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Schultz LS, Murphy MA, Donegan M, Knights J, Baker JT, Thompson MF, Waters AJ, Roy M, Gray JC. Evaluating the Acceptability and Feasibility of Collecting Passive Smartphone Data to Estimate Psychological Functioning in U.S. Service Members and Veterans: A Pilot Study. Mil Med 2024:usae144. [PMID: 38619334 DOI: 10.1093/milmed/usae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/17/2024] [Accepted: 03/23/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION This study investigated the acceptability and feasibility of digital phenotyping in a military sample with a history of traumatic brain injury and co-occurring psychological and cognitive symptoms. The first aim was to evaluate the acceptability of digital phenotyping by (1a) quantifying the proportion of participants willing to download the app and rates of dropout and app discontinuation and (1b) reviewing the stated reasons for both refusing and discontinuing use of the app. The second aim was to investigate technical feasibility by (2a) characterizing the amount and frequency of transferred data and (2b) documenting technical challenges. Exploratory aim 3 sought to leverage data on phone and keyboard interactions to predict if a participant (a) is depressed and (b) has depression that improves over the course of the study. MATERIALS AND METHODS A passive digital phenotyping app (Mindstrong Discovery) functioned in the background of the participants' smartphones and passively collected phone usage and typing kinematics data. RESULTS Fifteen out of 16 participants (93.8%) consented to install the app on their personal smartphone devices. Four participants (26.7%) discontinued the use of the app partway through the study, primarily because of keyboard usability and technical issues. Fourteen out of 15 participants (93.3%) had at least one data transfer, and the median number of days with data was 40 out of a possible 57 days. The exploratory machine learning models predicting depression status and improvement in depression performed better than chance. CONCLUSIONS The findings of this pilot study suggest that digital phenotyping is acceptable and feasible in a military sample and provides support for future larger investigations of this technology.
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Affiliation(s)
- Lauren S Schultz
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Mikela A Murphy
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA
| | | | | | | | - Matthew F Thompson
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Michael Roy
- Department of Medicine and Center for Neuroscience and Regenerative Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Joshua C Gray
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA
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Prince N, Stav M, Cote M, Chu SH, Vyas CM, Okereke OI, Palacios N, Litonjua AA, Vokonas P, Sparrow D, Spiro A, Lasky-Su JA, Kelly RS. Metabolomics and Self-Reported Depression, Anxiety, and Phobic Symptoms in the VA Normative Aging Study. Metabolites 2023; 13:851. [PMID: 37512558 PMCID: PMC10383599 DOI: 10.3390/metabo13070851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Traditional approaches to understanding metabolomics in mental illness have focused on investigating a single disorder or comparisons between diagnoses, but a growing body of evidence suggests substantial mechanistic overlap in mental disorders that could be reflected by the metabolome. In this study, we investigated associations between global plasma metabolites and abnormal scores on the depression, anxiety, and phobic anxiety subscales of the Brief Symptom Inventory (BSI) among 405 older males who participated in the Normative Aging Study (NAS). Our analysis revealed overlapping and distinct metabolites associated with each mental health dimension subscale and four metabolites belonging to xenobiotic, carbohydrate, and amino acid classes that were consistently associated across all three symptom dimension subscales. Furthermore, three of these four metabolites demonstrated a higher degree of alteration in men who reported poor scores in all three dimensions compared to men with poor scores in only one, suggesting the potential for shared underlying biology but a differing degree of perturbation when depression and anxiety symptoms co-occur. Our findings implicate pathways of interest relevant to the overlap of mental health conditions in aging veterans and could represent clinically translatable targets underlying poor mental health in this high-risk population.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
- Harvard Medical School, Boston, MA 02115, USA;
| | - Meryl Stav
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
| | - Margaret Cote
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
| | - Su H. Chu
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
- Harvard Medical School, Boston, MA 02115, USA;
| | - Chirag M. Vyas
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Olivia I. Okereke
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Natalia Palacios
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children’s Hospital at Strong, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Pantel Vokonas
- Department of Veterans Affairs, Boston, MA 02114, USA; (P.V.); (D.S.)
- VA Normative Aging Study, VA Boston Healthcare System, Boston, MA 02130, USA;
| | - David Sparrow
- Department of Veterans Affairs, Boston, MA 02114, USA; (P.V.); (D.S.)
- VA Normative Aging Study, VA Boston Healthcare System, Boston, MA 02130, USA;
- Department of Medicine, Boston University Chobanian and Avidisian School of Medicine, Boston, MA 02118, USA
| | - Avron Spiro
- VA Normative Aging Study, VA Boston Healthcare System, Boston, MA 02130, USA;
- Department of Medicine, Boston University Chobanian and Avidisian School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Department of Psychiatry, Boston University Chobanian and Avidisian School of Medicine, Boston, MA 02118, USA
| | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
- Harvard Medical School, Boston, MA 02115, USA;
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (N.P.); (M.S.); (M.C.); (S.H.C.); (O.I.O.); (J.A.L.-S.)
