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Oliver D. The future of preventive psychiatry is precise and transdiagnostic. Neurosci Biobehav Rev 2024; 160:105626. [PMID: 38492764 DOI: 10.1016/j.neubiorev.2024.105626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Dominic Oliver
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK.
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Fletcher CME, Woolford D, Gladigau J, Gunn KM. A 'Vocal Locals' social network campaign is associated with increased frequency of conversations about mental health and improved engagement in wellbeing-promoting activities in an Australian farming community. BMC Public Health 2024; 24:673. [PMID: 38431599 PMCID: PMC10909292 DOI: 10.1186/s12889-024-18193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Farmers face numerous barriers to accessing professional mental health services and instead report a preference for informal support systems, such as lay or peer networks. Farmers also experience barriers to investing time in maintaining or improving their wellbeing, stemming from sociocultural norms and attitudes that are widespread in agricultural communities. The Vocal Locals social network campaign is an ifarmwell initiative that aims to promote conversations about wellbeing and challenge attitudes and behaviours that contribute to farmers' poor mental health. METHODS The Vocal Locals campaign was underpinned by the socio-ecological model which explains human behaviour as stemming from interactions between the individual, their closest social circle, the community, and broader society. The campaign ran in Loxton, South Australia, from June to August 2022. Ten community members (8/10 farmers) became 'Vocal Locals' and were supported to share 'calls-to-action' to encourage people in their social networks to engage in wellbeing-promoting activities. A broader communications campaign reinforced key messages and amplified Vocal Locals' activities in the community. The intrapersonal and community-level impacts of the campaign were evaluated via pre- and post-campaign surveys of Vocal Locals and community members respectively. RESULTS Vocal Locals reported significantly lower psychological distress (p = .014), and higher positive mental wellbeing (p = .011), levels of general mental health knowledge (p = .022), and confidence helping someone with poor mental health (p = .004) following the intervention. However, changes in stigmatising beliefs about mental illness, confidence recognising poor mental health, and confidence and comfort speaking to others about mental health were non-significant. Community members who were familiar with the campaign reported having significantly more wellbeing-related conversations post-campaign compared to before (p = .015). Respondents also reported being more comfortable speaking to others about mental health or wellbeing (p = .001) and engaging more in activities to maintain or improve their wellbeing (p = .012) following the campaign. CONCLUSIONS The Vocal Locals social network campaign is an example of how science and community can be brought together to achieve meaningful outcomes. The campaign may serve as a model for others who wish to challenge attitudinal or knowledge-related barriers to help-seeking and improve engagement in wellbeing-promoting activities in difficult-to-reach communities.
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Affiliation(s)
- Chloe M E Fletcher
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia
| | - Dale Woolford
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia
| | - John Gladigau
- Gladigau Enterprises Pty Ltd, Loxton, SA, 5333, Australia
| | - Kate M Gunn
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia.
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Convoy SP, Heflin M, Alston BM, Hoffler U, Barzee M, Thompson JA, Westphal R. Stress First Aid for Health-care Workers: An Indicated Mental Illness Prevention Program for Nursing Education. Nurs Clin North Am 2024; 59:49-61. [PMID: 38272583 DOI: 10.1016/j.cnur.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Spurred by a global pandemic, the incidence and prevalence of stress-related injury and illness continues to increase amid an overburdened nursing workforce that has remarkably and reliably performed on the frontlines of health care. Indicated mental illness prevention programs such as Stress First Aid for Healthcare Workers create an opportunity to target the acute and chronic expressions of stress experienced by nurses earlier through coordinated peer support with the goals of preserving life, preventing further harm, and promoting recovery. This article will describe how a Stress First Aid program was operationalized at a school of nursing at a private university.
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Affiliation(s)
- Sean P Convoy
- School of Nursing, Duke University, 307 Trent Drive, Durham, NC 27710, USA.
| | - Mitchell Heflin
- Center for Interprofessional Education and Care (IPEC), Duke University, 307 Trent Drive, Durham, NC 27710, USA; Division of Geriatrics, Duke University School of Medicine, Aging Center at Duke, Geriatric Evaluation and Treatment Clinic, 307 Trent Drive, Durham, NC 27710, USA; Duke University School of Nursing, DUMC 33223, 307 Trent Drive, Durham, NC 27700, USA
| | - Bernice M Alston
- Duke University School of Nursing, DUMC 33223, 307 Trent Drive, Durham, NC 27700, USA
| | - Undi Hoffler
- North Carolina Central University, 1801 Fayetteville Street, Durham, NC 27707, USA
| | - Mary Barzee
- Duke University School of Nursing, DUMC 33223, 307 Trent Drive, Durham, NC 27700, USA
| | - Julie Anne Thompson
- Duke University School of Nursing, DUMC 33223, 307 Trent Drive, Durham, NC 27700, USA
| | - Richard Westphal
- Family, Community & Mental Health Systems, University of Virginia School of Nursing, 225 Jeanette Lancaster Way, Charlottesville, VA 22903, USA
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Aschentrup L, Steimer PA, Dadaczynski K, Mc Call T, Fischer F, Wrona KJ. Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review. BMC Public Health 2024; 24:69. [PMID: 38167010 PMCID: PMC10763397 DOI: 10.1186/s12889-023-17517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Though still a young field of research, gamified digital interventions have demonstrated potential in exerting a favourable impact on health and overall well-being. With the increasing use of the internet and digital devices, the integration of game elements presents novel opportunities for preventing mental disorders and enhancing mental health. Hence, this review aims to assess the effectiveness of gamified interventions focusing on preventing mental disorders or promoting mental health among adults. METHODS Based on a scoping review across four databases (MEDLINE, Embase, PsycInfo and Web of Science), 7,953 studies were initially identified. After removing duplicates and screening titles, abstracts and full texts, 16 studies were identified as suitable for inclusion in a narrative synthesis of findings. We included interventional studies encompassing an intervention and a control group aiming to investigate the effectiveness of the use of gamified digital mental health interventions and the use of gamified digital elements. RESULTS Overall, positive effects of gamified interventions on mental health-related outcomes were identified. In particular, beneficial consequences for psychological well-being and depressive symptoms were observed in all studies. However, further outcomes, such as resilience, anxiety, stress or satisfaction with life, showed heterogenous findings. Most game elements used were reward, sensation and progress, whilst the quantity of elements was not consistent and, therefore, no substantiated conclusion regarding the (optimal) quantity or composition of game elements can be drawn. Further, the outcomes, measurements and analyses differed greatly between the 16 included studies making comparisons difficult. CONCLUSION In summary, this review demonstrates the potential of integrating digital game elements on mental health and well-being with still a great gap of research. A taxonomy is needed to adequately address relevant game elements in the field of mental health promotion and prevention of mental disorders. Therefore, future studies should explicitly focus on the mechanisms of effect and apply rigorous study designs.
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Affiliation(s)
- Leona Aschentrup
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Pia Anna Steimer
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Global Public Health, Karolinska Institute, Solna, Sweden
| | - Kevin Dadaczynski
- Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Sciences, Leuphana University Lueneburg, Lueneburg, Germany
| | - Timothy Mc Call
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany.
| | - Kamil J Wrona
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
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Kane JC, Figge C, Paniagua-Avila A, Michaels-Strasser S, Akiba C, Mwenge M, Munthali S, Bolton P, Skavenski S, Paul R, Simenda F, Whetten K, Cohen J, Metz K, Murray LK. Effectiveness of trauma-focused cognitive behavioral therapy compared to psychosocial counseling in reducing HIV risk behaviors, substance use, and mental health problems among orphans and vulnerable children in Zambia: a community-based randomized controlled trial. AIDS Behav 2024; 28:245-263. [PMID: 37812272 DOI: 10.1007/s10461-023-04179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/10/2023]
Abstract
Orphans and vulnerable children (OVC) in sub-Saharan Africa are at high risk for HIV infection and transmission. HIV prevention and treatment efforts with OVC are hindered by mental health and substance use problems. This randomized controlled trial compared a mental health intervention, Trauma Focused Cognitive Behavioral Therapy (TF-CBT), to an enhanced version of an existing HIV Psychosocial Counseling (PC+) program among 610 adolescents who met PEPFAR criteria for OVC and had HIV risk behaviors in Lusaka, Zambia. Outcomes included HIV risk behaviors (e.g., risky sexual behaviors), mental health (internalizing symptoms, externalizing behaviors, PTSD) and substance use. At 12-month follow-up, there were significant within group reductions in both groups for all outcomes, with the only significant between group difference being for substance use, in which OVC who received TF-CBT had significantly greater reductions than OVC who received PC+. In a subgroup analysis of OVC with high levels of PTSD symptoms, TF-CBT was superior to PC + in reducing internalizing symptoms, functional impairment, and substance use. Findings support TF-CBT for reducing substance use among OVC. Subgroup analysis results suggest that a robust intervention such as TF-CBT is warranted for OVC with significant mental and behavioral health comorbidities. The similar performance of TF-CBT and PC + in the overall sample for risky sexual behavior and mild mental health problems indicates that enhancing existing psychosocial programs, such as PC, with standard implementation factors like having a defined training and supervision schedule (as was done to create PC+) may improve the efficacy of HIV risk reduction efforts.Clinical Trials Number: NCT02054780.
