Common Health Disorders Research Articles

Effectiveness of an add-on guided internet-based emotion regulation training (E-TRAIN) in adolescents with depressive and/or anxiety disorders: study protocol for a multicenter randomized controlled trial

BackgroundDuring adolescence, depressive and anxiety disorders are among the most common mental health disorders. Both disorders tend to persist, are predictive for other mental disorders, and are associated with severe impairment in diverse areas. Although Cognitive Behavioral Therapy (CBT) has proven to be an effective treatment, a considerable number of adolescents do not respond to CBT and residual symptoms often remain. Therefore, it is of great importance to improve treatment outcomes for depressed and/or anxious adolescents. Dysfunctional emotion regulation appears to be a transdiagnostic factor in the development and maintenance of aforementioned disorders. Enhancing emotion regulation skills may therefore reduce symptom severity. In light of this, we developed a guided internet-based emotion regulation training (E-TRAIN) that will be added to CBT. This study aims to evaluate the effectiveness of E-TRAIN + CBT compared to CBT alone on depressive and anxiety outcomes among adolescents with depressive and/or anxiety disorder.MethodsIn this multicenter two-arm randomized controlled trial with parallel group design, we aim to include 138 adolescents, aged 13–19 years, referred for treatment and diagnosed with depressive and/or anxiety disorder. Participants will be allocated to either CBT or CBT + E-TRAIN. Assessments will take place at baseline, and at 3 (T1), 6 (T2) and 12 (T3) months after baseline. We will conduct multi-informant assessments: the adolescent, a parent/caregiver, and the CBT therapist will be asked to fill in questionnaires. The continuous primary outcome measure is self-reported depressive and anxiety symptoms at six months after baseline, measured with the RCADS25. Secondary outcome measures include anxiety or depression diagnosis based on a semi-structured clinical interview, emotion (dys) regulation, and parent-report measures of anxiety, depression and emotion (dys) regulation.DiscussionThis study is the first randomized controlled trial to examine the additional value of a guided internet-based emotion regulation training to regular CBT in adolescents with depressive and/or anxiety disorders. If this intervention is effective, it can be implemented in mental health care and improve treatment for these young people.Trial registrationRegistered on June 23, 2021 in The Netherlands Trial Register (NL9564). Retrospectively registered. Recruitment started in May 2021 and is ongoing.

Mainstreaming adult ADHD into primary care in the UK: guidance, practice, and best practice recommendations

BackgroundADHD in adults is a common and debilitating neurodevelopmental mental health condition. Yet, diagnosis, clinical management and monitoring are frequently constrained by scarce resources, low capacity in specialist services and limited awareness or training in both primary and secondary care. As a result, many people with ADHD experience serious barriers in accessing the care they need.MethodsProfessionals across primary, secondary, and tertiary care met to discuss adult ADHD clinical care in the United Kingdom. Discussions identified constraints in service provision, and service delivery models with potential to improve healthcare access and delivery. The group aimed to provide a roadmap for improving access to ADHD treatment, identifying avenues for improving provision under current constraints, and innovating provision in the longer-term. National Institute for Health and Care Excellence (NICE) guidelines were used as a benchmark in discussions.ResultsThe group identified three interrelated constraints. First, inconsistent interpretation of what constitutes a ‘specialist’ in the context of delivering ADHD care. Second, restriction of service delivery to limited capacity secondary or tertiary care services. Third, financial limitations or conflicts which reduce capacity and render transfer of care between healthcare sectors difficult. The group recommended the development of ADHD specialism within primary care, along with the transfer of routine and straightforward treatment monitoring to primary care services. Longer term, ADHD care pathways should be brought into line with those for other common mental health disorders, including treatment initiation by appropriately qualified clinicians in primary care, and referral to secondary mental health or tertiary services for more complex cases. Long-term plans in the NHS for more joined up and flexible provision, using a primary care network approach, could invest in developing shared ADHD specialist resources.ConclusionsThe relegation of adult ADHD diagnosis, treatment and monitoring to specialist tertiary and secondary services is at odds with its high prevalence and chronic course. To enable the cost-effective and at-scale access to ADHD treatment that is needed, general adult mental health and primary care must be empowered to play a key role in the delivery of quality services for adults with ADHD.

