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Introduction: In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives: The objectives of the study are to understand barriers/ facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods: The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results: Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion: Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes. [ABSTRACT FROM AUTHOR]

Although several studies have examined race differences in gun‐related attitudes, researchers are only beginning to explore how racial attitudes might contribute to the gun policy preferences of white Americans. While many white Americans tend to oppose firearm restrictions, it is unclear whether racialized policy preferences tend to support these leanings. Our analysis of national data from Wave 4 of the Baylor Religion Survey (n = 1,063) indicates that white Americans who report more implicit resentment are more likely to support policies that would increase the number of armed people in schools and allow more people to carry concealed firearms and less likely to support policies that would limit the possession of handguns, semiautomatic weapons, and high‐capacity magazines. Interestingly, white Americans who report more implicit resentment are also less likely to support policies that would expand gun safety programs and background checks that include mental health screenings. These associations persisted with adjustments for age, gender, race or ethnicity, education, household income, marital status, the presence of children, religious identity, religiosity, political orientation, region of residence, and urban residence. We conclude that implicit resentment is consistently associated with less restrictive and more precarious gun policy preferences among white Americans. These patterns are noteworthy because they support the same general conclusion: white Americans who report more implicit resentment tend to want more guns in society with fewer legal restrictions related to access and safety. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing amount of research regarding mental health in elite athletes in recent years, athletes with impairments are hardly represented. Due to this lack of data and the significant need of athlete‐specific mental health screening tools, a continuous mental health monitoring program for elite Para athletes was implemented. Objective: Validation of the Patient Health Questionnaire‐4 (PHQ‐4) as a suitable tool for continuous mental health evaluation in elite Para athletes. Design: A 43‐week prospective observational cohort study. Setting: Online questionnaire, provided weekly via web browser and mobile app. Participants: Seventy‐eight Para athletes preparing for Paralympic Summer and Winter Games. Interventions: Not applicable. Main Outcome Measures: Weekly PHQ‐4 scores, stress level, and mood. Results: With a mean weekly response rate of 82.7% (SD = 8.0), 2149 PHQ‐4, 2159 stress level and 2153 mood assessments were completed. Mean PHQ‐4 score among all participating athletes was 1.2 (SD = 1.8; 95% confidence interval [CI], [1.1–1.3]). Individual weekly scores ranged from 0 to 12 and showed significant floor effects, with 54% of the scores being zero. PHQ‐4 scores were significantly higher among female athletes and team sport members (p <.001). Internal consistency of the PHQ‐4 was satisfying, Cronbach's α being 0.839. There were significant cross‐sectional as well as longitudinal correlations of PHQ‐4 and stress level as well as mood values (p <.001). 39.7% of all athletes (n = 31) had at least one positive screen for mental health symptoms. Conclusions: The PHQ‐4 was shown to be a valid tool for mental health surveillance in elite Para athletes. Significant correlations of the PHQ‐4 and stress level as well as mood were shown. High weekly response rates among participating athletes indicated good acceptance of the program. The weekly monitoring allowed for the identification of individual fluctuations and could identify potential athletes at risk for mental health problems when combined with clinical follow‐up. [ABSTRACT FROM AUTHOR]

This document is a collection of abstracts from the 19th annual conference of INEBRIA, focusing on the evaluation of digital interventions for alcohol and other drugs. The abstracts provide insights into the effectiveness, feasibility, and acceptability of various interventions, such as the Drink Less app and digital Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs. The document also includes studies and presentations on brief interventions for substance use and alcohol misuse in different settings, as well as the impact of the COVID-19 pandemic on these interventions. Additionally, there are studies on the implementation of screening and brief interventions in healthcare settings, the knowledge of health workers on brief interventions, and the use of self-administered screening for substance use in youth. The document highlights the importance of tailored interventions, training for healthcare professionals, and addressing biases and power differentials in reproductive health counseling. It also includes studies on the implementation of screening and brief interventions in various settings, such as cardiology services, high schools, and city halls, as well as the development of standardized protocols and contextually relevant interventions. The document concludes with a scoping review on healthcare workers' perspectives on the outpatient provision of methadone for individuals with opioid use disorder, emphasizing the need for improved education and support structures. Finally, there are studies on the effectiveness of a culturally adapted brief negotiation interview (BNI) combined with SMS boosters in reducing binge drinking behavior in Tanzania, as well as the perceived family support for patients undergoing [Extracted from the article]

Background: Substance use and mental distress are known barriers to HIV care engagement among trans women. Less is known about access and utilization of mental health and substance use care among trans women and the relationship between unmet behavioral health needs and HIV viral suppression. We examined the relationship between mental health and substance use on HIV viral load among trans women living with HIV. We also examined the relationship between mental health and substance use services needs with HIV care engagement and having a detectable viral load by comparing engagement in care cascades. Methods: Data are from a 2022 baseline assessment for an intervention with trans women living with HIV (n = 42) in San Francisco. Chi-Squared or Fisher's exact tests were conducted to determine associations between HIV viral load, mental health, and substance use. We also examine characteristics associated with each step in the HIV, mental health, and substance use care cascades. Results: Most participants were trans women of color (85.7%), 40 years of age or older (80.9%), with low income (88.1%), and almost half were unstably housed (47.6%). Of the 32 participants who screened positive for depression, anxiety and/or psychological distress, 56.3% were referred for mental health services in the past 12 months. Of those who were referred, 44.4% received mental health services. Of the 26 participants who screened positive for a substance use disorder, 34.6% were referred to substance use services in the past 12 months. Of those referred, 33.3% received substance use services in the past 3 months. Latina trans women had a low referral rate to meet their mental health needs (50%) and only 16.7% of African American/Black trans women who screened positive for a substance use disorder were referred for services, while trans women of other race/ethnicities had high referral and services utilization. No significant results were found between HIV viral load and screening positive for a mental health disorder. Methamphetamine use was statistically associated with having a detectable HIV viral load (p = 0.049). Conclusions: We identified significant unmet mental health and substance use services needs and noted racial/ethnic disparities in the context of high HIV care engagement among trans women living with HIV. We also found that methamphetamine use was a barrier to having an undetectable viral load for trans women living with HIV. To finally end the HIV epidemic, integration of behavioral health screening, linkage, and support are needed in HIV care services for populations most impacted by HIV, especially trans women. Trial registration: NCT, NCT 21–34,978. Registered January 19, 2022. [ABSTRACT FROM AUTHOR]

Depression is the most frequently detected and preventable mental illness among people with human immunodeficiency syndrome, with rates two to four times higher than in the general population. Currently, depression is estimated to affect 350 million people worldwide. To assess the prevalence of depression and associated factors among HIV/AIDS patients attending antiretroviral therapy clinic at Adama Hospital Medical College, Adama, Central Ethiopia. An institutional-based cross-sectional study was conducted from April 01 to September 30, 2021, at Adama Hospital Medical College, Adama, Ethiopia. A total of 420 individuals were selected using a systematic random sampling technique. After informed consent was obtained from each study participant, data were collected through face-to-face interviews, observations, and document reviews. Subsequently, the data were entered into EPI-Info Version 7 and analyzed by Statistical Package for the Social Sciences version 21. Variables with p-values less than 0.25 in the univariable logistic regression analysis were subsequently included in the multivariable logistic regression analysis to account for potential confounding factors. The association was measured using adjusted odds ratio (AOR) with a 95% confidence interval (CI), and variables with p-values less than 0.05 were considered statistically significant. The prevalence of depression was 52.4% (95% CI 47.6–57.1). Factors significantly associated with depression among HIV-positive patients on antiretroviral therapy included employment status [AOR = 0.22(95% CI 0.13–0.36)], the patient's most CD4 count [AOR = 6.99 (95% CI 2.81–17.38)], duration of months on antiretroviral therapy [AOR = 5.05 (95% CI 2.38–10.74)] and presence of chronic non-communicable diseases [AOR = 7.90 (95% CI 4.21–14.85)]. The highest proportion of HIV-positive patients taking antiretroviral drugs exhibited depression. Employment was identified as a preventive factor, whereas having a low CD4 count, recently initiating antiretroviral therapy, and having chronic non-communicable diseases were associated with increased odds of depression among HIV-positive patients on antiretroviral therapy. There need to strengthen mental health screening and treat depression among HIV-positive patients, particularly by targeting identified factors. [ABSTRACT FROM AUTHOR]

