Association Of Mental Illness Research Articles

The Association of Mental Illness With Outcomes of Emergency Surgery for Bowel Obstruction

IntroductionBowel obstruction is one of the most common surgical emergencies. The management of SBO is variable and influenced by numerous confounding factors. Recent studies have identified mental health as a health disparity that affects surgical outcomes. We aim to assess whether mental illness is a health disparity and its association with postoperative complications and secondary outcomes for bowel obstruction in Emergency General Surgery (EGS). MethodsThis was a retrospective study utilizing the National Inpatient Sample. Individuals aged 18-64 who underwent emergency adehesiolysis or bowel resection from 2015 to 2017 were identified. Postoperative complications, in-hospital mortality, length of stay, and total cost for surgical patients with and without mental illness were recorded. Univariate and multivariate analyses were used to evaluate the association between mental health and bowel obstruction. Results20,574 patients who underwent surgery for bowel obstruction were identified. 3756 of these patients had mental illness and 16,998 patients did not. Patients with mental illness did not have significantly worse outcomes compared to patients without mental illness. Among 3576 patients with mental illness, sex, race, patient location, insurance, location/teaching status of hospital, hospital control and procedure type were significant predictors of prolonged length of stay, higher cost, and increased postoperative complications. ConclusionsMental health does not appear to be a health disparity in outcomes for bowel obstruction procedures. However, the intersection of mental health with race and insurance status predicts worse outcomes. This essential area should be further explored to determine how marginalized populations are affected in emergency surgical care.

Association of Mood Disorders, Substance Abuse, and Anxiety Disorders in Children and Teens With Serious Structural Eye Diseases

We sought to evaluate the association between 5 eye diseases (including glaucoma, cataract, congenital optic nerve disease, congenital retinal disease, and blindness/low vision) and mental illness in a pediatric population. Cross-sectional study. A de-identified commercial insurance claims database, OptumLabs Data Warehouse, between January 1, 2007, and December 31, 2018, was used. Children and teens less than 19 years of age at the time of eye diagnosis were included. Demographics and mental illness claims were compared, looking at the association of mental illness and eye disease claims. A total of 11,832,850 children and teens were included in this study with mean age of 8.04 ± 5.94 years at the first claim. Of the patients with at least 1 of the 5 eye diseases (n=180,297), 30.5% had glaucoma (n=54,954), 9.5% had cataract (n=17,214), 21.4% had congenital optic nerve disease (n=38,555), 26.9% had congenital retinal disease (n=48,562), and 25.9% had blindness or low vision (n=46,778). There was a statistically significant association, after adjusting for confounding variables, between at least 1 of the 5 eye diseases and schizophrenia disorder (OR=1.54, 95% CI=1.48-1.61, P < .001), anxiety disorder (OR=1.45, 95% CI=1.43-1.48, P < .001), depressive disorder (OR=1.27, 95% CI=1.25-1.29, P < .001), and bipolar disorder (OR=1.27, 95% CI=1.21-1.31, P < .001), but a reversed association with substance use disorder (OR=0.88, 95% CI=0.86-0.90, P < .001). We found associations between eye disease in children and teens and mental illness. Understanding these relationships may improve mental illness screening and treatment in the pediatric population.

The Modern Character of Mental Health Stigma: A 30-Year Examination of Popular Film

ABSTRACT Popular film contains an abundance of information pertaining to identity and stigma attributions popularly linked with those experiencing mental health concerns. However, this domain remains under-examined with regard to health identity representations, notably as they intersect with other social identities. Thirty years of the most popular films emphasizing mental health were content analyzed for the purpose of obtaining a contemporary assessment of the stigmatizing potential of representation patterns, notably, extending beyond popularly established associations of mental illness with danger. Distortions were observed disproportionately connecting those experiencing mental illness with stigmatizing attributes in myriad ways, including risky health behaviors (e.g., drinking alcohol, smoking cigarettes, eating issues), various forms of aggression (e.g., physical, verbal, sexual), and reactions to adversity (e.g., crying, attempting self-harm, and having struggles diminished by others). Additionally, evidence suggests a relative dearth of displaying the experiences of non-culturally dominant social identities and their intersections with mental health identity. Prior research has indicated that that mediated portrayals of those experiencing mental illness can influence self-perceptions and social inclinations pertaining to this health identity. Findings are discussed in terms of these potential outcomes.

