Self-reported Disability Among Recently Resettled Refugees in the United States: Results from the National Annual Survey of Refugees

The prevalence rates and correlates of mental or physical disability among recently resettled refugees, who undergo strenuous journeys before arriving in the US, remain unknown, masking potential health disparities. Self-reported disability was measured by the 2018 Annual Survey of Refugees (ASR), and defined as having a physical, mental, or other health condition for more than 6 months that precluded one from working. Prevalence rates of self-reported disability and sample correlates were investigated using descriptive and logistic regression analyses. Of N = 4259 participating refugees in ASR (Mean Age = 28.2, SD = 17.2; 52.5% male), 2875 responded to the disability question and 21.4% reported disability. About 33.7% were born in the Middle East region, 29.5% had no formal education, and 35% had an income of less than $15,000. Age (OR = 1.06, 95% Confidence Interval (CI) [1.06,1.07], p < 0.001), region of birth (OR = 1.82, 95% CI [1.31, 2.51], p < 0.001), employment status (OR = 3.31, 95% CI [2.67, 4.11], p < 0.001), and receiving food stamps (OR = 2.09, 95% CI [1.66, 2.62], p < 0.001) were associated with self-reported disability. Disability levels among refugees recently resettled in the United States are comparable to national disability rates in the US. Our results suggest that multiple aspects of the refugee experience (i.e., demographics, socioeconomic status, contextual migration history) need to be considered to understand the risk for health outcomes. Future investigations of disabilities in diverse refugee populations over time and tailored public health interventions to mitigate potential risk factors are warranted to promote health equity.

LFC study: Protocol for a longitudinal follow-up cohort study on ageing and mental health in community-dwelling older adults in Singapore

The rapid pace of population ageing worldwide has prompted the need to better understand the ageing process. The current study, titled the Longitudinal Follow-up of the CHI (LFC) study, was a 3-year follow-up study of an earlier study titled the Community Health and Intergenerational (CHI) study. The LFC study looked to examine longitudinal changes in their cognitive functioning and psychosocial outcomes across the 3-year period. Additionally, the current study built upon the earlier CHI study by collecting neuroimaging data and exploring the long-term effects of non-pharmacological interventions, which were not examined in the prior study. A total of 653 community-dwelling participants from the baseline CHI study cohort were invited to take part in the LFC study, where they underwent a battery of neuropsychological assessments, psychosocial questionnaires, a Magnetic Resonance Imaging scan and a voice recording segment. The current study would holistically track longitudinal changes in cognitive functioning and psychosocial outcomes in the ageing population in Singapore. Unique associations between linguistics and neuroimaging data alongside cognitive and psychosocial outcomes would be explored. This study also serves to guide the development of new interventions for older adults and assist in improving the well-being of the local and global ageing population.

Juvenile Justice-Based Interdisciplinary Collective Care: An Innovative Approach

Mental health concerns among juvenile-justice-involved youth (JJIY) continue to be a major health crisis in the United States (US). While scholarship has explored mental health concerns among JJIY, and the link to negative life outcomes, there are gaps in the existing research, particularly in effective interventions and models aimed at addressing both the mental health concerns and criminogenic risk contributing to recidivism and other negative life outcomes of this population. In this paper, we present Justice-Based Interdisciplinary Collective Care (JBICC), an innovative framework to address both the mental health needs and delinquent behavior of youth offenders. The model bridges community partners, with the purpose of informing future interventions, implementations, and research in this area. Increased justice-based interdisciplinary collective collaboration between the juvenile justice system and community programs/organizations would be a major benefit to youth offenders and their families. We also focus on the need for cultural responsiveness to be interwoven throughout all aspects of treatment. JBICC offers an opportunity to expanded services outside traditional settings and methods to ensure that youth offenders and their families receive validating and culturally responsive access to services.

Self-reported suicidal behaviour among people living with disabilities: prevalence and associated factors from a cross-sectional nation-wide survey in Bangladesh

BACKGROUND

Disability marginalises a large portion of Bangladesh's population. Global pre- and post-pandemic research evidently states that, this group is more prone to develop mental health problems, which increases the risk of self-harm and suicide among them. It is crucial to comprehend and mitigate the mental health challenges among the people with disabilities which in turn can promote their greater participation in community, and in national socioeconomic development. However, currently there is limited information available, regarding the suicidal behaviour of this group in Bangladesh. Therefore, this study aimed to investigate the prevalence and contributing factors of suicidal behaviour among people with disabilities.

METHOD

A cross-sectional survey was conducted during September and October 2022, among the participants who had selected disabilities, by using probability proportional to size sampling technique across all eight divisions of Bangladesh. A semi-structured questionnaire comprising information about sociodemographic, lifestyle, health; and Suicidal Behaviour Questionnaire-Revision (SBQ-R) was used. The association between the determinants and mental health outcome was investigated using the Chi-square test, and the contributing factors were investigated using the multiple binary logistic regression.

RESULT

About 10.45% of the participants reported to have suicidal behaviour (e.g., suicidal ideation, attempts, completed suicide), considering the cut-off score as 7 for the SBQ-R in the study period. Approximately, 40% respondents mentioned suicidal ideation in their lifetime, whereas, 9.01% had suicidal ideation over the past 12 months. Additionally, 8.87% of the person with disabilities, mentioned about their suicidal intent to the family members, and 5.94% reported the likelihood of suicide in the future. Being female, having multiple disabilities, and not being connected with family and friends were found to be significantly associated with suicidal behaviour.

CONCLUSION

This research demonstrates the significance of treating mental health issues and expanding accessibility to pre-existing services to lessen the impact of the limitations generated by disabilities. Policymakers can utilize this baseline findings to design large scale research and develop measures for suicide prevention, and management for at-risk groups.

Help-seeking processes related to targeted school-based mental health services: systematic review

BACKGROUND

One in seven adolescents globally are affected by mental health conditions, yet only a minority receive professional help. School-based mental health services have been endorsed as an effective way to increase access to mental health support for people at risk, or currently presenting with mental health conditions, throughout adolescence. Despite this, low treatment utilisation prevails, therefore the aim of this review is to contribute insights into the processes related to adolescents' accessing and engaging with essential targeted mental health support within schools.

METHODS

This systematic review extracted qualitative, quantitative and mixed-methods data to determine what processes affect adolescents seeking help from targeted school-based mental health services (TSMS). Searches were conducted in EMBASE, Medline, PsycINFO, CINAHL, ERIC, Web of Science, in addition to manual searching and expert consultations. Data were synthesised following guidelines for thematic synthesis and narrative style synthesis.