The Democratic Republic of Congo (DRC) has been the subject of several armed conflicts for more than two decades, causing the displacement of millions of Congolese in and outside the country and impacting on their mental health and wellbeing. Mental healthcare interventions are a vital component for the displaced to holistically integrate into their new communities. This policy brief draws from a systematic review of various laws and policies as well as stakeholders' analysis to address the mental health issues of internally displaced persons (IDPs) in the DRC. In addition, we examine data from 32 interviews with various stakeholders at the national level and in 4 provinces of the DRC (Kasai Central, Tanganyika, South Kivu and Ituri). The findings show that while the DRC has committed to progressive policies and conventions the implementation of these policies and conventions, however, remains insufficient. There are also limited local and international stakeholders that provide forms of psychosocial support to IDPs and, effectively address mental health challenges in context. In addition, the provision of such care is limited by the scarcity of specialized and skilled staffs. These findings point to the need to strengthen mental health system governance. This should include scaling up of the integration of mental healthcare at the operational level, the training of community health workers in the screening of mental health issues and the sensitization of the IDPs and the host population to help them change their perception of mental ill-health. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Atopic dermatitis (AD) is chronic inflammatory skin disorder. It typically begins in infancy or childhood and might persist into adulthood. AD is characterized by dry, itchy, eczematous skin. The lesions can vary in intensification from mild to severe according to patient age or body region. AD requires ongoing management to control the symptoms. Skin manifestations along with the demand of treatment and care regimens significantly impact quality of life (QOL) in patients with AD. Individuals suffering from this condition are more prone to developing mental health disorders, which are often linked to emotional stress they experience. Exposure to stress exacerbates AD and stimulates skin changes, which in turn leads to intensification of treatment regimens. This cause-and-effect chain can be considered as a vicious circle mechanism. The aim of the review is to highlight the phenomenon by examining current literature on this topic in order to raise the awareness of healthcare professionals regarding this subject as well as implement appropriate and complete support for patients struggling with AD. A brief description of the state of knowledge: The pathophysiology of AD is multifactorial. Numerous studies explore the impact of stress on the deterioration of AD symptoms and delve into its pathogenic concepts. Simultaneously, researchers highlight increased psychological distress in AD patients, which surpass that observed in many other chronic conditions. Psychological factors play a significant role in AD. It demands considering mental health screening and support as a part of clinical practice, treating AD patients. Further research is necessary to provide efficient and comprehensive interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic resulted in increased parenting stress and substance use. At the same time that mental health and social service needs increased, access to services, including among those receiving treatment, decreased due to stay-at-home orders. Few programs were equipped or prepared to translate their interventions to a virtual format at the start of the pandemic. There is a critical need to identify effective adaptations to substance use and family-focused treatment during the COVID-19 pandemic. Effective program adaptations have continued relevance for the expansion of access to family-focused addiction services beyond the pandemic itself, particularly for rural or other hard to reach populations. Seventy-three semi-structured interviews were conducted with the five agencies participating in the implementation of the In-Home Recovery Program (IHRP), an in-home, substance use disorder (SUD) treatment program. Using a rapid analysis approach two coders analyzed interviews for recurring concepts and themes. Facilitators for adapting services included: (1) the introduction of virtual toxicology screens, (2) helping parents access technology, (3) assisting parents with non-identified children to decrease their stress, and (4) anticipating reoccurrences of substances during the pandemic. Barriers to adapting services included: (1) engaging young children in virtual treatment, (2) privacy, and (3) engaging in telehealth with parents experiencing domestic violence or reoccurrence of substances. Findings reveal virtual substance use treatment is possible. Facilitators to adaptation such as providing access to technology and virtual toxicology screens demonstrate the feasibility and acceptability of utilizing telehealth interventions for substance use. Barriers to adaptations were primarily related to the infant mental health component. Telehealth is likely not appropriate for children below the age of five. Individual sessions focusing on caregiving, rather than dyadic treatment may be more suitable to virtual formats. [ABSTRACT FROM AUTHOR]

Background: Women living with mental health conditions may not have shared in improvements in breast cancer screening and care. No studies have directly examined the link between reduced screening participation and breast cancer spread in women using mental health (MH) services. Methods: Population‐wide linkage of a population cancer register, BreastScreen register, and mental health service data set in women aged 50 to 74 years in New South Wales, Australia, from 2008 to 2017. Incident invasive breast cancers were identified. Predictors of degree of spread (local, regional, metastatic) at diagnosis were examined using partial proportional odds regression, adjusting for age, socioeconomic status, rurality, and patterns of screening participation. Results: A total of 29 966 incident cancers were identified and included 686 (2.4%) in women with MH service before cancer diagnoses. More than half of MH service users had regional or metastatic spread at diagnosis (adjusted odds ratio, 1.63; 95% CI, 1.41‐1.89). MH service users had lower screening participation; however, advanced cancer was more common even when adjusting for screening status (adjusted odds ratio, 1.53; 95% CI, 1.32‐1.77). Advanced cancer was more common in women with severe or persistent MH conditions. Conclusions: Low screening participation rates explain only small part of the risk of more advanced breast cancer in women who use MH services. More study is needed to understand possible mechanisms contributing to more advanced breast cancer in women living with MH conditions. Health systems need strategies to ensure that women living with MH conditions enjoy population gains in breast cancer outcomes. Data were examined for 29,966 women aged 50 to 74 years with invasive breast cancer in New South Wales, Australia. Mental health service users had lower BreastScreen participation rates and were 53% more likely to have regional or metastatic spread when diagnosed; however, lower screening participation only explained a small part of this increased risk. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities. [ABSTRACT FROM AUTHOR]

Background: Quality of life studies in low- and middle-income countries have demonstrated the influence of socioeconomic factors on the quality of life (QoL). However, further studies are required to confirm this association in developing countries with rapidly ageing populations. Using Ferrans et al.'s QoL model, this study aimed to identify the factors associated with the QoL of community-dwelling adults in Indonesia. Methods: A cross-sectional study among 546 community-dwelling adults aged 50+ years was conducted in Yogyakarta, Indonesia, in 2018. QoL was measured using the Short Form 12 questionnaire, which consists of a summary of physical and mental health. We performed stepwise logistic regression analyses to determine odds ratios (ORs) with 95% confidence intervals (CIs) and examined the association between the QoL (physical and mental health) and demographic characteristics, socioeconomic status, financial management behaviour, multimorbidity status, nutritional status, cognitive impairment status, depression status, and independence. Statistical significance was set at p<0.05. Results: Among the respondents, 15% reported poor physical health, and 9.2% reported poor mental health. Good physical health was significantly associated with the absence of chronic disease (OR 2.39; 95% CI: 1.07–5.33), independence in activities of daily living (OR 3.90; 95% CI 1.57–9.67) and instrumental activities of daily living (OR 4.34; 95% CI 2.28–8.26). Absence of depression was significantly associated with good mental health (OR 2.80; 95% CI 1.3–5.96). Conclusion: The QoL of community-dwelling adults in Indonesia is associated with activities of daily living and instrumental activities of daily living, as well as the absence of chronic disease and depression. Efforts should be made to prevent chronic disease and delay functional decline through healthy lifestyles and routine physical and mental health screenings. [ABSTRACT FROM AUTHOR]