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Affiliation(s)
- Jeremy C Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Caleb Figge
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alejandra Paniagua-Avila
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Susan Michaels-Strasser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- ICAP, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher Akiba
- Department of Health Behavior, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Mwamba Mwenge
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Saphira Munthali
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Paul Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephanie Skavenski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ravi Paul
- School of Medicine, University of Zambia, University Teaching Hospital, Lusaka, Zambia
| | | | - Kathryn Whetten
- Duke Global Health Instittute, Durham, NC, USA
- Duke Sanford School of Public Policy, Durham, NC, USA
- Center for Health Policy and Inequalities Research, Durham, NC, USA
| | - Judith Cohen
- Drexel University College of Medicine, Allegheny Health Network/Allegheny General Hospital, Pittsburgh, PA, USA
| | - Kristina Metz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Overbeek G. Editorial: Prevention is the best cure - or is it? A cautionary tale. J Child Psychol Psychiatry 2024; 65:1-3. [PMID: 38100680 DOI: 10.1111/jcpp.13916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/17/2023]
Abstract
In large parts of the Western world prevention is considered a necessary, core component of successful youth care practice. Yet, mental health problems in young people do not appear to have declined over the past decades. How to explain this paradox? In this editorial for the Journal of Child Psychology and Psychiatry, several possible explanations are explored, one of which centers around how prevention is being operationalized-primarily, nowadays, as a screen-and-resolve 'troubleshooting' approach, rather than as an approach that supports the development of good health, competence, and resilience.
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Affiliation(s)
- Geertjan Overbeek
- Research Institute Child Development and Education, University of Amsterdam (UvA), Amsterdam, The Netherlands
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Raymond IJ, Burke KJ, Agnew KJ, Kelly DM. Wellbeing-responsive community: a growth target for intentional mental health promotion. Front Public Health 2023; 11:1271954. [PMID: 38152662 PMCID: PMC10751296 DOI: 10.3389/fpubh.2023.1271954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023] Open
Abstract
With mental illness remaining a significant burden of disease, there is an ongoing need for community-based health promotion, prevention, and responses (or "mental health promotion activities"). The health promotion, community development, and positive psychology literature identifies significant heterogeneity in the design and delivery of these activities. This variability spans: (1) individual vs. group outcomes, (2) psychological vs. sociological determinants of change, (3) promoting wellbeing vs. reducing mental health symptoms, and (4) the degree activities are contextualized vs. standardized in design and delivery. Mental health promotion activities do not easily accomplish this level of complexity within design and implementation. This has led to the emergence of the complexity-informed health promotion literature and the need for innovative tools, methods, and theories to drive this endeavor. This article directly responds to this call. It introduces "wellbeing-responsive community": a vision and outcome hierarchy (or growth target) for intentionally delivered mental health promotion. The construct enables the design and implementation of interventions that intentionally respond to complexity and contextualization through the drivers of co-creation, intentionality, and local empowerment. It represents a community (support team, programme, agency, network, school, or region) that has the shared language, knowledge, methods, and skills to work together in shared intent. In other words, to integrate best-practice science with their local knowledge systems and existing strengths, and intentionally co-create and deliver contextualized wellbeing solutions at both the individual and community levels that span the "system" (e.g., whole-of-community) to the "moment" (e.g., intentional support and care). Co-creation, as applied through a transdisciplinary lens, is emerging as an evidence-based method to respond to complexity. This article describes the rationale and evidence underpinning the conceptualization of a wellbeing-responsive community through the integration of three key disciplines: (1) positive psychology, (2) ecological or systems approaches, and (3) intentional practice (implementation science). A definitional, contextual, and applied overview of the wellbeing-responsive community is provided, including a hierarchy of outcomes and associated definitions. Its purported application across education, mental health, community service, and organizational settings is discussed, including its potential role in making complexity-informed health promotion practical for all knowledge users.
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Affiliation(s)
| | - Karena J. Burke
- College of Psychology School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Adelaide, SA, Australia
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Fehily C, Jackson B, Hansen V, Stettaford T, Bartlem K, Clancy R, Bowman J. Increasing chronic disease preventive care in community mental health services: clinician-generated strategies. BMC Psychiatry 2023; 23:933. [PMID: 38082423 PMCID: PMC10714530 DOI: 10.1186/s12888-023-05311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND People with a mental health condition experience a high prevalence of chronic disease risk behaviours e.g., tobacco smoking and physical inactivity. Recommended 'preventive care' to address these risks is infrequently provided by community mental health services. This study aimed to elucidate, among community mental health managers and clinicians, suggestions for strategies to support provision of preventive care. METHODS Three qualitative focus groups (n = 14 clinicians) were undertaken in one regional community mental health service to gather perspectives of barriers to preventive care provision, deductively coded against the domains of the Theoretical Domains Framework (TDF). Drawing on the learnings from the focus groups, individual interviews (n = 15 managers and clinicians) were conducted in two services to identify suggestions for strategies to increase preventive care. Strategies were inductively coded and mapped into TDF domains. RESULTS Barriers were identified across a wide range of TDF domains, most notably knowledge and environmental context and resources. Nine strategies were identified across three themes: training, resources and systems changes; mapping to all 14 TDF domains. CONCLUSION Future research seeking to increase implementation of preventive care may be guided by these findings. There is need for greater recognition and resourcing of preventive care as a priority and integral component of mental health treatment.
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Affiliation(s)
- Caitlin Fehily
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia.
| | - Belinda Jackson
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
| | - Vibeke Hansen
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
| | - Tegan Stettaford
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Kate Bartlem
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Richard Clancy
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- Hunter New England Mental Health, Hunter New England Local Health District, NSW Health, New Lambton, NSW, Australia
- School of Nursing and Midwifery, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Jenny Bowman
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
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Hultqvist J, Zhang P, Staland-Nyman C, Bertilsson M. Managers' Influence on the Prevention of Common Mental Disorders in the Workplace: A Cross-Sectional Study Among Swedish Managers. J Occup Environ Med 2023; 65:1008-1016. [PMID: 37621038 DOI: 10.1097/jom.0000000000002950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To investigate the association among managers' attitudes toward subordinates with common mental disorders (CMDs), self-confidence in supporting these subordinates, and managerial preventive actions (MPAs). METHODS A cross-sectional study was conducted among Swedish managers (n = 2988) and two types of MPAs: reviewing assignments and work situation (MPA-review), and talking about CMD at the workplace (MPA-talk). Binary logistic regression models were applied and adjusted for individual and organizational covariates. RESULTS Managers with negative attitudes toward subordinates with CMD were less likely to have done both MPAs. Managers with higher self-confidence in supporting these subordinates were more likely to have done both MPAs compared with managers with lower self-confidence. CONCLUSIONS Managerial negative attitudes toward CMD and self-confidence in supporting subordinates with CMD have a role in MPAs and should be addressed in manager training programs to encourage preventive actions.
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Affiliation(s)
- Jenny Hultqvist
- From the Department of Health and Rehabilitation, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (J.H.); School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (P.Z., C.S.-N., M.B.); and School of Health and Welfare, Halmstad University, Halmstad, Sweden (C.S.-N.)
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Skinner A, Occhipinti JA, Song YJC, Hickie IB. Population-level effectiveness of alternative approaches to preventing mental disorders in adolescents and young adults. Sci Rep 2023; 13:19982. [PMID: 37968445 PMCID: PMC10652005 DOI: 10.1038/s41598-023-47322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 11/12/2023] [Indexed: 11/17/2023] Open
Abstract
Preventive interventions that are effective in reducing the incidence of mental disorders in adolescence and early adulthood may impact substantially on lifetime economic, educational, and health outcomes; however, relatively few studies have examined the capacity of alternative approaches to preventing youth mental disorders (specifically, universal, selective, and indicated prevention) to reduce disorder incidence at a population level. Using a dynamic model of the onset of non-specific, relatively mild symptoms and progression to more severe disease, we show that: (1) indicated preventive interventions, targeting adolescents and young adults experiencing subthreshold symptoms, may often be more effective in reducing mental disorder prevalence than universal interventions delivered to the general population (contrary to the widely accepted view that a 'high risk' prevention strategy, focussing on those individuals with the greatest risk of developing a disorder, will generally be less effective than a whole-population strategy); and (2) the ability of selective preventive interventions (targeting vulnerable, asymptomatic youth) to alter the prevalence of mental disorders is severely restricted by an inverse relationship between the prevalence of significant risk factors for mental illness and the relative risk of developing symptoms.
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Affiliation(s)
- Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Computer Simulation and Advanced Research Technologies (CSART), Sydney, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Prina E, Ceccarelli C, Abdulmalik JO, Amaddeo F, Cadorin C, Papola D, Tol WA, Lund C, Barbui C, Purgato M. Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis. Int J Soc Psychiatry 2023; 69:1578-1591. [PMID: 37183793 DOI: 10.1177/00207640231174451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM to assess the efficacy of psychosocial interventions delivered through task-sharing approaches for preventing perinatal common mental disorders among women in low- and middle-income countries. METHODS We conducted a systematic review of randomized controlled trials following a prespecified protocol registered in the Open Science Framework (osf.io/qt4y3). We searched MEDLINE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) through June 2022. Two reviewers independently extracted the data and evaluated the risk of bias of included studies using the Cochrane risk of bias tool. We performed random-effects meta-analyses and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS We included 23 studies with 24,442 participants. At post-intervention, task-shared psychosocial interventions, were effective in preventing the development of mental disorders in general (RR 0.57, 95% CI [0.35, 0.91]), and specifically depression (RR 0.51, 95% CI [0.35, 0.75]), but not anxiety disorders (RR 0.46, 95% CI [0.06, 3.33]). Similarly, psychosocial interventions reduced psychological distress (SMD -1.32, 95% CI [-2.28, -0.35]), and depressive symptoms (SMD -0.50, 95% CI [-0.80, -0.16]), and increased parenting self-efficacy (SMD -0.76, 95% CI [-1.13, -0.38]) and social support (SMD -0.72, 95% CI [-1.22, -0.22]). No effect was detected for anxiety symptoms at post-intervention. At follow-up the beneficial effects of interventions progressively decreased. CONCLUSIONS Psychosocial interventions delivered through the task-sharing modality are effective in preventing perinatal common mental disorders and fostering positive mental health among women in low- and middle-income countries. However, our findings are tentative, due to the low number of preventative intervention strategies considering outcomes as the incidence of mental disorders, especially in the long-term. This evidence supports calls to implement and scale up psychosocial prevention interventions for perinatal common mental disorders in low- and middle-income countries.
