Cause Of Global Burden Research Articles

Bibliographic analysis of psychiatric publications in Taiwan: An analysis of Web of Science subject category from 1970 to 2023.

Mental diseases continue to rank among the top 10 leading causes of global burden. Psychiatric research is a crucial avenue through which mental healthcare can be enhanced. Taiwanese academics have constantly concentrated their efforts on psychiatric research and published their findings. A systematic examination of these papers will provide an assessment of the present state and contribute to the formulation of future policies for psychiatric research in Taiwan. We assessed psychiatric papers from Taiwan using the Web of Science (WoS) database. Academic papers in the Psychiatry category of the WoS database from Taiwan were retrieved and evaluated. The analysis included papers published in Science Citation Index-Expanded and Social Science Citation Indexed journals between 1970 and 2023, excluding meeting abstracts and corrections. Of the 1 049 281 papers published globally in the Psychiatry category of the WoS system between 1970 and 2023, 6117 (0.58%) were published in Taiwan. Taiwan ranked 26th globally in terms of number of papers published. These publications have received 150 519 citations. Over the past 53 years, both the annual number of psychiatric papers from Taiwan and their citations received have significantly and rapidly increased. However, the average impact factor of publications remained constant over time. Over the last five decades, the number of psychiatric publications from Taiwan has increased. However, the average impact factor of these published papers did not increase over time. Investing in advanced research infrastructure and interdisciplinary projects may improve the quality and relevance of Taiwanese psychiatric research publications, potentially increasing their global citations and impact.

Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

BackgroundCoronary artery disease (CAD) is an important cause of global burden of disease. There is a paucity of data on the burden and risk factors for CAD in sub-Saharan Africa (SSA), despite the rising trends in the shared risk factors across regions. The recent introduction of cardiac catheterization laboratory services in SSA could shed light on the burden of CAD in the region. We aimed to assess the angiographic characteristics among patients undergoing diagnostic coronary angiography (CAG) at a single tertiary care hospital in Tanzania.MethodsThis study was a retrospective chart review. A total of 728 patients ≥ 18 years of age who underwent CAG from January 2020 to December 2022 were recruited into the study. Basic demographic variables, risk factors and clinical characteristics including CAG findings were obtained from the registry. In addition, CAG images were retrieved for assessment of angiographic features. The luminal vessel stenosis was assessed based on eyeballing and the degree of obstruction was agreed by two independent and experienced cardiologists. The coronary stenosis of ≥ 50% was considered significant for obstructive CAD. The study was approved by the local ethics committee.ResultsOf patients who were recruited into the study, 384 (52.23%) were female. The study participants had a mean age of 59.46 ± 10.83 standard deviation (SD) and mean body mass index (BMI) of 31.18 kg/m2. The prevalence of CAD of any degree was estimated at 24.43% (34.18% in male, 15.50% in female), while that of obstructive CAD was 18.27%. Forty six percent of those with obstructive CAD had multiple vessel disease (MVD). Nearly 77% of patients were found to have ≥ 50–70% luminal stenosis and while those with ≥ 70% luminal coronary artery stenosis constituted 56.65%. Right coronary artery (RCA) was the most commonly affected vessel, accounting for 36.84% when any vessel disease or 56% when single vessel disease were considered. Being 65 years or older and comorbidity with type 2 diabetes (T2D) were independent risk factors for developing CAD.ConclusionThere is a high prevalence of obstructive CAD among patients undergoing diagnostic CAG in Tanzania, with male gender preponderance and increasingly higher in older age, often with severe disease. A large, prospective study is needed to provide epidemiological and clinical data for developing a locally-relevant cardio-preventive strategy for CAD intervention in Tanzania.

Effects of cumulative COVID-19 cases on mental health: Evidence from multi-country survey.