Mental health comorbidities among individuals with serious illness are prevalent and negatively impact outcomes. Mental healthcare is a core domain of palliative care, but little is known about the experiences of palliative care clinicians delivering such care. This national survey aimed to characterize the frequency with which palliative care providers encounter and manage common psychiatric comorbidities, evaluate the degree of mental health integration in their practice settings, and prioritize strategies to meet the mental health needs of palliative care patients. A e-survey distributed to the American Academy of Hospice and Palliative Medicine membership. Seven hundred eight palliative care clinicians (predominantly physicians) were included in the analysis. Mood, anxiety, and neurocognitive disorders were frequently encountered comorbidities that many respondents felt comfortable managing. Respondents felt less comfortable with other psychiatric comorbidities. Eighty percent of respondents noted that patients' mental health status impacted their comfort delivering general palliative care at least some of the time. Mental health screening tool use varied and access to specialist referral or to integrated psychiatrists/psychologists was low. Respondents were unsatisfied with mental health training opportunities. Palliative care clinicians play a crucial role in addressing mental health comorbidities, but gaps exist in care. Integrated mental health care models, streamlined referral systems, and increased training opportunities can improve mental healthcare for patients with serious illness. [ABSTRACT FROM AUTHOR]

School-based mental health screening has been identified as a major component of social, emotional, and behavioral multitiered systems of support models, and a promising practice that can be used to address unmet mental health needs of children and adolescents. However, there are frequently noted concerns about the feasibility of implementing school-based screening programs. In this case study, findings from a school-university partnership, intended to address the most commonly reported screening concerns while reducing screening burdens on the school, are described. Students enrolled in a public middle school in a large, urban city in central Texas completed the self-report version of the Behavioral and Emotional Screening System. Participation in initial school-based screening was high (n = 390), with 35.9% of participants considered at-risk. Screening results informed immediate school-based counseling. However, subsequent screening and comprehensive evaluation for at-risk students—completed at an external university clinic—were low. Implications of these findings, as well as recommendations based on the study methods and related literature, are discussed. [ABSTRACT FROM AUTHOR]

The objective of this paper is to report on the effectiveness of a mental health addition to a national nurse-delivered home visiting program. The methods are as follows: analysis of pre/post-launch of the standard Mental Health Intervention and comparison of 356 teams randomized to standard versus enhanced implementation. Stepwise regression controlled for significant client characteristics that were related to relevant outcomes. These characteristics were used in generalized mixed effect models comparing pre/post implementation and intervention and control groups. Pre/post analysis showed that only clients with no elevated mental health screening scores or mental health diagnoses at enrollment showed a significant decrease in depressive symptoms. Clients enrolled with and without mental health needs at enrollment significantly decreased on anxiety scores while referrals to mental health care increased. Teams receiving enhanced implementation enrolled more clients with mental health needs and clients completed more well-child visits and use of safe sleep practices. By integrating mental health care into maternal, infant, and early childhood home visiting programs, a new equitable model of primary mental health care can reach populations in need. This example provides a new paradigm of accessible and equitable mental health care for the future that can be implemented in a variety of home visiting programs. [ABSTRACT FROM AUTHOR]

Mental health issues in adolescents with obesity are multifold, with no explicit screening recommendations. The aim of this research is to explore how this screening is performed by physicians and, thus, how it impacts adolescents' care pathways, offering insights into how to improve it through a qualitative study using interpretative phenomenological analysis. Twenty physicians (non-psychiatrist physicians and child and adolescent psychiatrists) involved at various stages in the care pathway were interviewed with semi-structured questionnaires. The findings connect 2 meta-themes. Non-psychiatrist physicians perceive widespread but ill-defined suffering in adolescents with obesity. Non-psychiatrist physicians see screening for mental conditions as mandatory. Unlike child and adolescent psychiatrists, they are not experts in distinguishing psychosocial suffering from psychiatric disorders. Screening is clinical. Adolescents' demand to lose weight in a context of shaming and alexithymia limits their access to psychiatric care. Child and adolescent psychiatrists then redefine the medical response to polymorphous symptoms. Psychiatric diagnoses mainly involve anxiety and depression symptoms, seldom eating disorders. Conclusion: Physicians have overtly conflicting perspectives over the intensity of mental conditions. Non-psychiatrists, sensitive to perceived distress, seek to have it quickly appraised if they detect a significant suffering. Child and adolescent psychiatrists find appraisal complex to perform in the absence of means, interest, and/or experience. Improving screening requires training health professionals and using multidisciplinary assessment means. What is Known: • Mental health and eating disorders are contributing factors of obesity but their relationship remains complex between cause and consequence. • Mental health conditions and psychosocial suffering are the main complications among adolescents suffering from obesity with guilt, sadness, or stigma. What is New: • Non-psychiatric physicians express their need of a specialized diagnosis to define this suffering, but the lack of availability of psychiatrists and the necessity of time and of a multidisciplinary team lead to a delayed assessment. • For psychiatrists, this suffering is often not a psychiatric condition. Though requiring attention, this can lead to a misunderstanding between professionals. [ABSTRACT FROM AUTHOR]

The purpose of this study was to validate the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) Cross-Cutting Symptom Measure (CCSM) as a screening tool for a wide variety of disorders within busy community outpatient mental health settings. Participants (N = 851) were referred for coordinated specialty care services (mean age = 20.26 years (SD = 2.97); 82.5 % Caucasian, 7.5 % African American, 0.7 % Native American, 0.7 % Pacific Islander, 0.8 % Asian, 7.8 % Multiracial; 15.1 % Latinx; 53.1 % female, 45.5 % male, 1.4 % other gender). At optimal cut-score, specificity ranged from 57 to 77 % for depression, anxiety, substance use and psychosis domains; sensitivity ranged from 63 to 72 %. Scores for depression, anxiety, substance use and psychosis domains differed significantly by groups with and without diagnoses. Correlations among domains were larger where expected (r = 0.52, depression-suicidal ideation), and relatively smaller where expected (r = 0.28, suicidal ideation-inattention). Depression, anxiety, substance use and psychosis domains evidenced incremental validity for their respective diagnoses (change in explained variance, 3–15 %). Psychometric features of CCSM were broadly supported. Criterion measures did not have inter-rater reliabilities as this is generally prohibitive in clinic settings. The CCSM could provide a first step in screening for multiple disorders; however, it cannot replace structured interviews for making diagnoses related to these conditions. • This study provided evidence for the psychometric characteristics of a modified version of the CCSM • Regarding sensitivity and specificity, best support was found for depression, anxiety, substance use and psychosis cut-scores • CCSM scores for depression, anxiety, substance use, and psychosis domains show known group differences and criterion validity • Convergent, construct, and divergent validities were supported via correlations among CCSM/CLSM constructs and CCSM domains • Regression results show incremental predictive validity for depression, anxiety, substance use, memory, and psychosis domains [ABSTRACT FROM AUTHOR]

INTRODUCTION: Psychological burden of frontliners increased during the COVID-19 pandemic, leading to psychiatric illnesses reducing productivity. Assessing their mental health status is vital in providing effective care. Our aim was to investigate the levels of depression, anxiety, stress, and associated factors among frontlines of International Islamic University Malaysia (IIUM), Sultan Ahmad Shah Medical Centre (SASMEC) and Kuantan-Campus during the recent COVID-19 pandemic. MATERIALS AND METHODS: Cross-sectional study among 261 SASMEC@IIUM and 125 Kuantan-campus IIUM frontliners from March 2021 to June 2022 using self-administered validated DASS-21 questionnaire. Descriptive statistics, Chi-Square and Fisher's Exact tests were used for data analysis. Frontliners with severe and very severe DASS scores were offered psychoeducational counselling for intervention. RESULTS: Out of 386 respondents, 82.1% were clinical frontliners, 65.8% were female, and 65.8% were married. The prevalence was 15.8%, 29.5% and 9.3% for depression, anxiety and stress, respectively. This study showed no statistical differences between the clinical and non-clinical, and between SASMEC@IIUM and Kuantan-campus frontliners on depression, anxiety and stress levels. Those with post-traumatic events had significant association with depression (p<0.001) and anxiety (p<0.001), while anxiety significantly associated with chronic diseases (p=0.034). CONCLUSION: Over one-fourth of frontline staff suffered from anxiety during the COVID-19 pandemic, whereas 9-15% experienced depression and stress. Frontliners with post-traumatic events or chronic diseases required additional support in coping with their mental health burden. No significant difference was found in anxiety, depression and stress levels between clinical and non-clinical or between hospitalbased and on-campus frontliners, suggesting a comprehensive mental health screening and timely intervention to all frontliners regardless of their post or area of service. [ABSTRACT FROM AUTHOR]

