six women also participated in qualitative interviews regarding their experience of the program. Descriptive statistics and interpretive phenomenological analysis were used to analyse quantitative and qualitative data, respectively. Four of nine participants with probable PTSD at baseline were asymptomatic at Week 10. Three superordinate themes were generated from the interview data: (1) Empowerment: the experience in Phase 1, (2) Recovery: an ongoing process, and (3) "Hey, I'm human": connection through shared experience. Phase 1 of the program demonstrated promising findings in terms of symptom improvement. Furthermore, participants perceived it as an empowering experience. The group modality enabled women to create connections that validated and normalised their experiences. Future studies of phase-based interventions with larger, well-powered samples are needed. What is already known about this topic: (1) Phase-based approaches are a recommended treatment option for individuals with complex trauma histories. Despite this, little research has examined such treatments for women who have experienced complex trauma. (2) Phase-based approaches assume that individuals who have experienced complex trauma may benefit from a period of safety and stabilisation, to develop the required coping skills to engage in trauma memory processing. (3) Capitalising on the Australian Medicare Rebate Scheme, combining a group phase and individual phase may reduce the cost burden for clients and enable clients to experience benefits unique to group and individual modalities. What this topic adds: (1) This paper presents Australian-first findings regarding the outcomes of the initial phase of a phase-based approach to treat women with complex trauma. (2) Phase 1 of the Women's Trauma Recovery Program, delivered in a group format, was associated with decreases in mental health symptoms for most participants and was perceived as empowering experience that facilitated interpersonal connections. (3) Using a group intervention as phase 1 of phase-based approaches may be an acceptable, effective, and cost-effective option for women with complex trauma histories. [ABSTRACT FROM AUTHOR]

Prior research suggests that social connectedness is associated with lower levels of depression among college students. The aim of this exploratory study was to determine if an association existed between social activity, need to belong, and depression. Variations in study measures by race, gender, and student status were also explored. Data was collected from students attending a large university in the southeastern United States during the Spring 2019 academic semester (N = 299). Participants completed an anonymous self-administered survey, which was offered in both electronic and paper formats. Need to belong significantly predicted depression among college students even when accounting for social activity and response bias. Study measures varied significantly based on race, gender, and student status. Belonging and social connectedness may be utilized by collegiate stakeholders to increase student and university outcomes. [ABSTRACT FROM AUTHOR]

Background: Since the end of 2019, the coronavirus disease (COVID-19) outbreak rapidly became a pandemic. The psychological state of people during the COVID-19 pandemic has gained interest. Our aim was to study the prevalence of anxiety, depression, and stress in college students during the COVID-19 pandemic. Methods: A systematic search of Medline, Embase, Web of Science, and the Cochrane Library was conducted up to September 20, 2020. Reviewers independently assessed full-text articles according to predefined criteria. Stata14/SE was used to calculate the prevalence and 95% confidence intervals (CIs) of anxiety, depression, and stress among college students from different countries. A random effects model was adopted. The Egger test was used to determine publication bias. Results: A total of 280 references were retrieved, and 28 papers met our inclusion criteria, for a total of 436,799 college students. Thirteen studies involved non-Chinese college students, and 15 studies involved Chinese college students. The prevalence of anxiety, depression, and stress was 29% (95% CI, 19–25%), 37% (95% CI, 32–42%), and 23% (95% CI, 8–39%), respectively. Conclusion: The COVID-19 pandemic has had a negative psychological effect on college students, and the prevalence of anxiety, depression, and stress among Chinese college students is lower than among non-Chinese college students. [ABSTRACT FROM AUTHOR]

This paper is a comparative reading of J.M. Coetzee's Disgrace (1999) and Ling Ma's Severance (2018), analysing their shared affective mood of detachment, which I will call "diasporic dysphoria". In these works, I propose that this dispassionate mood depicts both protagonists as diasporic citizens of their postcolonial and late capitalist societies. Coetzee and Ma use the affective mood of diasporic dysphoria as a form of representation in these novels, to represent historical and contemporary contexts through the alienation of labour, the countryside and the city through a visitorial aestheticisation, and unspeakable topics through metaphors and allusions. The purpose of this essay is to decipher and define this particular mood—one of historical alienation, distanced spectatorship, and the difficulty of articulation—through close readings, examining how diasporic dysphoria manifests thematically, structurally and linguistically in both novels. [ABSTRACT FROM AUTHOR]

Chronic pelvic pain (CPP) is highly prevalent among women and the condition is poorly understood. In addition to multiple symptoms from the pelvis, CPP patients frequently suffer bodily distress like musculoskeletal pain and negative emotional, behavioral, and sexual implications. This paper is based on a qualitative study including semi-structured interviews with eight women with CPP. Our project has been conducted within the framework of phenomenology, particularly shaped by the concept of embodiment. We discuss the link between the lived body and CPP and address the value of making the life experiences of the patient relevant to understand this complex condition. [ABSTRACT FROM AUTHOR]