Depression and anxiety were both ranked among the top 25 leading causes of global burden of diseases in 2019 prior to the coronavirus disease 2019 (COVID-19) pandemic. The pandemic affected, and in many cases threatened, the health and lives of millions of people across the globe and within the first year, global prevalence of anxiety and depression increased by 25% with the greatest influx in places highly affected by COVID-19. To explore the psychological impact of the pandemic and resultant restrictions in different countries using an opportunistic sample and online questionnaire in different phases of the pandemic. A repeated, cross-sectional online international survey of adults, 16 years and above, was carried out in 10 countries (United Kingdom, India, Canada, Bangladesh, Ukraine, Hong Kong, Pakistan, Egypt, Bahrain, Saudi Arabia). The online questionnaire was based on published approaches to understand the psychological impact of COVID-19 and the resultant restrictions. Five standardised measures were included to explore levels of depression [patient health questionnaire (PHQ-9)], anxiety [generalized anxiety disorder (GAD) assessment], impact of trauma [the impact of events scale-revised (IES-R)], loneliness (a brief loneliness scale), and social support (The Multi-dimensional Scale of Perceived Social support). There were two rounds of the online survey in 10 countries with 42866 participants in Round 1 and 92260 in Round 2. The largest number of participants recruited from the United Kingdom (112985 overall). The majority of participants reported receiving no support from mental health services throughout the pandemic. This study found that the daily cumulative COVID-19 cases had a statistically significant effect on PHQ-9, GAD-7, and IES-R scores. These scores significantly increased in the second round of surveys with the ordinary least squares regression results with regression discontinuity design specification (to control lockdown effects) confirming these results. The study findings imply that participants' mental health worsened with high cumulative COVID-19 cases. Whist we are still living through the impact of COVID-19, this paper focuses on its impact on mental health, discusses the possible consequences and future implications. This study revealed that daily cumulative COVID-19 cases have a significant impact on depression, anxiety, and trauma. Increasing cumulative cases influenced and impacted education, employment, socialization and finances, to name but a few. Building a database of global evidence will allow for future planning of pandemics, particularly the impact on mental health of populations considering the cultural differences.

Clinical Applications of State Alcohol Biomarkers: An update

Alcohol Use Disorder (AUD) is one of the most prevalent causes of global burden of disease. It is associated with significant physical and mental health problems as well as social and economic consequences. Alcohol consumption is considered to be one of the most important preventable risk factors for adverse health outcomes, hence proper assessment is must for alcohol use disorder. The assessment pattern of alcohol use based on self-report of patients may not be always reliable due to recall bias and minimization highlighting the need of accurate biomarkers. In this narrative review we discuss about the different state biomarkers of alcohol, their properties and their utility in different settings during patient care. Despite many limitations traditional state markers are still useful and we recommend clinicians to familiarize themselves to use them as additional outcome measures in clinical interventions for AUDs and associated medical complications.

Magnitude of Unsuppressed HIV Viral Load at Amhara Public Health Institute Dessie Branch, Northeast Ethiopia

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)/is the leading cause of global burden of disease. The main goal of antiretroviral treatment is to suppress the replication of the virus in the body.

Discovery of 1-(Hetero)aryl-β-carboline Derivatives as IDO1/TDO Dual Inhibitors with Antidepressant Activity.

Depression is the leading cause of global burden of disease and disability. Abnormalities in the kynurenine pathway of tryptophan degradation have been closely linked to the pathogenesis of depression. An integrative bioinformatics analysis demonstrated that indoleamine 2,3-dioxygenase 1 (IDO1) and tryptophan 2,3-dioxygenase (TDO) are potential targets for the development of antidepressants. A series of 1-(hetero)aryl-β-carboline derivatives were designed, synthesized, and evaluated as novel IDO1/TDO dual inhibitors. Among them, compound 28 displayed potent inhibition of both IDO1 (IC50 = 3.53 μM) and TDO (IC50 = 1.15 μM) and had an acceptable safety profile and pharmacokinetic properties. Compound 28 also rescued lipopolysaccharide-induced depressive-like behavior in mice. Further studies revealed that 28 likely had unique antidepressant mechanisms involving suppressing microglial activation, lowering IDO1 expression, and reducing proinflammatory cytokine and kynurenine levels in the mouse brain. Overall, this work provides practical guidance for the development of IDO1/TDO dual inhibitors to treat inflammation-induced depression.