An 18-month follow-up of the Covid-19 psychology research consortium study panel: Survey design and fieldwork procedures for Wave 6.

Established in March 2020, the C19PRC Study monitors the psychological and socio-economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August-September 2021). The survey assessed: COVID-19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N=3170) were re-invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on-going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors. 1643 adults were re-interviewed at Wave 6 (51.8% retention rate). Non-participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N=1100) participated in Wave 6. New respondent (N=415) entered the panel at this wave, resulting in cross-sectional sample for Wave 6 of 2058 adults. The raking procedure re-balanced the longitudinal panel to within 1.3% of population estimates for selected socio-demographic characteristics. This paper outlines the growing strength of the publicly available C19PRC Study data for COVID-19-related interdisciplinary research.

A Digital Mental Health Intervention (Inuka) for Common Mental Health Disorders in Zimbabwean Adults in Response to the COVID-19 Pandemic: Feasibility and Acceptability Pilot Study.

BackgroundCommon mental health disorders (CMDs) are leading causes of disability globally. The ongoing COVID-19 pandemic has further exacerbated the burden of CMDs. COVID-19 containment measures, including lockdowns, have disrupted access to in-person mental health care. It is therefore imperative to explore the utility of digital mental health interventions to bridge the treatment gap. Mobile health technologies are effective tools for increasing access to treatment at a lower cost. This study explores the utility of Inuka, a chat-based app hinged on the Friendship Bench problem-solving therapy intervention. The Inuka app offers double anonymity, and clients can book or cancel a session at their convenience. Inuka services can be accessed either through a mobile app or the web.ObjectiveWe aimed to explore the feasibility of conducting a future clinical trial. Additionally, we evaluated the feasibility, acceptability, appropriateness, scalability, and preliminary effectiveness of Inuka.MethodsData were collected using concurrent mixed methods. We used a pragmatic quasiexperimental design to compare the feasibility, acceptability, and preliminary clinical effectiveness of Inuka (experimental group) and WhatsApp chat-based counseling (control). Participants received 6 problem-solving therapy sessions delivered by lay counselors. A reduction in CMDs was the primary clinical outcome. The secondary outcomes were health-related quality of life (HRQoL), disability and functioning, and social support. Quantitative outcomes were analyzed using descriptive and bivariate statistics. Finally, we used administrative data and semistructured interviews to gather data on acceptability and feasibility; this was analyzed using thematic analysis.ResultsAltogether, 258 participants were screened over 6 months, with 202 assessed for eligibility, and 176 participants were included in the study (recruitment ratio of 29 participants/month). The participants’ mean age was 24.4 (SD 5.3) years, and most participants were female and had tertiary education. The mean daily smartphone usage was 8 (SD 3.5) hours. Eighty-three users signed up and completed at least one session. The average completion rate was 3 out of 4 sessions. Inuka was deemed feasible and acceptable in the local context, with connectivity challenges, app instability, expensive mobile data, and power outages cited as potential barriers to scale up. Generally, there was a decline in CMDs (F2,73=2.63; P=.08), depression (F2,73=7.67; P<.001), and anxiety (F2,73=2.95; P=.06) and a corresponding increase in HRQoL (F2,73=7.287; P<.001) in both groups.ConclusionsStudy outcomes showed that it is feasible to run a future large-scale randomized clinical trial (RCT) and lend support to the feasibility and acceptability of Inuka, including evidence of preliminary effectiveness. The app’s double anonymity and structured support were the most salient features. There is a great need for iterative app updates before scaling up. Finally, a large-scale hybrid RCT with a longer follow-up to evaluate the clinical implementation and cost-effectiveness of the app is needed.

