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INTRODUCTION: This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022. METHOD: Region-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders. RESULTS: A total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work. CONCLUSION: Attention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.

Background: Illicit drug toxicity (i.e., overdose) is the leading cause of death in British Columbia (BC) for people aged 10–59. Stimulants are increasingly detected among drug toxicity deaths. As stimulant use and detection in deaths rises, it is important to understand how people who die of stimulant toxicity differ from people who die of opioid toxicity. Methods: BC Coroners Service records were retrieved for all people who died of unintentional illicit drug toxicity (accidental or undetermined) between January 1, 2015, and December 31, 2019, whose coroner investigation had concluded and who had an opioid and/or stimulant detected in post-mortem toxicology and identified by the coroner as relevant to the death (N = 3788). BC Chronic Disease Registry definitions were used to identify people with chronic disease. Multinomial regression models were used to examine the relationship between chronic disease diagnoses and drug toxicity death type. Results: Of the 3788 deaths, 11.1% (N = 422) had stimulants but not opioids deemed relevant to the cause of death (stimulant group), 26.8% (N = 1014) had opioids but not stimulants deemed relevant (opioid group), and 62.1% (N = 2352) had both opioids and stimulants deemed relevant (opioid/stimulant group). People with ischemic heart disease (1.80 (1.14–2.85)) and people with heart failure (2.29 (1.25–4.20)) had approximately twice the odds of being in the stimulant group as compared to the opioid group. Conclusions: Findings suggest that people with heart disease who use illicit stimulants face an elevated risk of drug toxicity death. Future research should explore this association and should identify opportunities for targeted interventions to reduce drug toxicity deaths among people with medical comorbidities. [ABSTRACT FROM AUTHOR]

Background: There are numerous papers focusing on diagnosing mental health disorders using unimodal and multimodal approaches. However, our literature review shows that the majority of these studies either use unimodal approaches to diagnose a variety of mental disorders or employ multimodal approaches to diagnose a single mental disorder instead. In this research we combine these approaches by first identifying and compiling an extensive list of mental health disorder markers for a wide range of mental illnesses which have been used for both unimodal and multimodal methods, which is subsequently used for determining whether the multimodal approach can outperform the unimodal approaches. Methods: For this study we used the well known and robust multimodal DAIC-WOZ dataset derived from clinical interviews. Here we focus on the modalities text and audio. First, we constructed two unimodal models to analyze text and audio data, respectively, using feature extraction, based on the extensive list of mental disorder markers that has been identified and compiled by us using related and earlier studies. For our unimodal text model, we also propose an initial pragmatic binary label creation process. Then, we employed an early fusion strategy to combine our text and audio features before model processing. Our fused feature set was then given as input to various baseline machine and deep learning algorithms, including Support Vector Machines, Logistic Regressions, Random Forests, and fully connected neural network classifiers (Dense Layers). Ultimately, the performance of our models was evaluated using accuracy, AUC-ROC score, and two F1 metrics: one for the prediction of positive cases and one for the prediction of negative cases. Results: Overall, the unimodal text models achieved an accuracy ranging from 78% to 87% and an AUC-ROC score between 85% and 93%, while the unimodal audio models attained an accuracy of 64% to 72% and AUC-ROC scores of 53% to 75%. The experimental results indicated that our multimodal models achieved comparable accuracy (ranging from 80% to 87%) and AUC-ROC scores (between 84% and 93%) to those of the unimodal text models. However, the majority of the multimodal models managed to outperform the unimodal models in F1 scores, particularly in the F1 score of the positive class (F1 of 1s), which reflects how well the models perform in identifying the presence of a marker. Conclusions: In conclusion, by refining the binary label creation process and by improving the feature engineering process of the unimodal acoustic model, we argue that the multimodal model can outperform both unimodal approaches. This study underscores the importance of multimodal integration in the field of mental health diagnostics and sets the stage for future research to explore more sophisticated fusion techniques and deeper learning models. [ABSTRACT FROM AUTHOR]

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with an unknown etiology and various clinical manifestations, course, and prognosis. Classes of medication used in the management of SLE include non-biological immunosuppressives, corticosteroids, biologic therapy, and immunoglobulins. The effect of using corticosteroids in the management of SLE still evokes debate regarding the emergence of mental health disorders. Case: A 24-year-old female patient was admitted to the hospital with an initial diagnosis of acute confusional stage, anemia, chronic disease, and systemic lupus erythematosus (SLE). Anticonvulsants, corticosteroids, and packed red blood transfusions had been given to the patient. The course of the disease during the hospitalization the next days, the patient experienced slurred speech, giggling, place and time disorientation, and visual hallucinations. The patient was consulted to a psychiatrist, got atypical antipsychotics and benzodiazepines, and then experienced improvement. Discussion: Patients with moderate SLE, in this case characterized by lupus nephritis, were given corticosteroids. Administration of corticosteroids to SLE patients will increase the risk of developing neuropsychiatric symptoms such as acute confusional state, anxiety, mood disorders, cognitive disorders, and seizures. This can occur due to increased permeability of the blood-brain barrier mediated by pro-inflammatory cytokines, resulting in the formation of autoantibodies against neural antigens, in which phospholipid proteins appear intracranially. Conclusion: Corticosteroid administration in SLE will cause neuropsychiatric symptoms such as slurred speech, giggling to herself, delirium, and visual hallucinations. Further design studies are needed to address the neuropsychiatric effects of corticosteroids in SLE. [ABSTRACT FROM AUTHOR]

Child and adolescent mental health are major public health concerns in the US. Overall, 20% of US children have a reported mental health condition, while an estimated 40% will be diagnosed with one by age 18. Despite these concerns, little is known about factors associated with access to mental health services among children and adolescents. We analyzed data from a sample of 6655 children (aged 6 to 17 years) with either anxiety and/or depression drawn from the 2020–2021 National Survey of Children's Health (NSCH). A multivariable logistic regression model was fit to investigate predisposing, enabling, and need factors associated with caregiver's (i.e., parent or other guardian) perceived access to mental health services for their children. Approximately 50.8% of caregivers perceived obtaining mental health services for their children to be somewhat difficult, very difficult, or impossible. Children meeting criteria for having a medical home had lower odds of experiencing such difficulties (adjusted [a]OR = 0.38; 95% CI: 0.30–0.49). Further, compared to children who sometimes or never had health insurance coverage for mental or behavioral health needs, children who were always insured (aOR: 0.19; 95% CI 0.14, 0.25) and those who usually had coverage (aOR: 0.38; 95% CI 0.28, 0.51) had lower odds of experiencing perceived difficulties in obtaining care. The results indicate several enabling and need predictors of perceived access to mental health services––highlighting potential structural barriers to care access. Efforts to address access challenges should adopt a multifaceted approach and be tailored to families living in poverty, those with limited health coverage, and minoritized children with less than optimal general health. [ABSTRACT FROM AUTHOR]