Covid-19: Lessons for Mental and Brain Health

Psychiatry is facing major challenges during times of a pandemic as illustrated by the current COVID-19 pandemic. The challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to the mentally ill while at the same time providing relief to general medicine. Since psychiatric disorders are the top leading causes of global burden of disease, we need to strengthen mental health care in the wake of the massive onslaught of the pandemic. While nobody can deny the need to act decisively and swiftly and ramp up intensive care readiness, we believe that the immediate availability of psychiatric care is just as important. In order to provide the best possible treatment conditions for people suffering from mental illness but as well for those suffering from the immediate pandemic’s consequences such as isolation, reduced social interaction etc. instant and comprehensive provision is inevitable.DisclosureNo significant relationships.

Manifestations of Stigma among HIV Infected Adolescents in Samia Sub-County, Busia, Kenya

Human immunodeficiency virus (HIV) is a leading cause of global burden of disease. Recently, significant progress has been made in increasing access to antiretroviral therapy (ART) for people living with HIV to suppress the replication of the virus. Suppressed viral replication facilitates restoration of the immune function and significantly reduces the risk of onward HIV transmission. Despite the increasing access to ART, compelling evidence indicate suboptimal levels of viral suppression among adolescents in many low-resource settings. This has been associated with failure of adolescents to adhere to medication due to stigma. The purpose of this study was to examine the manifestations of enacted stigma among adolescents living with HIV in Samia Sub County, Busia County, Kenya. The study was guided by the theory of planned behavior and the Social cognitive theory. The study adopted the mixed method research design. The study population comprised 4 peer educators,740 caregivers, 1580 adolescent HIV+ boys and girls, and 1 Sub County Aids and Sexually Transmitted Infections Coordinator (SCASCO). The sample size was 4 Peer educators, each drawn from the four wards, 74 caregivers for HIV + adolescents, 158 HIV+ adolescents and the I SCASCO. The stratified and simple random sampling techniques were used to select the 158 HIV+ adolescents and 74 caregivers, while saturated sampling was employed to select 4 peer educators and one health officer. Questionnaires, Focus Group Discussion and interview schedule were used to collect data from the respondents. All the instruments were piloted before administration in order to determine their validity and reliability. The test-retest method was used and a reliability coefficient of 0.70 was accepted. Data wasanalysed using descriptive statistics such as the frequency counts and percentages. Qualitative data was organized in terms of relevant themes and sub-themes and interpreted. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) Version 23.0. The study established that enacted stigma mainly manifests itself in the form of discrimination towards infected adolescents in Samia Sub-County. They experience discrimination in health care settings, including being denied health services because of their HIV status and health care professionals disclosing their HIV status without their consent. In addition, these adolescents experienced negative stereotypes such as sexual promiscuity, deviant sexual behaviors and discrimination, all of which create social barriers including access to healthcare. It is recommended that there is need to address enactment of stigma in community, homes and schools in Samia Sub County which are significant settings for the safety and welfare of HIV infected adolescents.

Management of Atopic Dermatitis with Individualised Homoeopathic Treatment

AbstractSkin being an important protective organ of body has its own functional and cosmetic values. Atopic dermatitis (AD) is a disease comprising of heterogenous skin manifestations with intense itching. AD affects people of all age groups and ethnicities and has psychosocial impact on the patient. Being the leading cause of global burden of skin disease, this disease also enhances the chances of developing food allergy, allergic asthma etc. Moreover, due to poor hygiene and decreased protective barrier function, AD often gets infected by certain pathogens (Staphylococcus aureus, Malassezia, Molluscum etc.), as a result of which patient suffers from life-threatening complications. Absence of specific diagnostic test with gradual escalation in the disease burden makes it one of the chief concerns for the health care workers. For dermatological diseases, homoeopathy stands out as a prime choice for many patients. In this case, a 72-year-old male patient presented with symptoms of dry, itchy eruptions on right hand for the last 2 years. He also developed similar itching eruptions in and around navel. The patient was clinically diagnosed with AD and treated with individualised homoeopathic treatment. Initially, he was prescribed Tuberculinum which improved the patient and finally he was cured by Sulphur.

