Chronic Mental Health Research Articles

Flat Recovery Process in Mental Health: A Qualitative Analysis of Autoethnography

This study aims to provide a new perspective on the concept of recovery by qualitatively analyzing the experiences of mentally ill people from the Japanese perspective through autoethnography. Traditionally, the recovery process has been viewed as a series of “ups and downs” that may not apply to individuals with chronic mental health issues. A qualitative autoethnography analysis used personal diary entries from 20XX through 20XX + 4. Using text mining with KH Coder and cluster analysis, I first classified and visualized the data from the diary content and then, after confirming the content chronologically, examined the validity of the concept of the recovery process based on the theoretical framework of the Japanese cultural perspective. External validity was ensured through triangulation with the author’s work. Coding revealed four to six groups of mental health recovery keywords for each year. Confirmation of the results according to the life history also revealed problems with the conventional recovery process concept and advantages of the flat recovery process based on the Japanese cultural perspective.

Bias, Prejudice, Discrimination, Racism, and Social Determinants: The Impact on the Health and Well-Being of Latino Children and Youth

This narrative review focuses on the impact of bias, prejudice, discrimination, racism (BPDR), social determinants of health, and structural racism on Latino children’s health and well-being. The race/ethnicity, country of origin, immigrant/generational status, limited English proficiency (LEP), acculturation level, and social class of Latino children and their parents can heighten or modify the impact of BPDR. These differences have been shown to affect BPDR among Latino adults and presumably for their children. Surveys of Latino adolescents reveal that 60% have experienced discrimination, with first- and second-generation teens having a higher prevalence. These experiences are magnified by adverse social determinants/structural racism. BPDR can impact Latino children prenatally through adolescence. Bias involving neonatal, primary, and inpatient pediatric services has been reported. In 2021, Latino children were 19% less likely to complete preventive care, and 32% of LEP children had no medical home. School-age Latino children experience system inequities associated with chronic physical and mental health conditions. BPDR is also seen in educational performance but can be buffered by a strong racial/ethnic self-identity. To address BPDR/structural racism for Latino children, we suggest pediatricians: 1) increase the Latino child-health workforce to address BPDR internally and externally, 2) advocate for data collection on and monitoring of Latino children’s disparities and racism metrics in pediatric services, to improve quality of care for Latino children and their families, and 3) advocate for child health equity. Together, these steps will help eliminate BPDR for Latino children and ensure they obtain their full potential.

From Institutional Trauma to Institutional Healing

The societal struggles in American higher education have intensified in recent years, impacting various facets of academic life. Enrollment declines, rising costs, student debt, and emerging alternatives pose significant threats to colleges and universities. The COVID-19 pandemic further strained institutions, leading to deeper budget cuts and potential closures. Falling tuition revenue coupled with culture wars and political polarization have led to prolonged institutional trauma in higher education institutions. Conservative-leaning states have restricted faculty tenure, courses dealing with social and political inequity, and DEI initiatives, while progressives emphasize universities’ role in fostering critical thinking and truth. Organizational trauma can significantly impact an organization’s well-being. It can arise from a single catastrophic event or persistent issues such as workplace biases, discrimination, and poor communication. For many campuses, this manifests as chronic stress, apathy, and mental health challenges, leading to turnover of faculty and staff and low productivity. Understanding and addressing organizational trauma is crucial. Strategies include fostering resilience through supportive leadership, trust-building, and inclusive practices. Thoughtful solutions and collective efforts are needed to heal and strengthen American democracy. The 2024 elections remain uncertain, raising questions about the future of not only higher education, but American democracy. Addressing these challenges requires a concerted effort to bridge divides, promote critical thinking, and uphold the purpose of higher education. The path forward remains complex, but collective action is essential to repair and strengthen American civic health.