Assessment of anxiety and depression, and coping mechanisms during COVID-19 lockdown among pregnant women

BackgroundCOVID-19 lockdown was associated with disruption of daily life, economy, essential health services including maternal health service, and psychological reflexes such as panic, sleep disorders, fear, anxiety, and depression. AimTo assess the perception of pregnant women on the COVID-19 pandemic lockdown and the prevalence of common mental health disorders (CMHD) among pregnant women. MethodsA cross-sectional study was conducted among 380 pregnant women at the University College Hospital (UCH) Ibadan; participants were enrolled using a simple random sampling technique. Data was collected using pretested interviewer-administered questionnaire. Information obtained – sociodemographic and obstetric characteristics, perception and reaction to the COVID-19 pandemic and lockdown, effect on ANC, coping mechanisms, and presence of CMHD (anxiety and depression) were measured using Hospital Anxiety and Depression Scale (HADS). Data were analysed using STATA 16.0 Software. Descriptive and bivariate statistics were performed. The level of significance was p-value < 0.05. ResultsThe mean age was 32 ± 4.78 years, most respondents were <35 years (75%), married (97.1%), had a higher education (89%) and multiparous (70%). About 43.9% were worried that COVID-19 would affect pregnancy care, 42.9% reported it affected care and 81.6% were not worried it would affect the delivery care. Among respondents, 96.6% were able to cope with the effects of the pandemic and 96.8% enjoyed good social support. Respondents did not have CMHD (88.16%), 7.9% had CMHD (4.74% had depression and 3.16% had anxiety) and 3.95% had co-morbid depression and anxiety. On multinomial regression analysis, relative to anxiety or depression only, respondents with combined depression and anxiety had higher odds of having no delivery plan and thought COVID-19 may affect their delivery. ConclusionOnly a few women reported anxiety and depression symptoms during the lockdown and those with anxiety or combined symptoms of anxiety and depression had no birth plan and believed that COVID-19 would affect their delivery.

3.7 Prevalence and Risk Factors for the Development of ADHD in Patients with Childhood Trauma

ADHD is the most common mental health disorder among children. We aim to investigate incidence, characteristics, and risk factors for ADHD in patients diagnosed with childhood trauma (CT) using Cerner Health Facts, a national longitudinal database representing approximately 69 million patients.

Use of Edible, Medicinal, and Aromatic Plants in Various Health Disorders: A Cross-Sectional Evaluation among Inhabitants in the Area of Thrace, North-Eastern Greece.

Background: Medicinal and aromatical plants (MAPs) have been historically used as traditional remedies in many cultures in Europe and globally. The aim of this study was to evaluate the use of MAPs in various health disorders in association to dietary habits and other lifestyle factors among residents in Thrace, NE Greece. Methods: Data were collected through anonymous and voluntary responses to a structured online questionnaire, via convenience (snowball) sampling. Results: The 561 responders (age: 39.7 ± 11.6 y) were mostly female (59.7%), with higher education (69.8%), working as state or private employees (55.4%), and having low/medium income (77.1%). Overall, more than 70% were using MAPs in various symptoms and common health disorders, such as chamomile against common cold and the flu. More than 20 different MAPs were being used in smaller frequencies against various conditions. Key contributing factors to the consumption of MAPs were sex (female over male), employment (employed vs. unemployed), education (higher education vs. lower) and higher Body Mass Index (overweight and obese vs. normal), while consumption of fruit, fish, and vegetables was mainly associated with the use of MAPs as common items of diet and in health disorders. Conclusions: The use of MAPs as part of the diet and as traditional remedy is present in the examined population, while particular choices seem to be affected by sociodemographic and lifestyle factors.

PSYCHIATRIC ASSESSMENT OF THE VERY YOUNG CHILD IN THE CLINIC

There is a clear shortage of child and adolescent psychiatrists in general and an even greater shortage of child and adolescent psychiatrists who are comfortable assessing and treating children younger than 5 years of age. Evidence shows that the rates of common child mental health disorders in preschoolers are similar to those seen in later childhood. Although AACAP has described practice parameters for the assessment of infants and toddlers, and standardized structured interviews and assessment tools exist, the lack of training as well as time constraints in the office prevent many practitioners from feeling competent in their ability to assess very young children.