Associations of mental illness with smoking and vaping in university students in New Zealand

Abstract Background People with mental illness have higher smoking prevalence, and vaping is generally higher among smokers than non-smokers. However, data on associations of mental illness with smoking and vaping in New Zealand (NZ) is lacking. This study examines associations of history of mental illness (HMI) with smoking and vaping in NZ university students. Methods Data came from a March 2018 national cross-sectional study. χ2 tests compared patterns of smoking and vaping in students with and without HMI. An HMI was defined as a diagnosis, or treatment for depression, anxiety or nervous disorder, or other mental health condition in the previous 12 months. Logistic regression model assessed the association of an HMI with smoking and vaping. Results 1622 students were included: 82.7% aged &amp;lt;25 years, 17.3% ≥25 years; 38.6% male, 61.4% female; 7.8% Māori, 92.2% non-Māori; 18.1% reported an HMI. Of respondents, 50.5% (95% CI 48.0-53.0) reported ever, 10.0% (8.6-11.6) current and 5.0% (4.0-6.2) daily smoking. Students with HMI were significantly more likely to report ever (p&amp;lt;.001), current (p=.008) and daily smoking (p=.014) than those without HMI. 36.7% (34.3-39.1) of students reported ever, 6.7% (5.5-8.0) current and 2.5% (1.8-3.4) daily vaping. Students with HMI were significantly more likely to report ever (p&amp;lt;.001), current (p=.002) and daily vaping (p=.022) than those without HMI. The full model containing all predictors was statistically significant, χ2 (5, N = 1621) = 34.843, p &amp;lt; .001. Female gender: OR 0.55 (0.41-0.73); current smoking: OR 1.76 (1.19-2.60), and current vaping: OR 2.07 (1.32-3.25) were significantly associated with an HMI. Conclusions There were strong associations between an HMI and smoking and vaping (controlling for age, gender, ethnicity). These findings extend earlier work on the relationship between smoking and mental illness by demonstrating similar associations in university students, and generate new information on HMI and vaping. Key messages Significant numbers of students may have an HMI. Students with an HMI have higher prevalence of smoking and vaping than students without an HMI.

Mental health in adolescents displaced by the armed conflict: findings from the Colombian national mental health survey

BackgroundColombia has one of the largest populations of internally displaced individuals by an armed conflict. However, there is no data demonstrating its effect on health, particularly in adolescents.PurposeTo describe the prevalence and associations of mental illness in the adolescent population displaced by violence in Colombia.MethodsWe conducted a secondary analysis of the 2015 National Mental Health Survey (NMHS), which provides data of mental health issues (SRQ), mental health disorders (CIDI-CAPI) and sociodemographic characteristics.ResultsOf the 1754 adolescents interviewed 5.3% (95% CI 4.1 to 6.9) mentioned a change in residence due to violence. Among them 38.5% lived in poverty compared to 23.6% of those non-displaced by the conflict. Suicidal thoughts and suicide attempt were present in 19.8% and 9.1% of displaced adolescents respectively, compared to 5.8% and 2.1% of non-displaced adolescents. The prevalence of post-traumatic stress disorder (PTSD) and any mental health disorder (measured with the CIDI-CAPI) was higher in the displaced population 12.3%, 11% respectively, in contrast to 2.1% and 7% of those non-displaced. Finally, anxiety and depressive disorders were more common among displaced adolescents.ConclusionA higher prevalence of mental health conditions and disorders is observed among displaced adolescents.

An examination of physical illness and health service use in homeless veterans with PTSD, major depressive disorder, anxiety disorder, and/or bipolar disorder in Nebraska

ABSTRACT This study examined physical health problems and health service use among homeless veterans with a reported mental health diagnosis. The current sample included a total of 156 homeless male veterans living in Nebraska. Each participant completed a single structured interview with questions pertaining to sociodemographics, clinical characteristics, and use of health services. The results showed that veterans with mental health diagnoses endorsed several physical health problems not endorsed by veterans without such a diagnosis. Participants with a mental health diagnosis were also more likely to report the use of several health services for treatment of medical, mental health, and substance abuse problems. These findings highlight the association of mental illness with physical health problems among homeless veterans and suggest that further work may be needed to address the unique health care needs of this population.

Patients with stroke and psychiatric comorbidities have lower carotid revascularization rates.