57 Nature based social prescribing for enhancing mental health and well-being

Abstract Objectives Nature Based Social Prescribing (NBSP) is a means of connecting people with non-clinical, nature-based community-led interventions delivered by 3rd sector organisations using local community assets. This research used a mixed-method Social Return on Investment (SROI) of a six-month pilot ‘Making Well’ NBSP programme to support individuals with chronic mental health conditions in Wales. Methods The ‘Making Well’ programme costs were estimated by means of SROI along projected 20% overheads, were incorporated to reflect sustainable costs as the charity develops and more accurately estimate the future social value expected to be generated. The ‘Making Well’ project delivered two separate programmes between October 2021 and April 2022. Data was collected from participants (n = 12) at baseline and eight-week follow-up along with interviews to collect in-depth data on individuals lived experience of participating in the programme. The ‘Making Well’ programme costs were estimated and financial proxies from the HACT Social Value (SV) bank were applied to identified benefits. Results The estimated cost of ‘Making Well’ programme inputs were £1,312 per participant and the net value of well-being benefits were £4,313 to £6,130 per participant, giving a range of SVR’s between £3.30 to £4.70 for every £1 invested in this NBSP intervention. The SROI forecast provides a three-year projection of the annual social value created and the estimated forecast cost of programme inputs was £797 per participant. The net value of well-being benefits was £4,313 to £6,130 per participant, giving a range of social value ratios between £5.40 to £7.70 for every £1 invested. Conclusions The SROI results demonstrate that the ‘Making Well’ programme is an effective NBSP intervention for supporting people with enduring mild to moderate mental health conditions. This SROI contributes to emerging evidence on the use of community assets and NBSP in generating a return on investment and positive social value. SROI forecasting for socially prescribed interventions delivered by local community assets, such as The Fathom Trust, can help organisations demonstrate transparent and effective investment of public funds and support optimal future social value creation and long-term public health outcomes.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding VA Maternity Care Coordinators Interactions and Collaboration With Primary Care Providers.

Maternal morbidity is higher among the Veteran population in part because of high rates of chronic medical and mental health conditions. To improve care for pregnant Veterans, the Department of Veteran Affairs created the position of the Maternity Care Coordinator (MCC) to provide care coordination during a Veteran's pregnancy. Maternity Care Coordinators must work with primary care providers (PCPs); yet, little is known about their collaboration and interaction. The objective of this work is to better understand how MCCs interact with PCPs. Between March and May of 2021, we conducted qualitative interviews with 30 MCCs using a semi-structured interview guide to learn about their role and interactions with PCPs. We identified 3 main themes in interactions between MCCs and PCPs, which correlated to times during the Veteran's pregnancy: initial interactions, care coordination during the pregnancy, and end of pregnancy transitions of care. Most MCCs indicated a positive and collaborative relationship with PCPs. There was significant variability in how closely MCCs worked with PCPs. MCCs reported that PCPs were not always comfortable caring for pregnant Veterans. Although MCCs generally indicated a positive and collaborative interaction with PCPs, our data suggest that there are opportunities to improve communication between PCPs and MCCs and to educate PCPs on knowledge of maternity benefits, the role of the MCC, and how to care for pregnant and postpartum Veterans. The Veteran Affairs MCC can also serve as a model for other health systems aiming to improve care coordinator among pregnant patients.

A Pilot Interprofessional Education Curriculum for Optimizing Mental Health in Chronic Pain Treatment and Understanding Interprofessional Practice.

With the urgent need for clinicians capable of responding to the opioid crisis, an interprofessional education (IPE) pilot curriculum was launched to assess trainee self-efficacy in managing chronic pain and mental health conditions, and attitudes toward interprofessional practice among resident physicians, family nurse practitioners (FNP), and physician assistant (PA) students. This study involved the implementation of a pilot curriculum consisting of five interactive IPE sessions. All invited trainees across two academic institutions were asked to complete the assessments. Self-efficacy in managing chronic pain and mental health was measured at baseline and following IPE training using a researcher-developed tool, while attitudes toward interprofessional practice were measured with the Attitudes Toward Health Care Teams scale. Resident physicians were compared to FNP/PA students to examine differences between groups and within groups over time. The final analysis involved 25 trainees who attended at least one IPE training session and completed pre-session and post-session surveys. The total pre-session survey and post-session survey response rate was 37.5% (n=36). Self-efficacy in chronic pain management improved among the resident physician (mean=3.85 ±0.40) and FNP/PA groups (mean=3.84±0.46) (p=0.05 and p=0.001), respectively. Self-efficacy in mental health management was not significantly improved among resident physicians (mean=3.41±0.49, p=0.48), but improved among FNP/PA students (mean=3.46±0.31, p<0.001). There was no difference in attitudes toward interprofessional practice. While IPE training did not result in attitudinal changes toward interprofessional practice, it shows potential for improving self-efficacy in managing chronic pain and mental health, particularly among FNP/PA trainees. This study was limited by a small sample size of trainees included in the finalanalysis.