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Affiliation(s)
- Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Caterina Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Wietse A Tol
- Department of Public Health, University of Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
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Simon KM. Mitigating the Negative Mental Health Impact of Racism on Black Adolescents-A Preventive Perspective. JAMA Netw Open 2023; 6:e2340577. [PMID: 37910107 PMCID: PMC11005054 DOI: 10.1001/jamanetworkopen.2023.40577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Kevin M Simon
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
- Division of Addiction Medicine, Boston Children's Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Behavioral Health and Wellness, Boston Public Health Commission, Boston, Massachusetts
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Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik JO, Amaddeo F, Arcari L, Churchill R, Jordans MJ, Lund C, Papola D, Uphoff E, van Ginneken N, Tol WA, Barbui C. Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries. Cochrane Database Syst Rev 2023; 10:CD014722. [PMID: 37873968 PMCID: PMC10594594 DOI: 10.1002/14651858.cd014722.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. OBJECTIVES To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. SELECTION CRITERIA Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. DATA COLLECTION AND ANALYSIS Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. MAIN RESULTS Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants). AUTHORS' CONCLUSIONS The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.
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Affiliation(s)
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Caterina Ceccarelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Jd Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Nadja van Ginneken
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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Pierce M, Bai Y, Nevriana A, Dalman C, Hope HF, Kosidou K, Ohlis A, Wicks S, Abel KM. Prevention of Childhood Adversities and Children's Common Mental Disorders and School Grades. JAMA Netw Open 2023; 6:e2336408. [PMID: 37796502 PMCID: PMC10556962 DOI: 10.1001/jamanetworkopen.2023.36408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
Importance Adversity during childhood can limit children's chances of achieving their optimal developmental and psychological outcomes. Well-designed observational studies might help identify adversities that are most implicated in this, thereby helping to identify potential targets for developing interventions. Objective To compare the association between preventing childhood poverty, parental mental illness and parental separation, and the population rate of offspring common mental disorders (ages 16-21 years) or average school grades (age 16 years). Design, Setting, and Participants A population-based, longitudinal cohort study using Swedish registries was conducted. A total of 163 529 children born in Sweden between January 1, 1996, and December 31, 1997, were followed up until their 21st birthday. They were linked to registries using Sweden's national personal identification number. Children were linked to birth parents, hospital records, and school data. Parents were linked to registries containing health, income, sociodemographic, and obstetric data. Analyses were conducted between January 10, 2021, and August 26, 2022. Exposures Childhood adversities of relative poverty (household disposable income <50% of the median), parental inpatient admission for a mental illness, or parental separation. Adversities were categorized into developmental periods: ages 0 to 3, 4 to 7, 8 to 11, and 12 to 16 years. Main Outcomes and Measures The main outcomes were children's hospital records with a diagnosis of anxiety or depression between ages 16 and 21 years and school grades at the end of compulsory education (age 16 years). The parametric g-formula modeled population changes in outcomes associated with the counterfactual, hypothetical preventing adversity exposures, accounting for fixed and time-varying confounders. Adjustments were made for parental demographic characteristics, obstetric variables, and socioeconomic data at birth. Results A total of 163 529 children were included in the cohort (51.2% boys, 51.4% born in 1996). Preventing all adversities was associated with an estimated change in the prevalence of offspring common mental disorders from 10.2% to 7.6% and an improvement in school grades with an SD of 0.149 (95% CI, 0.147-0.149). Preventing parental separation provided for the greatest improvement, with an estimated 2.34% (95% CI, 2.23%-2.42%) fewer children with a common mental disorder and an improvement in school grades by 0.127 SDs (0.125-0.129). Greater improvements were shown by hypothetically targeting adolescents (age 12-16 years) and those whose parents had a mental illness when the child was born. Conclusions and Relevance The results of this cohort modeling study suggest that preventing childhood adversity could provide notable improvements in the rates of common mental disorders and school grades. Many children might achieve better life outcomes if resources are properly allocated to the right adversities (parental separation), the right groups (children with parental mental illness), and at the right time (adolescence).
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Affiliation(s)
- Matthias Pierce
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Yushi Bai
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Alicia Nevriana
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Holly F. Hope
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Anna Ohlis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Susanne Wicks
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Center for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Kathryn M. Abel
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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15
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Tinnerholm Ljungberg H, Olsson C, Jensen I, Nybergh L, Björk Brämberg E. Managers' experience of causes and prevention of sick leave among young employees with Common Mental Disorders (CMDs)-A qualitative interview study with a gender perspective. PLoS One 2023; 18:e0292109. [PMID: 37756352 PMCID: PMC10529614 DOI: 10.1371/journal.pone.0292109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Young adults entering the workforce have an almost 40% greater risk of work-related mental health problems than other working age groups. Common mental disorders (CMDs) constitute the majority of such mental health problems. Managers are crucial in promoting a good psychosocial work environment and preventing sick leave. The study aims to explore managers' experience of 1) causes of sick leave in the personal and work-life of young employees with CMDs, and 2) prevention of such sick leave. A gender perspective is applied to examine managers' experience of causes and prevention of sick leave in relation to male and female employees and male and female-dominated occupations. MATERIAL AND METHODS A qualitative design was applied and 23 semi-structured interviews were conducted with Swedish managers experienced in supervising young employees with CMDs. The interviews were analysed with conventional content analysis and the managers' experience of similarities and differences between young female and male employees and occupations were explored through reflective notes. RESULTS Four main categories and eight subcategories describe the managers' experience of the causes of sick leave due to CMD among young employees. The main categories are: 1) entering work life when already worn-out, 2) struggling with too high expectations at work, 3) having a challenging personal life, and 4) being unable to manage specific occupational challenges and demands. Gender differences were found in six subcategories regarding, e.g., work demands and problems in personal relationships. One main category and three subcategories describe how this type of sick leave might be prevented, with managers emphasizing the need to ease the transition into work life. Gender differences in the prevention of sick leave were found in one subcategory regarding communication about workers' health and problems at work. CONCLUSION Our findings show that gender norms and the expectations of young men and women are factors of importance in managers' experience of the development and prevention of CMDs. These results can inform their preventive work and their supervision and introduction of newly-employed young adults.
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Affiliation(s)
- Helena Tinnerholm Ljungberg
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Olsson
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Nybergh
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Björk Brämberg
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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16
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Puchol-Martínez I, Vallina Férnandez Ó, Santed-Germán MA. Preventive interventions for children and adolescents of parents with mental illness: A systematic review. Clin Psychol Psychother 2023; 30:979-997. [PMID: 36997159 DOI: 10.1002/cpp.2850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Children of parents with mental disorders have a relatively high risk of developing a mental illness or behavioural disorder. OBJECTIVE The aim of this systematic review was to evaluate the efficacy of preventive psychotherapeutic interventions in children of parents with mental illness. In particular, the development of mental illness and/or psychological symptomatology in this population was assessed. METHOD This qualitative systematic review looked at interventions targeting children aged 4-18 years without a diagnosed mental disorder, alone or with their families, with a parent with a diagnosed mental disorder. The protocol was pre-registered in Open Science Framework. A total of 1255 references were retrieved from MEDLINE, PsychArticles, PsycINFO, Springer Link, Science Direct, Scopus and WOS databases, and 12 references from grey literature. This search was replicated by an external reviewer. RESULTS Fifteen studies involving 1941 children and 1328 parents were included. Interventions were based on cognitive-behavioural and/or psychoeducational components, including six randomized controlled trials. Internalizing symptomatology was assessed in 80% of the studies, externalizing and prosocial behaviour in 47%, and coping style in 33%. Only two studies measured the future risk of developing a mental disorder (ORs of 2.37 and 6.6). There was variability in the format of the intervention (group; family) as well as in the type of intervention and its duration (from one session to 12 sessions). CONCLUSIONS Interventions for children of parents with mental disorder were clinically and statistically significant, especially in preventing internalizing symptomatology at one-year follow-up, with effect sizes ranging from d = -0.28 to 0.57 (95% CI).
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Affiliation(s)
- Itzal Puchol-Martínez
- Escuela Internacional de Doctorado, Institute of Public and Occupational Health of Navarre, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Miguel A Santed-Germán
- Department of Personality Evaluation and Psychological Treatment, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Saijonkari M, Paronen E, Lakka T, Tolmunen T, Linnosmaa I, Lammintakanen J, Isotalo J, Rekola H, Mäki-Opas T. Promotive and preventive interventions for mental health and well-being in adult populations: a systematic umbrella review. Front Public Health 2023; 11:1201552. [PMID: 37719731 PMCID: PMC10501832 DOI: 10.3389/fpubh.2023.1201552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Mental health disorders are increasing worldwide, leading to significant personal, economic, and social consequences. Mental health promotion and prevention have been the subject of many systematic reviews. Thus, decision makers likely face the problem of going through literature to find and utilize the best available evidence. Therefore, this systematic umbrella review aims to evaluate the effectiveness of interventions for promoting mental health and mental well-being, as well as for the primary prevention of mental health disorders. Methods Literature searches were performed in APA PsycInfo, Medline, and Proquest Social Science databases from January 2000 to December 2021. The search results were screened for eligibility using pre-defined criteria. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool. The key findings of the included reviews were narratively synthesized and reported with an emphasis on reviews achieving higher methodological quality. Results Out of the 240 articles found, 16 systematic reviews and four systematic umbrella reviews were included. The methodological quality of included reviews was low or critically low. Discussion This review suggests that interventions using cognitive-behavioral therapy and those developing resilience, mindfulness, or healthy lifestyles can be effective in the promotion of mental health and well-being in adult populations. Motivational interviewing may reduce alcohol consumption in young adults. Indicated or selective prevention is likely to be cost-effective compared to universal prevention. Parenting interventions and workplace interventions may be cost-effective in terms of promoting mental health. Due to the low methodological quality of the included reviews and substantial heterogeneity among the reported results, the findings from the reviews we summarized should be interpreted with caution. There is a need for further rigorous, high-quality systematic reviews.