This study was aimed at screening for anxiety symptoms among educators in the Capricorn District of Limpopo Province, South Africa. Recent literature has identified the school environment as a risk factor for anxiety, putting teachers at a higher risk. We collected data from 381 teachers using a quantitative cross-sectional study design. The Generalized Anxiety Disorder (GAD-7) scale, along with a researcher-developed socio-demographic questionnaire, was used to determine the prevalence and associated risk factors for anxiety symptoms. Stata-14 was used to analyze the data through the use of bivariate and multivariate analysis. The sample consisted largely of black (n=318, 83.46%), female (n=270, 70.87%) teachers from 25 schools. The prevalence of anxiety was 36.85%, with a majority falling under the mild category (n=85, 22.31%). Personal factors such as gender, race, home language, whether the participant had sought professional mental health assistance in the past 6 months, and the impact of COVID-19 were significantly (p=0.05) associated with the symptoms of anxiety. Additionally, workplace factors such as school of employment and subjects taught were also significantly associated with anxiety symptoms. There is a high prevalence of anxiety symptoms among educators, which may negatively affect the students under their care. [ABSTRACT FROM AUTHOR]

Abstract Background There are numerous papers focusing on diagnosing mental health disorders using unimodal and multimodal approaches. However, our literature review shows that the majority of these studies either use unimodal approaches to diagnose a variety of mental disorders or employ multimodal approaches to diagnose a single mental disorder instead. In this research we combine these approaches by first identifying and compiling an extensive list of mental health disorder markers for a wide range of mental illnesses which have been used for both unimodal and multimodal methods, which is subsequently used for determining whether the multimodal approach can outperform the unimodal approaches. Methods For this study we used the well known and robust multimodal DAIC-WOZ dataset derived from clinical interviews. Here we focus on the modalities text and audio. First, we constructed two unimodal models to analyze text and audio data, respectively, using feature extraction, based on the extensive list of mental disorder markers that has been identified and compiled by us using related and earlier studies. For our unimodal text model, we also propose an initial pragmatic binary label creation process. Then, we employed an early fusion strategy to combine our text and audio features before model processing. Our fused feature set was then given as input to various baseline machine and deep learning algorithms, including Support Vector Machines, Logistic Regressions, Random Forests, and fully connected neural network classifiers (Dense Layers). Ultimately, the performance of our models was evaluated using accuracy, AUC-ROC score, and two F1 metrics: one for the prediction of positive cases and one for the prediction of negative cases. Results Overall, the unimodal text models achieved an accuracy ranging from 78% to 87% and an AUC-ROC score between 85% and 93%, while the unimodal audio models attained an accuracy of 64% to 72% and AUC-ROC scores of 53% to 75%. The experimental results indicated that our multimodal models achieved comparable accuracy (ranging from 80% to 87%) and AUC-ROC scores (between 84% and 93%) to those of the unimodal text models. However, the majority of the multimodal models managed to outperform the unimodal models in F1 scores, particularly in the F1 score of the positive class (F1 of 1s), which reflects how well the models perform in identifying the presence of a marker. Conclusions In conclusion, by refining the binary label creation process and by improving the feature engineering process of the unimodal acoustic model, we argue that the multimodal model can outperform both unimodal approaches. This study underscores the importance of multimodal integration in the field of mental health diagnostics and sets the stage for future research to explore more sophisticated fusion techniques and deeper learning models.

Abstract Background Comprehensive, timely, and integrated primary care services have been proposed as a response to the increased demand for mental health and substance use services especially among young people. However, little is known about the care utilization patterns of young people with mental and substance use disorders. Our aim was to characterize profiles of care use in young Finnish adults with mental or substance use disorders, and the potential factors associated with the service use profiles. Methods Primary and specialized care visits of young adults (16–29 years) diagnosed with a psychiatric or a substance use disorder (n = 7714) were retrieved from the national health care register from years 2020 and 2021. K-Means clustering was used to detect different profiles based on the utilization of care services. Multinomial logistic regression was used to analyze the factors associated with different profiles of care use. Results Five different profiles were identified: low care use (75%), and use of principally primary health care (11%), student health services (9%), psychiatric services (5%), or substance use services (1%). Female gender was associated with membership in the primary health care focused profiles (OR 2.58 and OR 1.99), and patients in the primary health care and student health services profiles were associated with a better continuity of care (OR 1.04 and OR 1.05). Substance use disorders were associated with psychiatric service use (OR: 2.51) and substance use services (OR: 58.91). Living in smaller municipalities was associated with lower service use when comparing to the largest city. Conclusions Young adults diagnosed with a psychiatric or a substance use disorder had remarkably different and heterogeneous care patterns. Most of the participants had low care utilization, indicating potential gaps in service use and care needs. Measures should be taken to ensure equal access to and availability of mental health services. The profiles that utilized the most services highlights the importance of integrated services and patient-oriented improvement of treatment.

Treatment courts have played a key role in criminal justice reform by offering an alternative to incarceration for individuals who have substance use and mental health disorders. The treatment court model requires programs to complete evaluations, as well as measure potential racial and ethnic disparities in outcomes. This study contributes to literature by using the Racial and Ethnic Disparities (RED) Program Assessment Tool to see if treatment courts (n = 151) have fidelity to the model by completing regular evaluation and to assess for racial and ethnic disparities in graduation rates. Treatment courts in this study, for the most part, were not faithful to the model by completing regular evaluation. Specifically, only 34% of the programs regularly examined graduation outcomes by race and ethnicity. Additionally, racial and ethnic disparities did exist where white participants were more likely than African American and Hispanic participants to graduate treatment court. Implications for policy advocacy, treatment court practice, and future research are discussed. [ABSTRACT FROM AUTHOR]

This paper investigated the effect of dance and exercise on the health promotion of adults with mental health disorders. As mental health is a social issue, the characteristics of physical movement through dance and exercise were reviewed to find ways to effectively approach mental health services and treatment. Based on existing papers, a systematic review was conducted using Web of Science, Google Scholar, and Scopus to comprehensively investigate and organise the correlation between physical movement and mental health, the characteristics of dance therapy, and psychotherapy of exercise. Studies have shown that dance and exercise therapy helps reduce side effects, relieve depression and anxiety from actual antipsychotics, and helps to recognise one's problems and increase the willingness to treat them. New therapy development according to the online era and limitations according to difficulty need to be addressed. [ABSTRACT FROM AUTHOR]