Chronic Illness Perceptions and Cardiovascular Disease Risk Behaviors in Black and Latinx Sexual Minority Men with HIV: A Cross-Sectional Analysis.

Ethnic and racial sexual minority men with HIV have a disproportionately higher risk of HIV-related cardiovascular disease (CVD). There is a lack of tailored and culturally salient behavioral interventions to address HIV-related chronic illness in ethnic and racial sexual minority men, and literature on their understanding and awareness of modifiable behavioral risks is limited. The purpose of this study was to assess illness perceptions about HIV and HTN, and describe physical activity, tobacco, and e-cigarette use in Black and Latinx sexual minority men living with HIV. We used the validated Illness Perception Questionnaire-Revised (IPQ-R) to assess perceptions about two interrelated chronic diseases, HIV and CVD. To assess CVD behavioral risk, we assessed physical activity using the International Physical Activity Questionnaire. Tobacco and e-cigarette use were assessed using items from the Behavioral Risk Factor Surveillance System. Sleep difficulties were the most prevalent symptom attributed to HIV, and were statistically associated with fatigue, upset stomach, and loss of strength. Anxiety was reported to be caused by HIV (57%) and HTN (39%). Half of the participants engaged in vigorous activity for 128 min (SD = 135) daily, and 63% engaged in moderate activity for 94 min (SD = 88) daily. Over a third reported current tobacco use and 20% reported current e-cigarette use. This study provides formative data to better understand how Black and Latinx sexual minority men with HIV perceive intersecting chronic illnesses and their engagement in modifiable CVD risk behaviors. Sleep, mental health disparities, and financial hardships were commonly reported. More research is needed to address intersecting chronic illnesses and mental health conditions that are influenced by social positioning over the life course, and impact CVD risk factors. This study was not registered.

Childhood Health and Educational outcomes afteR perinatal Brain injury (CHERuB): protocol for a population-matched cohort study

IntroductionOver 3000 infants suffer a brain injury around the time of birth every year in England. Although these injuries can have important implications for children and their families, our understanding...

A Scoping Review of Trauma, Mental Health and First Responders in Australia.

Exposure to traumatic and/or violent events is an inherent part of the first responder role, which increases the risk of developing acute and chronic mental health symptoms and conditions. Suicidality for Australian first responders have recently increased with prevalence considered much higher compared with the general population. To inform specific recommendations for Australian first responders, there is a need to establish what evidence is available regarding these issues within the Australian context. The aim of this scoping review was to explore the impacts of trauma on the mental health of Australian first responders, the strategies recommended to address these issues and any unique needs in rural contexts. A scoping review was undertaken following PRISMA guidelines for scoping reviews. Peer-reviewed articles on Australian first responder mental health from seven databases were screened for inclusion. This review highlights that despite available evidence on the types of traumas and adverse mental health outcomes experienced, less evidence exists pertaining to intervention effectiveness. There are major gaps in evidence within rural and remote contexts which hinders effective planning and delivery of support for rural and regional first responders. Clinicians such as mental health nurses, particularly in rural areas, need to be aware of these gaps which impact planning and delivery of support and are in prime position to ensure screening, interventions and strategies are used and evaluated to determine their suitability for rural first responders.