RESULTS

The search resulted in 22 articles reflecting 16 studies with participant sample sizes ranging from n = 7 to n = 122. Three main themes were identified: 'access-related factors', 'concerns related to stigma', and 'the school setting'. These findings elucidate how help-seeking processes are variable and can be facilitated or hindered depending on the circumstance. We identified disparities with certain groups, such as those from low-socio economic or ethnic minority backgrounds, facing more acute challenges in seeking help. Help-seeking behaviours were notably influenced by concerns related to peers; an influence further accentuated by minority groups given the importance of social recognition. Conflicting academic schedules significantly contribute to characterising treatment barriers.

CONCLUSIONS

The findings of this review ought to guide the delivery and development of TSMS to facilitate access and promote help-seeking behaviours. Particularly, given the evidence gaps identified in the field, future studies should prioritise investigating TSMS in low- and middle-income settings and through quantitative methodologies.

REGISTRATION

The protocol for this systematic review was registered on PROSPERO (ID CRD42023406824).

Suicide among psychiatrists: From healers to seekers of mental health care

Addressing suicide and mental health issues among psychiatrists, particularly during a crisis such as the COVID-19 pandemic is important. several factors contribute to this risk, such as long duty hours, burnout, emotional exhaustion, exposure to secondary trauma, and the impact of the pandemic on the mental health of healthcare workers. This paper emphasizes the urgent need for interventions at individual and organizational levels to address burnout and mental health issues among psychiatrists. Supporting the mental resilience of mental health professionals will improve the mental health of the community.

Differences between rural and urban residence in the detection and treatment of perinatal mood and anxiety disorders

BACKGROUND

Perinatal mood and anxiety disorders are common, serious complications of pregnancy. Disparities exist by race and income in the prevalence and treatment of these conditions, and overall treatment rates remain low. Outside of pregnancy, a small body of literature suggests that rural residency may contribute to higher rates of depression for those who identify as women. However, among more diverse populations, evidence suggests urban residency may be associated with higher rates of depression among women of color. It is not known whether these trends hold for mood and anxiety disorders during pregnancy and postpartum.

OBJECTIVE

We examined differences in the detection and treatment of perinatal mood and anxiety disorders by rural and urban residents and assessed if the observed differences varied by maternal race or ethnicity.

STUDY DESIGN

We conducted a cross-sectional study using linked Medicaid claims and birth certificate records from Oregon and South Carolina from 2016 to 2020. We identified perinatal mood and anxiety disorder diagnoses during the perinatal period (pregnancy and within 60 days postpartum) using International Classification of Disease 10th edition codes and enumerated receipt of pharmacotherapy and psychotherapy treatment using Medicaid claims. We used logistic regression models controlling for relevant clinical and sociodemographic characteristics to estimate associations between rural residence and mood disorder detection and treatment.

RESULTS

Among the 185,809 births in our sample, 27% of births (n=50,820) were to people who lived in rural areas and 73% (n=134,989) to those in urban areas. The prevalence of any perinatal mood and anxiety disorders diagnosis was higher for urban residents (19.5%) than for rural residents (18.0%; P<.001). Overall treatment rates were low among people with a perinatal mood and anxiety disorder (42% [n=14,789]). In our adjusted models, those living in urban areas had higher odds of a perinatal mood and anxiety disorder diagnosis (adjusted odds ratio, 1.059 [95% confidence interval, 1.059-1.059], P<.001). We found a significant interaction between maternal race and rurality (P<.001). When we stratified by race, we found that among those who identified as Black, the odds of a perinatal mood and anxiety disorder diagnosis were increased for urban residents (odds ratio, 1.188 [95% confidence interval, 1.188-1.188]), whereas among those who identified as White, there were no such increased odds (odds ratio, 1.027 [95% confidence interval, 0.843-1.252]).

CONCLUSION

We saw small but meaningful differences between rural and urban residents in perinatal mood and anxiety disorder diagnosis rates. We detected an interaction between race and rural vs urban maternal residence that impacted the observed differences. By elucidating the intersection between race and other sociodemographic factors, we hope more targeted and meaningful investments can be made in the communities most in need.

Routine Sensitive Enquiry of Adult Interpersonal Trauma in Community Mental Health Teams: An Audit of the Initial Assessment Tool

This audit aimed to evaluate the utility of the Initial Assessment Tool (IAT) in documenting routine sensitive enquiry of adult interpersonal trauma within three Community Mental Health Teams (CMHTs) in North-East Glasgow. In addition, it sought to evaluate if disclosures informed patient risk assessments and if patients were signposted to additional support services. 57% of 90 IATs had evidence of routine sensitive enquiry. Of 51 casefiles with evidence of routine sensitive enquiry, 61% had evidence of the information informing their risk assessments and 14% had documented recommendations of support organisations. The IAT appeared able to assist clinicians with routine sensitive enquiry in adulthood. However, there may be advantage in supporting staff understanding of how to ask questions to specific populations and to use this information to inform treatment planning. Given the prevalence of adult interpersonal trauma experienced by patients presenting to CMHTs, trauma-informed approaches to care should be implemented.

The Correlates of Collective and Individual Trauma on Mental Health Outcomes Among Afghan Refugees: A Study of Sociodemographic Differences