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Affiliation(s)
- Maija Saijonkari
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Elsa Paronen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | | | - Ismo Linnosmaa
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- Department of Public Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Johanna Lammintakanen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Jenni Isotalo
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Hanna Rekola
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tomi Mäki-Opas
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services Research Center, North Savo Wellbeing Services County, Kuopio, Finland
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Xiong RG, Li J, Cheng J, Zhou DD, Wu SX, Huang SY, Saimaiti A, Yang ZJ, Gan RY, Li HB. The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients 2023; 15:3258. [PMID: 37513676 PMCID: PMC10384867 DOI: 10.3390/nu15143258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
The number of individuals experiencing mental disorders (e.g., anxiety and depression) has significantly risen in recent years. Therefore, it is essential to seek prevention and treatment strategies for mental disorders. Several gut microbiota, especially Firmicutes and Bacteroidetes, are demonstrated to affect mental health through microbiota-gut-brain axis, and the gut microbiota dysbiosis can be related to mental disorders, such as anxiety, depression, and other mental disorders. On the other hand, dietary components, including probiotics (e.g., Lactobacillus and Bifidobacterium), prebiotics (e.g., dietary fiber and alpha-lactalbumin), synbiotics, postbiotics (e.g., short-chain fatty acids), dairy products, spices (e.g., Zanthoxylum bungeanum, curcumin, and capsaicin), fruits, vegetables, medicinal herbs, and so on, could exert protective effects against mental disorders by enhancing beneficial gut microbiota while suppressing harmful ones. In this paper, the mental disorder-associated gut microbiota are summarized. In addition, the protective effects of dietary components on mental health through targeting the gut microbiota are discussed. This paper can be helpful to develop some dietary natural products into pharmaceuticals and functional foods to prevent and treat mental disorders.
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Affiliation(s)
- Ruo-Gu Xiong
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Jiahui Li
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China;
| | - Jin Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Dan-Dan Zhou
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Si-Xia Wu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Si-Yu Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Adila Saimaiti
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Zhi-Jun Yang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
| | - Ren-You Gan
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, Singapore 138669, Singapore
| | - Hua-Bin Li
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (R.-G.X.); (J.C.); (D.-D.Z.); (S.-X.W.); (S.-Y.H.); (A.S.); (Z.-J.Y.)
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Yolken R. Infections and neuropsychiatric disorders: new studies document pathways to prevention and treatment. Mol Psychiatry 2023; 28:2624-2626. [PMID: 37106118 PMCID: PMC10134699 DOI: 10.1038/s41380-023-02072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Robert Yolken
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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20
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Affiliation(s)
- Anne Duffy
- Department of Psychiatry, Queen's University, Canada
- Department of Psychiatry, University of Oxford, UK
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21
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Asselmann E, Zenker M, Rückert F, Kische H, Pieper L, Beesdo-Baum K. Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders. PLoS One 2023; 18:e0286750. [PMID: 37289760 PMCID: PMC10249886 DOI: 10.1371/journal.pone.0286750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range β = -0.31 for DASS-depression to β = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (β = -0.10) and PROMIS-anger (β = -0.09) remained until follow-up. Moreover, positive affect (β = 0.19), internal control beliefs (β = 0.15), favorable coping (β = 0.60), and unfavorable coping (β = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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22
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Bhamani SS, Arthur D, Van Parys AS, Letourneau N, Wagnild G, Degomme O. Development and Validation of Safe Motherhood-Accessible Resilience Training (SM-ART) Intervention to Improve Perinatal Mental Health. Int J Environ Res Public Health 2023; 20:ijerph20085517. [PMID: 37107799 PMCID: PMC10138860 DOI: 10.3390/ijerph20085517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 05/11/2023]
Abstract
Perinatal mental health issues in women can lead to a variety of health complications for both mother and child. Building resilience can strengthen coping mechanisms for pregnant women to improve their mental health and protect themselves and their children. The study aims to develop and validate the contextual and cultural appropriateness of the Safe Motherhood-Accessible Resilience Training (SM-ART) intervention for pregnant women in Pakistan. A three-phase approach was used to develop and validate an intervention that promotes resilience in pregnant women. Phase I comprised a needs assessment with stakeholders (pregnant women and key informants) to elicit opinions regarding module content. In Phase II, an intervention to build resilience was developed with the help of a literature review and formative assessment findings, and Phase III involved the validation of the intervention by eight mental health experts. The experts assessed the Content Validity Index (CVI) of the SM-ART intervention on a self-developed checklist. The resultant SM-ART intervention consists of six modules with strong to perfect CVI scores for each of the modules. Qualitative responses endorsed the strengths of the intervention as having innovative and engaging activities, contextual and cultural relevance, and a detailed, comprehensive facilitator guide. SM-ART was successfully developed and validated and is now ready for testing to promote the resilience of pregnant women at risk of perinatal mental illness.
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Affiliation(s)
- Shireen Shehzad Bhamani
- School of Nursing and Midwifery, Aga Khan University, Karachi 74800, Pakistan
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.-S.V.P.); (O.D.)
- Correspondence: ; Tel.: +92-21-34865458
| | - David Arthur
- School of Nursing, Peking Union Medical College, Beijing 100005, China;
| | - An-Sofie Van Parys
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.-S.V.P.); (O.D.)
| | - Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | | | - Olivier Degomme
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (A.-S.V.P.); (O.D.)
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Breznoscakova D, Kovanicova M, Sedlakova E, Pallayova M. Autogenic Training in Mental Disorders: What Can We Expect? Int J Environ Res Public Health 2023; 20:4344. [PMID: 36901353 PMCID: PMC10001593 DOI: 10.3390/ijerph20054344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
Autogenic training (AT) is a well-established self-induced relaxation technique based on autosuggestion. From the past two decades, an increasing number of AT studies strongly suggests the practical usefulness of psychophysiological relaxation in the area of medicine. Despite this interest, to date, limited critical clinical reflection on the application and effects of AT in mental disorders exists. The present paper reviews psychophysiological, psychopathological, and clinical aspects of AT in persons with mental disorders with emphasis on implications for future research and practice. Based on a formal literature search, 29 reported studies (7 meta-analyses/systematic reviews) were identified that examined the effects and impact of AT on mental disorders. The main psychophysiological effects of AT include autonomic cardiorespiratory changes paralleled by central nervous system activity modifications and psychological outputs. Studies demonstrate consistent efficacy of AT in reducing anxiety and medium range positive effects for mild-to-moderate depression. The impact on bipolar disorders, psychotic disorders, and acute stress disorder remains unexplored. As an add-on intervention psychotherapy technique with beneficial outcome on psychophysiological functioning, AT represents a promising avenue towards expanding research findings of brain-body links beyond the current limits of the prevention and clinical management of number of mental disorders.
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Affiliation(s)
- Dagmar Breznoscakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
- Center for Mental Functions, Crystal Comfort, LLC, M. R. Stefanika 2427, 093 01 Vranov nad Toplou, Slovakia
| | - Milana Kovanicova
- 2nd Department of Psychiatry, University Hospital of Louis Pasteur, Rastislavova 43, 041 90 Kosice, Slovakia
| | - Eva Sedlakova
- Department of Pathological Physiology, Faculty of Medicine, Pavol Jozef Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Maria Pallayova
- Department of Human Physiology, Faculty of Medicine, Pavol Jozef Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
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Kurisu K, Song YH, Yoshiuchi K. Developing Action Plans Based on Machine Learning Analysis to Prevent Sick Leave in a Manufacturing Plant. J Occup Environ Med 2023; 65:140-145. [PMID: 36075358 PMCID: PMC9897279 DOI: 10.1097/jom.0000000000002700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to develop action plans for employees' health promotion based on a machine learning model to predict sick leave at a Japanese manufacturing plant. METHODS A random forest model was developed to predict sick leave. We developed plans for workers' health promotion based on variable importance and partial dependence plots. RESULTS The model showed an area under the receiving operating characteristic curve of 0.882. The higher scores on the Brief Job Stress Questionnaire stress response, younger age, and certain departments were important predictors for sick leave due to mental disorders. We proposed plans to effectively use the Brief Job Stress Questionnaire and provide more support for younger workers and managers of high-risk departments. CONCLUSIONS We described a process of action plan development using a machine learning model, which may be beneficial for occupational health practitioners.