Repeat wildfire and smoke experiences shared by four communities in Southern California: local impacts and community needs

Abstract Families in unincorporated communities in Southern California’s Eastern Coachella Valley (ECV) increasingly experience the burden of repeat wildfires and smoke. This study describes their lived wildfire and smoke experiences, health impacts, unique community-level inequities that compound wildfire risk and air quality effects, communication preferences, and resource needs for future wildfire preparedness. A wildfire community vulnerability framework informed the focus group discussion guide, exploring individual, community, and local government level factors that potentially influence community response and mitigation behaviors to repeat wildfire and smoke. Ten focus groups with 118 participants occurred in spring 2023 with four communities in ECV, California. Findings center on narratives of acute wildfire-related experiences, including evacuation and burned trailer homes, acute and chronic self report physical and mental health impacts of wildfires and smoke, daily life disruptions, staying indoors for protection, and local interactions described as a community strength in responding to fires. Participants from unincorporated, low-income, and monolingual Spanish-speaking communities predominantly consisting of farm workers requested greater emergency preparedness and response information, training and education in Spanish, postfire resources, lower trash service fees, increased enforcement of illegal dumping and burning, and use of multimodal and bilingual communication channels for wildfire, smoke, and wind alerts.

Exploring the Landscape of Social Epidemiological Research: A Scoping Review of AJE Publications.

As social epidemiology is a growing interdisciplinary field with a broad scope, this scoping review investigated its current landscape based on articles published in the American Journal of Epidemiology. Among 1,194 extracted records between 2013 and 2022 submitted under the "social" category, we identified 178 accepted articles that had a social factor as a primary exposure. We categorized social exposures into nine major domains, and health outcomes into eight domains. Study design, population, and authorship were also analyzed. Our findings indicate that social epi studies reflect a range of social exposures, including socioeconomic position (37%), neighborhood and built environment (20%), race, racism, and discrimination (16%), and policy and social welfare (12%). The most frequently studied health outcomes were non-communicable diseases and chronic conditions (42%), mental health (14%), and maternal and child health outcomes (11%). Most studies had quantitative observational designs and focused on high-income countries, particularly the U.S. contexts. Most authors appeared only once, suggesting a range of voices as contributors. Findings suggest that, to enhance knowledge, social epi could benefit from a greater representation of social factors beyond tangible resources, a broader range of health outcomes, study designs and populations, and low- and middle-income countries.

Disability and Identity in English- and Spanish-Speaking Individuals of Mexican Descent

The purpose of this study was to assess disability identity among Spanish- and English-speaking individuals of Mexican descent. This was an online, cross-sectional study with self-report measures. One-hundred thirty-six persons of Mexican descent (i.e., first, second, and third generation) addressed three research questions: (a) What is the relationship between disability identity and specific types of disability factors? (b) Do differences in disability identities exist across gender? (c) Do differences in disability identities exist across household language use? Participants with chronic conditions, assistive devices, and mental health conditions answered no to the disability identity question. More women with chronic conditions, who used assistive devices, or with mental health conditions denied a disability identity compared with men. Individuals from Spanish-speaking households were more likely to report a mental health diagnosis and deny disability identity compared with those from English-speaking households. English-only surveys that use a single disability identity question will undercount Mexican Americans who are more comfortable with or are predominantly speaking Spanish. There are subtle changes in meaning and emphasis from English to Spanish. This may represent the need to increase cultural competence for health professionals, including the level and preference of linguistically appropriate services, and identify the need for translating materials and intervention protocols. Policies related to mental health and disability should be available in Spanish to increase information related to mental illnesses that potentially qualify as a disability.

Identification of differentially expressed genes in the medial prefrontal cortex of rats subjected to chronic unpredictable mild stress and treated with electroacupuncture

Major depressive disorder is a chronic mental health condition that seriously impacts afflicted individuals. Although electroacupuncture has proven to be an effective therapy for depression, its underlying biological mechanism remains largely unknown. In this study, we aimed to investigate the effects of electroacupuncture on depression-like behavior and to identify potential target genes related to those effects. To achieve this, we subjected rats to chronic unpredictable mild stress (CUMS) and used sucrose preference, forced swimming, and open-field tests to determine their depression-like behavior in the absence or after receipt of electroacupuncture treatment. RNA sequencing technology was then used to reveal the differentially expressed genes associated with depression and electroacupuncture treatment effects in the medial prefrontal cortex (mPFC). Repeated electroacupuncture treatments at the Baihui (GV20) and Taichong (LR3) acupoints significantly alleviated depression-like behavioral defects in the animals. Genomic RNA sequencing revealed several significant changes in the mPFC transcriptome of rats that received treatment. Through differential gene expression analysis, we found that electroacupuncture reversed the CUMS-induced downregulation of 46 genes and upregulation of 13 genes. Among the differentially expressed genes, Casr, Bdkrb2, Gnb3, and Ccl1 were found to be associated with depression and electroacupuncture treatment effects. In conclusion, we verified that electroacupuncture treatment has an effective antidepressant effect, and the underlying mechanism involves multiple systems and targets.