Following the U.S. military's departure from Afghanistan, a significant number of Afghan refugees have resettled in the United States, presenting complex mental health challenges exacerbated by extensive traumatic exposure. This demographic is particularly affected by collective trauma due to war, genocide, and the loss of homeland. However, detailed investigations into the correlations between collective trauma and mental health outcomes among Afghan refugees are limited. This study sought to explore the relationship between collective trauma and mental health outcomes within the Afghan refugee population in the United States, paying particular attention to the influence of sociodemographic factors. Identifying subgroups at greater risk allows for the development of more targeted mental health interventions. The study surveyed 173 Afghan refugees employing snowball sampling, utilizing a cross-sectional design. Data collection was facilitated through online and in-person surveys in English, Dari, and Pashto. Key measures included the Harvard Trauma Questionnaire for individual trauma experiences, the Historical Loss Scale for collective trauma, the Historical Loss Associated Symptoms Scale for collective trauma symptoms, the Afghan Symptom Checklist-22 for mental health symptoms, and the Post-Migration Living Difficulties Scale for post-migration stressors. Statistical analyses involved Pearson's correlation for variable associations, with nonparametric Mann-Whitney U and Kruskal-Wallis tests conducted to assess sociodemographic impacts due to data's non-normal distribution. The analysis revealed significant variations in collective trauma and mental health outcomes across subgroups. Afghan women, minoritized ethnic groups, those who experienced extended displacement, and refugees with uncertain visa statuses reported higher collective trauma levels and worse mental health outcomes. Statistical significance was noted in the correlations between collective trauma and mental health symptoms (r = .53, p < .01) and between post-migration difficulties and mental health (r = .33, p < .01). The disparities in mental health outcomes based on sociodemographic characteristics were significant, with nonparametric tests showing clear distinctions across different groups (Kruskal-Wallis H = 14.76, p < .05 for trauma experience by visa status). This study emphasizes the critical need for mental health interventions that account for the complex experiences of collective trauma among Afghan refugees, especially among identified subgroups. Tailoring mental health services to address the specific needs highlighted through disaggregated data can enhance support for Afghan refugees in the United States. This research contributes to a deeper understanding of the relationship between collective trauma and refugee mental health, advocating for nuanced care strategies in resettlement environments.

The impact of internet-based cognitive behavior therapy for perfectionism: a reinterpretation through the lens of the Model of Excellencism and Perfectionism

BACKGROUND

Grieve et al. (2022) tested the effects of an intervention designed to reduce perfectionism. Contrary to their hypotheses, the intervention reduced both perfectionism and excellencism. Furthermore, excellencism positively correlated with negative outcomes (e.g. anxiety).

AIMS

A theory-driven framework (with five hypothetical scenarios) is proposed to reconsider how we interpret the effectiveness of interventions designed to reduce perfectionism. Our goal was to offer a constructive reinterpretation of the results of Grieve et al. (2022) using our new framework derived from the Model of Excellencism and Perfectionism.

METHOD

Secondary data analyses using the experimental and correlational results are published in the randomized control trial of Grieve et al. (2022).

RESULTS

Our re-examination of the results reveals that excellencism was reduced by a smaller extent (approximately 25% less) than perfectionism. Based on our framework, such a ratio provides conclusive evidence for the effectiveness of this intervention. Students entered the intervention as perfectionists and they ended up somewhere between the zones of excellence striving and non-perfectionism. Furthermore, our multivariate re-analysis of the bivariate correlations indicates that excellence strivers experienced better adjustment (lower anxiety, depression, stress, body-related acceptance, and higher self-compassion) compared with perfectionists.

CONCLUSION

Future interventions should target the reduction of perfectionism and the maintenance of excellencism because excellencism relates to desirable outcomes. Our secondary data analysis was needed to inform researchers and practitioners about an alternative interpretation of Grieve and colleagues' findings. Future interventions to reduce perfectionism should closely monitor excellencism and follow the interpretational guidelines advanced in this article.

Relationship between trauma, psychological distress and help-seeking among corrective service workers

BACKGROUND

Corrective service workers (CSWs) are at high risk of post-traumatic stress disorder (PTSD) and other mental health problems. Prevalence rates and help-seeking behaviours are under-researched within this population.

AIMS

To assess rates of PTSD and distress, and identify predictors of intention to seek help, among workers at an Australian corrective service agency.

METHODS

A cross-sectional online survey was used to collect data on staff demographics, employment, PTSD symptoms and current distress. Participants received a tailored feedback report including referral to relevant mental health services (where applicable) and were asked to indicate their likelihood of seeking help. Prevalence data are reported. Binary logistic regression was used to examine relationships between participant characteristics and help-seeking for those with probable PTSD and/or high psychological distress.

RESULTS

Participants (n=1001) were predominantly men (56.8%) with a mean age of 46.72 (SD=11.00). Over half (58.0%) were classified as probable PTSD cases, and one-third (33.0%) were experiencing high psychological distress. Around a third (34.3%) of participants with probable PTSD and/or elevated distress indicated they were likely to seek help. Older age and fewer years of service were associated with increased help-seeking intentions.

CONCLUSIONS

CSWs were found to be experiencing probable PTSD at higher rates than reported in previous studies. Relatively few intended to seek help from mental health services, despite being provided with personalised screening and feedback along with access to specialised care. Future research should investigate the potential role of organisational support as a facilitator of help-seeking within this population.

The impact of empathy on medical students: an integrative review

INTRODUCTION

Empathy is considered the ability to understand or feel others emotions or experiences. As an important part of medical education, empathy can affect medical students in many ways. It is still lacking a comprehensive evaluation of the existing articles on empathy's impact on medical students, despite the existence of many articles on the topic.

OBJECTIVES

To summarize the impact of empathy on medical students during medical education from four perspectives: mental health, academic performance, clinical competence, and specialty preference.

METHODS

The search terms used for retrieval were "empathy", "medical student", "mental health", "depression", "anxiety", "burnout", "examinations", "academic performance", "clinical competence", "specialty preference" on PubMed, EBSCO, and Web of Science before January 2024. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed based on inclusion/exclusion criteria. A consensus was drawn on which articles were included.

RESULTS

Our results indicated that high empathy was a positive factor for mental health, However, students with high affective empathy were more likely to suffer from depression, anxiety, and burnout. Empathy was found to be unrelated to academic performance, but positively correlated with clinical competence, particularly in terms of communication skills. Medical students with high levels of empathy tended to prefer people-oriented majors.

CONCLUSIONS

Medical students who score higher on the self-reported empathy scales often have better mental health, better communication skills, and tend to choose people-oriented specialties. But empathy is not related to academic performance. Additionally, the different dimensions of empathy have different impacts on medical students. It is necessary to design targeted courses and training for medical students to enhance their empathy.

Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy.

METHODS

From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model.

RESULTS

578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06-4.35]), family stigma (2.42 [1.65-3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder.

CONCLUSIONS

In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.

Preoperative Symptoms of Depression are Associated with Worse Capability 6-weeks and 6-months After Total Hip Arthroplasty for Osteoarthritis

BACKGROUND

Symptoms of depression have been associated with greater incapability following total hip arthroplasty (THA). A brief, 2-question, measure of symptoms of depression - the Patient Health Questionnaire 2 (PHQ-2) - may be sufficient to measure associations with the magnitude of incapability during recovery from THA. This study investigated whether preoperative symptoms of depression (measured with the PHQ-2) correlated with levels of incapability 6 weeks and 6 months after THA, accounting for demographic and clinical factors.