Objective: Suicidal behaviours among students pose a significant public health concern, with mental health problems being well-established risk factors. However, the association between food insecurity (FIS) and suicidal behaviours remains understudied, particularly in Bangladesh. This study aimed to investigate the relationship between FIS and suicidal behaviours among Bangladeshi university students. Design: A cross-sectional survey using convenience sampling was conducted between August 2022 and September 2022. Information related to socio-demographics, mental health problems, FIS and related events and suicidal behaviours were collected. Chi-squared tests and multivariable logistic regression models, both unadjusted and adjusted, were employed to examine the relationship between FIS and suicidal behaviour. Setting: Six public universities in Bangladesh. Participants: This study included 1480 students from diverse academic disciplines. Results: A substantial proportion of respondents experienced FIS, with 75·5 % reporting low or very low food security. Students experiencing FIS had a significantly higher prevalence of suicidal ideation, plans and attempts compared with food-secure students (18·6 % v. 2·8 %, 8·7 % v. 0·8 % and 5·4 % v. 0·3 %, respectively; all P  < 0·001). In addition, students who have personal debt and participate in food assistance programmes had a higher risk of suicidal behaviours. Conclusions: This study highlights the association between FIS and suicidal behaviours among university students. Targeted mental health screening, evaluation and interventions within universities may be crucial for addressing the needs of high-risk students facing FIS. [ABSTRACT FROM AUTHOR]

During pregnancy, a woman experiences many changes, not only physical, but also mental, which is why perinatal mental health is of great importance at this stage. The majority of pregnant women who develop a mental illness during pregnancy, such as depression or anxiety, are not diagnosed, which can cause adverse effects for the mother and baby. In this sense, the screening, diagnosis, management and follow-up of this group is of great importance. Thanks to technological advances, we can count on the Information and Communication Technologies (ICT) to find ways to approach women in the perinatal stage for screening and monitoring their mental health. So this review article focuses on seeing its acceptability, perception, barriers to access and new developments focused on improving mental health in perinatal women. [ABSTRACT FROM AUTHOR]

The authors sought to explore the availability of mental health supports within public schools during the COVID-19 pandemic by using survey data from a nationally representative sample of U.S. K–12 public schools collected in October–November 2021. The prevalence of 11 school-based mental health supports was examined within the sample (N=437 schools). Chi-square tests and adjusted logistic regression models were used to identify associations between school-level characteristics and mental health supports. School characteristics included level (elementary, middle, or high school), locale (city, town, suburb, or rural area), poverty level, having a full-time school nurse, and having a school-based health center. Universal mental health programs were more prevalent than more individualized and group-based supports (e.g., therapy groups); however, prevalence of certain mental health supports was low among schools (e.g., only 53% implemented schoolwide trauma-informed practices). Schools having middle to high levels of poverty or located in rural areas or towns and elementary schools and schools without a health infrastructure were less likely to implement mental health supports, even after analyses were adjusted for school-level characteristics. For example, compared with low-poverty schools, mid-poverty schools had lower odds of implementing prosocial skills training for students (adjusted OR [AOR]=0.49, 95% CI=0.27–0.88) and providing confidential mental health screening (AOR=0.42, 95% CI=0.22–0.79). Implementation levels of school-based mental health supports leave substantial room for improvement, and numerous disparities existed by school characteristics. Higher-poverty areas, schools in rural areas or towns, and elementary schools and schools without a health infrastructure may require assistance in ensuring equitable access to mental health supports. [ABSTRACT FROM AUTHOR]

Family physicians play a pivotal role in the early detection, diagnosis, and management of mental health disorders within the community. This review article delves into the multifaceted responsibilities of family physicians in the realm of mental health care. Emphasizing the importance of primary care settings as the first point of contact for many patients, the article underscores the need for effective screening tools and methodologies tailored for these environments. The diagnostic precision of family physicians, often challenged by the broad spectrum of mental health symptoms, is explored alongside the potential implications of misdiagnoses. Furthermore, the article evaluates various treatment options, from pharmacological interventions to psychotherapy, and their applicability in primary care settings. The integration of technological advancements, such as electronic health records and telemedicine, is also discussed in the context of enhancing patient care. The review concludes by highlighting the importance of educating primary care physicians to not only pay close attention to the mental health of their patients, but also to be able to accurately screen and diagnose mental health issues using various diagnostic tools. Moreover, it is critical to develop more useful tools that can be used in the context of primary care settings. [ABSTRACT FROM AUTHOR]

Objective: Regular clinical assessment for complications of systemic sclerosis (SSc) such as pulmonary arterial hypertension (PAH) is essential for early institution of therapy and improved outcomes. The objective of this study was to determine the impact of COVID‐19 pandemic‐related restrictions on health care access of patients with SSc, including screening for PAH. Methods: South Australian and Victorian patients enrolled in the Australian Scleroderma Cohort Study were surveyed about their perceptions of the impact of the pandemic on mental well‐being, access to medications, investigations, and management of SSc. Frequency of annual rheumatology assessments, pulmonary function tests (PFT), and transthoracic echocardiography (TTE) to screen for PAH were compared with rates from before the pandemic. Results: A total of 312 of 810 patients with SSc responded (38.5% response); 273 were female (87.5%), the median age was 64.7 years, 77.2% had limited disease, the median illness duration was 15.6 years, 15.7% were immunosuppressed, 32.1% had interstitial lung disease, and 6.4% had PAH. A total of 65.7% of consultations were by telehealth, of which 81.2% were by telephone. Compared with respondents in South Australia (n = 109), Victorian respondents (n = 203) experiencing prolonged lockdown, reported reduced access to their rheumatologist (49.3% vs 27.9%; P = 0.004), greater use of consultation by video (17.3% vs 2.1%; P = 0.008), greater health care disruption (49.0% vs 23.2%; P < 0.001), and worse mental health (P = 0.002). Respondents reported reduced access to PFT and TTE (31.7% and 22.5%, respectively). Annual visits, PFT, TTE, and new diagnoses of PAH were reduced in 2020 to 2022 compared with 2011 to 2019. Conclusion: The COVID‐19 pandemic–related disruption to health care for patients with SSc was associated with worse mental health and reduced screening and diagnosis of PAH, which may impact long‐term outcomes. [ABSTRACT FROM AUTHOR]

Background and Aims: Data on mild cognitive impairment (MCI) in low‐ to middle‐income countries are still being determined, despite the fact that most future older adults are expected to reside in these regions. This study aimed to investigate the prevalence and associated factors of MCI in Iran. Methods: A cross‐sectional study was conducted on 4938 community‐dwelling subjects aged 50 years or above in the first wave of the Ardakan Cohort Study on Aging. MCI was evaluated using the Mini‐Mental State Examination (MMSE) and the Abbreviated Mental Test Score (AMTS) in literate and illiterate individuals. The relationship between factors associated with the odds of MCI was assessed through logistic regression. Results: The prevalence of MCI among all participants, the literates and illiterates, was 15.8%, 6.3%, and 36.4%, respectively. It was found that failure to accomplish any of the MMSE or AMTS items was significantly related to MCI (p < 0.001). Age ([odds ratio (OR): 1.05; p < 0.001 in the literates], [OR: 1.06; p < 0.001 in the illiterates]), sex (OR: 0.13; p < 0.001 in the illiterates), history of stroke ([OR: 2.86; p = 0.006 in the literates], [OR: 2.04; p = 0.045 in the illiterates]), and depression ([OR: 1.87; p < 0.001 in the literates], [OR: 1.41; p = 0.008 in the illiterates]) were significantly associated with MCI. Conclusion: This study highlights the significant associations between age, education, depression, stroke, and MCI in Iranian participants. These findings emphasize the need for targeted interventions in low‐literacy populations, mental health screening, and stroke prevention strategies to mitigate the burden of MCI and enhance cognitive health. [ABSTRACT FROM AUTHOR]