STUDY OF CORRELATION OF RETINOPATHY AND MICROALBUMINURIA IN PATIENT OF ESSENTIAL HYPERTENSION

Background: Hypertension is one of the leading causes of global burden of disease. Essential hypertension produces clinical proteinuria and microalbuminuria and is an early sign of kidney disease. Microalbuminuria has been shown to be a marker for end organ damage and results in retinopathy in the eye. Aims: The aim of the study was to determine the correlation between microalbuminuria and hypertensive retinopathy in patients of essential hypertension. Methods:This cross-sectional study was performed in 100 patients with essential hypertension of a tertiary care teaching hospital in eastern India, conducted between July 2020 to June 2021. Urinary albumin excretion was assessed by turbidimetry method and fundus was examined for grading of hypertensive retinopathy Result: Microalbuminuria was found to be present in 36 % patients of whom 65 % were males and 35% were females. Hypertensive retinopathy was observed in 66.7 % (24) patients, out of which 36 % patients had associated microalbuminuria. (p=0.001871) Conclusion: Investigation must be initiated for evidence of early renal disease in hypertensive patients to prevent MA and the resultant end organ damage. Furthermore, MA had a signicant correlation with retinopathy therefore fundus examination should be undertaken to predict the presence of ongoing vascular damage which can prevent atherosclerotic processes in the entire vascular system

Follow-up of the Cool Little Kids translational trial into middle childhood.

Public health advocates have highlighted internalising problems as a leading cause of global burden of disease. Internalising problems (anxiety/depression) affect up to 20% of school-age children and can impact peer relations, school engagement and later employment and mortality. This translational trial aimed to determine whether a selective/indicated parenting group programme to prevent internalising distress in shy/inhibited preschool children had sustained effects in middle childhood. Translational design aspects were a brief parent-report screening tool for child inhibition offered universally across the population via preschools in the year before school, followed by an invitation to parents of all inhibited children to attend the parenting programme at venues in their local community. Design of the study was a randomised controlled trial. The setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited four-year-old children of which 456 (84%) were retained during middle childhood (age of seven to 10 years). Early intervention was the Cool Little Kids parenting group programme, and control was 'usual care' access to available support services in the community. Primary outcomes were child anxiety and depression symptoms (parent and child report) and DSM-IV anxiety disorders (assessor masked). Secondary outcomes were parenting practices and parent mental health. There was no significant difference in anxiety disorders between the intervention and control group during the three annual follow-ups of the cohort in middle childhood (2015 43% vs. 41%, 2016 40% vs. 36%, 2017 27% vs. 30%, respectively; p's > .05). There were also no significant differences in child anxiety or depression symptoms (by child or parent report), parenting practices or parent mental health, between the intervention and control group during middle childhood. However, a priori interaction tests suggested that for children with anxious parents, early intervention attenuated risk for middle childhood internalising problems. An issue for population translation is low levels of parent engagement in preventive interventions. Initial effects of the Cool Little Kids parenting group programme in reducing shy/inhibited preschool children's internalising distress at school entry dissipated over time, perhaps due to low engagement. Future translational research on early prevention of internalising problems could benefit from screening preschool children in the population at higher risk (combining temperamental inhibition and parent distress) and incorporating motivational techniques to facilitate family engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662.

Relationship between Body Mass Index and Gender with Asthma

Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p<0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.