An Integrative Review Exploring Womens' Experiences of Retraumatization Within Perinatal Services.

Evidence indicates that retraumatization has a detrimental effect for those women who are accessing perinatal services. One in five women worldwide has a history of childhood adversity. Between 18% and 34% of women experience trauma, which is a well-known risk factor for the onset of chronic mental health disorders. There is a lack of evidence on women's experiences on retraumatization in perinatal care settings and how to prevent retraumatization from occurring. The purpose of this study was to conduct an integrative review on women experiences of retraumatization to determine preventive measures within perinatal services. This integrative review followed Whittemore and Knafl's 5-stage framework as it allows for the inclusion and integration of diverse research methodologies into an overall synthesis of the evidence. A systematic search of 5 databases was conducted (Web of Science, MEDLINE, CINAHL, ASSIA, and PsychINFO) with no date, language, or geographical limits set due to the paucity of research published in this subject area. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Fifteen studies met the inclusion criteria and were included in the thematic synthesis. The review identified that participants across the studies had a history of child sexual abuse, sexual abuse, and rape. Three main themes plus subthemes were identified: (1) activating (subthemes: positions in labor, intimate procedures, communications with health care professionals, loss of control); (2) outcomes (subtheme: emotional responses); and (3) interventions reducing or preventing retraumatization (subthemes: role of the health care professional, screening for abuse and history of trauma). Our findings demonstrate that women are experiencing retraumatization in perinatal services, and there is evidence of formalized approaches being applied in clinical settings to prevent retraumatization from occurring. This study is the first to examine the factors that contribute to retraumatization in perinatal services and make recommendations to reduce the harmful practices in place in perinatal care settings.

Breaking the cycle: Exploring the relationship of metacognition beliefs, obsessive-compulsive symptoms, and psychosocial performance among individuals diagnosed with schizophrenia.

This research paper explores the intricate relationship between metacognitive dysfunctional beliefs, obsessive-compulsive symptoms, and psychosocial performance in patients diagnosed with schizophrenia. Understanding these dynamics can help mental health nurses identify and address each patient's needs more effectively. It can guide them in devising personalized care plans that not only manage the symptoms but also improve the underlying mechanism that exacerbates the psychotic symptoms and social functioning and the overall quality of life. Moreover, the findings of this research can contribute to developing training programs for mental health nurses, equipping them with the necessary skills and knowledge to provide optimal care. What the paper adds to existing knowledge? • This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. • It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. • It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. • It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains. What are the implications for practice? • The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well-being. • Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. • The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation. What are the implications for future research? • Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. • Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. • Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs. BACKGROUND: Schizophrenia is a chronic mental health disorder that significantly impacts an individual's cognitive, emotional and social functioning. Recent research has highlighted the role of metacognitive beliefs and obsessive-compulsive symptoms (OCS) in the psychosocial performance of individuals diagnosed with schizophrenia. Understanding these relationships could provide valuable insights for developing more effective nursing interventions. This study aimed to investigate the relationship between metacognitive beliefs, OCS and psychosocial performance among individuals diagnosed with schizophrenia. A cross-sectional survey was conducted involving 174 purposively selected participants diagnosed with schizophrenia. The Meta-Cognitions Questionnaire-30, Young Adult Self-Report Scale for OCS and Specific Level of Functioning Scale were used to gather the necessary data. The study found a significant positive correlation between OCS and metacognitive dimensions. Age was a significant predictor with an Oddis Ratio of 2.471. The metacognitive dysfunction was a highly significant predictor in univariate and multivariate analyses, with Oddis Ratios of 1.087 and 1.106, respectively. The study also discovered that higher levels of metacognitive dysfunctional beliefs were associated with lower levels of psychosocial functioning. Age and the metacognitive dysfunction score were significant predictors of psychosocial functioning scores, accounting for 26.8% of the variance in these scores. The study reveals a compelling inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning in individuals diagnosed with schizophrenia. It also identifies certain demographic factors, such as younger age, as significant contributors to elevated OCS. Importantly, metacognitive dysfunction emerged as a critical predictor of psychosocial functioning across various domains. These findings underscore the potential of incorporating metacognitive-focused interventions in the treatment plans for schizophrenia patients. By addressing these cognitive patterns, healthcare professionals can enhance overall functioning and well-being in individuals diagnosed with schizophrenia.