Background: Comprehensive, timely, and integrated primary care services have been proposed as a response to the increased demand for mental health and substance use services especially among young people. However, little is known about the care utilization patterns of young people with mental and substance use disorders. Our aim was to characterize profiles of care use in young Finnish adults with mental or substance use disorders, and the potential factors associated with the service use profiles. Methods: Primary and specialized care visits of young adults (16–29 years) diagnosed with a psychiatric or a substance use disorder (n = 7714) were retrieved from the national health care register from years 2020 and 2021. K-Means clustering was used to detect different profiles based on the utilization of care services. Multinomial logistic regression was used to analyze the factors associated with different profiles of care use. Results: Five different profiles were identified: low care use (75%), and use of principally primary health care (11%), student health services (9%), psychiatric services (5%), or substance use services (1%). Female gender was associated with membership in the primary health care focused profiles (OR 2.58 and OR 1.99), and patients in the primary health care and student health services profiles were associated with a better continuity of care (OR 1.04 and OR 1.05). Substance use disorders were associated with psychiatric service use (OR: 2.51) and substance use services (OR: 58.91). Living in smaller municipalities was associated with lower service use when comparing to the largest city. Conclusions: Young adults diagnosed with a psychiatric or a substance use disorder had remarkably different and heterogeneous care patterns. Most of the participants had low care utilization, indicating potential gaps in service use and care needs. Measures should be taken to ensure equal access to and availability of mental health services. The profiles that utilized the most services highlights the importance of integrated services and patient-oriented improvement of treatment. [ABSTRACT FROM AUTHOR]

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

Anxiety disorders are psychiatric conditions characterized by prolonged and generalized anxiety experienced by individuals in response to various events or situations. At present, anxiety disorders are regarded as the most widespread psychiatric disorders globally. Medication and different types of psychotherapies are employed as the primary therapeutic modalities in clinical practice for the treatment of anxiety disorders. However, combining these two approaches is known to yield more significant benefits than medication alone. Nevertheless, there is a lack of resources and a limited availability of psychotherapy options in underdeveloped areas. Psychotherapy methods encompass relaxation techniques, controlled breathing exercises, visualization exercises, controlled exposure exercises, and cognitive interventions such as challenging negative thoughts. These methods are vital in the treatment of anxiety disorders, but executing them proficiently can be demanding. Moreover, individuals with distinct anxiety disorders are prescribed medications that may cause withdrawal symptoms in some instances. Additionally, there is inadequate availability of face-to-face psychotherapy and a restricted capacity to predict and monitor the health, behavioral, and environmental aspects of individuals with anxiety disorders during the initial phases. In recent years, there has been notable progress in developing and utilizing artificial intelligence (AI) based applications and environments to improve the precision and sensitivity of diagnosing and treating various categories of anxiety disorders. As a result, this study aims to establish the efficacy of AI-enabled environments in addressing the existing challenges in managing anxiety disorders, reducing reliance on medication, and investigating the potential advantages, issues, and opportunities of integrating AI-assisted healthcare for anxiety disorders and enabling personalized therapy.

Amir Kabunga,1 Halimah Namata,2 Eustes Kigongo,3 Marvin Musinguzi,4 Raymond Tumwesigye,5 Anna Grace Auma,6 Jannat Nabaziwa,4 Enos Mwirotsi Shikanga,7,8 Ponsiano Okalo,1 Viola Nalwoga,1 Samson Udho9 1Department of Psychiatry, Lira University, Lira City, Uganda; 2Department of Mental Health, Makerere University, Lira City, Uganda; 3Department of Environmental Health and Disease Control, Lira University, Lira City, Uganda; 4Department of Community Health, Lira University, Lira City, Uganda; 5Department of Critical Nursing, Mbarara University of Science and Technology, Mbarara City, Uganda; 6Department of Nursing, Lira University, Lira City, Uganda; 7Department of Education Psychology, Moi University, Eldoret City, Kenya; 8Department of Psychiatry, Gulu University, Gulu City, Uganda; 9Department of Midwifery, Lira University, Lira City, UgandaCorrespondence: Amir Kabunga, Department of Psychiatry, Lira University, P.O. Box, 1035, Lira City, Uganda, Tel +256777929576, Email amirkabs2017@gmail.comBackground: Integrating mental health services into HIV clinics is recognized as a promising strategy. However, the literature reveals gaps, particularly in the unique context of Northern Uganda, where factors such as historical conflict, stigma, and limited resources pose potential barriers.Material and Methods: This qualitative study, conducted between October and November 2023, employed a phenomenological design. The study involved primary healthcare facilities across diverse urban and rural settings, focusing on healthcare providers, village health teams, and service users. A purposive sampling approach ensured diverse demographics and perspectives. In-depth interviews and focus group discussions were conducted, with healthcare providers and service users participating individually, and village health teams engaged in group discussions. Thematic analysis was employed during data analysis.Results: Findings revealed a predominance of females among healthcare providers (18 of 30) and service users (16 of 25), as well as in VHTs. Average ages were 33.4 (healthcare providers), 38.5 (service users), and 35.1 (VHTs). Most healthcare providers (15) held diplomas, while 12 service users and 4 VHTs had certificates. The majority of healthcare providers (n=20) and 4 VHTs had 6– 10 years of experience. Thematic analysis highlighted three key themes: benefits of integrated mental health services, implementation challenges, and the role of community engagement and cultural sensitivity.Conclusion: This study contributes valuable insights into the integration of mental health services into HIV clinics in Northern Uganda. The perceived benefits, challenges, and importance of cultural sensitivity and community engagement should guide future interventions, fostering a holistic approach that enhances the overall well-being of individuals living with HIV/AIDS in the region. Policymakers can use this information to advocate for resource allocation, training programs, and policy changes that support the integration of mental health services into HIV clinics in a way that addresses the identified challenges.Keywords: HIV clinic, integration, mental health disorder, Uganda