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Moghadam MT, Ramírez-Coronel AA, Darijani S, Akbarizadeh MR, Naderifar M, Soltaninejad S, Shahbazi S, Dousari AS, Mojtahedi A, Akhavan-Sigari R. Perturbations in Microbiota Composition as a Novel Mediator in Neuropsychiatric, Neurological and Mental Disorders: Preventive and Therapeutic Complementary Therapies to Balance the Change. Curr Alzheimer Res 2023; 20:213-223. [PMID: 37464825 DOI: 10.2174/1567205020666230718160914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023]
Abstract
Although microbiology and neurology are separate disciplines, they are linked to some infectious and neurological diseases. Today, microbiome is considered as one of the biomarkers of health by many researchers. This has led to the association of microbiome changes with many neurological diseases. The natural microbiota has many beneficial properties. If disrupted and altered, it can lead to irreversible complications and many neurological diseases. Therefore, according to previous studies, some preventive and therapeutic complementary therapies can prevent or restore microbiome dysbiosis and inflammation in the nervous system. With our current perception of the microbiological basis for different neurological disorders, both aspects of drug treatment and control of perturbations of the microbiome should be considered, and targeting them simultaneously will likely help to attain favorable results.
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Affiliation(s)
- Majid Taati Moghadam
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Andrés Alexis Ramírez-Coronel
- Laboratory of Psychometrics, Comparative Psychology and Ethology (LABPPCE), Azogues Campus Nursing Career, Health and Behavior Research Group (HBR), Catholic University of Cuenca, Ecuador
- Epidemiology and Biostatistics Research Group, CES University, Medellín, Colombia
- Department of Psychology, University of Palermo, Buenos Aires, Argentina
| | - Samaneh Darijani
- School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | | | - Mahin Naderifar
- School of Nursing & Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Simin Soltaninejad
- Department of Radiation Oncology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahla Shahbazi
- Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Akhavan-Sigari
- Department of Neurosurgery, University Medical Center Tuebingen, Tuebingen, Germany
- Department of Health Care Management and Clinical Research, Collegium Humanum Warsaw Management University, Warsaw, Poland
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Oluka EM, Dossen SB, Ebuenyi ID. Flooding in Nigeria, towards prioritizing mental health and psychosocial support. Pan Afr Med J 2022; 43:199. [PMID: 36942136 PMCID: PMC10024557 DOI: 10.11604/pamj.2022.43.199.38251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
In the past decade, Nigeria has been experiencing worsening flooding. Beyond the physical injuries caused, it can impact the mental health of affected individuals. While new mental health disorders can emerge, exacerbation of preexisting mental conditions are common in the aftermath of flooding. Therefore, it is critical to integrate mental health and psychosocial support as part of the emergency response available to affected populations on both short-term and long-term basis.
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Affiliation(s)
| | | | - Ikenna Desmond Ebuenyi
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pennsylvania, USA
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Yong R, Nomura K, Takatsuka Y, Imuta H, Taniguchi H, Ito H, Ohira T, Tstsumi A. [Challenges, prevention, and countermeasures for social withdrawal (hikikomori) by age group]. Nihon Koshu Eisei Zasshi 2022; 69:923-930. [PMID: 36261343 DOI: 10.11236/jph.22-025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The term "hikikomori" was recognized by society between 1980 and 2000, when the term "NEET" also appeared and it was regarded as a problem of irresponsible youth. However, accumulation of surveys and research both in Japan and abroad, including those conducted by the Cabinet Office, has revealed that the reasons behind social withdrawal are not only limited to mental illness. There are many people who exhibit withdrawal because they are unable to establish relationships with the community and other people owing to various factors such as social systems, attachment formation, family background, and education. In other words, withdrawal is better described as a "symptom" or "condition" than a disease. Therefore, it is necessary to understand and analyze the diverse backgrounds and needs of individuals with withdrawal and confront them about their state. Currently, many hikikomori people with prolonged withdrawal are now in their 40s and 50s. With their parents' aging, there are cases where people with hikikomori and their families become socially isolated and are unable to make ends meet. It is undeniable that, until now, the society we live in as a whole has little interest in or understanding of hikikomori. In contrast, withdrawal among older adults (tojikomori), which has become a problem in the super-aging society. Tojikomori is defined as "going out less than once a week and not requiring nursing care", which is not equivalent with hikikomori. Owing to the decline in the frequency of going out among the elderly in the recent coronary crisis, the number of pre-frailty in older adults has become a nationwide problem. Thus, both hikikomori and tojikomori are reversible conditions, and can be alleviated by providing necessary support. This paper summarizes the findings of the symposium "Challenges, Prevention, and Countermeasures for Social Withdrawal (Hikikomori) by Age Group" organized by the Committee on Mental Health and Suicide Prevention of the Japanese Society of Public Health at the 79th Annual Meeting of the Japanese Society of Public Health. This article is a compilation of findings that can benefit public health practitioners and researchers.
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Affiliation(s)
- Roseline Yong
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine
- Suicide Prevention Committee, Japanese Society of Public Health
| | | | - Hiromi Imuta
- Faculty of Health Sciences, Tokyo Metropolitan University
| | | | - Hiroto Ito
- Division of Health Administration and Policy, Tohoku Medical and Pharmaceutical University
- Suicide Prevention Committee, Japanese Society of Public Health
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
- Suicide Prevention Committee, Japanese Society of Public Health
| | - Akizumi Tstsumi
- Public Health, Kisato University School of Medicine
- Suicide Prevention Committee, Japanese Society of Public Health
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28
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Panza M, Redman G, Vierimaa M, Vella SA, Bopp M, Evans MB. Developing and evaluating a peer-based mental health literacy intervention with adolescent athletes. PLoS One 2022; 17:e0274761. [PMID: 36520806 PMCID: PMC9754252 DOI: 10.1371/journal.pone.0274761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/02/2022] [Indexed: 12/23/2022] Open
Abstract
Widespread adolescent involvement in organized sport means that sport contexts are well-suited to 'actively' integrate prevention programs that may promote population-level change. This mixed methods study aimed to evaluate the feasibility and acceptability of a peer-based mental health literacy intervention. The intervention (i.e., Team Talk) was presented to eleven adolescent sport teams in the United States, with a total of 174 participants. Athlete participants completed surveys immediately before and after the intervention-including measures of workshop acceptability, social identity, and help-seeking behaviors. Semi-structured interviews were also conducted with a subset of five athletes, nine parents, and two coaches. With respect to recruitment as an indicator of feasibility, club-level adoption of the intervention was low, with difficulty recruiting clubs for intervention delivery. This signals that feasibility of the intervention-as it is currently designed and implemented by the research team-is low when considering similar competitive adolescent sport clubs and delivered as team-level workshops. Meanwhile, participants reported high acceptability of the intervention, and acceptability levels across participants was predicted by contextual factors related to implementation such as session duration. Regarding limited efficacy testing with measures completed before and after the intervention session: (a) social identity scores increased following the intervention, and (b) significant differences were not identified regarding efficacy to recognize symptoms of mental disorders. Athlete, coach, and parent interview responses also described potential adaptations to mental health programs. This research demonstrates the potential utility of peer-based mental health literacy interventions, while also revealing that further implementation research is necessary to adapt mental health literacy interventions to suit diverse adolescent sport contexts.
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Affiliation(s)
- Michael Panza
- Department of Kinesiology, Pennsylvania State University, University Park, PA, United States of America
| | - Grace Redman
- Department of Kinesiology, Pennsylvania State University, University Park, PA, United States of America
| | | | - Stewart A. Vella
- School of Psychology, University of Wollongong, Wollongong, NSW, AUS
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, PA, United States of America
| | - M. Blair Evans
- Department of Psychology, Western University, London, ON, CAN
- * E-mail:
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29
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Buitrago Ramírez F, Ciurana Misol R, Fernández Alonso MDC, Tizón JL. [Prevention of mental health disorders in primary care: Children of single-parent families. Pregnancy in adolescence]. Aten Primaria 2022; 54 Suppl 1:102445. [PMID: 36435588 PMCID: PMC9705223 DOI: 10.1016/j.aprim.2022.102445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Francisco Buitrago Ramírez
- Medicina Familiar y Comunitaria, Centro de Salud Universitario La Paz, Servicio Extremeño de Salud, Badajoz, España.
| | | | | | - Jorge L Tizón
- Psiquiatría y Neurología, Psicología y Psicoanálisis, Institut Universitaria de Salut Mental, Universitat Ramon Llull, Barcelona, España
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30
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Yu J. Research on the Intervention and Prevention of College Students' Mental Health Crisis From the Perspective of Ideological and Physical Education. Front Public Health 2022; 10:905905. [PMID: 35812494 PMCID: PMC9257002 DOI: 10.3389/fpubh.2022.905905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Present study has aimed to understand the intervention and prevention of the mental health crisis of college students. For this purpose, this study has checked the effect of trust in wellbeing information on preventive behavior and mental wellbeing. The target population taken for this study is the students of colleges situated in Mainland in China. The data was collected from the 458 students of the college. Smart PLS has been employed on the data to get the results using partial least square structural equation modeling. For this purpose, the data were analyzed in two stages, i.e., measurement model stage and the structural model stage. Results of this study have revealed that trust in wellbeing information plays a significant and positive role in setting preventive behavior and the mental wellbeing of students. Further, it has also been revealed that preventive behavior also plays a significant and positive role in mental wellbeing. Additionally, preventive behavior has been found as an important mediating variable among the relationship of trust in wellbeing information and mental wellbeing. Moreover, family support is crucial by positively moderating the relationship between preventive behavior and mental wellbeing. Many practical implications have been found among which the foremost is that the education institutes must undertake those efforts that aim to ensure the fairness in the information spread regarding the mental wellbeing during seminars, workshops and administration should play a positive role responsible for strengthening the mental health of students by managing ideas, improving student education management, innovating management techniques and methods.