CON perspective

Abstract BodyPsychiatry is facing major challenges during times of a pandemic as illustrated by the current COVID-19 pandemic. The challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to the mentally ill while at the same time providing relief to general medicine. Although psychiatric disorders are the top leading causes of global burden of disease, we can witness mental health care being de-emphasized in the wake of the massive onslaught of the pandemic: psychiatric wards are being downsized, clinics closed, psychiatric support systems discontinued etc. in order to make room for emergency care. While nobody can deny the need to act decisively and swiftly and ramp up intensive care readiness, we believe that there is no need to do this at the expense of psychiatric care. Using the pandemic COVID-19 contingency plan developed at the Department of Psychiatry and Psychotherapy of the University Hospital of LMU Munich as a case in point, we demonstrate how a psychiatric hospital can share in the acute care of a health care system facing an acute and highly infectious pandemic like COVID-19 and at the same time provide for the mentally ill, with or without a COVID-19 infection, and develop mid and long-term plans for coping with the aftermath of the pandemic.DisclosureNo significant relationships.

Metabolomic predictors for late-life depression

<h3>Introduction</h3> Depression is a major public health problem among older adults and among the leading causes of global burden of disease and disability. Yet, current understanding of pathophysiology and optimal prevention and/or treatment of late-life depression (LLD) is limited. Advanced approaches involving methods such as metabolomics present an innovative path to identify novel biomarkers of LLD outcomes. Several known biological pathways involving tryptophan and lipid-inflammatory molecules (eicosanoids) are relevant to depression; however, there have been few systematic investigations of metabolomic predictors of long-term trajectories of LLD. <h3>Methods</h3> This is a convenience sample of ∼7000 Nurses' Health Study (NHS) participants with known metabolites and who completed depression items every four years from 1992-2016. Between 1989 and 1990, blood samples were collected and stored under standard conditions. In NHS, data on known metabolites were generated by merging the data from multiple case-control studies; however, all metabolites were profiled using liquid chromatography mass spectrometry in the same laboratory. Continuous metabolite values were transformed to probit scores to account for batch effects. We used a previously developed harmonized depressive symptom scale that was indexed to the five-item Mental Health Inventory (MHI-5, range=0-100 points). For cross-sectional analysis, we performed multivariable logistic regression models to evaluate the associations of baseline metabolite levels and likelihood of the moderate or severe depressive symptoms (MHI-5 cut-off=60); for longitudinal analysis, we used latent growth-curve analysis to identify group-based trajectories of depressive symptoms and then related baseline metabolite levels to long-term trajectories. <h3>Results</h3> The mean age of female nurses at blood draw was 57.0 (range=42.6-70.2) years. There were ∼6300 NHS participants with available data on tryptophan metabolites and ∼1300 NHS participants with available data on eicosanoids. We observed stronger signals for cross-sectional associations of higher circulating levels of tryptophan, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) with lower risk of moderate or severe depressive symptoms, adjusted for age at blood draw, fasting status, case-control status, physical activity, body mass index, diet index, alcohol use, and cigarette smoking [multivariable odds ratio (95% confidence interval): for tryptophan=0.86 (0.80-0.93), p<0.01; for EPA=0.84 (0.71-1.01), p=0.06; for DHA=0.85 (0.71-1.02), p=0.07]. From 1992-2016, we identified four depressive symptom trajectory groups: minimal depressive symptoms (63%), worsening depressive symptoms (12%), improving depressive symptoms (20%), and persistent severe depressive symptoms (5%). Additional results from multinomial models evaluating the associations between metabolites and long-term LLD trajectories will be presented. <h3>Conclusions</h3> In this sample, tryptophan and omega-3 fatty acid metabolites were significantly related to LLD outcomes; these metabolites may play a role in the pathophysiology of LLD. <h3>Funding</h3> HMS Livingston Fellowship Award

Ambient air pollution exposure and risk of chronic kidney disease: A systematic review of the literature and meta-analysis