Mental health disorder is highly prevalent worldwide, and factors attributable to its development have not been fully understood. We aimed to explore the association of adverse childhood experiences (ACEs) with mental health disorder using data from the China Health and Retirement Longitudinal Study (CHARLS). CHARLS is an ongoing nationwide survey enrolling 17,708 residents aged ≥45 years in China. Total 20 ACE indicators were extracted. Unmeasured confounding and potential mediation were assessed, and effect-size estimates are expressed as odds ratio (OR) with 95 % confidence interval (CI). Of 10,961 assessable participants with complete information, 3652 were reported to have mental health disorder. The risk for mental health disorder was increased by 20.7 % for participants with one to less than four events of ACEs (OR: 1.207, 95 % CI: 0.711 to 2.049), and this number reached 102.7 % for participants with four or more events (OR: 2.027, 95 % CI: 1.196 to 3.436) relative to those with no ACE. In subgroup analyses, between-group risk estimates differed significantly for residence, marital status, personal asset, life satisfaction, and living standard. The E -value of 2.35 for ACEs of 4 or more events indicated the low likelihood of unmeasured confounders. In mediation analyses, the proportion eliminated was 5.1 % for continuous ACEs and 6.1 % for categorical ACEs (both P < 0.001). Our findings indicate that ACEs, especially with four or more events, can predict the significant risk of mental health disorder, underscoring the necessity of screening mental illness based on ACEs to reduce the resultant morbidity and mortality in China. • Mental health disorder is prevalent and represents a global public health challenge. • Adverse childhood experiences (ACEs) are implicated in mental illness development. • Mental illness screening based on ACEs should be prioritized in China. [ABSTRACT FROM AUTHOR]

In an effort to understand the correlates of stalking, 62 male federal prisoners with one or more convictions for stalking (n = 54) or a subsequent arrest for stalking (n = 8) were extracted from a larger group of 3,039 federal prison inmates on whom file data had been collected. Comparisons between this group of 62 inmates and the remaining 2,977 inmates with no history of stalking revealed more extensive histories of violence, mental health difficulties, and alcohol abuse in the former. Constructing a control group of 62 non-stalking inmates from the larger sample of 2,977 non-stalking participants by matching stalking and non-stalking inmates on age and race, it was discovered that differences in past violence toward significant others persisted while differences in mental health difficulties and alcohol abuse did not. Findings such as these suggest that when more stringent criteria are used to construct control and comparison groups for research on stalking, differences between stalking and non-stalking participants on all but past history of violence toward intimates tend to disappear. [ABSTRACT FROM AUTHOR]

Informed by social support theory, this study examined gender differences of revocation and relapse of 526 probationers diagnosed with a substance use disorder, mental health disorder, or co-occurring disorder who were court-ordered for treatment. Within 18 months of starting probation, 51% of men and 56% of women were revoked. Although not statistically significant, the relapse rate was 34% for women and 26% for men. Significant predictors of revocation were similar across gender with a lack of family support being the strongest predictor for both groups, though notably stronger for women. Family support was a significant predictor of relapse for women but not for men. Inpatient treatment of at least 180 days had the greatest effect in reducing relapse and revocation for women. Treatment dosage of at least 90 days had modest effects in reducing men's revocation, but the treatment effect was less pronounced for men's relapse rates. [ABSTRACT FROM AUTHOR]

Mental health issues are detrimental to quality of life and frequently increase the dangers of mental disease like suicidal thoughts, depression, and many are frequently misdiagnosed and remain untreated. Accurate diagnosis of indicators of mental health disorders is especially crucial because they may be life-threatening when left untreated. Therefore, it is essential to have a thorough understanding of the sources to recognize a person's mental illness. Social media is the major source of identifying individual mental diseases, and hence their needs a sophisticated analysis from several angles to prevent death. On the other hand, researchers are examining whether computer methods could track the communication on social networks, which might help in the early identification of mental health issues. This paper creates a new system for analyzing mental health disorders via social media data that avoids the problem from becoming serious. Preprocessing, feature extraction, and classification are the three steps of this approach. First, stemming and stop word removal will be processed as the preprocessing step of input text. From the preprocessed text, Improved Semantic Similarity features, content features, BoVW, features like n-grams, LIWC features, and are extracted. The ensemble classifier, which includes the classifiers from the Bidirectional Gated Recurrent Unit (Bi-GRU), Deep Maxout, and Improved Convolution Neural Network (ICNN), performs a categorization using the extracted characteristics. Also, to improve the efficiency of classification, a training model is introduced in the ICNN termed as self-adaptive Shuffled shepherd optimization method (SASSOA) that tunes the optimal weights. Finally, the efficacy of the projected method is verified to the convolutional procedures. [ABSTRACT FROM AUTHOR]

This article discusses the potential roles of gangliosides in chemical-induced neurodegenerative diseases and mental health disorders. It emphasizes the importance of environmental factors, particularly toxicants like pesticides, in the development of these illnesses. The article also mentions the use of toxic chemicals as chemical warfare agents and their potential risks to human health. It suggests that gangliosides may play a role in protecting and promoting regeneration of the central nervous system in these diseases and disorders. The article concludes by highlighting the importance of understanding the mechanisms by which chemical agents affect the nervous system and the potential therapeutic strategies involving gangliosides. Additionally, the document provides a list of references for further research on the role of gangliosides in neurological conditions. One of the articles mentioned explores the effects of sarin, a nerve agent, on individuals in Japan, providing insights into the immediate toxicity and long-term effects of sarin exposure. [Extracted from the article]

IntroductionThis study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022.MethodRegion-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders.ResultsA total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work.ConclusionAttention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.

Youth at-risk for HIV are also at-risk for mental health disorders and psychiatric hospitalization. Understanding the association between engagement in HIV prevention, concurrent risk behaviors, and psychiatric hospitalization may lead to improvements in integrated prevention and mental health treatment efforts. Youth at-risk for HIV, aged 14-24 years old, predominantly Black/African American and Latinx (75%) were recruited through youth-serving clinics and community sites in Los Angeles (n = 839) and New Orleans (n = 647). We compared youth with and without histories of psychiatric hospitalization on engagement in HIV prevention, concurrent risk behaviors, and demographic characteristics. We examined predictors of hospitalization using multiple imputations for missing data. Hospitalized youth (30%) were more involved in HIV programs, but were less likely to use PrEP/PEP or condoms than non-hospitalized youth. The odds of hospitalization were higher for transgender/gender nonconforming youth relative to cisgender youth; the OR was increased after adjustment for concurrent risk behaviors. Hospitalization was associated with homelessness, trauma, incarceration, substance use, and involvement in substance abuse treatment programs. There is a continuing need to integrate the diagnosis and treatment of mental health disorders into HIV prevention programs to better address multiple challenges faced by vulnerable youth.