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Affiliation(s)
- Jiang Yu
- College of Sports and Leisure, Guangdong Ocean University, Zhanjiang, China
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31
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Joosen MCW, Lugtenberg M, Arends I, van Gestel HJAWM, Schaapveld B, Terluin B, van Weeghel J, van der Klink JJL, Brouwers EPM. Barriers and Facilitators for Return to Work from the Perspective of Workers with Common Mental Disorders with Short, Medium and Long-Term Sickness Absence: A Longitudinal Qualitative Study. J Occup Rehabil 2022; 32:272-283. [PMID: 34580811 PMCID: PMC9232415 DOI: 10.1007/s10926-021-10004-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 05/26/2023]
Abstract
Purpose Although common mental disorders (CMDs) highly impact individuals and society, a knowledge gap exists on how sickness absence can be prevented in workers with CMDs. This study explores: (1) workers' perceived causes of sickness absence; (2) perceived return to work (RTW) barriers and facilitators; and (3) differences between workers with short, medium and long-term sickness absence. Methods A longitudinal qualitative study was conducted involving 34 workers with CMDs. Semi-structured interviews were held at two time-points during their RTW process. The 68 interviews were audio-taped, transcribed and thematically analyzed to explore workers' perspective on sickness absence causes, RTW barriers and facilitators, and compare data across the three sub-groups of workers. Results Workers reported various causes for their absence, including: (1) high work pressure; (2) poor work relationships; (3) unhelpful thoughts and feelings, e.g. lacking self-insight; and (4) ineffective coping behaviors. According to workers, RTW was facilitated by work adjustments, fulfilling relationships with supervisors, and adequate occupational health guidance. Workers with short-term leave more often reported favorable work conditions, and proactive coping behavior. In contrast, the long-term group reported reactive coping behavior and dissatisfaction with their work. Conclusion Supporting workers with CMDs in gaining self-awareness and regaining control, discussing the value of their work, and creating work conditions that enable workers to do valuable work, seem central for successful RTW and might prevent sickness absence. Supervisors play a key role in enabling workers to do valuable work and further research should focus on how supervisors can be supported in this task.
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Affiliation(s)
- Margot C W Joosen
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands.
| | - Marjolein Lugtenberg
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands
| | - Iris Arends
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Hanneke J A W M van Gestel
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands
| | | | - Berend Terluin
- Department of General Practice, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jaap van Weeghel
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands
- Phrenos Centre of Expertise, Utrecht, The Netherlands
| | - Jac J L van der Klink
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands
- Optentia, North West University of South Africa, Vanderbijlpark, South Africa
| | - Evelien P M Brouwers
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welbeing, Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands
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Garber J. The Development of Psychosocial Therapeutic and Preventive Interventions for Mental Disorders (R61/R33): A User's Guide. J Clin Child Adolesc Psychol 2022; 51:360-373. [PMID: 35549571 PMCID: PMC9177818 DOI: 10.1080/15374416.2022.2062762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
One of the four major goals outlined in the National Institute of Mental Health (NIMH) strategic plan (2021) is to develop and test new treatments and prevention strategies. The aim of the Funding Opportunity Announcement (FOA) for the R61/R33 grant mechanism has been to support the efficient pilot testing of exploratory clinical trials of novel interventions for mental disorders in adults and children through an experimental therapeutics approach. The present commentary (a) describes the R61/R33 grant mechanism, defines terms, and summarizes information about current grants in the system, (b) outlines the review criteria, and (c) highlights several common critiques. Frequent concerns expressed by applicants as well as reviewers include defining and measuring the target/mechanism, establishing dose, selecting an appropriate control group, measuring fidelity, and determining power. Finally, alternative pathways for conducting randomized clinical trials for intervention development are discussed in contrast to or in addition to the experimental therapeutics approach for discovering novel interventions aimed at reducing and preventing mental illness across the lifespan.
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Affiliation(s)
- Judy Garber
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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33
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Ludin N, Holt-Quick C, Hopkins S, Stasiak K, Hetrick S, Warren J, Cargo T. A chatbot to support New Zealand young people during the COVID-19 pandemic: Evaluation of a real world roll out of an open trial (Preprint). J Med Internet Res 2022; 24:e38743. [PMID: 36219754 PMCID: PMC9640203 DOI: 10.2196/38743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/04/2022] Open
Abstract
Background The number of young people in New Zealand (Aotearoa) who experience mental health challenges is increasing. As those in Aotearoa went into the initial COVID-19 lockdown, an ongoing digital mental health project was adapted and underwent rapid content authoring to create the Aroha chatbot. This dynamic digital support was designed with and for young people to help manage pandemic-related worry. Objective Aroha was developed to provide practical evidence-based tools for anxiety management using cognitive behavioral therapy and positive psychology. The chatbot included practical ideas to maintain social and cultural connection, and to stay active and well. Methods Stay-at-home orders under Aotearoa’s lockdown commenced on March 20, 2020. By leveraging previously developed chatbot technology and broader existing online trial infrastructure, the Aroha chatbot was launched promptly on April 7, 2020. Dissemination of the chatbot for an open trial was via a URL, and feedback on the experience of the lockdown and the experience of Aroha was gathered via online questionnaires and a focus group, and from community members. Results In the 2 weeks following the launch of the chatbot, there were 393 registrations, and 238 users logged into the chatbot, of whom 127 were in the target age range (13-24 years). Feedback guided iterative and responsive content authoring to suit the dynamic situation and motivated engineering to dynamically detect and react to a range of conversational intents. Conclusions The experience of the implementation of the Aroha chatbot highlights the feasibility of providing timely event-specific digital mental health support and the technology requirements for a flexible and enabling chatbot architectural framework.
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Affiliation(s)
- Nicola Ludin
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Chester Holt-Quick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Computer Science, The University of Auckland, Auckland, New Zealand
| | - Sarah Hopkins
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Sarah Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jim Warren
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Computer Science, The University of Auckland, Auckland, New Zealand
| | - Tania Cargo
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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An N, Chuo J. Walking and Activeness: The First Step toward the Prevention of Strokes and Mental Illness. Comput Intell Neurosci 2022; 2022:3440437. [PMID: 35321459 PMCID: PMC8938141 DOI: 10.1155/2022/3440437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/17/2022]
Abstract
Physical activity, especially routine walking, is an imperative factor for the prevention of strokes, mental illness, and cardiovascular diseases (CVDs). The NIH (National Institute of Health) has also acknowledged walking as the most important factor of the stroke rehabilitation program. Many research studies are presented by physicians and researchers in the literature that highlight the positive impacts of walking on human health (physical and mental). This paper has the objective of studying the impact of regular walking, especially on mental illness, CVDs, and strokes. The C-reactive protein (CRP), P-selectin protein, and homocysteine biomarkers are considered to decide the improvement in the health of an individual with respect to CVDs and strokes. The other parameters considered for the recommendations of physicians and healthcare experts for mental health are PSS (perceived stress score) and ESS (Epworth sleepiness score) that control mental illness. The values are measured for the participating subjects before participating in the walking activity and after the end of the walking schedule to see the impact on individuals. The overall mental and physical health of an individual contributes to the chances of occurrence of CVDs, mental illness, and strokes in individuals aged between 40 years and 55 years, as per the study presented in this paper. The results show that the PSS and ESS scores are improved after the walking activity. Eventually, it improved recovery from many kinds of mental illness and also reduced the chances of strokes. Similarly, the levels of the biomarkers that determine the chances of an individual having CVD or stroke also improved. Walking can impact our overall health in many ways, however, in this paper, the focus is given to ailments, such as strokes, CVDs, and mental illness. The results show that stress and improper sleepiness can impact mental health negatively. The research outcome is measured by adding walking in a routine life so that every individual can get rid of many physical and mental ailments. The results presented in the paper reveal that the 90-day walking program has created a good impact on the health of individuals by improving their physical and mental health.
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Affiliation(s)
- Ning An
- College of Physical Education, Taiyuan University of Technology, Taiyuan 030024, China
| | - Jing Chuo
- College of Physical Education, Taiyuan University of Technology, Taiyuan 030024, China
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Puglisi M, D'Agostini R, Ruggeri M. [The importance of promoting adolescent mental health in schools.]. Recenti Prog Med 2022; 113:167-171. [PMID: 35315446 DOI: 10.1701/3761.37481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
During adolescence, the summation of the "physiological" crisis to stressful or excessive demands from the environment can represent a source of significant discomfort and difficulties for the person. For mental health operators, and not only, it is always important to know how to distinguish, in the complexity that adolescence entails, the "typical" adolescence behaviours from risky behaviours or incipient signs of a mental disorder. Psychological distress can most frequently result when, together with difficulties in completing developmental tasks, individual vulnerabilities add up to inadequacy of an environmental system. To date, scientific evidence shows an earlier onset of many mental illnesses in the last decades. This explains the need and the usefulness of implementing interventions for promotion and prevention of mental health in this specific age group. The school, where teenagers spend most of their time, is the best place where provide information, skills and strategies to implement mental and physical well-being, resilience factors and identify fragilities. This article aims to make a survey of mental health promotion interventions carried out in schools nationally and internationally.
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Affiliation(s)
- Martina Puglisi
- UOC di Psichiatria, Azienda Ospedaliera Universitaria Integrata, Verona
| | | | - Mirella Ruggeri
- UOC di Psichiatria, Azienda Ospedaliera Universitaria Integrata, Verona - Dipartimento Neuroscienze, Biomedicina e Movimento, Università di Verona
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Stewart SE. The Case for Prevention Research in Adolescent-Onset Mental Illness-Game On! JAMA Netw Open 2022; 5:e2149037. [PMID: 35179592 DOI: 10.1001/jamanetworkopen.2021.49037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Evelyn Stewart
- BC Mental Health & Addictions Research Institute, Vancouver, British Columbia, Canada
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Comacchio C, Antolini G, Ruggeri M, Colizzi M. Gender-Oriented Mental Health Prevention: A Reappraisal. Int J Environ Res Public Health 2022; 19:1493. [PMID: 35162515 PMCID: PMC8835536 DOI: 10.3390/ijerph19031493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.