This paper examines patterns of response to a multi-disciplinary wrap-around program for homeless adolescents and transition-aged youth with substance use and/or mental health disorders. A cluster analysis of outcome data from 148 youth was conducted. Cluster 1 (n = 67) demonstrated significant decreases in risky behavior (e.g., engaging in unprotected sex, crime, and substance use) and poor interpersonal relationships (e.g. more interaction with family and friends and lower rates of violence) but experienced relatively fewer interactions with family and friends. Cluster 2 (n = 57) demonstrated a significant decrease in poor life functioning (e.g., lower rates of employment/education, better quality of life, and less symptoms of internalizing disorders). Cluster 3 (n = 24) experienced significant increases in risky behavior, poor life functioning, and poor interpersonal relationships. Clusters 1 and 2 improved over six months of care. Cluster 3 deteriorated despite receiving similar services and used more opioids and stimulants. Peer engagement in programs for this population are important. Recommendations for cluster 3 include targeted outreach, medication assisted treatment, and additional research-supported treatments. Further research is needed to test these interventions over longer periods of time. [ABSTRACT FROM AUTHOR]

Research on Black/African American males' depressive experiences and expressions is still developing. While research has shown that men are less likely to be diagnosed with depression when compared to women, the experiences of Black/African Americans are often ignored at a far greater level. This study aimed to highlight how Black/African American men understood, discussed, and dealt with their depression. Interviews of N = 4 Black/African American men were analyzed from a larger qualitative study that examined depression among Blacks/African Americans. Qualitative content analysis techniques, which included open coding, were used to identify themes within the interviews that identified similarities across participant's experiences. The themes highlighted within this report included: (a) depressive episodes as responses to traumatic life events; (b) family and paternal significance for Black/African American men; (c) substance use and sleeping as coping/treatment; and (d) stigma as the greatest impediment to help-seeking and service use. Blacks/African Americans experienced depression within the classical contextualization of the DSM-V. However, they quickly learned to adapt to their experiences, push through the pain, and identify their experiences as normal parts of everyday living. The paper ends with some recommended practice implications for service providers who are interested in working with Black/African American men. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral adherence is vital to the successful long-term rollout of the antiretroviral therapy program in South Africa. At present, there are no studies that look at the effects of disability on antiretroviral adherence. Methods: Drawing on the baseline data from an existing cohort of 1042 people on antiretrovirals in a public healthcare setting in KwaZulu-Natal, the paper investigated a variety of existing covariates relating to antiretroviral adherence, together with functional limitations, depressive symptoms, and health symptoms. Disability was defined according to the International Classification of Functioning, Disability, and Health framework and measured using the World Health Organization Disability Assessment Schedule. Results: In a proportional odds logistic regression functional limitations, depressive symptoms, health symptoms and gender emerged as significant associated with decreased adherence to antiretrovirals (Odds ratio [95% confidence interval]: 1.86 [1.31, 2.66], 1.61 [1.02, 2.55], 2.33 [1.47, 3.69], and 1.65 [1.16, 2.35], respectively). This was found for both severe and milder forms of functional limitations/disability. Conclusion: The paper highlights the need to better understand the role of these limitations in achieving adequate adherence to antiretrovirals and viral suppression. It also calls for investigations into integrated mitigating services such as integrating rehabilitation into routine human immunodeficiency virus care. This study provides a starting point to understand the association between functional limitations and challenges in maintaining adherence to antiretroviral therapy. Addressing functional limitations is currently a neglected factor in efforts targeting HIV-treatment adherence and retention. Rehabilitation is a key intervention that could address this gap. Even mild forms of disability can have profound effects on adherence to antiretroviral therapy, which highlights the need for better screening, early identification, and referrals to rehabilitative support and treatment [ABSTRACT FROM AUTHOR]

Purines, pyrimidines, and amino acid level have gained attention recently as potential determinants of mental disorders. However, eating disorders patients (ED) have not been yet appropriately studied, especially subjects with coexisting mood disorders. This paper examines the serum level of nucleotide catabolites and plasma amino acids in eating disorders with hyperphagia, with and without Major Depressive Disorder (MDD). Samples were taken from adult persons suffering from eating disorders (two forms: simple obesity and binge eating disorder) with MDD (n = 20) and without (n = 17). Serum nucleotides and plasma amino acids concentrations were analyzed with high-performance liquid chromatography-mass spectrometry. The nucleotides metabolite in MDD patients had a significantly (p < 0.05) lower uridine. Among MDD patients with ED significantly (p < 0.05) higher levels of asparagine, glutamine, proline, and arginine were found as compared to the control group. This study demonstrated differences in nucleotide metabolite and amino acid pattern in depression patients with eating disorders. This may be relevant to the mechanisms and may help identify biomarkers. [ABSTRACT FROM AUTHOR]