- Harvard Medical School, Boston, MA 02115, USA;
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Hansen KT, Plouffe RA, Walker DL, Wanklyn SG, Lamrock L, Maher P, Nazarov A, Richardson JD. Impact of the COVID-19 pandemic on the mental health and well-being of Veterans' spouses: a cross sectional analysis. BMC Psychiatry 2023; 23:188. [PMID: 36949446 PMCID: PMC10032243 DOI: 10.1186/s12888-023-04687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/15/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND COVID-19 has negatively impacted the mental health and well-being of both Canadians and the world as a whole, with Veterans, in particular, showing increased rates of depression, anxiety, and PTSD. Spouses and common-law partners often serve as primary caregivers and sources of support for Veterans, which may have a deleterious effect on mental health and increase risk of burnout. Pandemic related stressors may increase burden and further exacerbate distress; yet the effect of the pandemic on the mental health and well-being of Veterans' spouses is currently unknown. This study explores the self-reported mental health and well-being of a group of spouses of Canadian Armed Forces Veterans and their adoption of new ways to access healthcare remotely (telehealth), using baseline data from an ongoing longitudinal survey. METHODS Between July 2020 and February 2021, 365 spouses of Veterans completed an online survey regarding their general mental health, lifestyle changes, and experiences relating to the COVID-19 pandemic. Also completed were questions relating to their use of and satisfaction with health-care treatment services during the pandemic. RESULTS Reported rates of probable major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and PTSD were higher than the general public, with 50-61% believing their symptoms either directly related to or were made worse by the pandemic. Those reporting being exposed to COVID-19 were found to have significantly higher absolute scores on mental health measures than those reporting no exposure. Over 56% reported using telehealth during the pandemic, with over 70% stating they would continue its use post-pandemic. CONCLUSIONS This is the first Canadian study to examine the impact of the COVID-19 pandemic specifically on the mental health and well-being of Veterans' spouses. Subjectively, the pandemic negatively affected the mental health of this group, however, the pre-pandemic rate for mental health issues in this population is unknown. These results have important implications pertaining to future avenues of research and clinical/programme development post-pandemic, particularly relating to the potential need for increased support for spouses of Veterans, both as individuals and in their role as supports for Veterans.
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Affiliation(s)
- Kevin T Hansen
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada.
- Department of Psychiatry, Western University, London, ON, Canada.
| | - Rachel A Plouffe
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| | - Deanna L Walker
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Sonya G Wanklyn
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | - Laryssa Lamrock
- The Atlas Institute for Veterans and Families, Ottawa, ON, Canada
| | - Polliann Maher
- The Atlas Institute for Veterans and Families, Ottawa, ON, Canada
| | - Anthony Nazarov
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - J Don Richardson
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Zadeh AR, Eghbal AF, Mirghazanfari SM, Ghasemzadeh MR, Nassireslami E, Donyavi V. Nigella sativa extract in the treatment of depression and serum Brain-Derived Neurotrophic Factor (BDNF) levels. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:28. [PMID: 35548175 PMCID: PMC9081508 DOI: 10.4103/jrms.jrms_823_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/14/2021] [Accepted: 01/19/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Here, we aimed to investigate the therapeutic effects of Nigella sativa extract on serum brain-derived neurotrophic factor (BDNF) and depression score in patients with depression. MATERIALS AND METHODS This clinical trial was performed in 2021 in the hospitals of military forces in Tehran on 52 male patients with major depressive disorder treated with sertraline. We used the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) questionnaire to assess the patients. Serum BDNF levels were measured by the enzyme-linked immunosorbent assay. Patients were then divided into two groups receiving 1000 mg N. sativa oil extract, daily, and placebo. Both groups received sertraline for at least 3 months. DASS-21 questionnaire and serum BDNF levels were measured after 10 weeks. RESULTS After treatments, we observed significantly decreased DASS-21 score (-11.24 ± 5.69) in the intervention group (P < 0.001) and placebo (-2.72 ± 6.19, P = 0.032), but patients in the intervention group had significantly lower scores (50.1 ± 6.8 vs. 58.2 ± 5.6, respectively, P < 0.001). Furthermore, patients in the intervention group had significantly decreased depression score (-5.5 ± 2.47, P < 0.001) and lower scores compared to the placebo (P < 0.001) (18.6 ± 2.7 vs. 23.4 ± 2.1 in intervention and placebo, respectively). We also observed significantly increased BDNF levels in the intervention group after the treatments (6.08 ± 3.76, P < 0.001) compared to the placebo group (29.4 ± 3.6 vs. 24.9 ± 2.1, P < 0.001). Serum BDNF levels had also significant reverse correlations with DASS-21 score (r = -0.35, P = 0.011) and depression score (r = -0.45, P = 0.001). CONCLUSION The use of N. sativa resulted in decreased depression score and increase in serum BDNF levels that indicate the importance and efficacy of this drug.