Background: Identification of mental health disorders during childhood is crucial for healthy 'adult roles' in the society, so this study aimed to estimate the magnitude of 'any mental health disorder' and to find out its correlates among children attending the pediatric out-patient department (OPD) of a medical college in West Bengal and to estimate parental stress among their parents. Materials and Methods: It was a descriptive cross-sectional study done in the pediatric OPD of Burdwan Medical College, West Bengal, during July--December, 2021. The calculated size of 288 children aged between 4 and 12 years and attending with either of their parents was selected through systematic random sampling. One of their parents (preferably mother) was interviewed using a schedule, containing a pre-validated pediatric symptom checklist and parental stress scale. Ethical clearance was obtained from the Institutional Ethics Committee. Data were analyzed using SPSS-v23. Results: The median age of the children was 7 years (5--8 y.). The majority of them were male (57.6%), lived in urban areas (59.0%), and lived in joint families (57.6%). One-fifth (20.5%) of the children were found to have any mental health disorder (AMHD). Living in an urban area (aOR = 2.5, 95% CI: 1.1--5.7), belonging to a nuclear family (aOR = 3.6, 95% CI: 1.7--8.1), and belonging to a family with social problems (aOR = 7.8, 95% CI: 2.3--27.2) were significant correlates of AMHD. Parental stress [median: 60 (55--63)] was found significantly higher (P < 0.001) among parents of children with AMHD as compared to the parents of others. Conclusion: The magnitude of AMHD was high in this study, indicating toward the necessity of implementing opportunistic screening and appropriate public health action. [ABSTRACT FROM AUTHOR]

Individuals with a psychiatric diagnosis and those with a history of trauma are at high risk for depression and posttraumatic stress symptoms (PTSS) following exposure to new traumatic events. Nevertheless, research is scarce on how having both a psychiatric diagnosis and a trauma history affect reactions to new traumatic events, and how different trauma types may affect individuals with a psychiatric diagnosis. We thus examined whether different stressful contexts (War and COVID‐19) affected individuals with and without a psychiatric diagnosis differentially and whether results might be explained by prior trauma exposure. In the same cohort, we assessed depression and PTSS during wartime (2014), routine time (2016), and during the COVID‐19 pandemic (2020) in a sample with (n = 89) and without (n = 104) a self‐reported psychiatric diagnosis. This cohort was recruited during the 2014 Israel‐Gaza War using social media, snowballing and outreach to mental health rehabilitation centres. We used a linear mixed modelling approach on data from the entire sample, as well as on the two study groups separately. We found that trauma history predicted PTSS and depression whereas a history of psychiatric diagnosis did not. Regarding trauma types, we found that individuals in the psychiatric diagnosis group relative to themselves had more symptoms during COVID‐19 compared to war and routine time, while those without diagnosis had more PTSS and depression symptoms during wartime compared to routine time and COVID‐19. In conclusion, a traumatic past may have an important influence on reactions to different types of traumatic events. Distinct traumatic events may affect individuals with or without a psychiatric diagnosis differentially. [ABSTRACT FROM AUTHOR]

Background: Rates of suicide have increased by over 35% since 1999. Despite concerted efforts, our ability to predict, explain, or treat suicide risk has not significantly improved over the past 50 years. Objective: The aim of this study was to use large language models to understand natural language use during public web-based discussions (on Reddit) around topics related to suicidality. Methods: We used large language model--based sentence embedding to extract the latent linguistic dimensions of user postings derived from several mental health--related subreddits, with a focus on suicidality. We then applied dimensionality reduction to these sentence embeddings, allowing them to be summarized and visualized in a lower-dimensional Euclidean space for further downstream analyses. We analyzed 2.9 million posts extracted from 30 subreddits, including r/SuicideWatch, between October 1 and December 31, 2022, and the same period in 2010. Results: Our results showed that, in line with existing theories of suicide, posters in the suicidality community (r/Suicide- Watch) predominantly wrote about feelings of disconnection, burdensomeness, hopeless, desperation, resignation, and trauma. Further, we identified distinct latent linguistic dimensions (well-being, seeking support, and severity of distress) among all mental health subreddits, and many of the resulting subreddit clusters were in line with a statistically driven diagnostic classification system--namely, the Hierarchical Taxonomy of Psychopathology (HiTOP)--by mapping onto the proposed superspectra. Conclusions: Overall, our findings provide data-driven support for several language-based theories of suicide, as well as dimensional classification systems for mental health disorders. Ultimately, this novel combination of natural language processing techniques can assist researchers in gaining deeper insights about emotions and experiences shared on the web and may aid in the validation and refutation of different mental health theories. [ABSTRACT FROM AUTHOR]

Abstract Background and aim Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. Methods This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. Results GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. Conclusion We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context.

Abstract Women are at greater risk of common mental disorders. The intersectionality concept provides a framework to examine the effects of multiple social disadvantages on women’s mental health. We conducted a systematic review to collect and analyse information to identify the quantitative methodologies and study designs used in intersectional research to examine women’s mental health and multiple social disadvantages. Included studies used accepted statistical methods to explore the intersectional effects of gender and one or more types of social disadvantage from the PROGRESS-Plus inequity framework: a place of residence, race/ethnicity, occupation, gender/ sex, religion, education, socioeconomic status, social capital (O’Neill et al. J Clin Epidemiol 67:56–64, 2014). The scope of this systematic review was limited to studies that analysed common mental disorders in women and men comparatively. Studies focusing on only one gender were excluded, ensuring a comprehensive comparative analysis of the intersection of social disadvantages in mental health. Twelve papers were included in the narrative synthesis (Table 1). Eight of the included papers (67%) reported an intersectional effect of gender and one or more additional types of social disadvantage. The multiplicative effect of gender and socioeconomic status on the risk of common mental disorders was the most commonly reported interaction. This systematic review shows that multiplicative and simultaneous interactions of multiple social disadvantage increase the risk of common mental disorders experienced by women. Moreover, it underlines the potential for quantitative research methods to complement qualitative intersectionality research on gender and mental health. The findings of this systematic review highlight the importance of multiple social disadvantage in understanding the increased risk of mental health experienced by women.

The paper examines the potential of artificial intelligence (AI) in parsing text and conducting sentiment analysis to identify early markers of mental health and neurodegenerative disorders. Through the analysis of textual data, we investigate whether AI can provide a noninvasive, continuous, and objective complement to traditional diagnostic practices.

AimsTo investigate whether reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders.Design, setting and participantsIn a randomized controlled trial, adults with OUD were randomized to 24 weeks of either BUP or MET treatment and were followed up in 3-yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments.MeasurementsThe outcome measure was the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: life-time mood disorder (n = 302), life-time mental disorder other than mood disorder (n = 114) and no mental disorder (n = 181). Medication treatment (BUP, MET, no treatment) during the follow-up period was a time-varying predictor.FindingsBased on zero-inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP [odds ratio (OR) = 0.12, 95% confidence interval (CI) = 0.07-0.21 for any use; risk ratio (RR) = 0.77, 95% CI =0.66-0.89 for days of use] and by MET [OR = 0.33, 95% CI = 0.25-0.45 for any use; RR = 0.78, 95% CI = 0.72-0.84 for days of use]. Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR = 0.52, 95% CI = 0.36-0.74) and for participants without mental disorder (OR = 0.37, 95% CI = 0.21-0.66) and fewer number of days using opioids (RR = 0.37, 95% CI = 0.25-0.56) among participants with other mental disorders.ConclusionsAmong adults with comorbid opioid use disorder and mental disorders, treatment with buprenorphine-naloxone produced greater reductions in opioid use than treatment with methadone.