Bovine viral diarrhea virus (BVDV) is one of the most important pathogens of the reproductive systems that have a significant socioeconomic impact on the dairy industry. A cross-sectional study was conducted on 17 randomly selected farms out of 133 registered dairy farms in Holeta, a town in the Walmera district of Ethiopia. The study aimed to detect BVDV antigen-positive animals and investigate the seroprevalence of BVDV infection. A total of 337 serum samples were collected from selected farms with no history of BVDV vaccination. The indirect enzyme-linked immunosorbent assay (I-ELISA) test was the screening test used to detect antibodies against BVDV. In contrast, antigencapture ELISA was used for the detection of BVDV antigens in seronegative animals. A logistic regression model was used to assess the association between potential predictors and BVDV exposure. The overall animal level seroprevalence was 15.4%, and 64.7% of the herds had at least one seropositive animal. From 285 seronegative animals, one animal (0.4%) was found positive for BVDV antigen. The same animal was found positive in a double check 21 days later. In this study, cows with a history of abortion (OR = 6.3; 95% CI: 1.61 -13.1), history of repeated breeding (OR = 7; 95% CI: 2.5 - 14.3), animals managed intensively (OR = 4.6; 95% CI: 1.6 - 13.0) and multiparous cows (OR = 3.6; 95% CI: 1.5 - 8.9) had higher proportion of seroreactors in their respective comparison category (p<0.05). Besides, cows with a history of congenital defective calve birth (OR = 15.2; 95% CI: 3.2 - 73.6), adult age groups (OR = 2.9; 95% CI: 1.0-7.9), and cows bred both artificially and natural mating (OR = 4.6; 95% CI: 1.7 - 12.6) were statistically associated with BVDV seropositivity (p<0.05). In conclusion, this report demonstrated the presence of persistently infected (PI) dairy cattle in Ethiopia. Thus, the findings warrant the need for immediate control intervention that involves both screening and culling of PI animals and vaccination. [ABSTRACT FROM AUTHOR]

A study published in the Annals of the Academy of Medicine, Singapore examines the prevalence and correlates of illicit drug consumption in Singapore. The study found that the lifetime and past 12-month prevalence of illicit drug consumption in Singapore are 2.3% and 0.7%, respectively. However, these rates may be underestimated due to potential underreporting and the exclusion of institutionalized individuals. The study also highlights the need for targeted prevention and intervention strategies, particularly among youth, and emphasizes the importance of screening for substance abuse. Additionally, the study found that cannabis is the most commonly consumed drug in Singapore, despite arrest data suggesting otherwise. The authors call for increased vigilance, education, and treatment/rehabilitation efforts to address illicit drug consumption in Singapore. [Extracted from the article]

Abstract Background Avoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen. Methods Among 50,082 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated. Chi-square tests and t-tests compared demographics, eating disorder attitudes and behaviors, suicidal ideation, current eating disorder treatment status, and eating disorder treatment-seeking intentions between respondents with possible ARFID and other eating disorder diagnostic and risk categories. Clinical characteristics of respondents with possible ARFID were also examined. Results 2378 (4.7%) adult respondents screened positive for ARFID. Respondents with possible ARFID tended to be younger, male, and have lower household income, and were less likely to be White and more likely to be Hispanic/Latino than most other diagnostic/risk groups. They had lower weight/shape concerns and eating disorder behaviors than most other diagnoses and higher BMI than those with AN. 35% reported suicidal ideation, 47% reported intentions to seek treatment for an eating disorder, and 2% reported currently being in treatment. The most common clinical feature of ARFID was lack of interest in eating (80%), followed by food sensory avoidance (55%) and avoidance of food due to fear of aversive consequences (31%). Conclusions Findings from this study indicated that ARFID was prevalent among adult screen respondents and more common among individuals who were younger, male, non-White, Hispanic, and lower income relative to those with other eating disorders, at risk for an eating disorder, or at low risk. Individuals with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Further research is urgently needed to improve advances in the assessment and treatment of ARFID and improve access to care in order to prevent prolonged illness duration.

Measures of positive well-being are needed to support the shift away from a deficit-based approach to mental health. This study examined one measure, the Mental Health Continuum-Short Form (MHC-SF), as a measure of positive well-being used in school-based mental health monitoring efforts. This study used latent profile analysis (LPA) to explore the mental health classifications of 10,880 California high school students' responses to MHC-SF emotional, psychological, and social well-being items. Five latent mental wellness profiles emerged, including two ordered profiles (i.e., High Well-Being and Low Well-Being) and three profiles spanning the two ordered profiles. The High Well-Being profile had the most favorable psychological adjustment, and the three moderate well-being range profiles had differentiated functioning. Informing the utility of the MHC-SF, this study also compared the MHC-SF categorical diagnostic criteria with the LPA's empirical classification approach and found the two classification approaches to be congruent. The findings provide an impetus for educators to attend to students in moderate well-being ranges and emphasize promoting positive mental well-being as an essential component of school-based mental health services.

AIM: Outcomes for individuals with psychotic disorders can be improved through early intervention services; however, identification continues to be a major problem in connecting individuals with these services. Social workers form a vast majority of the human service and mental health workforce in the United States and therefore have the potential to play a unique role in identifying and referring those who may benefit from specialty early intervention services. METHODS: The current article describes the methodological design, implementation, and participant recruitment procedures of a large-scale, web-based training program for social workers promoting identification and referral of individuals with emerging symptoms of a mental illness with psychosis in the context of a randomized clinical trial. RESULTS: The web-based study enrolled 1384 individuals. More than half of study participants enrolled within the first 3 months of the 14-month recruitment period. Completion of all study components was achieved by 959 individuals (69% of total enrolled), and completion status did not vary significantly by gender, ethnicity, or facility at which the individual was employed. Completion rates varied by race, such that participants identifying as White were more likely to complete the study, while those identifying as Black were less likely. DISCUSSION: The results suggest the feasibility of using a web-based training program to engage social workers in early psychosis identification practices. Challenges related to encouraging participants to complete the training and lessons learned during the study recruitment are discussed.

Background: The emergence of the new coronavirus pneumonia (COVID-19) pandemic has placed an unprecedented burden on healthcare systems worldwide. Medical personnel on the frontlines have faced unique challenges, including high patient volumes, limited resources, and the constant risk of infection. This study aimed to investigate the mental health status of medical personnel directly involved in treating COVID-19 patients to better understand the impact of the pandemic on their psychological well-being. Materials and Methods: A cross-sectional study was conducted among medical personnel working in hospitals designated for COVID-19 treatment. A structured questionnaire, including validated mental health assessment tools such as the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS), was administered electronically to assess anxiety, depression, and stress levels. Additionally, demographic and work-related information, including age, gender, job role, and years of experience, were collected. Results: A total of 450 medical personnel participated in the study. The results revealed that 65% of the respondents reported moderate to severe symptoms of anxiety, 53% reported moderate to severe symptoms of depression, and 70% reported high levels of perceived stress. Female healthcare workers and those with less than 5 years of experience showed a higher prevalence of psychological distress. Additionally, frontline workers, such as nurses and respiratory therapists, reported significantly higher levels of stress compared to other healthcare professionals. Conclusion: The mental health status of medical personnel dealing with COVID-19 is a matter of concern, with a substantial proportion experiencing symptoms of anxiety, depression, and high stress levels. Strategies to support the mental well-being of these healthcare workers should be implemented, including regular mental health screenings, access to counseling services, and the development of targeted interventions to alleviate stress and improve coping mechanisms. Addressing the mental health needs of medical personnel is crucial for ensuring their continued dedication and effectiveness in managing the ongoing pandemic. [ABSTRACT FROM AUTHOR]