METHODS

We performed a prospective cohort study across 5 centers and recruited 101 patients undergoing THA, of whom 90 (89%) completed follow-up. Patients completed demographics, a pre-operative two-item (PHQ-2) measure of symptoms of depression, and the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement HOOS JR at 6-weeks and 6-months postoperatively. Negative binomial regression models determined factors associated with HOOS JR at 6 weeks and 6 months, accounting for potential confounders.

RESULTS

Accounting for potential confounding factors, we found that higher preoperative PHQ-2 scores (reflecting greater symptoms of depression) were associated with lower HOOS JR scores (reflecting a greater level of hip disability) at both 6 weeks (Regression Coefficient (RC) = -0.67, P < 0.001) and 6 months (RC = -1.9, P < 0.001) after THA.

CONCLUSION

Symptoms of depression on a 2-question pre-operative questionnaire are common, and greater symptoms of depression are associated with reduced capability within the first year following THA. These findings support the prioritization of routine mental health assessments before THA. Measuring mindset using relatively brief instruments will be important considering the current shift toward implementing self-reported measures of health status in clinical practice and incorporating them within alternative payment models.

Genetic variation in endocannabinoid signaling: Anxiety, depression, and threat- and reward-related brain functioning during the transition into adolescence

BACKGROUND

The endocannabinoid system modulates neural activity throughout the lifespan. In adults, neuroimaging studies link a common genetic variant in fatty acid amide hydrolase (FAAH C385A)-an enzyme that regulates endocannabinoid signaling-to reduced risk of anxiety and depression, and altered threat- and reward-related neural activity. However, limited research has investigated these associations during the transition into adolescence, a period of substantial neurodevelopment and increased psychopathology risk.

METHODS

This study included FAAH genotype and longitudinal neuroimaging and neurobehavioral data from 4811 youth (46% female; 9-11 years at Baseline, 11-13 years at Year 2) from the Adolescent Brain Cognitive DevelopmentSM Study. Linear mixed models examined the effects of FAAH and the FAAH x time interaction on anxiety and depressive symptoms, amygdala reactivity to threatening faces, and nucleus accumbens (NAcc) response to happy faces during the emotional n-back task.

RESULTS

A significant main effect of FAAH on depressive symptoms was observed, such that depressive symptoms were lower across both timepoints in those with the AA genotype compared to both AC and CC genotypes (p's<0.05). There were no significant FAAH x time interactions for anxiety, depression, or neural responses (p's>0.05). Additionally, there were no main effects of FAAH on anxiety or neural responses (p's>0.05).

CONCLUSIONS

Our findings add to emerging evidence linking the FAAH C385A variant to lower risk of psychopathology, and extend these findings to a developmental sample. In particular, we found lower depressive symptoms in FAAH AA genotypes compared to AC and CC genotypes. Future research is needed to characterize the role of the FAAH variant and the eCB system more broadly in neurodevelopment and psychiatric risk.

Application of 'Readiness for Change' concept within implementation of evidence-based mental health interventions globally: protocol for a scoping review

Background

Concerning the growing burden of mental illnesses globally, there has been an increased investment into the implementation of evidence-based mental health interventions (EBmhIs) in routine care settings. However, the uptake and implementation of these EBmhIs has faced challenges in the real-world context. Among the many barriers and facilitators of implementation of EBmhIs identified by implementation science frameworks, evidence on the role of readiness for change (RFC) remains sparse. RFC constitutes the willingness and perceived capacity of stakeholders across an organization to implement a new practice. Theoretically, RFC has been defined at organizational, group, and individual levels, however, its conceptualization and operationalization across all these levels have differed in studies on the implementation of EBmhIs. By conducting a scoping review, we aim to examine the literature on RFC within the implementation of EBmhIs.

Methods

This scoping review will be conducted following the PRISMA-ScR guidelines. Iterative review stages will include a systematic and comprehensive search through four electronic databases (PubMed, Web of Science, Embase, and PsycINFO), selecting studies, charting data, and synthesizing the results. English-language studies meeting the inclusion criteria will be screened independently by two reviewers.

Discussion

This review will synthesize knowledge on the conceptualization of RFC across organizational, group, and individual levels within the implementation of EBmhIs. In addition, it will identify how RFC has been measured in these studies and summarize the reported evidence on its impact on the implementation of EBmhIs.

Conclusions

This review will assist mental health researchers, implementation scientists, and mental health care providers to gain a better understanding of the state of research on RFC within the implementation of EBmhIs.

Registration

The final protocol was registered with the Open Science Framework on October 21, 2022 ( https://osf.io/rs5n7).

Effects of yoga on impulsivity in patients with and without mental disorders: a systematic review

BACKGROUND

Yoga can be used as a complementary intervention to conventional treatments, whether pharmacological or non-pharmacological. Sustained practice of yoga can generate a series of benefits for individuals' quality of life and improve their physical fitness.

OBJECTIVE

To investigate the potential effects of yoga as an adjunct intervention in conditions involving impulse control issues, such as attention deficit hyperactivity disorder (ADHD), borderline personality disorder, bipolar affective disorder, and substance use disorders.

METHODS

We performed a systematic review of placebo-controlled, randomized trials of yoga in patients with impulsivity. PubMed, Web of Science, and Science Direct databases were searched for trials published up to January, 2023. Data were extracted from published reports and quality assessment was performed per Cochrane recommendations.

RESULTS

Out of 277 database results, 6 RCT were included in this systematic review. To assess the level of attention and impulsiveness, the following scales were analyzed: Barratt Impulsiveness, UPPS-P Impulsive Behavior scale, Conners' Continuous Performance Test IIª and Conners' Parent Rating Scale-Revised: Long.

CONCLUSIONS

Yoga didn't have a significant improvement in impulsivity when compared to placebo. There are many tools to assess impulsivity, but they mean different concepts and domains consisting in a weakness on comparison of yoga effects.

PROSPERO REGISTRATION

CRD42023389088.