Introduction: Mental disorder is a behavioral pattern which causes either suffering or poor ability to function in ordinary life. According to WHO health report 2022, 970 million people suffer from mental illness globally. 80% people with mental illness live in low and middle-income countries, which is a matter of concern for India being the most populated country in the world. This study aims to assess the attitude and perception of people towards mental illness and to identify the presence of stigma towards mental illness in the community. Methodology: This cross-sectional study was conducted among 320 individuals aged above 18 years from Jeppinamogaru, Boloor, Shiv Nagar and Neermarga of Mangalore. Data was collected using a pretested semi-structured questionnaire of the CAMI scale rates a total of 40 items on a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree) and analyzed using SPSS version 25. Results were expressed as proportions using appropriate tables and graphs. P< 0.05 was considered as statistically significant. Results: Out of 320 individuals assessed, 73.1% were females, with 50% aged over 45 years. The lower middle class constituted 35.3%, while only 0.6% belonged to the lower class. Awareness of mental illnesses was low, with only 42 individuals (13%) are knowledgeable. Most relied on behavior to identify mental illness, and 54.1% favored hospital treatment. 31.6% believed mental illness was genetically inherited as it is running through families. Medium stigma was prevalent across all domains of the CAMI scale, with the least stigma observed among the upper class. Conclusions: The study revealed low to medium level of stigma toward mental illness among lower and upper middle-class SEC individuals, alongside insufficient knowledge about mental health issues. Addressing these gaps, necessitates community awareness campaigns, enhanced education in schools, and increased accessibility to community-based mental health services and health camps.

Abstract Long‐term health conditions, whether mental or physical, often co‐occur in adolescents. For instance, adolescents with chronic pain may experience co‐occurring primary psychological disorders. In this scoping review, we determine the influence of co‐occurring chronic pain and primary psychological disorders on adolescents' functioning. A systematic search of six databases was conducted to identify articles if they were: (1) peer‐reviewed; (2) reported original findings; (3) included participants aged 11–19 years, who experienced chronic pain (i.e., pain lasting 3 months or more) and had a co‐occurring diagnosis of a primary psychological disorder; and (4) assessed functioning. Searches returned 9864 articles after the removal of duplicates. A two‐phase abstract and full‐text screening process identified two eligible articles which compared emotional functioning (n = 1) and social functioning (n = 2) between groups of adolescents with co‐occurring chronic pain and primary psychological disorders with adolescents only reporting chronic pain. Overall findings revealed no differences in social functioning, but adolescents with co‐occurring chronic pain and a primary psychological disorder (depression and anxiety) reported worse emotional functioning compared with adolescents with chronic pain alone. This review confirms the limited research on the co‐occurrence of primary psychological disorders and chronic pain in adolescents by only identifying two eligible articles exploring the co‐occurrence of chronic pain with depression, anxiety, and/or attentional disorders.

Abstract Background Law enforcement frequently responds to substance abuse and mental health crises. Crisis stabilization units (CSUs) operate as a public-receiving facility to provide short-term stabilization services for individuals experiencing these crises and offer law enforcement an important alternative to arrest. However, there is limited understanding about how and when law enforcement decides to use CSUs. There is also the challenge of retaining individuals in treatment after CSU stabilization to prevent future crises and persistent engagement with police. This study will respond to these gaps by exploring CSU procedures and examining the feasibility and acceptability of a technology-assisted mobile aftercare intervention designed for individuals brought to a CSU by law enforcement. Methods This study will consist of three aims. Aim 1 will include qualitative interviews with law enforcement and CSU-affiliated mental health staff (n=80) regarding CSU utilization and collaboration logistics between the groups. Findings from Aim 1 will be synthesized for the development of an implementation guide of our intervention, mobile, and technology-assisted aftercare, designed for individuals brought to a CSU by law enforcement, during Aim 2. During Aim 2, intervention services will be pilot-tested for 6 months through a small sample (n=24), randomized control trial (RCT). Control participants will receive standard services available for individuals discharging from a CSU. Treatment participants will receive the mobile aftercare intervention. Qualitative and quantitative data will be collected at 2 weeks, 3 months, and 6 months post-recruitment for all study participants. Aims 1 and 2 will inform the design of a multi-site RCT to compare CSUs with and without mobile and technology-assisted aftercare (Aim 3). Discussion The study will offer decision making and procedural insight into law enforcement use of CSUs as an alternative to jail and provide opportunities to inform that process. This research will provide outcome trends for those who go through standard CSU services compared to those who receive mobile and technology-assisted aftercare services. The current study will inform a larger RCT efficacy study of CSUs with and without technology-assisted aftercare services. Trial registration This study was registered on ClinicalTrials.gov (reference #NCT04899934) on May 25, 2021.

The current study evaluated the Kiswahili version of General Health Questionnaire (GHQ-12) in a Kenyan context comprising of women exposed to gender-based violence. Participants were randomly drawn from community sampling using household screening methods in peri-urban areas in Nairobi. A total of 1,394 participants with varying levels of literacy (years of education: mean [M] = 9.42; standard deviation [SD] = 3.73) and aged between 18 and 89 years were recruited for the study. The observed factor structure of the GHQ-12 was evaluated using six most tested models querying the dimensionality of the instrument insofar as the impacts of positive and negative wording effects in driving multidimensionality. Results from the confirmatory factor analysis supported a bifactor model, consisting of a general distress factor and two separate factors representing common variance due to the positive and negative wording of items. Overall, the findings support the use of the Kiswahili version of the GHQ-12 as a unidimensional construct with method-specific variance owing to wording effects. Importantly, GHQ-12 responses from a sample of Kenyan women with relatively low levels of literacy are congruent with the factor structure observed in other cross-cultural settings in low- and-middle-income countries.