20.4 The Cultural Adaptation of Mental Health Measures for Youth Living With HIV in Kenya

Evidence suggests that youth living with HIV (YLHIV) are at an increased risk for multiple mental health disorders. However, the ability of researchers to characterize the mental health challenges faced by YLHIV in many sub-Saharan African settings is often limited by the lack of locally adapted and validated tools for measuring symptoms of common mental health disorders. We sought to adapt a set of mental health screening tools developmentally and culturally for YLHIV in Kenya.

Recommendations to Counselors in Dealing with Clients Suffering from Depressive Mental Health Issues

Depression is a common mental health disorder. According to a survey by the Ministry of Health Malaysia (MOH), 1 in 5 adolescents tend to suffer from depression. Depression is characterized by persistent sadness and a lack of interest or enjoyment in their previously beneficial or enjoyable activities. Thus, as a counselor or therapist, self -preparation such as preparation in terms of skills, knowledge of depression issues and preparation in dealing with individuals with depressive illness is very important to help them rise again. The main concept of this paper discusses recommendations that can be referred to by counselors or therapists in dealing with clients who have mental health issues especially depression issues. Efforts in screening for depression issues and identifying the level of depression are also discussed in this paper. The researcher also used the method by making self -reflection based on observations, as well as reading the literature for this study. Thus, the implications of the discussion are also stated in this paper

Prevalence of common mental health problems and associated factors among university students visiting Supara mental health service: A cross-sectional study.

Background: Early studies found that the mental health problems rate was relatively high in university students. We aimed to investigate the prevalence of mental problems and associated factors in university students. Methods: We conducted a cross-sectional descriptive study at Supara mental health service in the Faculty of Medicine Vajira Hospital between February 2020 to June 2021. The primary outcome was the prevalence of psychiatric diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The secondary assessments included the Patient Health Questionnaire-9 (PHQ-9), 8 items from the Mini International Neuropsychiatric Interview (MINI) to assess suicidal risk (8Q), and the Thai Mental Health Indicator (TMHI-15). The prevalence of mental health problems was presented by frequency and percentage. In addition, multivariable regression analysis was used to identify potential predictors of mental health problems. Results: A total of 184 participants (62% female; mean age = 22.49 years (SD 3.93) were recruited. The depressive disorders, adjustment disorders, and anxiety disorders rates were 57.1%, 15.2% and 13.6%, respectively. Grade point averages (GPAs) below 3.0 (OR=3.09, 95%CI: 1.17-8.14) and a family history of mental disorder (OR=3.40, 95%CI: 1.10-10.48) were significant associated factors of moderate to severe mental health problems. Detecting and screening these factors may help the university to provide early detection and treatment for students. Conclusions: Depressive disorders were the most common mental health disorders. Females, low GPAs and a family history of mental disorder were predictors of moderate to severe mental health problems.

Early prediction of hypothyroidism and multiclass classification using predictive machine learning and deep learning

Thyroid disease is considered one of the most common health disorders, which may lead to various health problems. Recent studies reveal that approximately 42 million people in India face thyroid dysfunction or disorder problems. The thyroid hormone is responsible for thyroid disorder which may lead to hypothyroidism or hyperthyroidism problems. TSH (Thyroid Stimulating Hormone), T3 (Triiodothyronine, T3-RIA), FT4 (FT4, Free Thyroxine), T4 (Thyroxine), FTI (Free Thyroxine Index, FTI, T7) are the significant components of thyroid test which is performed to diagnose the behavior of thyroid hormone. However, manual analysis of these parameters on large databases to diagnose and predict hypothyroidism or hyperthyroidism is tedious. In this article, various machine learning-based techniques have been applied to build predictive models, which includes decision tree, random forest, naive Bayes and multiclass classifier and a deep learning (DL) based model Artificial Neural Network (ANN), which is best known for dealing with text data has been applied to predict the class of hypothyroidism. The performance evaluation indicates that the decision tree and random forest provide better results with the highest accuracy of 99.5758% and 99.3107% and very few error rates of 0.0424 and 0.0689, respectively. Furthermore, a comparison among the presented classifiers has been made, and also the proposed model has been compared with previous works, and it has been found that it shows better accuracy as compared to other related works. The DL-based ANN model also offers a competitive accuracy which is 93.8226%. Furthermore, this study can be useful for researchers to identify a suitable model for hypothyroidism detection and classification.

Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems

BackgroundMental health disorders in children and young people (CYP) are increasing but the provision of current evidence-based treatment for common mental health problems is limited. Treatment effects vary widely with no clear superiority of a single treatment approach. Further evaluation of contemporary and effective treatments in CYP is needed. Metacognitive therapy (MCT) has shown enhanced efficacy over ‘gold standard’ approaches in adult mental health, but so far has not been evaluated in a randomised trial of CYP. As such, we aim to assess the acceptability and feasibility of group-MCT for CYP with common mental health problems in comparison to usual treatment within Child and Adolescent Mental Health Services (CAMHS).MethodYoMeta is a multicentre, two-arm, single-blind randomised feasibility trial comparing group-MCT to usual care in CYP with common mental health problems in CAMHS. CYP (target sample n = 100) with a common mental health problem will be recruited across at least three CAMHS services in the UK. Participants in the intervention arm will receive up to eight sessions of group-MCT delivered by a CAMHS mental health practitioner. The control arm will receive usual care in CAMHS which includes individual or group-based therapy. Feasibility will be assessed by the success of recruitment, retention, and data quality. Acceptability of the intervention will be assessed by the number of sessions attended and through qualitative interviews aimed at exploring CYP acceptability and understanding of the intervention. Symptoms of psychological distress will be assessed using the Revised Children Anxiety and Depression Scale (RCADS) at 20 weeks. We will also assess psychological well-being, symptoms of depression, metacognitive beliefs, quality of life, and measures to support economic evaluation (health status and health and social care use). Qualitative interviews will be conducted to understand practitioner’s views on training and delivery of group-MCT.DiscussionThe trial is designed to evaluate the acceptability and feasibility of group-MCT for CYP with common mental health problems. Group-MCT may aid in improving access to treatment, reduce waiting times, and improve outcomes for CYP with common mental health disorders. The study will provide important information and data to evaluate future research potential and confirm sample size estimation for a definitive large-scale RCT to test the effectiveness and cost-effectiveness of group-MCT in CYP.Trial registrationNCT05260060; ISCTRN18335255

Analyzing physiological responses to quantify anxiety disorders: A scoping review

Anxiety disorder is the most common mental health disorder in the United States. One of the key factors that leads to the development and aggravation of anxiety disorders is mental stress. In this study, we reviewed publications that used physiological responses and symptoms to assess mental stress. This review found that mental stress affects heart rate, hear rate variability, blood pressure, and skin conductance. Fuzzy logic, time series, and Poincare plots are prominent data analysis tools for physiological data. Most studies used a threshold (e.g., Poincaré plot) or variance (e.g., moving average models) to distinguish stress from normal conditions. The variations and thresholds, however, might fluctuate across various activities and individuals. Moreover, most research evaluated lab-generated stress data, which may be biased. Therefore, more naturalistic studies should be conducted for future research.

Emotion dysregulation mediates the relationship between adverse childhood experiences and problematic gaming

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience.

Investigating the Feasibility of Assessing Depression Severity and Valence-Arousal with Wearable Sensors Using Discrete Wavelet Transforms and Machine Learning

Depression is one of the most common mental health disorders, affecting approximately 280 million people worldwide. This condition is defined as emotional dysregulation resulting in persistent feelings of sadness, loss of interest and inability to experience pleasure. Early detection can facilitate timely intervention in the form of psychological therapy and/or medication. With the widespread public adoption of wearable devices such as smartwatches and fitness trackers, it is becoming increasingly possible to gain insights relating the mental states of individuals in an unobtrusive manner within free-living conditions. This work presents a machine learning (ML) approach that utilizes retrospectively collected data-derived consumer-grade wearables for passive detection of depression severity. The experiments conducted in this work reveal that multimodal analysis of physiological signals in terms of their discrete wavelet transform (DWT) features exhibit considerably better performance than unimodal scenarios. Additionally, we conduct experiments to view the impact of severity on emotional valence-arousal detection. We believe that our work has implications towards guiding development in the domain of multimodal wearable-based screening of mental health disorders and necessitates appropriate treatment interventions.