Background: The Strengths and Difficulties Questionnaire (SDQ) is a screening questionnaire to identify children and youth's emotional symptoms, conduct problems, hyperactivity, peer issues, and prosocial behaviors. The objective of this study was to validate the SDQ-Arabic against trained clinicians' diagnoses for the first time in a Gulf Cooperation Council (GCC) country by examining its ability to discriminate between clinically referred and community youth samples, and to differentiate between major categories of diagnoses within a clinically referred youth sample. Results: We recruited two samples of 13–17-year-old Arabic-speaking youth and their parents in Qatar: a clinically-referred sample from a child and adolescent mental health services (CAMHS) outpatient clinic and a stratified, representative school sample. Survey data, including the SDQ-Arabic, were collected as well as the clinical diagnoses given by the youths' clinicians for the clinically referred sample. Using both areas under the curve and traditional analyses of variance, the SDQ-Arabic differentiated between the clinically referred and community samples of Arabic-speaking youth. In addition, the SDQ-Arabic differentiated between the main diagnoses in the clinically referred sample. Conclusion: The current study extends the validity of the SDQ-Arabic. The SDQ-Arabic, which had previously been validated in Arabic-speaking Levantine countries in the region, continues to demonstrate strong predictive value in a GCC sample. Implications for mental health screening are discussed. [ABSTRACT FROM AUTHOR]

Developmental shifts in infant temperament predict distal outcomes including emerging symptoms of psychopathology in childhood. Thus, it is critical to gain insight into factors that shape these developmental shifts. Although parental depression and anxiety represent strong predictors of infant temperament in cross-sectional research, few studies have examined how these factors influence temperament trajectories across infancy. We used latent growth curve modeling to examine whether mothers' and fathers' anxiety and depression, measured in two ways – as diagnostic status and symptom severity – serve as unique predictors of developmental shifts in infant temperament from 3 to 12 months. Participants included mothers (N = 234) and a subset of fathers (N = 142). Prior to or during pregnancy, both parents were assessed for lifetime diagnoses of depression and anxiety as well as current severity levels. Mothers rated their infants' temperament at 3, 6, and 12 months of age. Mothers' depression and anxiety primarily predicted initial levels of temperament at 3 months. Controlling for mothers' symptoms, fathers' depression and anxiety largely related to temperament trajectories across infancy. Lifetime diagnoses and symptom severities were associated with distinct patterns. Infant temperament was assessed using a parent-report measure. Including an observational measure would provide a more comprehensive picture of the infants' functioning. These results indicate that mothers' and fathers' mental health are uniquely associated with infant temperament development when measured using diagnostic status and/or symptom severity. Future studies should examine whether these temperament trajectories mediate intergenerational transmission of risk for depression and anxiety. • Mothers' depression and anxiety prior to birth predicted temperament at 3 months. • In fathers, these predictors related to shifts in temperament across infancy. • Lifetime diagnoses and symptom severities predicted distinct temperament profiles. • These results have implications for mental health screening and early intervention.s [ABSTRACT FROM AUTHOR]

Background: Psychiatric morbidity such as depression and anxiety are common among patients with CHD. One study indicated that 32.5%and 17.5%of patients with CHD have depression and anxiety symptoms, respectively. Most studies showed depression as an important disorder that leads to an increase in cardiovascular events, readmission to hospital, and CHD mortality. The coexistence of physical and psychiatric morbidity negatively affects the course and outcome of both the conditions resulting in increased over all burden of disease. Identification of psychiatric disorders (anxiety and depression) in CAD patients has shown to improve prognosis and quality of life of patients with CAD. Patients treated for their depression and anxiety might better adhere to risk factor modifications, prescribed medications, and rehabilitation programs. Materials and methods: Descriptive cross-sectional research study design was used to find out the anxiety and depression of patients with CAD attending Tertiary care Teaching Hospital. The nonprobability, purposive sampling technique was used to select the required sample size. Researcher identified the sample from OPD by verbally asking the patients about their age and purpose of visit to OPD. Then medical file was reviewed to confirm the information given by patient. Semistructured interview schedule for the sociodemographic variables, disease related variables, behaviour related variables, and support system was developed by researcher based on extensive literature review. Result: Table 1 shows that, out of 90 respondents, 50% were between the ages of 40-60 years. The mean age of the respondents was 55.03±15.99 years. Similarly, 66.7% were male, 96.4% were married, and 77.8% were living with their spouse. Our study shows that two-thirds (66.7%) of the respondentswere diagnosed with myocardial infraction followed by angina pectoris (20%) and ischemic heart failure (13.3%).Regarding mode of treatment, more than two-thirds (70%)of the respondents had surgery. Likewise, half of the respondents (50.0%) had other comorbid conditions. Conclusion: There was a high level of depression and anxiety in this sample of cardiac patients. The results point to characteristics of patients in particular need for mental health screening and suggest possible targets for intervention such as strengthening of social support and of physical activity. The integration of mental health services into cardiac rehabilitation in Palestine and comparable cultural settings is warranted from the time of first diagnosis and onward. [ABSTRACT FROM AUTHOR]

Background: Diagnosing a life-threatening disease like the human immunodeficiency virus (HIV) can be unbearable to the individual, which has implications for their subsequent care-seeking decision-making. However, an essential element of HIV testing is identifying infected individuals and linking them with adequate care services, thus contributing to the UNAIDS 95-95-95 targets. The attainment of these targets has been particularly challenging for lower and middle-income countries (LMIC). This study explored the psychological reactions to a positive HIV status in a hospital treatment centre to provide insight into mental health interventions' role in improving HIV screening and early antiretroviral therapy (ART) initiation to enhance the quality of life. Methods: An exploratory qualitative study was investigated among adults who were diagnosed as HIV positive. Participants were purposively recruited from an HIV Treatment Centre. Data were collected with semi-structured interviews that explored the interpretations and psychological reactions to their positive HIV status. Overall, 18 participants were interviewed to reach saturation. Data were transcribed verbatim and analysed thematically to produce findings that address the study's objective. Results: Following analysis of participants' interpretations, understanding and implications of their HIV-positive diagnosis, two major themes emerged: (1) anxiety regarding the impact of the disease on self, family and society was overwhelming. Participants were anxious because of the stigma, fear, worry, shock, and shame they faced. (2) Participants expressed hopelessness and could not see meaning or purpose in life. Suicidal ideation, suicide plans and self-harm characterised hopelessness. Conclusions: The initial reaction to the diagnosis of HIV in this LMIC context has the potential to impact linkage to care negatively and, thus, the attainment of the global 95-95-95 targets. It is, therefore, essential that mental health and psychological support services are integrated with testing services to manage the initial reactions and support individuals to improve early linkage to care and thus improve overall outcomes for the infected individual and society. [ABSTRACT FROM AUTHOR]

The relationship between suicidality, depression, anxiety, and well-being was explored in young adults (median age 20.7 years) from the State of Yucatan (Mexico), which has a suicide rate double that of other Mexican states. A cross-sectional study was carried out in 20 universities in Yucatan and 9,366 students were surveyed using validated questionnaires built into a smartphone app, applying partial least squares structural equation models. High suicide risk was assessed in 10.8% of the sample. Clinically relevant depression and anxiety levels were found in 6.6% and 10.5% of the sample, respectively, and 67.8% reported high well-being. Comparably higher levels of suicide risk, depression and anxiety, and lower well-being were found in women, who were also somewhat older than men in our study. Furthermore, path analysis in the structural equation model revealed that depression was the main predictor of suicidal behaviour as well as of higher anxiety levels and lower self-perceived well-being in the total sample and in both genders. Our findings draw attention to the association between suicidality, depression, anxiety, and well-being in Yucatan young adults and gender differences with this regard. Mental health screening via smartphone might be a useful tool to reach large populations and contribute to mental health policies, including regional suicide prevention efforts. [ABSTRACT FROM AUTHOR]