Women are at greater risk of common mental disorders. The intersectionality concept provides a framework to examine the effects of multiple social disadvantages on women's mental health. We conducted a systematic review to collect and analyse information to identify the quantitative methodologies and study designs used in intersectional research to examine women's mental health and multiple social disadvantages. Included studies used accepted statistical methods to explore the intersectional effects of gender and one or more types of social disadvantage from the PROGRESS-Plus inequity framework: a place of residence, race/ethnicity, occupation, gender/ sex, religion, education, socioeconomic status, social capital (O'Neill et al. J Clin Epidemiol 67:56–64, 2014). The scope of this systematic review was limited to studies that analysed common mental disorders in women and men comparatively. Studies focusing on only one gender were excluded, ensuring a comprehensive comparative analysis of the intersection of social disadvantages in mental health. Twelve papers were included in the narrative synthesis (Table 1). Eight of the included papers (67%) reported an intersectional effect of gender and one or more additional types of social disadvantage. The multiplicative effect of gender and socioeconomic status on the risk of common mental disorders was the most commonly reported interaction. This systematic review shows that multiplicative and simultaneous interactions of multiple social disadvantage increase the risk of common mental disorders experienced by women. Moreover, it underlines the potential for quantitative research methods to complement qualitative intersectionality research on gender and mental health. The findings of this systematic review highlight the importance of multiple social disadvantage in understanding the increased risk of mental health experienced by women. [ABSTRACT FROM AUTHOR]

Background and aim: Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. Methods: This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. Results: GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. Conclusion: We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context. [ABSTRACT FROM AUTHOR]

Background: Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. Objectives: To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. Method: A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. Results: The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. Conclusion: The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm. [ABSTRACT FROM AUTHOR]

Abstract Initiating drug use in adolescence is associated with greater risk of drug misuse and dependence in adulthood and co-occurring mental health disorders. Initiating drug use in adulthood has been linked to higher-risk drug use networks and primary use of “harder drugs”. The aim of our research is to examine racial/ethnic differences in age at drug use initiation and its relationship with adult outcomes. Based on data from the 2019 National Survey on Drug Use and Health (NSDUH), we used survey-weighted Poisson regression models with robust variance to identify associations between racial characteristics, age at drug use initiation, and three adult outcomes – past year polydrug use, substance use, and mental illness – adjusting for individual-level characteristics. Among 25,986 respondents who ever used drugs and reported their drug use initiation age, Asian-Americans reported the oldest drug use initiation age (19.5) on average, while Native Americans reported the youngest initiation age (16.6). While there were no significant differences in type of drug used during onset by race or ethnicity, generally, individuals start to use inhalants at the earliest age (17.4), while the misuse of sedatives is initiated at the oldest age (46.4). Initiation during late adolescence was associated with greater likelihood of a substance use disorder diagnosis, mental health diagnoses, and polydrug use in adulthood. Drug use prevention interventions should be tailored and accessible during adolescence to delay onset. Interventions that are culturally sensitive, screen for vulnerability to drug use, and offer age-appropriate services should be prioritized. [ABSTRACT FROM AUTHOR]

Introduction: According to the literature, early initiation to cannabis use and a dependent pattern of use are important risk factors for the development of mental health disorders. However, there are few cohort studies which look at the development of mental health disorders associated with cannabis use among young people with cannabis use disorder (CUD). The aim of the study was to determine the cumulative incidence of mental health disorders and the risk of developing mental health disorders among minors who commenced treatment for CUD in Catalonia during 2015–2019. Methods: This was a retrospective fixed cohort study, matched for confounding variables, based on data from the Catalan Health Surveillance System. The exposed cohort comprised young people who entered treatment for CUD during 2015–2019 (n = 948) and who were minors on the date of commencing treatment. Matching was done with a paired cohort (n = 4,737), according to confounding variables. Individuals with a diagnosis of a mental health disorder prior to the study period were excluded. The cumulative incidence was calculated for mental health disorders for the exposed and the paired cohorts and stratified by type of mental disorder. Incidence rate ratios were estimated using the conditional Poisson model with robust variance, stratified by sex. Results: The cumulative incidence for development of a mental health disorder was 19.6% in the exposed cohort and 3.1% in the paired cohort; with higher incidence among females (females 32.7%; males 15.8%). The exposed cohort had an 8.7 times increased risk of developing a mental health disorder than the paired cohort. The most frequent diagnoses were reaction to severe stress, adjustment disorder, and personality disorders. Conclusion: This study confirmed that the exposed cohort was at increased risk of developing mental health disorders compared to the paired cohort. To date, few studies have analyzed the association between cannabis use and the development of mental health disorders, considering cannabis dependence. Further studies should be undertaken considering CUD. In addition, more studies are needed to understand the factors that determine the development of CUD. Further research in these areas would contribute to the design of prevention strategies aimed at those young individuals with a higher risk of developing cannabis dependence and suffering its consequences. [ABSTRACT FROM AUTHOR]

BackgroundPrior studies have demonstrated that depression is an independent risk factor for developing a prosthetic joint infection (PJI) after total joint arthroplasty (TJA). To our knowledge, there is no literature examining whether PJI or aseptic failure increases the risk of developing a new mental health diagnosis.MethodsPearlDiver Patient Database (Colorado Springs, CO) was used to identify 80,826 patients who underwent TJA without a pre-existing diagnosis of depression, anxiety, a stress and/or adjustment disorder, and/or current use of a selective serotonin reuptake inhibitor within the year prior to surgery. The odds of developing a new mental health issue or being prescribed a selective serotonin reuptake inhibitor within 1 year of an uncomplicated TJA was compared to those who developed PJI or mechanical failure within 90 days after TJA as well as to those who subsequently underwent revision surgery within 30 days of either complication using Fisher's exact test and Baptista-Pike.ResultsA total of 6474 (8%) patients were diagnosed with a new mental health issue after TJA. PJI or mechanical failure led to significantly higher odds of new diagnoses with an odds ratio of 1.67 (95% confidence interval = 1.26, 2.22) and 1.57 (1.24, 2.00), respectively. Undergoing revision surgery for PJI or mechanical failure increased the odds of developing a new mental health diagnosis to 2.10 (1.29, 3.42) and 2.24 (1.36, 3.72), respectively. There was no significant difference comparing those who developed PJI vs those who sustained mechanical complications.ConclusionPatients who sustain complications after TJA are at increased odds of receiving a new mental health diagnosis, an effect further amplified if revision surgery is required.

