Comorbidity Of Mental Health Problems Research Articles

Mapping of the network connection between sleep quality symptoms, depression, generalized anxiety, and burnout in the general population of Peru and El Salvador

BackgroundA meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout.ObjectiveThe current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes.MethodsA total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item.ResultsThe results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador.ConclusionThe networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.

Prevalence and predictors of mental health problems in refugee children living in informal settlements in Lebanon

Millions of people are currently displaced. About half of them are children who are at increased risk of mental health problems. While some risk factors such as war exposure are well established, less is known regarding the effects of the local refugee environment. Here we show that the prevalence and comorbidity of mental health problems in Syrian refugee children living in settlements in Lebanon are high. We assessed individual, familial and social factors in a prospective cohort study (N = 1,591 child–caregiver dyads interviewed between October 2017 and January 2018; n = 1,000 interviewed at 1 yr follow-up). Of these children, 39.6% met the criteria for post-traumatic stress disorder, 26.9% for conduct/oppositional defiant disorder, 20.1% for depression and 47.8% for anxiety disorders. Exposure to daily stressors was the factor most strongly associated with children’s mental health problems. Interventions and policies addressing ongoing daily stressors are as important as scaling up mental health services for refugee families.

The Prevalence and Determinant Factors of Self-Reported Depressive Symptoms Among Elderly People with Visual Impairment Attending an Outpatient Clinic in Ethiopia.

BackgroundDepression among older adults with visual impairment is the commonest psychiatric problem and causes a range of effects in on disability and progression of visual health outcomes that may even end in death. In Ethiopia, there are gaps in the detection of the comorbidity of mental health problems especially depressive symptoms among those older people. This study aimed to assess the prevalence of self-reported depressive symptoms and determinant factors among the elderly people with visual impairment attending the ophthalmologic outpatient clinic.MethodsA group of 423 elderly people with visual impairment invited by systematic random sampling technique to took part in the interview for this cross-sectional study at Menelik II referral hospital, Addis Ababa, Ethiopia from January to June 2019. Descriptive statistics like frequency, percentage, mean and standard deviation were used to summarize the distribution of the data. Binary logistic regression analysis was employed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval was used for reporting the result, and a p-value of <0.05 was considered as statistically significant.ResultsThe prevalence of self-reported depressive symptoms among elderly people with visual impairment was 26.7% with a 95% confidence interval (22.6–30.8). Widowhood, single and/divorced [Adjusted Odds Ratio (AOR)= 3.17, 95% CI: 1.71, 5.91]; [AOR=2.70, 95% CI: 1.35, 5.38], respectively, poor social support [AOR=4.34, 95% CI: 1.84, 10.24], severe level [AOR=2.63, 95% CI: 1.73, 6.63] and longer duration (>5 years) of the illness [AOR=3.15, 95% CI: 1.60, 6.19] were the factors significantly associated with higher odds of depressive symptoms.ConclusionThe Prevalence of self-reported depressive symptoms among elderly people with visual impairment in Ethiopia was high. Public health interventions targeting risky individuals with high depressive symptoms are needed to reduce depressive symptoms and to prevent disability and poor medical illnesses outcomes related to depressive symptoms.

The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations.

BackgroundInformation on the comorbidity of mental health problems in prison populations is scarce. The aim of the present study was to assess the prevalence of comorbidities at intake to prison between three diagnostic groups: severe mental illnesses (SMIs), personality disorders (PDs), and substance use disorders (SUDs). The co-occurrence of those disorders in prison populations may require the integration of differential treatment approaches and novel treatment trials.MethodsA consecutive sample of N = 427 (229 male and 198 female) individuals committed to imprisonment in Santiago de Chile was assessed with the Mini Neuropsychiatric Interview and the Structured Clinical Interview for DSM-IV (module for borderline personality disorders) on arrival at prison. Diagnoses were a priori grouped as SMI including psychosis, bipolar disorder and major depression, PD including borderline and antisocial PD and SUD including alcohol and drug abuse or dependence. Sex stratified multivariate binary logistic regression analyses were conducted to assess sociodemographic, criminal and treatment characteristics of individuals with at least one diagnosis from each of the three diagnostic groups.ResultsThe triad of SMI, PD, and SUD was present in n = 138 (32.3%; 95% IC: 28.0–36.9) study participants, n = 105 (45.9%; 95% CI: 39.4–52.4) of the men and n = 33 (16.7%; 95% CI: 12.1–22.6) of the women. Among those with the disorder triad, n = 129 (30.2%; 95% CI: 26.0–34.8) had major depression, PD and SUD; n = 54 (12.6%; 95% CI: 9.8–16.2) had psychosis, PD and SUD. The disorder triad was more common in men (OR = 4.86; 95% IC: 2.63–8.95), younger age (OR = 0.94; 95% CI: 0.91–0.97), and participants with lower educational levels (OR = 1.69; 95% CI: 1.01–2.82). The disorder triad was significantly associated with previous incarcerations (OR 2.60; 95% CI: 1.55–4.34) and histories of psychiatric hospitalizations (OR 2.82; 95% CI: 1.27–6.28).DiscussionThe complex triad of disorders from different diagnostic groups is common in prison populations, especially among young men. Successful treatment interventions may have the potential to break a cycle of repeat institutionalization in prisons and psychiatric institutions.

Assessment and Treatment of Patients with Comorbidity of Mental Health Problems and Alcohol Use Disorders: Experiences of Clinicians and Patients in the UK and Poland.