We investigated whether mental illness is associated with lower rates of carotid endarterectomy (CEA)/carotid artery stenting (CAS) after stroke due to carotid stenosis. In this retrospective cross-sectional study, ischemic stroke cases due to carotid stenosis were identified in the 2007-2014 Nationwide (National) Inpatient Sample. Psychiatric conditions were identified by secondary ICD-9-CM diagnosis codes for schizophrenia/psychoses, bipolar disorder, depression, anxiety, or substance use disorders. Using logistic regression, we tested the association between psychiatric conditions and CEA/CAS, controlling for demographic, clinical, and hospital factors. Among 37,474 included stroke cases, 6,922 (18.5%) had a psychiatric comorbidity. The presence of any psychiatric condition was associated with lower odds of CEA/CAS (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.78-0.90). Schizophrenia/psychoses (OR 0.72, 95% CI 0.55-0.93), depression (OR 0.83, 95% CI 0.75-0.91), and substance use disorders (OR 0.73, 95% CI 0.65-0.83) were each associated with lower odds of CEA/CAS. The association of mental illness and CEA/CAS was dose-dependent: compared to patients without mental illness, patients with multiple psychiatric comorbidities (OR 0.74, 95% CI 0.62-0.87) had lower odds of CEA/CAS than those with only one psychiatric comorbidity (OR 0.86, 95% CI 0.79-0.92; p value for trend <0.001). The odds of carotid revascularization after stroke is lower in patients with mental illness, particularly those with schizophrenia/psychoses, depression, substance use disorders, and multiple psychiatric diagnoses.

Why You Should Vote in APA’s 2019 Election

Back to table of contents Previous article Next article From The PresidentFull AccessWhy You Should Vote in APA’s 2019 ElectionAltha Stewart,M.D.Altha Stewart,Search for more papers by this authorM.D.Published Online:14 Dec 2018https://doi.org/10.1176/appi.pn.2018.12b22It’s that time again: the APA election season is under way. The longstanding tradition of getting ready for the holidays and the coming new year also means that the candidates for the next group of APA’s elected leaders have begun campaigning hard for our vote. And despite that inevitable activity, here comes the now perennial question: why do so few APA members vote each year?In preparing this column, I took a moment to review columns on APA’s election by several of my predecessors that appeared around this same time in their presidency. Each used a different approach to discuss the election, but the conclusion always seemed to be the same—APA members care about the organization, the profession and the issues we face, and those we serve. Nonetheless, it’s been over three decades since at least half the members voted in an election, and we have been trying to figure out why this is so. This is a particularly poignant concern this year because of the recent national midterm elections. At a time when our country is severely polarized and approaching problem solving from a partisan perspective, we saw an increase in the number of citizens exercising their right to vote for those to represent and lead them for the next few years. With regard to APA elections, clearly there must be a “tipping point” where members decide they can no longer sit on the sidelines and want to use their voice to accomplish the changes they wish to see. Maybe this will be the year.Voting in APA elections is now easier than ever—click on a link in an email that APA will send to you in early January, vote for the candidates of your choice, and you’re done. To ensure you’ll get the email, make sure your contact information is up to date in your APA member profile. And if you don’t have an email address on file with APA, make sure your mailing address is correct so you’ll get a paper ballot (see instructions on how to access your profile at the end of this article).This issue of Psychiatric News provides information about APA’s 2019 election, including the candidates’ names, photos, member class, and website addresses. Want to learn more about a candidate and his or her views on issues of importance to psychiatry? Visit that candidate’s website and read the candidate’s biographical and candidacy statements on APA’s election website. You can also watch video interviews of the candidates for president-elect and secretary. Take the time to learn about the candidates’ priorities and ask them about issues that are important to you. Moreover, most of the allied psychiatric associations invite candidates to write statements about issues of importance to their members or subspecialty concerns and publish them widely. And while we no longer have the candidate debates of years ago, many district branches and state associations invite candidates to speak at their meetings during the campaign season, and that’s also a good way to hear directly from each one.The times in which we live and work demand that we become more involved in the process of selecting our future leaders. These are the folks that will help us shape and implement the national agenda to address the challenges facing psychiatry. From the overreaching regulations regarding programs, policy, and payments to achieving full mental health parity, reducing stigma, and educating the rest of medicine and the public about the significant scientific progress related to more effective therapeutic interventions, we have a lot of work facing us. Additional challenges related to the social determinants of mental health, impact of public unrest, climate change, association of mental illness with continuing acts of violence, and the impact of these traumas on overall health and well-being suggest that the need for psychiatric services may be greater now than ever before.So, join with me and make your voice heard by voting in APA’s election. What you think is best for psychiatry’s future matters, so stand up, click (or check the box on the paper ballot), and be counted. We know that now, more than ever, every single vote is important. ■To check your member profile, go to psychiatry.org, log in, click on the arrow to the right of your name, and select “Member Profile.” ISSUES NewArchived