Depression during pregnancy or postpartum carries the same risks as general depression as well as additional risks specific to pregnancy, infant health and maternal well-being. The purpose of this study is to document the prevalence of depression symptoms and diagnosis during pregnancy and in the first 3 months postpartum among a cohort of women receiving prenatal care in a large health system. Secondarily, we examine variability in screening results and diagnosis by race, ethnicity, language, economic status and other maternal characteristics during pregnancy and postpartum. A retrospective study with two cohorts of patients screened for depression during pregnancy and postpartum. Out of 7807 patients with at least three prenatal care visits and a delivery in 2016, 6725 were screened for depression (87%) at least once during pregnancy or postpartum. Another 259 were excluded because of missing race data. The final sample consisted of 6523 prenatal care patients who were screened for depression; 4914 were screened for depression in pregnancy, 4619 were screened postpartum (0–3 months). There were 3010 screened during both periods who are present in both the pregnancy and postpartum cohorts. Depression screening results are from the Patient Health Questionnaire (PHQ-9) and diagnosis of depression was measured using ICD codes. For patients screened more than once during either time period, the highest score is used for analysis. Approximately, 11% of women had a positive depression screen as indicated by an elevated PHQ-9 score (>10) during pregnancy (11.3%) or postpartum (10.7%). Prevalence of depression diagnosis was similar in the two periods: 12.6% during pregnancy and 13.0% postpartum. A diagnosis of depression during pregnancy was most prevalent among women who were age 24 and younger (19.7%), single (20.5%), publicly insured (17.8%), multiracial (24.1%) or Native American (23.8%), and among women with a history of depression in the past year (58.9%). Among women with a positive depression screen, Black women were less than half as likely as White women to receive a diagnosis in adjusted models (AOR 0.40, CI: 0.23–0.71, p =.002). This difference was not present postpartum. Depression symptoms and diagnoses differ by maternal characteristics during pregnancy with some groups at substantially higher risk. Efforts to examine disparities in screening and diagnosis are needed to identify reasons for variability in prenatal depression diagnosis between Black and White women. Women who were young, single, have public insurance, and women who identify as multiracial or non-Hispanic (NH) Native American were most likely to have a positive depression screen or a diagnosis for depression. After adjustment for confounders, NH Black women with a positive depression screen were about half as likely to have a diagnosis of depression during pregnancy as NH White women. Awareness of the differing prevalence of depression risk screening results, diagnoses and potential for variation in diagnosis may identify opportunities to improve equity in the delivery of essential mental health care to all patients. [ABSTRACT FROM AUTHOR]

This document is a compilation of summaries of various articles from the International Journal of Psychology. The articles cover a range of topics related to anxiety, including the effects of COVID-19 on anxiety and stress levels in Turkey, the development of a mental health screening tool for anxiety disorders in Korea, the relationship between perfectionism and anxiety in the Philippines, the use of progressive relaxation training to inhibit pre-competition anxiety in China, the impact of dialectical behavior therapy skills training on social anxiety disorder in Turkey, and the relationship between multidimensional perfectionism and test anxiety in Romania. These articles provide valuable insights into the different factors and interventions related to anxiety in diverse cultural contexts. [Extracted from the article]

Background: Avoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen. Methods: Among 50,082 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated. Chi-square tests and t-tests compared demographics, eating disorder attitudes and behaviors, suicidal ideation, current eating disorder treatment status, and eating disorder treatment-seeking intentions between respondents with possible ARFID and other eating disorder diagnostic and risk categories. Clinical characteristics of respondents with possible ARFID were also examined. Results: 2378 (4.7%) adult respondents screened positive for ARFID. Respondents with possible ARFID tended to be younger, male, and have lower household income, and were less likely to be White and more likely to be Hispanic/Latino than most other diagnostic/risk groups. They had lower weight/shape concerns and eating disorder behaviors than most other diagnoses and higher BMI than those with AN. 35% reported suicidal ideation, 47% reported intentions to seek treatment for an eating disorder, and 2% reported currently being in treatment. The most common clinical feature of ARFID was lack of interest in eating (80%), followed by food sensory avoidance (55%) and avoidance of food due to fear of aversive consequences (31%). Conclusions: Findings from this study indicated that ARFID was prevalent among adult screen respondents and more common among individuals who were younger, male, non-White, Hispanic, and lower income relative to those with other eating disorders, at risk for an eating disorder, or at low risk. Individuals with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Further research is urgently needed to improve advances in the assessment and treatment of ARFID and improve access to care in order to prevent prolonged illness duration. Plain English summary: This study examined data from adult respondents to a publicly available online eating disorders screen adult to examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen. 4.7% of respondents screened positive for ARFID. A positive ARFID screen was more common among respondents who were younger, male, non-White, Hispanic, and lower income relative to those in other eating disorder diagnostic/risk categories. Respondents with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Lack of interest in food or eating was the most common clinical feature among those with possible ARFID. [ABSTRACT FROM AUTHOR]

Poor mental health is associated with sexual and reproductive health (SRH) risks, including human immunodeficiency virus (HIV) and pre-exposure prophylaxis discontinuation. Adolescents and young people (AYP) are vulnerable to HIV and depression. This paper describes the prevalence and severity of depression and associated factors in AYP accessing SRH services in South Africa. A cross-sectional analysis of enrollment data (January 2019 to December 2021) from a cohort of individuals receiving pre-exposure prophylaxis services at eight clinics in three provinces in South Africa was conducted. Females (n = 1,074) and males (n = 231) aged 15–24 years were included. Interviewer-administered questionnaires were conducted, and the prevalence and severity of depression assessed using the Patient Health Questionnaire-9. Multivariate analysis was used to identify factors associated with depression. Over 40% of participants had experienced any depression symptoms (43.7% of females, 38.5% of males). For males, experiencing intimate partner violence was the only predictor of depression symptoms (adjusted odds ratio (AOR) 8.81, 95% confidence intervals (CI) 1.03–75.44). For females, living with both parents (AOR 1.70, 95% CI 1.15–2.51), having transactional sex (AOR 1.63, 95% CI 1.00–2.65), experiencing any intimate partner violence (AOR 1.96, 95% CI 1.34–2.89), and using drugs (AOR 1.78, 95% CI 1.03–3.11) were all positively associated with depression symptoms. Resilience was a protective factor against depression symptoms for both sexes (males: AOR 0.96, 95% CI 0.93–0.98; females: AOR 0.96, 95% CI 0.95–0.97). There is a high burden of depression among AYP accessing SRH services in South Africa. Mental health screening should be integrated into SRH and HIV prevention programs for AYP. [ABSTRACT FROM AUTHOR]

Violence in the emergency department (ED) setting is well documented in medical literature. Weapons can be used to cause significant injury or mortality, although there is a paucity of literature on weapons and weapons screening in the ED. The purpose of this study was to assess the impact of initiating a weapons screening process on the identification and removal of weapons. Multiple aspects of a weapons screening program were evaluated at 2 and 6 months prior to and after a weapons screening protocol was initiated at an urban ED. In the Pre-Screen periods, only patients primarily seeking care for mental health were screened prior to entry. In the Post-Screen periods, all patients and visitors were screened with walk-through magnetometers or wand metal detectors, and additional screening checks were initiated. The number of individuals screened and numbers of weapons found were measured. Descriptive statistics comparing Pre- and Post-Screen periods were performed. Prior to the new screening process, 511 and 1701 patients primarily seeking care for mental health were screened, with 15 and 103 weapons confiscated at 2 and 6 months, respectively. After the screening process was initiated, 13,149 and 43,321 ED patients and visitors were screened, with 194 and 567 weapons confiscated at 2 and 6 months, respectively. Persons screened increased by 25-fold at both 2 and 6 months after implementing the screening process. Weapons confiscated increased approximately 13-fold and sixfold at the respective 2- and 6-month Pre- and Post-Screen periods, respectively. Implementation of weapons screening significantly increased the number of weapons identified and confiscated prior to entry in the ED by patients and visitors. [ABSTRACT FROM AUTHOR]