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Affiliation(s)
- Aryan Rafiee Zadeh
- AJA University of Medical Sciences, Tehran, Iran
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Seyed Mahdi Mirghazanfari
- Department of Physiology and Iranian medicine, School of Medicine, AJA University of Medical science, Tehran, Iran
| | - Mohammad Reza Ghasemzadeh
- Assistant Professor of Psychiatry, School of Medicine, 505 Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Ehsan Nassireslami
- Toxin Research Center, AJA University of Medical Sciences, Tehran, Iran
- Department of Pharmacology and Toxicology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Vahid Donyavi
- Associate Professor of Psychiatry, AJA University of Medical Sciences, Tehran, Iran
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5
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Richardson JD, St Cyr K, Forchuk C, Liu JJW, Plouffe RA, Le T, Gargala D, Deda E, Soares V, Hosseiny F, Smith P, Dupuis G, Roth M, Bridgen A, Marlborough M, Jetly R, Heber A, Lanius R, Nazarov A. Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study. Eur J Psychotraumatol 2022; 13:2012374. [PMID: 35087643 PMCID: PMC8788339 DOI: 10.1080/20008198.2021.2012374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded stressors resulting from disruptions to familial, social, and occupational domains, and were faced with changes in health-care delivery (e.g. telehealth). The objectives of this study are to assess (a) the mental health impact of COVID-19 and related life changes on the well-being of Veterans and (b) perceptions of and satisfaction with changes in health-care treatments and delivery during the pandemic. METHODS A total of 1136 Canadian Veterans participated in an online survey. Participants completed questions pertaining to their mental health and well-being, lifestyle changes, and concerns relating to the COVID-19 pandemic, as well as experiences and satisfaction with health-care treatments during the pandemic. RESULTS Results showed that 55.9% of respondents reported worse mental health functioning compared to before the pandemic. The frequency of probable posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, alcohol use disorder, and suicidal ideation were 34.2%, 35.3%, 26.8%, 13.0%, and 22.0%, respectively. Between 38.6% and 53.1% of respondents attributed their symptoms as either directly related to or exacerbated by the pandemic. Approximately 18% of respondents reported using telehealth for mental health services during the pandemic, and among those, 72.8% indicated a choice to use telehealth even after the pandemic. CONCLUSIONS This study found that Veterans experienced worsening mental health as a result of the COVID-19 pandemic. The use of telehealth services was widely endorsed by mental health treatment-seeking Veterans who transitioned to virtual care during the pandemic. Our findings have important clinical and programmeadministrator implications, emphasizing the need to reach out to support veterans, especially those with pre-existing mental health conditions and to enhance and maintain virtual care even post-pandemic.
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Affiliation(s)
- J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Kate St Cyr
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Callista Forchuk
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Jenny J W Liu
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Rachel A Plouffe
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Tri Le
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Dominic Gargala
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Erisa Deda
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Vanessa Soares
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Fardous Hosseiny
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Patrick Smith
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Gabrielle Dupuis
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Maya Roth
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada.,School of Graduate Studies, Ryerson University, Toronto, Ontario, Canada
| | - Andrew Bridgen
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Michelle Marlborough
- Department of Psychiatry, Western University, London, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Rakesh Jetly
- The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Alexandra Heber
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.,Veterans Affairs Canada, Ottawa, Ontario, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Anthony Nazarov
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Fikretoglu D, Sharp ML, Adler AB, Bélanger S, Benassi H, Bennett C, Bryant R, Busuttil W, Cramm H, Fear N, Greenberg N, Heber A, Hosseiny F, Hoge CW, Jetly R, McFarlane A, Morganstein J, Murphy D, O'Donnell M, Phelps A, Richardson DJ, Sadler N, Schnurr PP, Smith P, Ursano R, Hooff MV, Wessely S, Forbes D, Pedlar D. Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective. Clin Psychol Rev 2021; 91:102100. [PMID: 34871868 DOI: 10.1016/j.cpr.2021.102100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/29/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022]
Abstract
Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.