Mad, bad, and dangerous to know: psychiatric illness in film and theatre

AimsTo describe and discuss the portrayal of psychiatric illness in film and theatre.MethodA review of psychiatric literature on psychiatric illness and stigma was carried out. This was combined with a review of selected films and plays. The dramatic function of mental illness, and the manner of its portrayal, were considered in a discursive manner.ResultsFrom Ancient Greek theatre to modern film, psychiatric illness has been used to exemplify “otherness”. This has frequently had connotations of danger and violence, either to others or to societal norms. Occasionally psychiatric illness is depicted as transformative, or an understandable reaction to an insane environment, and there is a trend towards more nuanced depictions of mental illness. However, the disproportionate association of mental illness with violence and danger is reflected in the public's perception of mental illness, and contributes to self-stigmatisation.ConclusionOngoing communication between psychiatry, service users and the arts may help to challenge the stereotype of “mad, bad and dangerous to know”.

Associations of mental illness and substance use disorders with prescription contraception use among women veterans

ObjectiveTo investigate whether mental illness and substance use disorder (SUD) are associated with having a prescription contraceptive method among women veterans. Study designWe conducted a retrospective analysis of National Veterans Administration (VA) administrative and clinical data for women veterans aged 18–45 years who made at least one primary care visit in 2008. We assessed associations between mental illness (depression, posttraumatic stress disorder, anxiety, bipolar disorder, schizophrenia and adjustment disorder) and SUD (drug/alcohol use disorder) with having a prescription contraceptive method from VA (pill, patch, ring, injection, implant and intrauterine device) using multivariable logistic regression with random effects for VA facility, adjusting for confounders. ResultsAmong 94,115 reproductive aged women, 36.5% had mental illness only, 0.6% had SUD only, 5.3% had both mental illness and SUD and 57.7% had neither diagnosis. In these groups, 22.1%, 14.6%, 18.2% and 17.7% (p<0.001), respectively, had documentation in 2008 of prescription contraception. After adjusting for potential confounders, women with mental illness only were as likely as women with neither diagnosis to have a prescription method and were more likely to use a highly effective prescription method (implant or intrauterine device) if using contraception [adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) = 1.08–1.27]. Women with SUD (with or without mental illness) were significantly less likely to have a prescription method than women with neither diagnosis (aOR 0.73, 95% CI = 0.57–0.95 and aOR 0.79, 95% CI = 0.73–0.86, respectively). ConclusionWomen veterans with SUD are less likely to have prescription contraception compared to other women, which may increase their risk of unintended pregnancy.

Role of omega-3 polyunsaturated fatty acids for the treatment of patients with major depression disorder

A rising number of studies have raised questions regarding the association of mental illness in a particular mood disorders such as depression with low intake of omega-3 fatty acids. Given all the side-effects that traditional antidepressants put patients at risk for, omega-3 is certainly a better alternative that might improve depressive symptoms and patient's compliance to treatment by removing the stigma of psychiatric drugs. This study critically reviewed 12 relevant studies from PubMed published between 1992 - 2013 in order to determine whether omega-3 supplements or diet rich in fish were likely to show affectivity in reducing depressive symptoms. Most of the studies showed clear association between omega-3 and reduced depressive symptoms. Studies support the adjunctive role of omega-3 and high fish consumption in reducing depression. Omega-3 fatty acids have also shown to be safe when used during pregnancy to prevent postpartum depression. Although some studies showed mixed results of positive findings, the use of omega-3 supplements could not be an absolute substitute of antidepressants due to limitation in their studies. Minority of the studies reviewed did not correlate omega-3 with the improvement of depressive symptoms for many reasons such as the healthy life-style of subjects, etc. Given the fact that depression has various causes, this puts the testing of omega-3 in a lot of bias due to several variables such as dose, formula, period administered as well as the candidates' state of health. Further research is definitely warranted on a larger sample size with close follow-up using proper assessment tools. Omega-3 has shown to have minimal or no side-effects at all, which makes it important for mental health professional to at least ensure that patients diagnosed with depression have adequate amounts of omega-3 fatty acids whether by supplementation or in their daily diet.

