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Background: There is limited literature available showing the mental health burden among adolescents following cyberbullying. Objective: The aim was to evaluate the association between low mood and suicidality among cyberbullied adolescents. Method: A cross-sectional analysis of the data was performed among adolescents from the National Youth Risk Behavior Surveillance System. Responses from adolescents related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to determine the association of cyberbullying with sadness/hopelessness and suicide consideration, plan, and attempts. Results: Of a total of 8274 adolescents, 14.8% of adolescents faced cyberbullying past year. There was a higher prevalence of cyberbullying in youths aged 15, 16, and 17 years (25%, 26%, 23%, respectively), which included more females than males (68% vs. 32%, p &lt, 0.0001). Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%) or African Americans (11%, 0.0001). There was an increased prevalence of cyberbullied youths, feelings of sadness/hopelessness (59.6% vs. 25.8%), higher numbers considering suicide (40.4% vs. 13.2%), suicide plan (33.2% vs. 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied (p &lt, 0.0001). On regression analysis, cyberbullied adolescents had a 155% higher chance of feeling sad and hopeless [aOR = 2.55, 95%CI = 2.39–2.72] and considered suicide [aOR = 1.52 (1.39–1.66)] and suicide plan [aOR = 1.24 (1.13–1.36)]. Conclusion: In our Study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact of cyberbullying among adolescents and guiding the policies to mitigate the consequences.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in nationwide stay-at-home orders in an effort to slow the spread severely impacting the healthcare sector. Telepsychiatry provides a platform bridging the gap through advanced technologies connecting mental health providers and patients who need their services, overcoming previous barriers of great distances, lack of transportation, and even time constraints. The most obvious benefit is increased accessibility to mental healthcare, especially in underserved and remote areas where there is no easy access for in-person care. It is important to note that benefits are not limited to patients, but also allow clinicians greater flexibility in scheduling and reduced practice overhead costs, both of which aid with physician burnout and burden. Telepsychiatry during COVID-19 provides its own unique advantages over in-person visits. The risk of exposure to healthcare workers and patients receiving care is reduced, allowing immunocompromised patients to receive much-needed psychiatric care. Without the need to meet in person, self-isolating psychiatrists can still provide care, decreasing strain on their co-workers. Although telepsychiatry is relatively new, it has already exhibited considerable success in its effectiveness at treating psychiatric conditions and widespread corollary benefits. Telepsychiatric consults may be carried out synchronously and asynchronously, each having benefits and setbacks. Different mobile application interventions have been explored, which are available for the purpose of both monitoring/assessing patients and/or providing treatment. The scope of conditions these applications address is broad, from anxiety disorders to schizophrenia to depression. As promising and beneficial telepsychiatry may seem, it is necessary to recognize that building the program can be challenging. It involves adapting to new methods in medicine. We highlighted barriers to general telepsychiatry, the most prominent being technological literacy of both physician and patient, and possible negative effects of eliminating the in-person patient-doctor interaction.

Background: Evaluation of mental health of acute ischemic stroke (AIS) patients is crucial to reduce health care burden. Objective: Aim of this study was to evaluate the prevalence and outcomes [morbidity, disability (APRDRG loss of function) and discharge disposition] of DOA amongst AIS patients. Methods: A cross-sectional study was conducted on Nationwide Inpatient Sample from 2003-2017. Adult primary hospitalizations with AIS were extracted and concurrent DOA were identified using ICD-9/10-CM codes. Weighted analysis using Chi-square test and mixed-effect multivariable survey logistic regression was performed to evaluate prevalence and role of DOA to predict the outcomes. Definitions of outcomes were mentioned in Table 1 . Results: Out of a total 5,690,773 AIS hospitalizations, 2.65%, 3.1% and 4.37% had depression, OSA, and anxiety, respectively. In AIS patients, females had higher prevalence of depression [3.43 vs 2.25%] and anxiety [5.92 vs 3.04%] and lower prevalence of OSA [2.21 vs 4.40%] in comparison to males. (p(Table 1) Conclusion: DOA is associated with poor outcomes amongst post-AIS patients. Prompt recognition by screening and timely management of DOA may mitigate the adverse outcomes.

Introduction The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches. Methodology We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student’s t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders. Results A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p

Pimavanserin was approved for treating Parkinson’s disease (PD) psychosis, based upon 21 completed studies. This review article is to understand PD psychosis and assess the efficacy and safety of pimavanserin. A literature search was carried out using the keyword “pimavanserin” and cross-referencing it with PD, psychosis, efficacy, safety and clinical trial. Participants in pimavanserin group were associated with a 5.79-point decrease in symptoms for PD psychosis (SAPS-PD) scale compared to the 2.73-point decrease seen in the placebo group (P

Background: Fenestrated endovascular repair (FEVAR) and chimney endovascular repair (ChEVAR) endovascular repair offer a less invasive alternative to open aortic repair (OAR) in managing juxtarenal, pararenal, and suprarenal abdominal aortic aneurysms (AAAs). The aim of this study is to evaluate the 30-day postoperative outcomes following endovascular and open repair of nonruptured AAA involving the renal vessels. Study Design: All patients undergoing endovascular (FEVAR and ChEVAR) and open repair of juxtarenal, pararenal, and suprarenal AAA in National Surgical Quality Improvement Program database from 2012 to 2016 were included. Continuous and categorical covariates were analyzed using medians and χ2/Fisher exact test, respectively. Multivariable logistic regression analyses were performed to evaluate primary (mortality) and secondary (renal and cardiopulmonary failure) outcomes between open versus endovascular approach. Results: A total of 1191 patients underwent AAA repair using open (72%) or endovascular (FEVAR: 14%, ChEVAR: 14%) approach. In univariate analysis, no significant difference in 30-day mortality was seen between the 3 groups (FEVAR: 2.47% vs ChEVAR: 7.32% vs OAR: 6.13%, P = .13). However, 30-day major complications including renal failure (9.36% vs 6.10% vs 1.85%, P = .003) and cardiopulmonary complications (19.77% vs 3.66% vs 4.94%, P < 001) failure were significantly higher in patients undergoing OAR versus ChEVAR versus FEVAR. After adjusting for potential confounders, OAR was associated with 2- to 5-folds increased risk of mortality (odds ratio, OR [95% confidence interval, CI]: 2.14 [1.09-4.21], P = .03), renal (OR [95% CI]: 2.87 [1.48-5.57], P = .002), and cardiopulmonary failure (OR [95% CI]: 4.63 [2.47-8.67], P < .001) compared to any endovascular repair. Conclusion: Using a large national surgical data set, our study found 2- to 5-folds higher mortality and morbidity in patients undergoing open versus endovascular repair of AAA involving the renal vessels. Endovascular repair seems to be a safer approach, especially when managing older patients with AAA.