Interventions for Integrating Behavioral Health into HIV Settings for US Adults: A Narrative Review of Systematic Reviews and Meta-analyses, 2010-2020

Mental health and substance use disorders can negatively affect physical health, illness management, care access, and quality of life. These behavioral health conditions are prevalent and undertreated among people with HIV and may worsen outcomes along the entire HIV Care Continuum. This narrative review of tested interventions for integrating care for HIV and behavioral health disorders summarizes and contextualizes findings from systematic reviews and meta-analyses conducted in the past decade. We sought to identify gaps in research that hinder implementing evidence-based integrated care approaches. Using terms from the Substance Abuse and Mental Health Services Administration-Health Resources & Services Administration standard framework for integrated health care, we searched PubMed and PsycInfo to identify peer-reviewed systematic reviews or meta-analyses of intervention studies to integrate behavioral health and HIV published between 2010 and 2020. Among 23 studies identified, only reviews and meta-analyses that described interventions from the United States designed to integrate BH services into HIV settings for adults were retained, leaving six studies for narrative review by the study team. Demonstrated benefits from the relatively small literature on integrated care interventions include improved patient- and service-level outcomes, particularly for in-person case management and outreach interventions. Needed are systems-level integration interventions with assessments of long-term outcomes on behavioral health symptoms, HIV viral suppression, HIV transmission rates, and mortality. HIV, primary care, and other providers must include behavioral health as a part of overall healthcare and must play a central role in behavioral health care delivery. Research is needed to guide their way.

Trajectories of Goth Music Preferences in Adolescence and Psychological Adjustment in Adulthood

Non-mainstream rock music preferences, like goth, are linked to psychological difficulties in adolescence and emerging adulthood. This study explored the persistence of these difficulties into adulthood, while considering gender moderation. From ages 15 to 22, 364 participants (59% female) annually indicated their preference for goth music. Their mental health and well-being were evaluated at age 30 and at ages 13-14 as a control. A latent class growth analysis on their goth preference revealed two trajectories: lower (non-fans; 77%) and higher (fans; 23%). Gender moderation analysis showed that only males on the higher trajectory reported lower well-being and poorer mental health at age 30. Male goth music fans, most likely attracted to this cultural expression of their difficulties, may face increased psychological challenges as adults due to societal gender norms and growing marginalization. This study indeed suggests that an extended affinity for goth music during adolescence and emerging adulthood indicates long-term psychological adjustment challenges among adult male fans.

Impact of Neighborhood Social Cohesion and Rodent Sightings on Mental Health among Residents of New York City During the COVID-19 Pandemic

Common mental disorders such as depression and anxiety are prevalent globally, and rates are especially high in New York City (NYC) since the COVID-19 pandemic. Neighborhood social and physical environments have been found to influence mental health. We investigated the impact of neighborhood social cohesion and neighborhood rodent sightings (as an indicator of neighborhood cleanliness) on nonspecific serious psychological distress (NSPD) status using 2020 NYC Community Health Survey data from 8781 NYC residents. Multivariable logistic regression was used to evaluate the relationships among social cohesion, rodent sightings, and NSPD adjusted for confounders and complex sampling and weighted to the NYC population. Effect measure modification of rodent sightings on the effect of social cohesion on NSPD was evaluated on the multiplicative scale by adding the interaction term to the multivariable model and, if significant, stratifying on the effect modifier, and on the additive scale using the relative excess risk due to interaction (RERI). Social cohesion was found to decrease the odds of NSPD, and rodent sightings were found to increase the odds of NSPD. We found significant evidence of effect measure modification on the multiplicative scale. In the stratified models, there was a protective effect of social cohesion against NSPD among those not reporting rodent sightings, but no effect among those reporting rodent sightings. Our findings suggest that both neighborhood social cohesion and rodent sightings impact the mental health of New Yorkers and that rodent infestations may diminish the benefit of neighborhood social cohesion.

Analyzing Alternative Behavioral Crisis Response Models in the U.S

In the U.S., communities often rely on the criminal justice system to respond to, house, and treat individuals with mental health and substance use problems. This has resulted in a crisis response system that relies on police officers to respond to mental and behavioral health crisis due to a lack of options. Unfortunately, these encounters can be dangerous for individuals in need of help. Additionally, this has led to a disproportionate number of individuals with mental illness and substance use disorders being housed in prisons. Alternatives to our current crisis response system already exist in the form of community-based mobile crisis response teams that rely on mental health workers instead of law enforcement. This review examines such programs that have been enacted in multiple cities across the country. Analysis of these alternative crisis response models shows that community-based programs are more effective, efficient, and safer than the current standard that relies on law enforcement. This analysis highlights the need for the establishment of community-based crisis response teams as the national standard.

Urgent Attention Needed for Mental Health Challenges Arising from Prolonged Grief During and in the Aftermath of COVID-19

N/a.

Assessing mental health among students in the UAE: A cross-sectional study utilizing the DASS-21 scale

Background

The escalating worldwide concerns for mental health, significantly amplified by the COVID-19 pandemic, necessitates understanding the impact on vulnerable populations, such as university students. This study aims to investigate the prevalence and implications of depression, anxiety, and stress among university students in the United Arab Emirates (UAE) using the Depression, Anxiety, and Stress Scale-21 Items (DASS-21).

Methods

This study utilized convenience sampling to investigate the mental health of undergraduates in UAE universities using a bilingual DASS-21 questionnaire via Google Forms. Analysis was conducted using SPSS version 29.0, employing descriptive statistics, Chi-squared tests, Mann-Whitney tests, Kruskal-Wallis tests, and Multinomial Logistic Regression to analyze relationships between sociodemographic variables and mental health scores.

Results

The study examined 332 students, with most female participants (81 %, n = 269) and individuals aged 18-20 (89.8 %, n = 298). It revealed higher mean DASS scores among females: Depression (M = 15.80, p = 0.030), Anxiety (M = 17.63, p < 0.001), and Stress (M = 22.61, p < 0.001). Fourth-year students exhibited the highest DASS scores for depression (M = 30.33, p = 0.002), anxiety (M = 21.33, p = 0.002), and stress (M = 27.00, p = 0.005). Younger participants aged 18-20 had an odds ratio (OR) of 4.925 for depression, indicating they were approximately five times more likely to experience depression.

Conclusions

This study reveals gender, age, and academic-year variations in depression, anxiety, and stress among UAE university students. Specifically, our findings indicate higher levels of anxiety and stress among females and reveal academic-year and age-related patterns in mental health conditions. University support services in the UAE should better address student needs, including counseling focused on high school to university transition challenges.

Exploring the role of psychological assistance hotlines in improving mental health problems among Chinese adult women: A perspective based on social expectations and gender roles

This paper looks at how social expectations and gender roles affect the mental health of Chinese women. Traditional Chinese culture, influenced by Confucianism and patriarchy, still has a negative impact on women's mental well-being, despite efforts for gender equality. Women's mental health is vital for both individuals and society, and this study aims to understand these issues better to help shape policies and interventions.

