Mental Disorder

This chapter explores three models (mutual independence, limited collaboration, and constructive integration) of interdisciplinary interaction between neuroscience and ethics and specifies three possible ways (solving ethical issues in specific contexts, developing normative standards that can be used to regulate and evaluate the behaviors of a group of individuals with particular cognitive abilities or disabilities, and identifying and correcting faulty moral intuitions) neuroscience can contribute to normative discourse of ethics. Among the three models, the author discusses and analyzes constructive integration wherein neuroscience can contribute to the development of a normative standard that refers to a group of individuals under particular psychological conditions. By surveying and analyzing recent studies of neuroscience, specifically neuroimaging studies on cognitive empathy and emotional empathy, the author argues that neuroscience can be integrated with ethics in developing a normative standard for autistic moral agency. The author also argues that, in developing and justifying a normative standard, its psychological relevance should be considered. Since a normative standard relates to a group of individuals, consideration of their cognitive and emotional abilities is critically important. In this regard, integration of neuroscience and ethics can be understood as the theoretical effort to bring neuroscience to the discussion of normative rules and standards that can be practiced by a particular group of individuals.KeywordsMoral agencyAutismEmotional empathyCognitive empathyTheory of mindNeuroethics

IntroductionAlthough several systematic reviews (SRs)/meta-analyses (MAs) on the association between specific mental disorders and specific somatic conditions are available, an overarching evidence synthesis across mental disorders and somatic conditions is...

First evidence of a general disease ("d") factor, a common factor underlying physical and mental illness.

Updating cross-cultural research of the past decade on the relationship between life aspirations and wellbeing, we compared Romanian (N=69) and US (N=64) undergraduates on the contribution of the importance and likelihood of attaining intrinsic and extrinsic aspirations to psychological maladjustment and life satisfaction, and on the qualitative meaning they assign to financial success. Similarly to prior studies, we found that extrinsic and intrinsic aspirations tended to be either negatively or positively correlated with life satisfaction, respectively; however, wealth predicted life satisfaction for Romanian students. Unlike previous research, we found generally negative relationships between intrinsic aspirations and psychological maladjustment. Although there were no differences between Romanian and US undergraduates on extrinsic and intrinsic orientation, on the overall importance of attaining aspirations, or on specific extrinsic and intrinsic aspirations, Romanian students expressed weaker expectations of fulfilling intrinsic aspirations than did US students. Finally, the groups produced similar rankings of aspirations and assigned similar meaning to financial success. The results favored a social cognitive rather than a self-determination model of psychological wellbeing in that expectations for attaining aspirations were more often predictive of life satisfaction than were their content. We interpret these findings and their convergence and departure from earlier research in terms of political economic, demographic, and cultural factors. We encourage future cross-cultural investigations of the social construction of aspirations, subsidiation of seemingly contradictory aspirations to each other, and cognitive and ecological mediation of the complex relationship of aspirations to psychological functioning.

ObjectiveThe purpose of this paper was to analyze the associated burden of mental illness and medical comorbidity using BioSense data 2008–2011.IntroductionUnderstanding the relationship between mental illness and medical comorbidity is an important aspect of public health surveillance. In 2004, an estimated one fourth of the US adults reported having a mental illness in the previous year (1). Studies showed that mental illness exacerbates multiple chronic diseases like cardiovascular diseases, diabetes and asthma (2). BioSense is a national electronic public health surveillance system developed by the Centers for Disease Control and Prevention (CDC) that receives, analyzes and visualizes electronic health data from civilian hospital emergency departments (EDs), outpatient and inpatient facilities, Veteran Administration (VA) and Department of Defense (DoD) healthcare facilities. Although the system is designed for early detection and rapid assessment of all-hazards health events, BioSense can also be used to examine patterns of healthcare utilization.MethodsWe used 4 years (2008 – 2011) of BioSense civilian hospitals’ EDs visit data to perform the analysis. We searched final diagnoses for ICD-9 CM codes related to mental illness (290 – 312), schizophrenia (295), major depressive disorder (296.2 – 296.3), mood disorder (296, 300.4 and 311) and anxiety, stress & adjustment disorders (300.0, 300.2, 300.3, 308, and 309). We used BioSense syndromes/sub-syndromes based on chief complaints and final diagnoses for comorbidity. For the purpose of this study, comorbidity was defined broadly as the co-occurrence of mental and physical illness in the same person regardless of the chronological order. The proportion was calculated as the number of mental health visits associated with comorbidity divided by the total number of mental illness relevant visits. We ranked the top 10 proportions of comorbidity for adult mental illness by year.ResultsFrom 2008–2011, there were 4.6 million visits where mental illness was reported in the EDs visits. Average age of those reported mental illness was 44 years, 55% were women and 45% were men. More women were reported with anxiety (67%), mood (66%), and major depressive disorders (59%) than men; while men were reported more with schizophrenia (56%) than women (44%). The most common comorbid condition was hypertension, followed by chest pain, abdominal pain, diabetes, nausea & vomiting and dyspnea (Table 1). Ranks of injury, falls, headache and asthma were slightly variant by year.ConclusionsThis study supports prior findings that adult mental illness is associated with substantial medical burden. We identified 10 most common comorbid condition associated with mental illness. The major limitation of this work was that electronic data does not allow determination of the causal pathway between mental illness and some medical comorbidity. In addition, data represents only those who have access to healthcare or those with health seeking behaviors. Familiarity with comorbid conditions affecting persons with adult mental illness may assist programs aimed at providing medical care for the mentally ill.