Treatment of patients with comorbidity of mental health problems and alcohol use disorder (AUD) constitutes a challenge in many countries. The article aimed at exploration of personal experiences of clinicians and patients with the comorbidity regarding its assessment, treatment and organization of care in Poland and the UK. Data were collected via in-depth, semi-structured interviews with clinicians (N = 28) and patients (N = 81) in both countries, according to a unified study protocol. Maximum variation sampling was applied to both study groups. All interviews' transcripts were coded (CAQDA) and the consistency of coding across centres was assessed. Data analysis was performed according to the principles of thematic analysis. Our data show that most patients with AUD admitted at the psychiatric wards-apart from assessment which is a standard procedure during admission-receive only minimal support during their hospital stay. This is the consequence of two factors: lack of trained staff prepared to help those patients and a priority given to self-referrals by AUD units. At the same time, it is recognized by clinicians and patients that more support is needed to encourage the utilization of AUD services and to prevent the drop-out. In order to improve the system response, the use of screening instruments in the process of the assessment of AUD and establishment of special procedures supporting motivation and adherence to treatment and preventing drop-out merits consideration. Moreover, the psychiatric wards and the AUD services could possibly profit from formalization of the collaboration between services.

Mental health problems and psychological burnout in Medical Health Practitioners: A study of associations and triadic comorbidity.

Background and Objective:Mental health problems not only affect the common person but also medical health practitioners (MHPs) dealing with health care issues of patients. The current study aimed to explore the triadic (three dimensional) comorbidity of mental health problems and its association with three forms of psychological burnout (person, client and work related).Methods:This correlational study was conducted at three hospitals of Islamabad/ Rawalpindi (Holy Family Hospital=57, District Headquarter Hospital=60, and Benazir Bhutto Hospital=40) from June 2018 to September 2018. The sample comprised of 157 medical health practitioners (medical doctors) serving in general ward (n=64), emergency (n=60) and OPD (n=33) sections. The participants were administered self-report measures of DASS-21 and Copenhagen Burnout Inventory.Results:Triadic comorbidity of depression, anxiety and stress ranged from 9% to 26% for excessive severe and normal levels respectively. Comorbidity of work related and personal related burnout at severe level was found 8%. Further, depression, anxiety and stress symptoms were strongly associated with psychological burnout at .0001 significance level.Conclusion:MHPs demonstrated excessive severe comorbidity of depression, anxiety and stress simultaneously. Along with this triadic comorbidity, the presence of severe psychological burnout is alarming and affecting overall efficiency and mental health of doctors which need to be identified, screened out and managed timely and managed properly.

Anxiety and depression among opiate users who misuse substances during treatment.

While treatment is known to improve drug and crime outcomes for opiate users, there is debate in the literature about the longitudinal effects of substance misuse and the comorbidity of mental health problems. We sought to describe and model anxiety and depression outcomes during opiate substance misuse treatment. The first national, longitudinal treatment outcome study of 404 opiate users entering a new episode of inpatient or outpatient treatment and followed up at one and three years and assessed using the Maudsley Addiction Profile instrument. A total of 404 opiate users were recruited representing approximately 8.2% of all new treatments and 17% of all new methadone treatments at national level in Ireland in 2003. At three years 97% (n = 392) were followed-up. At one year, analysis revealed the odds of experiencing depression was between five and 15 times the odds for opiate users who also used cocaine than non cocaine using opiate users, but this had decreased at three years. At three years those who were drug free, that is, not in treatment and not using illicit drugs, were less likely to experience feeling hopeless about the future than those in treatment or those not in treatment and using, but they were also more likely to experience feeling tense. Those in treatment were more likely to feel lonely. The concurrent misuse of cocaine and other substances during opiate treatment and the stage of the treatment pathway are associated with anxiety and depression among opiate users in treatment. These client factors need to be considered when implementing individualised treatment care plans.

Mental Health Considerations in Secondary HIV Prevention

Despite substantial attention in the past decade to the co-morbidity of mental health problems among people living with HIV/AIDS (PLWHA), these problems remain a significant barrier to maintaining health and secondary prevention. To address these issues, program staff from the Center for Mental Health Research on AIDS at the NIMH convened a meeting on 19th and 20th July 2007 to discuss the intersection of mental health and HIV. The conveners brought together leaders in the fields of mental illness and HIV to discuss current gaps in the research related to the prevention, diagnosis, and treatment of mental disorders among PLWHA, and how attention to mental health can affect a variety of health outcomes. Attendees were asked to discuss key questions that, if addressed through empirical investigation, could move the field toward the aim of reducing or alleviating the burden of mental illness for those living with HIV disease. The purpose of this brief report is to summarize this meeting's proceedings, overview key points of discussion, and outline areas that may be useful to consider for clinical researchers in the field.

Comorbidity of Mental Health Problems and Chronic Health Conditions in Children

Both mental and physical health problems have significant, costly effects on children and on society, particularly through the health-care delivery system. Many years of research show more mental health problems among children with chronic health conditions, but the research is contradictory and inconclusive. This study is the first to examine the physical health status and problems of children with known mental health problems.The study compares Medicaid children with and without serious mental health problems ( n = 965) using parent reports of global health status, physical functioning, and general health perceptions. Children with more serious mental health problems were significantly more likely to have chronic health conditions.The number of chronic health conditions was the most powerful variable in predicting children's global health status, physical functioning, and general health perceptions. Children's mental health status, however, was a significant predictor as well, and the inclusion of this variable in the analyses significantly improved the fit of the regression model. Implications for the health-care delivery system are discussed.