Mental and Physical Health Comorbidities in Traumatic Brain Injury: A Non-TBI Controls Comparison

OBJECTIVE

To examine whether ageing with a TBI was associated with a greater burden of health-related comorbidities compared to a non-TBI control cohort, and examine the associations between comorbidity burden, emotional outcomes, and health-related quality of life (HRQoL) after TBI across ages.

DESIGN

Cross-sectional.

SETTING

Research centre or telephone.

PARTICIPANTS

The study included 559 participants (NTBI=291, NControls=268). Participants with TBI were recruited during inpatient rehabilitation and had sustained a moderate-severe TBI 1-33 years previously. Non-TBI controls were a convenience sample recruited through advertisements in the community.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The number of cardiovascular, general physical health, and mental health comorbidities was compared between cohorts and age strata using Poisson regression. The relationships between comorbidities, age, emotional outcomes (Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-9) and HRQoL (PROMIS Global Health Measure) were examined with linear regression. Distinct subgroups of comorbidities were identified using latent class analysis. Associations between comorbidity classes with demographic and outcome variables were evaluated using multinomial logistic and linear regressions, respectively.

RESULTS

TBI participants had a significantly higher comorbidity burden than controls, primarily driven by elevated rates of mental health disorders (RR = 2.71, 95% CI [1.37, 5.35]). Cardiovascular and physical health comorbidities were not elevated in the TBI group compared to controls. Both cohorts had three similar comorbidity subgroups, suggesting consistent patterns of co-occurring health conditions regardless of TBI exposure. Physical and mental health comorbidities were associated with elevated depression and anxiety symptoms and diminished HRQoL after TBI compared to controls.

CONCLUSION

TBI was associated with greater mental, but not physical, health comorbidities in the decades following injury. However, physical and mental health comorbidities significantly impacted emotional and HRQoL status after TBI, underscoring a greater need for long-term support for individuals with TBI coping with both physical and mental health comorbidities.

Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

Background

Schizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions.

Aims

This study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage.

Methods

A multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires-Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire-along with personal data sheets. Pearson correlation and multinomial logistic regression were performed.

Results

The predominant personal recovery stage among participants was stage 3, 'living with disabilities', comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=-4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=-11.57-0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance.

Conclusion

The findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia.

School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008-2019), Norway

BACKGROUND

Social anxiety disorder (SAD) most commonly develops in adolescence-a period of life that includes a transition to upper secondary school. The aim of this study is to investigate the extent to which social anxiety in adolescence is associated with the completion of upper secondary school and progression to higher education.

METHODS

This longitudinal study includes 8,192 adolescents aged 13-19 years who participated in the Norwegian Young-HUNT 3 population-based study. Social anxiety is measured employing (1) diagnostic interview screening questions (interview) and (2) a self-reported symptom index (questionnaire). Notably, we define the cohorts based on these two methods. Using national educational data (2008-2019), we follow educational attainment among the cohorts until they turn 25 years of age.

RESULTS

We found that adolescents who screened positive (SP) for SAD had a predicted probability of upper secondary school completion at 21 years of age that was 14% points lower than those who screened negative (SN). Further, differences remained when looking at completion rates at age 25 years. Moreover, predicted probabilities for completion were inversely associated with increasing levels of self-reported social anxiety symptoms. Similarly, the proportion of the completers of an academic program in the SP group that were enrolled in higher education by 25 years of age, were lower than for the SN group (87 vs. 92%).

CONCLUSION

Social anxiety in adolescence, both self-reported symptoms and diagnostic screening, has long-term negative impact on upper secondary school completion and to some extent enrollment to higher education.

The Need to Adapt the Psychiatric Clinical Assessment to the Digital Age: A Practical Approach

The use of electronic devices and social media is becoming a ubiquitous part of most people's lives. Although researchers are exploring the sequelae of such use, little attention has been given to the importance of digital media use in routine psychiatric assessments of patients. The nature of technology use is relevant to understanding a patient's lifestyle and activities, the same way that it is important to evaluate the patient's occupation, functioning, and general activities. The authors propose a framework for psychiatric inquiry into digital media use, emphasizing that such inquiry should focus on quality of use, including emotional and behavioral consequences, rather than simply the amount of use.

Inadequate Social Housing and Health: The Case of Oliver Bond House, The Liberties, Dublin

Background

Inadequate housing is an important social justice issue that adversely affects health.

Methods

Drawing on an extended ethnography case study, this paper presents the results of a resident-led survey to highlight the health consequences of inadequate social housing, as residents wait for a 'fair regeneration' of their social housing 'flats' estate within a gentrifying inner-city Dublin neighbourhood.

Results

Four key concerns were identified by residents as part of this analysis: (1) substandard housing conditions which are physically harmful to health; (2) the emotional toll of an unsafe social environment; (3) lack of child friendly and community green spaces; and (4) constrained mobility due to inaccessible housing design.

Conclusions

The results highlight the urgent need to place greater priority on the maintenance of the existing social housing stock and demonstrate the need for public housing policies that recognize the quality and quantity of adequate housing provision, where care is at the heart of housing policies. The paper also presents a novel 'City of Care' framework, following the need to develop an ethics of care within cities where public health, community wellbeing, solidarity, residents' empowerment, and social justice principles are at the forefront. Given that housing is an essential contributor to good health, it is now time for a joint public housing and public health agenda to create healthier homes by confronting the everyday impact of inadequate housing to tackle social inequalities more broadly.

Climate Change Psychological Distress: An Underdiagnosed Cause of Mental Health Disturbances

The majority of climate change research and policy centers around the physical health effects of planetary degradation. The mental health impacts of climate change are just now starting to be elucidated and discussed more commonly among mental health providers and policymakers. There is a huge area of opportunity in primary care to discuss and address climate anxiety in patients, many of whom may not be forthcoming in discussing how climate anxiety is contributing to their mental health.

Occupation-specific risk estimates for suicide and non-fatal self-harm from a Swedish cohort of male construction workers followed 1987-2018

OBJECTIVES

While suicidal behaviour has become less prevalent in non-manual workers in recent decades, rates have increased in manual workers. We aimed to identify occupations within the construction industry with excess risk of suicide and non-fatal self-harm.