Ambient air pollution has been identified as one of the leading causes of global burden of disease. The relationship between ambient air pollution exposure and risk of chronic kidney disease (CKD) has stimulated increasing scientific interest in the past few years. However, evidence from human epidemiological studies is still limited and inconsistent. We performed an updated systematic review and meta-analysis to clarify the potential association comprehensively. Selected electronic databases were searched for related English language studies until March 1, 2020 with a final follow-up in December 31, 2020. Risk of bias assessment for individual studies were assessed using the OHAT (Office of Health Assessment and Translation) risk-of-bias rating tool. Confidence rating and level-of-evidence conclusions were developed for bodies of evidence for a given ambient air pollutant. Summary effect estimates were calculated using random-effects meta-analyses when three or more studies are identified for the same air pollutant–CKD combination. A total of 13 studies were finally identified in our study. The meta-analytic estimates (ORs) for risk of CKD were 1.15 (95% CI: 1.07, 1.24) for each 10 μg/m3 increase in PM2.5, 1.25 (95% CI: 1.11, 1.40) for each 10 μg/m3 increase in PM10, 1.10 (95% CI: 1.03, 1.17) for each 10 ppb increase in NO2, 1.06 (95% CI: 0.98, 1.15) for each 1 ppb increase in SO2 and 1.04 (95% CI: 1.00, 1.08) for each 0.1 ppm increase in CO, respectively. The level of evidence was appraised as moderate for four of the five tested air pollutant–CKD combinations using an adaptation of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool. In conclusion, this study suggests that certain ambient air pollutant exposure was significantly associated with an increased risk of CKD. Given the limitations, the results of this study should be interpreted with caution, and further well-designed epidemiological studies are needed to draw a definite evidence of a causal relationship.

Factors associated with the depression among people with disabilities: A cross-sectional study in Chinese communities of Shanghai.

Depression has become a growing health issue in the world and is projected to become a leading cause of global burden. However, there is little scientific research on the factors associated with depression in people with disabilities in China. In this cross-sectional study, we aimed to explore the prevalence and related factors of depression among people with disabilities in communities in mainland China.Participants with disability certificates were recruited via face-to-face interviews to complete questionnaires. Contents include participants’ demographic characteristics, the Modified Barthel Index (MBI), chronic medical history, and the Patient Health Questionnaire-9 (PHQ-9).A total of 1815 participants (M age = 60.35 ± 13.66) whose questionnaires are eligible were finally included. Among them the incidence rate of depressive symptoms was up to 39.9%. Multifactor regression analysis showed that grade I disability (odds ratio (OR) = 1.37, P < .05), impairment activities of daily living (OR = 3.23, P < .001), diabetes (OR = 1.43, P < .05), and hyperlipidemia (OR = 1.59, P < .001) were associated with depression in the disabled. However, intelligence disability is a protective factor of depression (OR = 0.69, P < .05).The data demonstrates that the depression of the disabled should arouse the attention of our society. Furthermore, the interventions to disability degree, impairment activities of daily living, diabetes, and hyperlipidemia may help to improve the mental health of the disabled people.

The Role of Exercise in Preventing and Treating Depression.

Depression is a leading cause of global burden. The mainstay of treatment is pharmacological and psychological interventions. While effective, not all people will respond to those treatments and alternative approaches for preventing and treating depression are required. Recent literature has demonstrated that higher physical activity (PA) levels and exercise confer protective effects on incident depression. Also, exercise has demonstrated efficacy on reducing symptoms for people with depression. Despite its effectiveness, similar to other treatments, some people may benefit more from exercise and identifying these potential predictors of response is necessary to deal with patients' and professionals' expectations. Dropout from exercise interventions is comparable to dropout from other treatments for depression and similar to dropout from exercise in other clinical populations. However, some strategies to increase adherence are important. In the present article, we provide an updated overview of the use of PA and exercise for the prevention and treatment of depression.