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Affiliation(s)
| | - Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy;
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Fischer C, Mayer S, Perić N, Simon J. Establishing a comprehensive list of mental health-related services and resource use items in Austria: A national-level, cross-sectoral country report for the PECUNIA project. PLoS One 2022; 17:e0262091. [PMID: 35061766 PMCID: PMC8782519 DOI: 10.1371/journal.pone.0262091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A comprehensive, comparable assessment of the economic disease burden and the value of relevant care forms a major challenge in the case of mental diseases. This study aimed to inform the development of a resource use measurement (RUM) instrument and harmonized reference unit costs valid for multi-sectoral and multi-national cost assessments for mental health diseases as part of the European PECUNIA project. METHODS An iterative, multi-methods approach was applied. Systematic literature reviews appended with national grey literature searches in six European countries were conducted to generate preliminary, literature-based, international, mental health-related service and resource use lists for all investigated sectors in 2018. As part of a multi-national expert survey, these lists were reviewed by 18 Austrian sector-specific experts regarding the clarity, relevance, comprehensiveness and availability in the Austrian context. RESULTS Out of 295 items included in the preliminary, international, sector-specific lists (health and social care-201 items, criminal justice-35 items, education-39 items; patient, family and informal care-20 items), a total of 261 items and descriptions (88%) were considered clear by all experts. 42 items (14%) were considered not existing in Austria, and 111 items (38%) were prioritized regarding their relevance in the national context. Thirteen additional items (4%) were suggested to be added to accommodate for Austria-specific features of the individual sectors. Major typological difficulties based on item names were observed. CONCLUSIONS The identified country-specific variations and general typological bias and their potential contributions to service and resource use cost variations across countries and sectors call for further systematic investigation. Next, PECUNIA will develop internationally harmonized and comparable definitions of the listed items and their units of analysis based on a new conceptual multi-sectoral costing framework. The developed lists will require consolidation and further prioritization for the development of a patient-reported RUM instrument and consequent reference unit cost valuation.
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Affiliation(s)
- Claudia Fischer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Nataša Perić
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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Gasol X, Navarro-Haro MV, Fernández-Felipe I, García-Palacios A, Suso-Ribera C, Gasol-Colomina M. Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System. Int J Environ Res Public Health 2022; 19:ijerph19010494. [PMID: 35010754 PMCID: PMC8744757 DOI: 10.3390/ijerph19010494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/18/2022]
Abstract
Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate the acceptability and preliminary effectiveness of an adapted Dialectical Behavior Therapy Skills Training program for Emotional Problem Solving in Adolescents (DBT STEPS-A) during secondary school. The sample included 93 adolescents (mean age = 12.78; SD = 0.54; and 53% female) studying in their 2nd year of secondary school in a public center in Catalonia (Spain). Measures of acceptability, difficulties of emotional regulation, mental health problems, and life satisfaction were completed before and after participation in the DBT STEPS-A program during one academic year. The majority of students rated the program as useful (64%) and enjoyed the classes (62%) and 48% of them reported practicing the newly learned skills. Statistically significant improvements were revealed in some emotional regulation-related variables, namely the number of peer problems (p = 0.003; d = 0.52) and prosocial behaviors (p < 0.001; d = −0.82). Although non-significant, the scores in the remaining outcomes indicated a general positive trend in emotional dysregulation, mental health, and life satisfaction. The adapted DBT STEPS-A was very well-accepted and helped overcome some emotional regulation difficulties in Spanish adolescents.
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Affiliation(s)
- Xavier Gasol
- Borderline Personality Disorder Institute Foundation, 08221 Terrassa, Spain; (X.G.); (M.G.-C.)
| | - María Vicenta Navarro-Haro
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón (IISA), 50009 Zaragoza, Spain
- Correspondence:
| | - Isabel Fernández-Felipe
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
| | - Azucena García-Palacios
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052 Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052 Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Miquel Gasol-Colomina
- Borderline Personality Disorder Institute Foundation, 08221 Terrassa, Spain; (X.G.); (M.G.-C.)
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Irish M, Zeiler M, Kuso S, Musiat P, Potterton R, Wagner G, Karwautz A, Waldherr K, Schmidt U. Students' perceptions of an online mental health intervention: a qualitative interview study. Neuropsychiatr 2021; 35:177-186. [PMID: 33369715 DOI: 10.1007/s40211-020-00383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND University students are at a heightened risk of developing mental health disorders. Online interventions are becoming increasingly popular in this target group, both to prevent the development of mental health disorders and to treat existing ones. The PLUS (Personality and Living of University Students) programme is a web-based targeted prevention intervention which has been tested across two European countries. Completion of this programme has been relatively poor. Understanding university students' opinions, experiences and perceptions of the PLUS programme can lead to future improvements in intervention design, engagement and dissemination. METHODS Semistructured interviews were conducted with university students from the UK (n = 10) and Austria (n = 14) who had previously had access to PLUS. Students were asked about their perception and experiences of the programme, and how it could be improved. Results were analysed using thematic analysis. RESULTS Experience of online prevention programmes in general were limited and as a result of this, few had specific expectations of the PLUS programme before signing up. The lack of guidance and accountability due to the online nature of the programme made engagement challenging for many, however, frequent reminder emails helped mitigate this. In terms of positives of the programme, participants found the flexibility suitable for students and many noticed that the programme created change in how they thought or behaved. CONCLUSION Overall, the PLUS programme was well received by students, despite study retention being poor. Although PLUS was viewed as a useful tool to integrate into the university setting, several improvements were suggested to increase engagement. By considering this feedback, uptake and intervention completion can be improved for future preventative interventions.
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Affiliation(s)
- Madeleine Irish
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box P059, SE5 8AF, London, UK.
| | - Michael Zeiler
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Stefanie Kuso
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Ferdinand Porsche Ring 3, 2700, Wiener Neustadt, Austria
| | - Peter Musiat
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box P059, SE5 8AF, London, UK
| | - Rachel Potterton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box P059, SE5 8AF, London, UK
| | - Gudrun Wagner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Andreas Karwautz
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Karin Waldherr
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Ferdinand Porsche Ring 3, 2700, Wiener Neustadt, Austria
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box P059, SE5 8AF, London, UK
- South London and Maudsley NHS Foundation Trust, SE5 8AZ, Camberwell, London, UK
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Barterian J, Williams S, Haban A. Starting Off on the Right Foot: Prevention Services for Med-1s. Acad Med 2021; 96:S175-S176. [PMID: 34705673 DOI: 10.1097/acm.0000000000004306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Justin Barterian
- Author affiliations: J.A. Barterian, Ohio State University Wexner Medical Center
| | | | - Amy Haban
- S. Williams, A. Haban, University of Illinois College of Medicine
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
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Lannes A, Bui E, Arnaud C, Raynaud JP, Revet A. Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials. Psychol Med 2021; 51:2321-2336. [PMID: 34435556 DOI: 10.1017/s0033291721003366] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Children with parents suffering from a psychiatric disorder are at higher risk for developing a mental disorder themselves. This systematic review and meta-analysis of randomized controlled trials aims to evaluate the efficacy of psychosocial interventions to prevent negative mental health outcomes in the offspring of parents with mental illness. Eight electronic databases, grey literature and a journal hand-search identified 14 095 randomized controlled trials with no backward limit to June 2021. Outcomes in children included incidence of mental disorders (same or different from parental ones) and internalizing and externalizing symptoms at post-test, short-term and long-term follow-up. Relative risks and standardized mean differences (SMD) for symptom severity were generated using random-effect meta-analyses. Twenty trials were selected (pooled n = 2689 children). The main therapeutic approaches found were cognitive-behavioural therapy and psychoeducation. A significant effect of interventions on the incidence of mental disorders in children was found with a risk reduction of almost 50% [combined relative risk = 0.53, 95% confidence interval (CI) 0.34-0.84]. Interventions also had a small but significant effect on internalizing symptoms at post-test (SMD = -0.25, 95% CI -0.37 to -0.14) and short-term follow-up (-0.20, 95% CI -0.37 to -0.03). For externalizing symptoms, a decreasing slope was observed at post-test follow-up, without reaching the significance level (-0.11, 95% CI -0.27 to 0.04). Preventive interventions targeting the offspring of parents with mental disorders showed not only a significant reduction of the incidence of mental illness in children, but also a diminution of internalizing symptoms in the year following the intervention.