METHODS

This cohort of Swedish construction workers comprises 389 132 individuals examined 1971-1993 and followed 1987-2018 using national hospital and cause of death registers. More than 200 job titles were merged into 22 occupational groups. For 296 891 men alive in 1987 and active in the construction sector, survival was calculated from baseline to first event of non-fatal self-harm or suicide and censored for emigration, long-term unemployment, disability pension, retirement, death from other causes or end of follow-up. HRs with 95% CIs were obtained from multiple Cox proportional hazard regression.

RESULTS

Overall, 1618 cases of suicide and 4774 events of non-fatal self-harm were registered. Self-harm before baseline was the single largest risk factor for suicide, HR 9.3 (95% CI 7.5 to 11.6). Compared with the overall mean, labourers and rock workers had excess risk for suicide, HR 1.4 (95% CI 1.1 to 1.7) and 1.5 (95% CI 1.0 to 2.3), respectively, while electricians, clerks and foremen had reduced risk. Labourers, concrete workers, sheet metal workers, painters, glaziers and the group 'other construction workers' were at increased risk for non-fatal self-harm. Almost all categories of manual workers were at increased risk for suicidal behaviour relative to clerks and foremen.

CONCLUSIONS

Specific occupations within the construction sector were associated with excess risk for suicidal behaviour. Future studies should identify underlying risk factors to inform tailored interventions.

Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic

OBJECTIVES

This study aims to determine how workplace experiences of National Health Service (NHS) staff varied by ethnicity during the COVID-19 pandemic and how these experiences are associated with mental and physical health at the time of the study.

METHODS

An online Inequalities Survey was conducted by the Tackling Inequalities and Discrimination Experiences in Health Services study in collaboration with NHS CHECK. This Inequalities Survey collected measures relating to workplace experiences (such as personal protective equipment (PPE), risk assessments, redeployments and discrimination) as well as mental health (Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)), and physical health (PHQ-15) from NHS staff working in the 18 trusts participating with the NHS CHECK study between February and October 2021 (N=4622).

RESULTS

Regression analysis of this cross-sectional data revealed that staff from black and mixed/other ethnic groups had greater odds of experiencing workplace harassment (adjusted OR (AOR) 2.43 (95% CI 1.56 to 3.78) and 2.38 (95% CI 1.12 to 5.07), respectively) and discrimination (AOR 4.36 (95% CI 2.73 to 6.96) and 3.94 (95% CI 1.67 to 9.33), respectively) compared with white British staff. Staff from black ethnic groups also had greater odds than white British staff of reporting PPE unavailability (AOR 2.16 (95% CI 1.16 to 4.00)). Such workplace experiences were associated with negative physical and mental health outcomes, though this association varied by ethnicity. Conversely, understanding employment rights around redeployment, being informed about and having the ability to inform redeployment decisions were associated with lower odds of poor physical and mental health.

CONCLUSIONS

Structural changes to the way staff from ethnically minoritised groups are supported, and how their complaints are addressed by leaders within the NHS are urgently required.

The importance of teaching climate-health literacy in psychotherapeutic training and continuing education

Climate-health literacy is the ability to find, access, understand, interpret, evaluate, and communicate information about the impact of climate change on human health and to make decisions and act accordingly to that information. Climate change affects people's health in numerous ways, both directly and indirectly, e.g., by increasing the risks of cardiovascular disease, infections, depression, anxiety disorders, and trauma. It is important for health professionals to understand the complex interaction between climate change and health. A teaching concept is presented that incorporates the core elements of climate-health literacy. On a first level, physical and climatological basics are taught, direct and indirect impacts of climate change on human health, climate protective measures, the psychological background of climate-protective behavior, and professional ethics. Furthermore, via self-awareness and self-reflection, the impact of climate change on the student's mental health should be evaluated. In an advanced level, the direct and indirect impacts of climate change on mental health are taught, coping strategies, resilience, and vulnerability, as well as the role of health-care professionals in the climate crisis. In expert-level lectures, the knowledge can be deepened, and special content like activist burnout can be addressed.

Allied health professionals' experiences and views towards improving musculoskeletal services in the UK for patients with musculoskeletal and co-existing mental health conditions: a qualitative study

BACKGROUND

Interplay between physical and mental health (MH) is widely recognised amongst patients with Musculoskeletal and co-existing MH conditions. Evidence suggests that psychological interventions improve outcomes and satisfaction in patients with physical conditions, however current healthcare models continue to separate physical and mental health care, as health services are fragmented. If the delivery of MH support could be facilitated by Allied Health Professionals (AHPs), such as physiotherapists and occupational therapists (OTs), this could be an effective, low-cost way to achieve routine integration. This study aimed to explore the experiences of UK physiotherapists and OTs working with patients with MSK and co-existing MH conditions and to understand views on improving MSK services.

METHODS

This was an exploratory-descriptive qualitative study using semi-structured interviews. Participants were recruited via social media and professional organisations using convenience sampling. Participants included registered UK physiotherapists or OTs within MSK settings who managed patients with MH conditions. Inductive thematic analysis was used, where single and double-level coding, single counting and inclusion of divergent cases were conducted to enhance methodological rigour.

RESULTS

Three overarching themes were identified. Overarching theme one referred to openness to provide MH support, with scope of practice and lack of confidence as themes. Overarching theme two described challenges, incorporating mental health stigma, the clinical environment, and limited experience. The overarching theme referring to training, identified the need for further training and strategies to implement as themes.

CONCLUSION

Many challenges to achieving optimal integration of physical and mental health care exist within MSK services. These challenges go beyond the need for additional training and knowledge acquisition and include departmental readiness such as funding, diary management, and supervision by senior colleagues/or psychologists. These need consideration in parallel to match the evolving needs of the MSK population.