Psychiatric Pharmacy: New Role of Pharmacists in Mental Health

Psychiatric disorders are one of the major causes of global burden of diseases. Stigma remains a major impediment in the delivery of mental healthcare. It has been found across various studies that attitudes of doctors of other specialties and other healthcare professionals also contribute to stigma due to their lack of knowledge and awareness about psychiatry and mental health problems. The number of mental health professionals remains abysmally low. Community pharmacists are accessible, knowledgeable, and capable of providing mental health promotion and care in communities. This may not be a role that is recognized by the public, and men in particular. However, psychotherapy paired with medication is the most effective way to promote recovery. Examples include: Cognitive Behavioral Therapy, Exposure Therapy, Dialectical Behavior Therapy, etc. Pharmacists can play a key role by providing mental health medication management support to improve access and address patients’ mental health needs.

Effects and Side Effects of Cannabinoid/Opioid Combination in a Chronic Pain Model in Rats

Chronic pain is considered a growing healthcare problem becoming a major cause of global burden. Prolonged use of the currently used analgesics such opioids is associated with adverse effects; urging the need for safer alternatives. Cannabinoids are a group of compounds structurally related to Δ9‐tetrahydrocannabinol (Δ9‐THC). Both cannabinoids and opioids produce antinociception in different chronic pain animal models. However, therapeutic doses of these drugs may be accompanied by undesirable side effects, such as abuse liability and decrease locomotion in animals. The aim of this study was to assess the outcomes of combining range of doses of opioids and cannabinoids that are sufficient to produce antinociception without producing unwanted side effects. Inflammatory pain was induced by intra‐plantar injection of Complete Freund's Adjuvant (CFA) into the left hindpaw of adult male Sprague Dawley rats. Von Frey filaments were applied to the mid‐plantar aspect of the left hind paw using the “up‐down” method to determine the CFA‐induced mechanical allodynia. Antinociceptive effect of morphine (0.32, 1 and 3.2 mg/kg; i.p), the synthetic cannabinoid CP55940 (0.032, 0.1 and 0.32 mg/kg; s.c.), their combinations, or their vehicles was evaluated 3–9 day post‐CFA administration. Intracranial self‐stimulation (ICSS) test was utilized to evaluate the abuse liability of these drugs or their combinations. Morphine produced significant antinociceptive effects at 1 and 3.2 mg/kg, but not at the lowest dose of 0.32 mg/kg with minimal changes in ICSS. CP55940 showed significant antinociceptive effects only at the highest administered dose (0.32 mg/kg), while producing depression in ICSS at 0.1 and 0.32 mg/kg. The sub‐theraputic dose of morphine (0.32 mg/kg) was co‐administered with the different doses of CP55940 (0.032, 0.1 and 0.32 mg/kg). 0.32 mg/kg morphine enhanced the antinocicpetive effects of CP55940, such that CP55940 produced antinociception at lower dose (0.1 mg/kg) compared to vehicle. However, in ICSS test, the aforementioned combinations did not change CP55940‐induced depression of ICSS. In conclusion morphine and CP55940 produce analgesic effects at lower doses if combined together with no additional risk of abuse liability side effects, which may be useful in clinical practice.Support or Funding InformationScientific Research Support Fund (MPH/1/29/2016)This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The Burden of Mental Illness: An Emerging Global Disaster

The global burden of disease (GBD) has shifted from communicable to non-communicable diseases, and from premature death to years live with disabilities (YLDs) over the past 30 years. Mental and substance use disorders constitute a major component in the scenario of the global health with a significant impact on the global burden of disease, especially in the developing countries. The 1990 GBD study listed depression as the fourth common cause of global burden of disease; while lower respiratory infections, diarrheal diseases and conditions arising during perinatal period are top in the list. In GBD 2000 study depressive disorders climbed to the third place, however still behind lower respiratory infections and diarrheal diseases. The subsequent 2010 GBD study ranked depression in the second place of the global disability burden, and are also considered as a major contributor to the burden of suicide and ischaemic heart disease. The WHO predicted that depressive disorders will be the leading cause of global burden in 2030.