Little is known about e-cigarette use among persons in substance use disorder (SUD) treatment, or their use of e-cigarettes for smoking cessation. Prevalence of e-cigarette use and correlates of e-cigarette use for smoking cessation were examined among clients in SUD treatment. Participants (n = 332) were current cigarette smokers recruited from 20 residential SUD programs in California. We used multivariable logistic regression to identify correlates of using e-cigarettes for quitting smoking. Almost half (45.2%) of the sample had ever used e-cigarettes for smoking cessation, and 34% had used e-cigarettes in the past 30 days. Smokers who had used e-cigarettes for smoking cessation, compared to those who had not, were younger (adjusted odds ratio [AOR] = 0.94, 95% confidence interval [CI] = 0.91, 0.96), had more than a high school education (AOR = 1.69, 95% CI = 1.07, 2.68), sought treatment for both SUD and mental health disorder (AOR = 2.62, 95% CI = 1.38, 5.00), wanted help quitting smoking (AOR = 1.90, 95% CI = 1.03, 3.50) and perceived e-cigarettes as equally harmful (AOR = 3.03, 95% CI = 1.10, 8.33) or less harmful than tobacco cigarettes (AOR = 2.82, 95% CI = 1.02, 7.77). Black/African American and Hispanic/Latino participants were less likely to use e-cigarettes for smoking cessation than participants who identify as White. E-cigarettes were favorably perceived by clients in residential SUD treatment as a quit smoking aid. Treatment programs should consider how to advise clients with respect to the use of e-cigarettes for smoking cessation.

Youth at-risk for HIV are also at-risk for mental health disorders and psychiatric hospitalization. Understanding the association between engagement in HIV prevention, concurrent risk behaviors, and psychiatric hospitalization may lead to improvements in integrated prevention and mental health treatment efforts. Youth at-risk for HIV, aged 14-24 years old, predominantly Black/African American and Latinx (75%) were recruited through youth-serving clinics and community sites in Los Angeles (n = 839) and New Orleans (n = 647). We compared youth with and without histories of psychiatric hospitalization on engagement in HIV prevention, concurrent risk behaviors, and demographic characteristics. We examined predictors of hospitalization using multiple imputations for missing data. Hospitalized youth (30%) were more involved in HIV programs, but were less likely to use PrEP/PEP or condoms than non-hospitalized youth. The odds of hospitalization were higher for transgender/gender nonconforming youth relative to cisgender youth; the OR was increased after adjustment for concurrent risk behaviors. Hospitalization was associated with homelessness, trauma, incarceration, substance use, and involvement in substance abuse treatment programs. There is a continuing need to integrate the diagnosis and treatment of mental health disorders into HIV prevention programs to better address multiple challenges faced by vulnerable youth.

BackgroundSevere self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited.ObjectivesTo investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors.MethodA cross sectional study (period 2019–2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report.ResultsThe target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset

Long‐term health conditions, whether mental or physical, often co‐occur in adolescents. For instance, adolescents with chronic pain may experience co‐occurring primary psychological disorders. In this scoping review, we determine the influence of co‐occurring chronic pain and primary psychological disorders on adolescents' functioning. A systematic search of six databases was conducted to identify articles if they were: (1) peer‐reviewed; (2) reported original findings; (3) included participants aged 11–19 years, who experienced chronic pain (i.e., pain lasting 3 months or more) and had a co‐occurring diagnosis of a primary psychological disorder; and (4) assessed functioning. Searches returned 9864 articles after the removal of duplicates. A two‐phase abstract and full‐text screening process identified two eligible articles which compared emotional functioning (n = 1) and social functioning (n = 2) between groups of adolescents with co‐occurring chronic pain and primary psychological disorders with adolescents only reporting chronic pain. Overall findings revealed no differences in social functioning, but adolescents with co‐occurring chronic pain and a primary psychological disorder (depression and anxiety) reported worse emotional functioning compared with adolescents with chronic pain alone. This review confirms the limited research on the co‐occurrence of primary psychological disorders and chronic pain in adolescents by only identifying two eligible articles exploring the co‐occurrence of chronic pain with depression, anxiety, and/or attentional disorders. [ABSTRACT FROM AUTHOR]

Background: Law enforcement frequently responds to substance abuse and mental health crises. Crisis stabilization units (CSUs) operate as a public-receiving facility to provide short-term stabilization services for individuals experiencing these crises and offer law enforcement an important alternative to arrest. However, there is limited understanding about how and when law enforcement decides to use CSUs. There is also the challenge of retaining individuals in treatment after CSU stabilization to prevent future crises and persistent engagement with police. This study will respond to these gaps by exploring CSU procedures and examining the feasibility and acceptability of a technology-assisted mobile aftercare intervention designed for individuals brought to a CSU by law enforcement. Methods: This study will consist of three aims. Aim 1 will include qualitative interviews with law enforcement and CSU-affiliated mental health staff (n=80) regarding CSU utilization and collaboration logistics between the groups. Findings from Aim 1 will be synthesized for the development of an implementation guide of our intervention, mobile, and technology-assisted aftercare, designed for individuals brought to a CSU by law enforcement, during Aim 2. During Aim 2, intervention services will be pilot-tested for 6 months through a small sample (n=24), randomized control trial (RCT). Control participants will receive standard services available for individuals discharging from a CSU. Treatment participants will receive the mobile aftercare intervention. Qualitative and quantitative data will be collected at 2 weeks, 3 months, and 6 months post-recruitment for all study participants. Aims 1 and 2 will inform the design of a multi-site RCT to compare CSUs with and without mobile and technology-assisted aftercare (Aim 3). Discussion: The study will offer decision making and procedural insight into law enforcement use of CSUs as an alternative to jail and provide opportunities to inform that process. This research will provide outcome trends for those who go through standard CSU services compared to those who receive mobile and technology-assisted aftercare services. The current study will inform a larger RCT efficacy study of CSUs with and without technology-assisted aftercare services. Trial registration: This study was registered on ClinicalTrials.gov (reference #NCT04899934) on May 25, 2021. [ABSTRACT FROM AUTHOR]

Abstract Objective: Among individuals with a mental health condition co‐occurring alcohol use disorders are common, but less is known about alcohol consumption in excess of recommended drinking guidelines. This study investigated the prevalence of lifetime risky drinking (>2 drinks daily) and single occasion risky drinking (>4 drinks on one occasion) among individuals with mental health conditions of different severities. Methods: Data from representative cross‐sectional population surveys among South Australians aged ≥15 years (n=11,761) were utilised. Logistic regression models assessed associations between risky alcohol consumption, presence of a mental health condition and demographic characteristics. Results: Prevalence of lifetime risky drinking was greater among both males and females with a mental health condition (p>0.001). Single occasion risky drinking was more prevalent among males with a severe mental health condition (p=0.01). Adjusted logistic regressions showed that only females with a mental health condition had greater odds of exceeding lifetime risky drinking levels (OR=1.39, CI 1.11 to1.75). Conclusions: There are sex‐specific relationships between risky alcohol consumption and mental health conditions. Implications for public health: Risky alcohol consumption, in excess of guidelines, is of concern among those with a mental health condition and requires attention at an individual and population level.