Depressive symptom mediates the association between the number of chronic diseases and cognitive impairment: a multi-center cross-sectional study based on community older adults.

The purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults. Participants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents' depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment. A total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (P<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247). The mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.

Bidirectional Associations Between Mental Health Disorders and Chronic Diabetic Complications in Individuals With Type 1 or Type 2 Diabetes.

To determine bidirectional associations between the timing of chronic diabetes complications (CDCs) and mental health disorders (MHDs) in individuals with type 1 or type 2 diabetes. We used a nationally representative health care claims database to identify matched individuals with type 1 or 2 diabetes or without diabetes using a propensity score quasirandomization technique stratified by age (0-19, 20-39, 40-59, and ≥60 years). CDCs and MHDs were identified using ICD-9/10 codes. We fit Cox proportional hazards models with time-varying diagnoses of CDCs or MHDs to investigate their association with the hazard of developing MHDs or CDCs, respectively. From 2001 to 2018, a total of 553,552 individuals were included (44,735 with type 1 diabetes, 152,187 with type 2 diabetes, and 356,630 without diabetes). We found that having a CDC increased the hazard of developing an MHD (hazard ratio [HR] 1.9-2.9; P < 0.05, with higher HRs in older age strata), and having an MHD increased the hazard of developing a CDC (HR 1.4-2.5; P < 0.05, with the highest HR in age stratum 0-19 years). In those aged <60 years, individuals with type 1 diabetes were more likely to have CDCs, whereas individuals with type 2 diabetes were more likely to have MHDs. However, the relationship between CDCs and MHDs in either direction was not affected by diabetes type (P > 0.05 for interaction effects). We found a consistent bidirectional association between CDCs and MHDs across the life span, highlighting the important relationship between CDCs and MHDs. Prevention and treatment of either comorbidity may help reduce the risk of developing the other.

Scratching the surface: the complex interface of chronic pain and mental health treatment needs in the United States

Scratching the surface: the complex interface of chronic pain and mental health treatment needs in the United States

The Power of Psyche, Self-berating As a Form of Self-restoration

Background: Self-berating, often seen as a negative behavior, is paradoxically used by some individuals as a means of self-restoration. This phenomenon involves a range of behaviors where individuals inflict harm upon themselves, both mentally and physically, as a response to guilt, societal pressures, and a need for self-improvement. This study explores the underlying motivations, mechanisms, and outcomes of self-berating as a form of self-restoration, aiming to understand its role in personal growth and mental health. Methods and Material: A comprehensive literature review was conducted, analyzing reports, studies, and articles related to self-harm, self-berating, and self-restoration. Data was collected from various psychological, sociological, and medical sources, focusing on both qualitative and quantitative analyses. Personal observations and interviews with individuals who engage in self-berating behaviors provided additional insights. The study also examined the role of societal and cultural influences on these behaviors. Results: The findings indicate that self-berating is often driven by a complex interplay of guilt, societal expectations, and personal desire for improvement. Individuals who engage in self-berating report temporary relief from emotional distress and a sense of control over their lives. However, the long-term effects are typically negative, leading to decreased self-esteem, chronic mental health issues, and in severe cases, physical harm. The study also found significant cultural and religious influences that shape the perception and acceptance of self-berating behaviors. Conclusion: While self-berating can provide temporary emotional relief and a perceived sense of control, it is ultimately a detrimental practice with long-lasting negative effects on mental health. Understanding the motivations behind self-berating and its impact is crucial for developing effective interventions. Future research should focus on alternative, healthier methods of self-restoration and coping mechanisms, and on the role of societal change in reducing the prevalence of self-harm behaviors.