Summary: Data linking body mass index (BMI) and dental service utilization with oral and general health, quality of life, wellbeing, and mental health are lacking. Adult patients with clinically severe obesity attending a hospital‐based obesity service in Greater Western Sydney were invited to participate in a cross‐sectional survey that collected data on dental utilization and visiting patterns, dental anxiety, and oral health‐related quality of life (OHRQoL). General health data were obtained from participants' medical records. Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire, and 74 (91.3%) answered additional screening questions related to their general wellbeing and mental health. Of the participants, 50 (61.7%) reported that their last dental visit was more than 1 year ago, 43 (53.1%) visited only as needed and 22 (27.2%) participants reported favourable dental visiting patterns. Twenty‐four (29.6%) participants reported high levels of dental anxiety, and low levels of OHRQoL compared with national data. Screening questions suggested low general wellbeing and poor mental health in this patient cohort. Within this group, BMI was not significantly correlated with any of the variables of dental service utilization, dental anxiety, OHRQoL, wellbeing, or mental health (p >.05). There was a negative correlation between dental anxiety and dental utilization (p <.05). Patients with clinically severe obesity reported poor dental utilization, low OHRQoL, and high levels of dental anxiety. This study highlighted the frequency of medical complications, lack of wellbeing, and poor mental health, which were evident in this cohort and may complicate dental management. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) is increasingly common in the United States and poses a significant threat to maternal and neonatal health. Universal screening for postpartum depression is recommended by numerous organizations, including the American College of Obstetricians and Gynecologists, but is not achieved in practice. Methods: A cross‐sectional, weighted, state‐representative study of California residents who gave birth in 2016 using the Listening to Mothers in California 2018 data set. Primary exposure was type of maternity care professional providing care during pregnancy, and the primary outcome was PPD screening. The secondary exposure was self‐reported depression or anxiety during pregnancy, and the secondary outcome was attending a postpartum office visit. Bivariate analyses were conducted using Rao‐Scott chi‐square tests, and multivariate analyses were conducted using logistic regression. Results: Compared to participants cared for by obstetricians, participants cared for by midwives had 2.6 times the odds of reporting being screened for PPD after controlling for covariates (95% CI = 1.5, 4.4). Receiving care from any other practitioner type compared with an obstetrician was not associated with a different rate of postpartum depression screening. Reporting depression or anxiety during pregnancy was associated with 0.7 times the odds (95% CI = 0.5, 1.0) of returning for postpartum care after controlling for covariates. Conclusions: Being cared for by a midwife during pregnancy increases the likelihood of being screened for postpartum depression. In addition, even perfectly implemented universal screening will miss a vulnerable sector of the population that is at high risk for postpartum depression and is less likely to return for postpartum care. [ABSTRACT FROM AUTHOR]

We conducted a population-based survey in 2013 in Kampala, Uganda, to examine violence and mental health outcomes among self-settled male refugees from the Eastern Democratic Republic of Congo (DRC). Male DRC refugees aged 18+ years were sampled through respondent-driven sampling. Key interview domains included demographics, experiences of sexual and nonsexual violence, social support, PTSD, depression and suicide ideation. Data analysis was weighted to generate population-level estimates. We sampled 718 men (mean age: 33 years), most of whom had lived in North or South Kivu. Nonsexual violence, such as beatings (79.4%) and torture (63.8%), was frequent. A quarter (26.2%) had been raped; 49.9% of rape victims had been raped on multiple occasions, and 75.7% of rape victims had been gang raped. We estimated 52.8% had post-traumatic stress disorder (PTSD); 44.4% reported suicidal ideation. Numerous traumas were significantly (p < 0.05) associated with PTSD such as rape (adjusted odds ratio [aOR] = 1.82), war-related injuries (aOR = 2.90) or having been exposed to >15 traumas (compared to ≤10; aOR = 6.89). Traumata are frequent experiences in this self-settled male refugee population and are often accompanied by adverse mental health outcomes. Screening for trauma and adverse mental health outcomes and providing targeted services are paramount to improve these refugees' lives. [ABSTRACT FROM AUTHOR]

We describe challenges to measuring the type and quantity of mental health programs, practices, and resources that schools provide to students, as well as variation in these resources. We conducted interviews and surveys with school and district staff representing 55 middle and high schools in MetroWest Massachusetts with the goal of collecting data on (1) school-wide preventive services, (2) use of mental health screenings and anonymous reporting systems, (3) supports for specific student populations, (4) mental health supports and services, (5) community partnerships, and (6) staff trainings in mental health. Findings revealed wide variation in the programs, services, and resources that school staff described providing to students, as well as specific challenges in systematically collecting these data. We discuss the implications of these challenges, including barriers to documenting which resources are used by schools and studying which are most effective in connecting youth with needed mental health services. We conclude with implications for school psychologists and suggestions for researchers and policymakers seeking to better understand and document school provision of mental health resources. [ABSTRACT FROM AUTHOR]

Background: Screening lies at the heart of preventive care. However, COVID-19 dramatically disrupted routine screening efforts, resulting in excess mortality not directly attributable to COVID-19. Screening rates during COVID varied markedly by facility and clinical condition, suggesting susceptibilities in screening and referral process workflow. To better understand these susceptibilities and identify new practices to mitigate interrupted care, we propose a qualitative study comparing facilities that exhibited high, low, and highly variable performance (respectively) in screening rates before and during the pandemic. We will be guided by Weaver et al.'s multi-team systems (MTS) model of coordination, using cancer and mental health screening rates as exemplars. Method: Qualitative analysis of interviews and focus groups with primary care personnel, leadership, and patients at 10 VA medical centers. We will select sites based on rurality, COVID-19 caseload at the beginning of the pandemic, and performance on five outpatient clinical performance indicators of cancer and mental health screening. Sites will be categorized into one of five screening performance groups: high performers, low performers, improvers, plummeters, and highly variable. We will create process maps for each performance measure to create a workflow baseline and then interview primary care leadership to update the map at each site. We will clinician conduct focus groups to elicit themes regarding clinician coordination patterns (e.g., handoffs), strategies, and barriers/facilitators to screening during COVID. We will also conduct patient interviews to examine their screening experience during this period, for context. All interviews and focus groups will be audio-recorded, transcribed, and enhanced by field notes. We will analyze clinician transcripts and field notes using iterative, rapid analysis. Patient interviews will be analyzed using inductive/deductive content analysis. Discussion: Our study represents a unique opportunity to inform the multi-team systems literature by identifying specific forms of information exchange, collective problem solving, and decision-making associated with higher and improved clinical performance. Specifically, our study aims to detect the specific points in the screening and referral process most susceptible to disruption and coordination processes that, if changed, will yield the highest value. Findings apply to future pandemics or any event with the potential to disrupt care. [ABSTRACT FROM AUTHOR]

Mental health issues are a growing concern in the workplace, linked to negative outcomes including reduced productivity, increased absenteeism, and increased turnover. Employer-sponsored mental health benefits that are accessible and proactive may help address these concerns. The aim of this retrospective cohort study was to evaluate the impact of a digital mental health benefit (Spring Health) on frontline healthcare service workers' clinical and workplace outcomes. The benefit was sponsored by a national health services company from 2021–2022 and included mental health screening, care navigation, psychotherapy and/or medication management. We hypothesized program use would be associated with improvements in depression and anxiety symptoms, and increased productivity and retention. Participants were employees enrolled in the benefit program, had at least moderate anxiety or depression, at least 1 treatment appointment, and at least 2 outcome assessments. Clinical improvement measures were PHQ-9 scale (range, 0–27) for depression and GAD-7 scale (range, 0–21) for anxiety; workplace measures were employee retention and the Sheehan Disability Scale (SDS) for functional impairment. A total of 686 participants were included. Participants using the mental health benefit had a 5.60 point (95% CI, 4.40–6.79, d = 1.28) reduction in depression and a 5.48 point (95% CI, 3.88–7.08, d = 1.64) reduction in anxiety across 6 months. 69.9% (95% CI, 61.8%–78.1%) of participants reliably improved (≥5 point change) and 84.1% (95% CI, 78.2%–90.1%) achieved reliable improvement or recovery (<10 points). Participants reported 0.70 (95% CI, 0.26–1.14) fewer workdays per week impacted by mental health issues, corresponding to $3,491 (95% CI, $1305–$5677) salary savings at approximately federal median wage ($50,000). Furthermore, employees using the benefit were retained at 1.58 (95% CI, 1.4–1.76) times the rate of those who did not. Overall, this evaluation suggests that accessible, proactive, and comprehensive mental health benefits for frontline health services workers can lead to positive clinical and workplace outcomes. [ABSTRACT FROM AUTHOR]