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Affiliation(s)
- Deniz Fikretoglu
- Defence Research and Development Canada, 1133 Sheppard Ave. West, Toronto, ON, Canada.
| | | | - Amy B Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | | | | | | | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | | | | | | | - Fardous Hosseiny
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | - Charles W Hoge
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rakesh Jetly
- Department of National Defence, Ottawa, ON, Canada
| | | | | | - Dominic Murphy
- Combat Stress, Leatherhead, Surrey, UK; King's College London, London, UK
| | - Meaghan O'Donnell
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Andrea Phelps
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Don J Richardson
- Parkwood Institute- St. Joseph's Health Care London, London, ON, Canada
| | - Nicole Sadler
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | | | - Patrick Smith
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | | | - Miranda Van Hooff
- Military and Emergency Services Health Australia (MESHA), Woodville, SA, Australia
| | | | - David Forbes
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research, Queen's University, Kingston, ON, Canada
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7
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Moradi Y, Dowran B, Sepandi M. The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies. BMC Psychiatry 2021; 21:510. [PMID: 34654386 PMCID: PMC8520236 DOI: 10.1186/s12888-021-03526-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 10/08/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Given the wide range of depressive disorders, suicidal ideation and suicide attempts in various military studies around the world, determining the exact prevalence of these disorders in line with health planning as well as care and treatment service designing for military forces can be useful. The aim of the present meta-analysis was to determine the pooled prevalence of depressive disorders, suicide thoughts, and attempts in the military. METHODS The present systematic review and meta-analysis study was performed based on PRISMA criteria in 5 steps of the search strategy, screening and selection of articles, data extraction, evaluation of article quality and meta-analysis. International databases (PubMed (Medline), Scopus, Web of science, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) were searched using related keywords extracted from Mesh and Emtree. After screening and final selection of articles, data were extracted and qualitative evaluation was performed using the NOS checklist. RESULTS The results of meta-analysis showed that the prevalence of depression in active military forces and veterans was 23% (%95 CI: 20-26%) and 20% (%95 CI: 18-22%), respectively. In addition, the prevalence of suicidal ideation and attempts in the military was 11% (%95 CI: 10-13%) and 11% (%95 CI: 9-13%), respectively. The prevalence of suicide ideation and attempts in drug-using military was 18% (%95 CI: 7-33%) and 30% (%95 CI: 23-36%), respectively. The prevalence of suicidal ideation and attempts in military consuming alcohol were 9% (%95 CI: 4-13%) and 8% (%95 CI: 7-10%), respectively. In militaries with AIDS / HIV, the prevalence of suicide attempts was 5% (%95 CI: 4-8%). CONCLUSION Therefore, it is necessary to develop and design training and intervention programs in order to increase the awareness of the military, especially veterans, to prevent the occurrence of suicide and depression.
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Affiliation(s)
- Yousef Moradi
- grid.411521.20000 0000 9975 294XHealth Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran ,grid.484406.a0000 0004 0417 6812Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Behnaz Dowran
- grid.411521.20000 0000 9975 294XBehavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mojtaba Sepandi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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8
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Zhao M, Feng Z. Machine Learning Methods to Evaluate the Depression Status of Chinese Recruits: A Diagnostic Study. Neuropsychiatr Dis Treat 2020; 16:2743-2752. [PMID: 33209029 PMCID: PMC7669500 DOI: 10.2147/ndt.s275620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/19/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Traditional questionnaires assessing the severity of depression are limited and might not be appropriate for military personnel. We intend to explore the diagnostic ability of three machine learning methods for evaluating the depression status of Chinese recruits, using the Chinese version of Beck Depression Inventory-II (BDI-II) as the standard. PATIENTS AND METHODS Our diagnostic study was carried out in Luoyang City (Henan Province, China; 10/16/2018-12/10/2018) with a sample of 1000 Chinese male recruits selected using cluster convenient sampling. All participants completed the BDI and 3 questionnaires including the data of demographics, military careers and 18 factors. The participants were randomly selected as the training set and the testing at 2:1. The machine learning methods tested for assessing the presence or absence of depression status were neural network (NN), support vector machine (SVM), and decision tree (DT). RESULTS A total of 1000 participants completed the questionnaires, with 223 reporting depression status and 777 not. The highest sensitivity was observed for DT (94.1%), followed by SVM (93.4%) and NN (93.1%). The highest specificity was observed for NN (60.0%), followed by SVM (58.8%) and DT (43.3%). The area under the curve (AUC) of the SVM was the largest (0.862) compared with NN (0.860) and DT (0.734). The regression prediction error and error volatility of the SVM were the smallest. CONCLUSION The SVM has the smallest prediction error and error volatility, as well as the largest AUC compared with NN and DT for assessing the presence or absence of depression status in Chinese recruits.
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Affiliation(s)
- Mengxue Zhao
- Department of Military Psychology, Faculty of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
| | - Zhengzhi Feng
- Faculty of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
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