Jail Incarceration, Homelessness, and Mental Health: A National Study

Jail Incarceration, Homelessness, and Mental Health: A National Study

Jail Incarceration, Homelessness, and Mental Health: A National Study

This study sought to investigate the rates and correlates of homelessness, especially mental illness, among adult jail inmates. Data from a national survey of jail inmates (N=6,953) were used to compare the proportion of jail inmates who had been homeless in the previous year with the proportion of persons in the general population who had been homeless in the previous year, after standardization to the age, race and ethnicity, and gender distribution of the jail sample. Logistic regression was then used to examine the extent to which homelessness among jail inmates was associated with factors such as symptoms or treatment of mental illness, previous criminal justice involvement, specific recent crimes, and demographic characteristics. Inmates who had been homeless (that is, those who reported an episode of homelessness anytime in the year before incarceration) made up 15.3% of the U.S. jail population, or 7.5 to 11.3 times the standardized estimate of 1.36% to 2.03% in the general U.S. adult population. In comparison with other inmates, those who had been homeless were more likely to be currently incarcerated for a property crime, but they were also more likely to have past criminal justice system involvement for both nonviolent and violent offenses, to have mental health and substance abuse problems, to be less educated, and to be unemployed. Recent homelessness was 7.5 to 11.3 times more common among jail inmates than in the general population. Homelessness and incarceration appear to increase the risk of each other, and these factors seem to be mediated by mental illness and substance abuse, as well as by disadvantageous sociodemographic characteristics.

Attitudes of the public to mental health: a church congregation

Attitudes towards those with mental illness vary amongst different groups in society. These attitudes affect the daily experience of mental health service users. It has been suggested that those from a theologically conservative Christian group might generally have more negative attitudes towards those with mental health difficulties because of the association of mental illness with personal sin and demon possession. The aim here is to test the hypothesis that members of a theologically conservative church congregation would have more negative attitudes than the general population towards people with mental illness. The sample consisted of 68 people from a predominantly white, middle class, evangelical Anglican congregation. Attitudes were measured by means of a questionnaire. Results are compared with those from the general UK population. The results showed that the church group expressed less negative and rejecting attitudes to people with mental illness than the population sample. Both groups could dif...

Attitudes of the public to mental health: A church congregation

Attitudes towards those with mental illness vary amongst different groups in society. These attitudes affect the daily experience of mental health service users. It has been suggested that those from a theologically conservative Christian group might generally have more negative attitudes towards those with mental health difficulties because of the association of mental illness with personal sin and demon possession. The aim here is to test the hypothesis that members of a theologically conservative church congregation would have more negative attitudes than the general population towards people with mental illness. The sample consisted of 68 people from a predominantly white, middle class, evangelical Anglican congregation. Attitudes were measured by means of a questionnaire. Results are compared with those from the general UK population. The results showed that the church group expressed less negative and rejecting attitudes to people with mental illness than the population sample. Both groups could differentiate between types of mental illnesses and had varying expectations of those with each illness. There was no evidence of judgmental attitudes towards those with mental illness. The church group has major concerns about dangerousness and unpredictability and finds service users hard to talk to. Further public education opportunities should aim to alter these damaging negative perceptions of those with mental illness.

Primary mental health care in a rural community: patient and illness profiles, treatment and referral.

The objective of this study was to determine the extent and nature of psychosocial morbidity and patterns of treatment and referral in rural general practice in a West Australian community. The research design was a survey based on structured questionnaires completed by the general practitioners about patients consulting with mental health problems in Bunbury in the rural south west region of Western Australia. Twenty-two general practitioners from five surgeries collected information on 428 patients, pertaining to socio-demographic characteristics, reasons for encounter, diagnoses, social problems, chronicity, counselling, medication and use of referral services. The positive stereotype of patients (i.e. most likely to be identified) consisted of a female preponderance in a ratio of 3:1, a high prevalence in the middle years (35-54), an overrepresentation of the divorced and separated, unemployed men and housewives. Neurosis was the most prevalent diagnosis at 68.5%, chronicity at 55%, and the most frequent social problems reported to the GPs related to relationship difficulties with partner, and being physically ill. Only a quarter of the patients were referred to other counselling services and social problems were an important reason for referral. Particular attention needs to be given to the negative stereotype in general practice of young people under the age of 25. With the bulk of psychosocial disorder concentrated in general practice, with the evident association of mental illness with physical illness and social problems, and with the lack of specialist resources in rural areas, innovative ways of support from other mental health professionals need to be addressed.

Are the mentally ill homeless a distinct homeless subgroup?

The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is needed on improving identification and management of serious mental illness among the homeless, this must be accomplished within the broader context of social and economic aspects of homelessness.

Psychiatry and the Jewish tradition

SynopsisThe attitude to mental illness in early Jewish thought and the contributions of some modern Jewish workers to psychiatry are summarized. The possible associations of mental illness among Jews are discussed.