Social isolation and reduced social participation are common after traumatic brain injury (TBI). Developing interventions that aim to increase social participation through recreation or leisure activities continues to be challenging. This scoping review was conducted to provide an overview of interventions used to increase social participation through in-person recreation or leisure activity for adults with moderate to severe TBI living in the community. Using the Arksey and O'Malley framework, a scoping review of the literature published from 2005 to 2023 was conducted across four databases: Medline, CINAHL, PsycINFO and Scopus. Quality appraisals were conducted for included studies. Following the removal of duplicates, 10,056 studies were screened and 52 were retained for full-text screening. Seven papers were included in the final review. Studies varied with respect to the type of intervention and program outcomes. The interpretation was impeded by study quality, with only two studies providing higher levels of evidence. Barriers and facilitators to successful program outcomes were identified. Few studies with interventions focused on increasing social participation in leisure or recreation activity were identified. Further research incorporating mixed methods and longitudinal design to evaluate effectiveness over time is needed to build the evidence base for increasing social participation through leisure activity. There is evidence to support participating in recreation and leisure activities that involve interactions with others can increase social participation outcomes for adults with moderate to severe traumatic brain injury. Participating in leisure-based interventions not only provides opportunities for social connection but may also impact positively on personal wellbeing, enjoyment, and confidence. Understanding the range of personal, practical, support, and activity factors that can facilitate or obstruct participation in leisure or recreational activity programs at an individual level may improve social participation outcomes. Measuring the impact of an intervention for social participation should include post-intervention changes across outcome domains and over time [ABSTRACT FROM AUTHOR]

To evaluate the reliability, internal consistency, and construct validity of the Swedish versions of PROMIS-29 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) instruments in patients with systemic sclerosis (SSc). In a cross-sectional study, consecutive SSc patients completed a paper-based survey. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was tested employing weighted Kappa (Kw) and intra-class correlation coefficient (ICC). Construct validity was evaluated by hypotheses testing using RAND-36, MRC Dyspnea score, Scleroderma Health Assessment Questionnaire (SHAQ) and clinical measurements. Forty-nine patients (86% female; 73% limited cutaneous SSc) completed the survey. The mean disease duration was 11 years and mean SHAQ was 0.5. Internal consistency and test–retest reliability were good with the exception of PROMIS-29 anxiety. PROMIS-29, FACIT-Dyspnea, and Functional limitation showed strong correlations to corresponding RAND-36 domains (|rs|=0.67 to −0.85). Relevant PROMIS-29 domains, FACIT-Dyspnea and Functional limitation correlated strongly to SHAQ and VAS overall disease severity (|rs|=0.60 to −0.75). Ceiling effects (>15%) were found in six PROMIS-29 domains and in both FACIT-Dyspnea and Functional limitations. Four (4/5) hypotheses were confirmed. PROMIS-29 and FACIT-Dyspnea meet the requirements for reliability and have adequate construct validity in Swedish patients with SSc. PROMIS-29v2 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) Index are patient outcome measures that gain increasing interest for the evaluation of patient with rheumatologic diseases. PROMIS-29v2 and FACIT-Dyspnea Index meet the requirements for reliability and have adequate construct validity compared to legacy measures in Swedish patients with systemic sclerosis. Translation and validation of PROMs is important for studies of rare diseases in multi-center collaborations. [ABSTRACT FROM AUTHOR]

In this paper, we use a UK case study to explore how the COVID-19 pandemic affected the mental health (emotional, psychological, social wellbeing) of farmers. We outline the drivers of poor farming mental health, the manifold impacts of the pandemic at a time of policy and environmental change, and identify lessons that can be learned to develop resilience in farming communities against future shocks. We undertook a survey answered by 207 farmers across the UK, focusing on drivers of poor mental health and the effect of the COVID-19 pandemic. We also conducted 22 in-depth interviews with individuals in England, Scotland and Wales who provide mental health support to farmers. These explored how and why the COVID-19 pandemic affected the mental health of farmers. These interviews were supplemented by 93 survey responses from a similar group of support providers (UK-wide). We found that the pandemic exacerbated underlying drivers of poor mental health and wellbeing in farming communities. 67% of farmers surveyed reported feeling more stressed, 63% felt more anxious, 38% felt more depressed, and 12% felt more suicidal. The primary drivers of poor mental health identified by farmers during the pandemic included decreased social contact and loneliness, issues with the general public on private land, and moving online for social events. Support providers also highlighted relationship and financial issues, illness, and government inspections as drivers of poor mental health. Some farmers, conversely, outlined positive impacts of the pandemic. The COVID-19 pandemic is just one of many potential stressors associated with poor farming mental health and its impacts are likely to be long-lasting and delayed. Multiple stressors affecting farmers at the same time can create a tipping point. Therefore, there is a need for long-term support and ongoing evaluation of the drivers of poor mental health in farming families. [ABSTRACT FROM AUTHOR]

Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently. The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up. Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory. Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group. The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful. [ABSTRACT FROM AUTHOR]