Principles for Primary Care Screening in the Context of Population Health

A key component of primary care pediatrics is health promotion through screening: applying a test or procedure to detect a previously unrecognized disease or disease risk. How do we decide whether to screen? In 1965, Wilson and Jungner published an influential set of screening principles focused on the health problem's importance, the screening tool's performance, and the evidence for treatment efficacy. However, if we want realistic estimates of the population effects of routine screening, we must also account for the healthcare system's real-world functioning and disparities in care. We offer revised principles to guide discussions about routine screening in the primary care setting. We add to Wilson and Jungner's principles: 1. A focus on life course epidemiology and its consequences for population health, 2. A need to screen for the early stages of chronic health problems, 3. A concern for screening's acceptability to providers and the community, 4. A recommendation for estimating the uncertainty in benefits and harms in evaluating screening, 5. Inclusion of systematic plans for population data collection and monitoring, and 6. Recognition that achieving population health improvement requires a high-performing system with sufficient throughput and monitoring to deliver accessible, affordable, and effective care, especially for the groups experiencing the greatest inequities in access. Above all, instead of assuming best practices in treatment delivery and monitoring after screening, we argue for realism about the healthcare system functioning in routine practice. WHAT'S NEW: We update Wilson and Jungner's (1965) principles for routine screening. If we want realistic estimates of the population effects of routine screening, we must consider not just screening accuracy and efficacy but also the healthcare system's real-world functioning and inequities.

Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China: a systematic review and meta-analysis

Background

The prevalence of prolonged grief disorder (PGD) and its symptoms among the bereaved population in China vary considerably.

Aims

This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China.

Methods

We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023, for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals. The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data ('JBI checklist') and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. The 'metaprop' package in R V.4.1.2 was used to synthesise the prevalence.

Results

A total of 28 studies involving 10 994 bereaved individuals were included in the analysis, with JBI checklist scores between 3 and 7. The combined prevalence (95% confidence interval) of PGD and its symptoms was 8.9% (4.2% to 17.6%) and 32.4% (18.2% to 50.8%), respectively. PGD and its symptoms were most prevalent among those who had lost their only child (22.7%) and those bereaved by earthquakes (80.4%), respectively. The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms.

Conclusions

The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China. This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes. Further methodologically rigorous studies are needed to provide more accurate prevalence estimates.

PROSPERO registration number

CRD42023432553.

Intimate partner violence during pregnancy against adolescents in sub-Saharan Africa: a systematic review

BACKGROUND

Adolescent pregnancy and intimate partner violence (IPV) are major public health issues that are linked to poor health outcomes particularly during pregnancy. In sub-Saharan Africa (SSA), previous studies on IPV during pregnancy have primarily focused on adults. This review examines the available evidence on adolescents' experience of IPV during pregnancy in SSA.

DESIGN

Systematic review.

METHODS

We searched multiple databases for articles that met our inclusion criteria. Included studies investigated IPV during pregnancy, including prevalence, risk factors and health outcomes among ever-pregnant adolescents aged 10-19 years old or younger in SSA. Studies were peer-reviewed studies from SSA, quantitative and/or qualitative; and published in English regardless of the year of publication.

RESULTS

Nine studies out of 570 abstracts screened, published between 2007 and 2020, met the inclusion criteria. The prevalence of IPV during pregnancy among adolescents in SSA ranged from 8.3% to 41%. Mental health symptoms, particularly depression, and anxiety, were associated with adolescent IPV during pregnancy and qualitatively linked to poor coping strategies when dealing with IPV.

CONCLUSION

This review found evidence of a linkage between pregnancy and IPV during pregnancy among adolescents. Given the long-term negative effects of IPV during pregnancy on adolescents and children, this conclusion points to the critical need for developing interventions to improve IPV detection during pregnancy in SSA among adolescents to interrupt its continuation into adulthood.

Fermented foods: Harnessing their potential to modulate the microbiota-gut-brain axis for mental health

Over the past two decades, whole food supplementation strategies have been leveraged to target mental health. In addition, there has been increasing attention on the ability of gut microbes, so called psychobiotics, to positively impact behaviour though the microbiota-gut-brain axis. Fermented foods offer themselves as a combined whole food microbiota modulating intervention. Indeed, they contain potentially beneficial microbes, microbial metabolites and other bioactives, which are being harnessed to target the microbiota-gut-brain axis for positive benefits. This review highlights the diverse nature of fermented foods in terms of the raw materials used and type of fermentation employed, and summarises their potential to shape composition of the gut microbiota, the gut to brain communication pathways including the immune system and, ultimately, modulate the microbiota-gut-brain axis. Throughout, we identify knowledge gaps and challenges faced in designing human studies for investigating the mental health-promoting potential of individual fermented foods or components thereof. Importantly, we also suggest solutions that can advance understanding of the therapeutic merit of fermented foods to modulate the microbiota-gut-brain axis.

Contextualizing Bicultural Competence Across Youths' Adaptation From High School to College: Prospective Associations With Mental Health and Substance Use

Bicultural competence, the ability to navigate bicultural demands, is a salient developmental competency for youth of color linked with positive adjustment. This study investigated how discrimination experiences informed developmental trajectories of behavioral and affective bicultural competence across youth's adaptation from high school to college, and how these biculturalism trajectories predicted later adjustment (i.e., internalizing symptoms and binge drinking). Data were collected between 2016 through 2020 and included 206 U.S. Latino youth (Mage=17.59, 64% female, 85% Mexican origin, 11% first and 62% second generation immigrants). Linear latent growth analyses revealed that youth who experienced greater time-varying discrimination demonstrated lower concurrent behavioral and affective bicultural competence. Higher behavioral bicultural competence intercepts were associated with fewer internalizing symptoms in the third college year. No other significant associations emerged for internalizing symptoms or binge drinking. These findings have implications for mental health equity among Latino youth during a critical period of psychopathology onset.

Challenges and Concerns in Assisting Indigenous People with Suicide Attempts

There has been an alarming rise in suicide attempts among Indigenous people in Brazil, leading to national concerns about the provision of psychosocial care and professional support. In this study, we make an attempt to understand the perspectives of professionals in assisting Indigenous people from a specific group, the Inỹ, and identify the specific challenges of addressing issues through the mental health care system related specifically to suicide prevention. Using a qualitative approach with participant observation and semi-structured interviews, the research included Indigenous and their families assisted by three public institutions and the professionals that work in public psychosocial assistance. For this paper, we examined the tensions, conflicts, and challenges of the healthcare professionals at one of these institutions, a Psychosocial Care Center in the state of Goiás/Brazil. For data analysis, a sociocultural protocol was built to identify dialogical tensions between the different thematic fields of mental health care. The findings reveal that the theme of suicide was an important concern in the daily work with the community. Still, there were significant issues related to the assumptions, methodology, and meaning of care between the professionals and the community, on account of which the objective of the programme to address suicide attempts had not been effective or successful. The discussion of the results raises several critical questions about the possible contributions of dialogical cultural psychology in the context of Indigenous health. Also, it has important implications for the global issue of the wellbeing of Indigenous people.