Association between sleep quality and internet addiction in high school students

Internet addiction and poor sleep quality are two types of common mental health disorders among high school students. This study was conducted to determine the prevalence of poor sleep quality and its association with internet addiction in high school students. A cross-sectional study was conducted on 820 high school students in Dong Hoa town, Phu Yen province in April 2021. The students were requested to fill out a structured questionnaire. internet addiction was evaluated by the short version Internet Addiction Test (s-IAT). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The prevalence of poor sleep quality was 33.5% among high school students. The proportion of students with internet addiction evaluated by the s-IAT was 21%. The association between internet addiction and poor sleep quality remained statistically significant with p&lt;0,001 (OR=2.98, 95% CI: 2.05-4.34) after adjusting for potential confounding variables. The proportions of internet addiction and poor sleep quality were high and there was an association between them. Students should not use the internet after 9 pm and should spend at least 8 hours each night on sleep.

Clinical perspectives on the management of common psychiatric disorders in India

Psychiatric disorders are common health problems in patients of all age groups, under-diagnosis and under-treatment of these disorders can result in disability and serious complications. With an objective of creating a comprehensive evidence-based consensus on common mental health disorders and their management in the Indian setting, 10 expert groups meetings involving 98 psychiatrists across India were conducted in the month of May 2020. Clinical insights related to burden, signs and symptoms, diagnosis and management were summarized based on the discussions during these meetings. Experts agreed that depressive disorders and anxiety disorders represent two important psychiatric disorders in India. Selective serotonin reuptake inhibitors (SSRIs) are commonly used for the treatment of depression. Benzodiazepines are effective for the treatment of comorbid anxiety in patients with depression, but their long-term use causes adverse events such as dependence and withdrawal reaction. Obsessive compulsive disorder (OCD), bipolar disorder, substance use especially alcohol withdrawal syndrome, and sleep disorders are other common psychiatric disorders found among Indian patients. Lithium and valproate represent the commonly used and effective pharmacological treatments for bipolar disorder. SSRIs are preferred drugs in the treatment of OCD, whereas benzodiazepines such as chlordiazepoxide and diazepam represent important pharmacological treatment options for alcohol withdrawal. Early identification and timely and effective treatment of psychiatric disorders is important for prevention of complications. Treatment should be individualized based on efficacy, tolerability profile of the medicine, risk of drug interactions, and cost. This consensus may be useful to psychiatrists and general practitioners treating common psychiatric conditions in Indian patients.

No association between perinatal mood disorders and hypertensive pregnancies.

Mental health disorders such as anxiety and/or depression are the most common mental health disorders seen among reproductive aged women and can increase during pregnancy. Many sociodemographic risk factors have been associated with anxiety and/or depression in pregnancy, which can lead to adverse maternal and infant outcomes including the risk of a hypertensive pregnancy. The current study prospectively examined self-reported anxiety, depression and stress in pregnant women without a history of fetal loss or mood disorders beginning at 20–26 weeks. At each study visit, circulating immune factors associated with perinatal mood disorders were measured in blood samples that were collected. A total of 65 women were eligible for data analysis, 26 of which had hypertensive pregnancies. There was not a significant difference in self-reported depression, anxiety or stress between hypertensive disorders of pregnancy and normotensive women. Black women were more likely to have a hypertensive pregnancy and develop a perinatal mood disorder compared to non-black women. Both the inflammatory cytokines interleukin-17 and tumor necrosis factor-alpha were increased in patients with perinatal mood disorders. However, additional research is needed in a larger sample to truly understand the relationship between these factors along with the underlying etiologies and the associated outcomes.

Common Mental Health Disorders and Mental Health Help-Seeking Behaviors among Caregivers of Diabetic Children in Ismailia

Common Mental Health Disorders and Mental Health Help-Seeking Behaviors among Caregivers of Diabetic Children in Ismailia