BackgroundParental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked.We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions.MethodsThis register-based cohort study included all live-born children born in Denmark from 2000 to 2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life.ResultsThe analyses included 964,395 children. Twenty percent of the mothers and 12 % of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04–1.06) and out-of-hour IRR 1.20 (CI95% 1.18–1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17–1.19) and out-of-hour IRR 1.39 (CI95% 1.37–1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23–1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45–1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21–1.24) and out-of-hour IRR 1.37 (CI95% 1.34–1.41)). This pattern was the same for all types of healthcare contacts.ConclusionsBoth maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.

Applying Procedural Justice Theory to Law Enforcement's Response to Persons With Mental Illness

Prior studies have identified associations between specific health conditions and occupational impairments in the U.S. military, but little is known about the relative magnitude of impairments associated with different mental and physical health conditions among military service members. The goal of this study is to comparatively assess occupational impairment associated with mental and physical conditions among active duty military service members. Data on 11,055 U.S. active duty service members were from the Department of Defense 2015 Health Related Behaviors Survey, an anonymous online health survey. Items assessed common mental and physical health conditions. Absenteeism was assessed as number of lost work days and presenteeism was assessed as number of work days with impaired functioning in the past 30 days. This research was approved by the RAND Human Subjects Protections Committee. Back pain (23%) and anxiety (14%) were the most prevalent conditions in the sample. Mental health conditions (anxiety, depression, and PTSD) were associated with more absentee and presentee days than physical conditions. Adjusting for physical health conditions, anxiety, depression, and PTSD showed robust associations with both absenteeism and presenteeism. Common mental health conditions such as anxiety, depression, and PTSD showed robust associations with absenteeism and presenteeism among active duty U.S. military service members. Efforts to rigorously evaluate and improve existing military screening programs and reduce barriers to accessing and engaging in mental healthcare may help to reduce work absenteeism and presenteeism among active duty service members.

Mental illness is prevalent in Ghana with an estimated population of over 3 million suffering from different forms of mental illness. The conceptions surrounding the causal explanation of mental illness, however, make the approaches adopted in managing or remedying it nuanced and more complex. In Ghana, and most parts of sub-Saharan Africa, mental illness is shrouded in beliefs about witchcraft, curses, and supernatural evil forces. This makes the sufferers of mental illness, their family relations and sometimes health practitioners, adopt not only a biomedical approach, but also spiritual approaches to remedy the mental illness. Following a period of six months of intensive fieldwork at two major prayer camps in Ghana, this study, through interviews with pastors, patients, and caregivers at the prayer camps, explored the experiences of individuals who have had chronic mental illness conditions. It also examined the role of culture, religion, spirituality and faith in the daily experience and management of mental illness and wellness. The data presented in this chapter suggest that despite the dilemma that surrounds the causal explanation of mental illness, the belief in mystical causality of the illness is more pervasive and, as a result, religious and spiritual resources accessed at prayer camps in Ghana, are believed to be effective in providing a powerful means of remediation. Patients often rely on such sacred spaces like the prayer camps to cope with their ailments. The findings show that the journey to remedy chronic mental health illness can be daunting and frustrating, due to the complex narrative production of diagnostic trial and error in seeking both medical and spiritual resources. The chapter concludes by arguing that religion and spirituality have served many participants well and remain an important factor when managing severe and persistent mental health conditions.