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Affiliation(s)
- Alice Lannes
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
| | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- University of Caen Normandy & Caen University Hospital, Caen, France
| | - Catherine Arnaud
- CERPOP, UMR 1295, Inserm, University Paul Sabatier Toulouse, Toulouse, France
- Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
| | - Jean-Philippe Raynaud
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, UMR 1295, Inserm, University Paul Sabatier Toulouse, Toulouse, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, UMR 1295, Inserm, University Paul Sabatier Toulouse, Toulouse, France
- CIC 1436, Team PEPSS, « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, Toulouse, France
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Zimmerman SC, Matthay EC, Rudolph KE, Goin DE, Farkas K, Rowe CL, Ahern J. California's Mental Health Services Act and Mortality Due to Suicide, Homicide, and Acute Effects of Alcohol: A Synthetic Control Application. Am J Epidemiol 2021; 190:2107-2115. [PMID: 33884408 DOI: 10.1093/aje/kwab123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
California's Mental Health Services Act (MHSA) substantially expanded funding of county mental health services through a state tax, and led to broad prevention efforts and intensive services for individuals experiencing serious mental disorders. We estimated the associations between MHSA and mortality due to suicide, homicide, and acute effects of alcohol. Using annual cause-specific mortality data for each US state and the District of Columbia from 1976-2015, we used a generalization of the quasi-experimental synthetic control method to predict California's mortality rate for each outcome in the absence of MHSA using a weighted combination of comparison states. We calculated the association between MHSA and each outcome as the absolute difference and percentage difference between California's observed and predicted average annual rates over the postintervention years (2007-2015). MHSA was associated with modest decreases in average annual rates of homicide (-0.81/100,000 persons, corresponding to a 13% reduction) and mortality from acute alcohol effects (-0.35/100,000 persons, corresponding to a 12% reduction). Placebo test inference suggested that the associations were unlikely to be due to chance. MHSA was not associated with suicide. Protective associations with mortality due to homicide and acute alcohol effects provide evidence for modest health benefits of MHSA at the population level.
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The Lancet Oncology. Provision of mental health care for patients with cancer. Lancet Oncol 2021; 22:1199. [PMID: 34478660 DOI: 10.1016/S1470-2045(21)00480-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Harvey SB, Epstein RM, Glozier N, Petrie K, Strudwick J, Gayed A, Dean K, Henderson M. Mental illness and suicide among physicians. Lancet 2021; 398:920-930. [PMID: 34481571 PMCID: PMC9618683 DOI: 10.1016/s0140-6736(21)01596-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/09/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.
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Affiliation(s)
- Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia.
| | - Ronald M Epstein
- Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Nicholas Glozier
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Katherine Petrie
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Jessica Strudwick
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Kimberlie Dean
- School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia; Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Max Henderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Malik K, Michelson D, Doyle AM, Weiss HA, Greco G, Sahu R, E. J. J, Mathur S, Sudhir P, King M, Cuijpers P, Chorpita B, Fairburn CG, Patel V. Effectiveness and costs associated with a lay counselor-delivered, brief problem-solving mental health intervention for adolescents in urban, low-income schools in India: 12-month outcomes of a randomized controlled trial. PLoS Med 2021; 18:e1003778. [PMID: 34582460 PMCID: PMC8478208 DOI: 10.1371/journal.pmed.1003778] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 08/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Psychosocial interventions for adolescent mental health problems are effective, but evidence on their longer-term outcomes is scarce, especially in low-resource settings. We report on the 12-month sustained effectiveness and costs of scaling up a lay counselor-delivered, transdiagnostic problem-solving intervention for common adolescent mental health problems in low-income schools in New Delhi, India. METHODS AND FINDINGS Participants in the original trial were 250 school-going adolescents (mean [M] age = 15.61 years, standard deviation [SD] = 1.68), including 174 (69.6%) who identified as male. Participants were recruited from 6 government schools over a period of 4 months (August 20 to December 14, 2018) and were selected on the basis of elevated mental health symptoms and distress/functional impairment. A 2-arm, randomized controlled trial design was used to examine the effectiveness of a lay counselor-delivered, problem-solving intervention (4 to 5 sessions over 3 weeks) with supporting printed booklets (intervention arm) in comparison with problem solving delivered via printed booklets alone (control arm), at the original endpoints of 6 and 12 weeks. The protocol was modified, as per the recommendation of the Trial Steering Committee, to include a post hoc extension of the follow-up period to 12 months. Primary outcomes were adolescent-reported psychosocial problems (Youth Top Problems [YTP]) and mental health symptoms (Strengths and Difficulties Questionnaire [SDQ] Total Difficulties scale). Other self-reported outcomes included SDQ subscales, perceived stress, well-being, and remission. The sustained effects of the intervention were estimated at the 12-month endpoint and over 12 months (the latter assumed a constant effect across 3 follow-up points) using a linear mixed model for repeated measures and involving complete case analysis. Sensitivity analyses examined the effect of missing data using multiple imputations. Costs were estimated for delivering the intervention during the trial and from modeling a scale-up scenario, using a retrospective ingredients approach. Out of the 250 original trial participants, 176 (70.4%) adolescents participated in the 12-month follow-up assessment. One adverse event was identified during follow-up and deemed unrelated to the intervention. Evidence was found for intervention effects on both SDQ Total Difficulties and YTP at 12 months (YTP: adjusted mean difference [AMD] = -0.75, 95% confidence interval [CI] = -1.47, -0.03, p = 0.04; SDQ Total Difficulties: AMD = -1.73, 95% CI = -3.47, 0.02, p = 0.05), with stronger effects over 12 months (YTP: AMD = -0.98, 95% CI = -1.51, -0.45, p < 0.001; SDQ Total Difficulties: AMD = -1.23, 95% CI = -2.37, -0.09; p = 0.03). There was also evidence for intervention effects on internalizing symptoms, impairment, perceived stress, and well-being over 12 months. The intervention effect was stable for most outcomes on sensitivity analyses adjusting for missing data; however, for SDQ Total Difficulties and impairment, the effect was slightly attenuated. The per-student cost of delivering the intervention during the trial was $3 United States dollars (USD; or $158 USD per case) and for scaling up the intervention in the modeled scenario was $4 USD (or $23 USD per case). The scaling up cost accounted for 0.4% of the per-student school budget in New Delhi. The main limitations of the study's methodology were the lack of sample size calculations powered for 12-month follow-up and the absence of cost-effectiveness analyses using the primary outcomes. CONCLUSIONS In this study, we observed that a lay counselor-delivered, brief transdiagnostic problem-solving intervention had sustained effects on psychosocial problems and mental health symptoms over the 12-month follow-up period. Scaling up this resource-efficient intervention is an affordable policy goal for improving adolescents' access to mental health care in low-resource settings. The findings need to be interpreted with caution, as this study was a post hoc extension, and thus, the sample size calculations did not take into account the relatively high attrition rate observed during the long-term follow-up. TRIAL REGISTRATION ClinicalTrials.gov NCT03630471.
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Affiliation(s)
| | - Daniel Michelson
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Aoife M. Doyle
- Medical Research Council International Statistics & Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Helen A. Weiss
- Medical Research Council International Statistics & Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Giulia Greco
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Paulomi Sudhir
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Michael King
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Pim Cuijpers
- Department of Clinical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, United States of America
| | | | - Vikram Patel
- Sangath, New Delhi, India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, United States of America
- Harvard TH Chan School of Public Health, Boston, United States of America
- * E-mail:
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Abstract
ABSTRACT It's important to be aware of the signs and symptoms of mental illness and to take action to ensure people experiencing mental health problems receive the assistance and treatment they need. For nurses, this is as true at home as it is at work, particularly so when a person is exhibiting aggressive tendencies or other behaviors that could potentially lead to harm. With the COVID-19 crisis leading many family members to live more closely together for extended periods, nurses should be able to identify concerning behaviors and know what to do if they observe these in their loved ones.
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Affiliation(s)
- Donna Sabella
- Donna Sabella is a psychiatric mental health NP and a professor at the Pennsylvania College of Health Sciences in Lancaster. She also coordinates Mental Health Matters : . The author has disclosed no potential conflicts of interest, financial or otherwise. A podcast with the author is available at www.ajnonline.com
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da Silva FCT, Barbosa CP. The impact of the COVID-19 pandemic in an intensive care unit (ICU): Psychiatric symptoms in healthcare professionals. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110299. [PMID: 33716042 PMCID: PMC7948677 DOI: 10.1016/j.pnpbp.2021.110299] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/07/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic period, the structure of the Intensive Care Unit (ICU) activities changed fast. It was observed that the mental and physical health of the frontline workers reached levels of extreme clinical and psychological concern. OBJECTIVE Understand the impact that COVID-19 is having on the front-line clinical team in the ICU environment, as well as reveal what proposals are being made to mitigate the clinical and psychological impacts that this group experiences. METHOD A systematic review was made following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). We included any type of study on health workers during the COVID-19 pandemic, with results about their mental health. We were, therefore, interested in quantitative studies examining the prevalence of problems and effects of interventions, as well as qualitative studies examining experiences. We had no restrictions related to study design, methodological quality or language. RESULTS Twenty-one studies reported on the urgent need for interventions to prevent or reduce mental health problems caused by COVID-19 among health professionals in ICU. Eleven studies demonstrated possibilities for interventions involving organizational adjustments in the ICU, particularly linked to emotional conflicts in the fight against COVID-19. CONCLUSION The disproportion between the need for technological supplies of intensive care medicine and their scarcity promotes, among many factors, high rates of psychological distress. Anxiety, irritability, insomnia, fear and anguish were observed during the pandemic, probably related to extremely high workloads and the lack of personal protective equipment.
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Affiliation(s)
| | - Caio Parente Barbosa
- Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil
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50
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Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has led to an exponential rise in mental health issues. Studies have shown that, in times of increased unemployment rates and economic downturn, rates of mental health issues, suicide, substance use, and domestic violence tend to increase. Barriers to care, including stigma and decreased access to providers, contribute to morbidity and mortality. Telehealth services are being utilized to help increase access to care, and economic stimulus packages have been created to help with the financial burden that is often associated with increased mental health stressors. Efforts to prevent burnout and other policy recommendations can help decrease mental health issues in first responders and health care professionals, who are at an increased risk for these problems. Increasing the ability to provide wellness screenings to the general population, to educate the public about preventive measures and practices, and to provide mental health and substance use treatment, such as medication management and therapy services, are among top priorities to further reduce the socioeconomic impact of COVID-19 on mental illness.
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