The incidence of anxiety may not be correlated with severity of psoriasis: A prospective pilot study

BackgroundBreastfeeding is a cornerstone of child health. We investigated the associations of any breastfeeding initiation and duration with physical, mental and behavioural health conditions among children aged 3–5 years in the USA.MethodsData were derived from the 2016 to 2022 National Survey of Children’s Health, which is a national, population-based, cross-sectional study. A total of 40 280 children aged 3–5 years were included. Any breastfeeding initiation and duration, physical (asthma, allergies, arthritis, cerebral palsy, diabetes, epilepsy or seizure disorder, heart conditions or severe headaches), mental (anxiety or depression) and behavioural (Tourette syndrome, attention-deficit/hyperactivity disorder or behavioural/conduct problems) health conditions were measured using parent-reported questionnaires.ResultsAny breastfeeding was significantly associated with lower odds of behavioural health conditions (OR=0.76, 95% CI: 0.58 to 0.99) and marginally with mental health conditions (OR=0.70, 95% CI: 0.48 to 1.02, p=0.067). There was a significant non-linear trend between any breastfeeding duration and having a mental or behavioural health condition (all Pnon-linear<0.001). The intervals of significant associations were 7.3–23.4 months for mental condition and 6.8–24.1 months for behavioural condition (the most associated points at 15.6 and 15.3 months). There were no significant associations of any breastfeeding initiation and duration with physical health.ConclusionsAny breastfeeding was linked to better behavioural health and marginally to mental health, with no association found for physical health among children aged 3–5 years in the USA. Any breastfeeding duration of approximately 15 months appears to have the strongest association with promoting children’s mental and behavioural health.

Neuroimaging and Psychotherapy: Tales From the Messy Middle

Mental disorders are increasingly common among adults in both the developed and developing world and are predicted by the WHO to be the leading cause of disease burden by 2030. Many common physical conditions are more common among people who also have a common mental disorder. This scoping review aims to examine the current literature about the prevention, identification and treatment of physical problems among people with pre-existing mental health disorders in primary care in Europe. The scoping review framework comprised a five-stage process developed by Arksey & O'Malley (2005). The search process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Both quantitative and qualitative studies were included, with no restriction on study design. The initial search identified 299 studies, with a further 28 added from the hand-search (total n = 327) of which 19 were considered relevant to the review research question and included for full analysis. Depression was the mental health condition most commonly studied (nine studies), followed by depression and anxiety (seven studies), with three studies examining any mental disorder. Eleven studies examined the effects of various interventions to address physical and mental comorbidity, with the most commonly studied intervention being collaborative care. With just 19 studies meeting our criteria for inclusion, there is clearly a paucity of research in this area. Further research is essential in order to understand the pathophysiological mechanisms underlying the association between mental disorders and chronic conditions.

Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients

Accessible summaryPeople with intellectual disability have multiple health problems.People with intellectual disability have more physical and mental health conditions than people without intellectual disabilities.People with intellectual disability may need more health checks due to increased prevalence of physical and mental illnesses.More studies are needed to understand what interventions are effective to reduce health problems in people with intellectual disability.AbstractBackgroundStudies have reported increased prevalence of physical and mental health conditions in people with intellectual disabilities (ID) compared to people without intellectual disabilities. However, there are no studies looking into specific health conditions at a national level and comparing with areas that are socio‐economically disadvantaged (e.g. low income and low education attainment). This study examines and compares the prevalence of physical and mental health morbidity in people with and without intellectual disabilities at a local and national level in the UK.MethodThis study was an anecdotal analysis of physical and mental health data and annual health check‐up for England (national), London (regional) and Haringey (inner‐city borough of London) in 2016/17 using data from the NHS Digital database.ResultsPatterns of mental and physical conditions for people with and without intellectual disabilities were similar across Haringey, London and England data. Severe mental illness was more prevalent among people with intellectual disabilities compared to non‐intellectual disability peers. This further increased in the inner‐city London borough for the intellectual disability group. Certain physical health conditions were also more prevalent in people with intellectual disabilities. Certain activities such as monitoring blood pressure, recording body mass index and checking HbA1C were better in people with intellectual disabilities. Uptake of annual health checks for people with intellectual disabilities remained around 50%.DiscussionThis study further highlights the increased prevalence of mental and physical disorders in people with intellectual disabilities compared to people without intellectual disabilities. Further increased risk of mental disorders in an inner London borough compared to national data aligns with existing literature that highlights the negative impact of socio‐economic deprivation on mental and physical health. Further studies are needed to assess the health and social care measures that can reduce the physical and mental health morbidity in people with intellectual disabilities.