Current Mental Status Research Articles

Extracellular microRNAs associated with psychiatric symptoms in the Normative Aging Study

Earlier studies have revealed microRNAs (miRNAs) as potential biomarkers for neurological conditions, however, such evidence on psychiatric outcomes is limited. We utilized the Normative Aging Study (NAS) cohort to investigate the associations between extracellular miRNAs (ex-miRNA) and psychiatric symptoms among a group of older male adults, along with the targeted genes and biological pathways. We studied 569 participants with miRNA profile primarily measured in extracellular vesicles isolated from plasma, and psychiatric symptoms reported over 1996–2014 with repeated measures. Global and dimension scales of psychiatric symptoms were measured via the administration of Brief Symptom Inventory (BSI) per visit covering nine aspects of psychiatric health, such as anxiety, depression, hostility, psychoticism, etc. Ex-miRNAs were profiled using small RNA sequencing. Associations of expression of 395 ex-miRNAs (present in >70% samples) with current mental status were assessed using single-miRNA as well as Least Absolute Shrinkage and Selection Operator (LASSO)-based multi-miRNAs linear mixed effects models adjusting for key demographic and behavioral factors. Biological functions were explored using pathway analyses. We identified ex-miRNAs associated with each BSI scale. In particular, hsa-miR-320d was consistently identified for two global scales. Similar overlapping miRNAs across global and dimension scores included hsa-miR-379-3p, hsa-miR-1976, hsa-miR-151a-5p, hsa-miR-151b, hsa-miR-144-3p, etc. Top KEGG pathways for identified miRNAs included p53 signaling, Hippo signaling, FoxO signaling, protein processing in endoplasmic reticulum and several pathways related with cancer and neurological diseases. This study provided early evidence supporting the associations between extracellular miRNAs and psychiatric conditions. MiRNAs may serve as biomarkers of subclinical psychiatric illness in older adults.

BIDIRECTIONAL INTERACTION OF BLOOD GLUCOSE AND MENTAL STATUS AND ITS ROLE IN DEVELOPING DIABETES MELLITUS AND PSYCHIATRIC DISORDERS – SYSTEMATIC REVIEW

Blood glucose concentration in certain situations affects current mental status. Anxiety occurring during hunger or lack of concentration associated with hypoglycemia are well-known phenomenon. Variations of glucose levels may also present a long-term impact on mental status and mental health. Moreover, impaired mental status leads to neglecting health-promoting life choices in some individuals, while psychiatric disorders may contribute much more to the development of metabolic diseases. Aims: The aim of this review is to assess the current state of knowledge about the bidirectional interaction of blood glucose levels, including its fluctuations and management, and mental status. Methods: In our publication we used scientific sources such as publications and textbooks. Results: Studies show the most significant correlation between diabetes and psychiatric disorders, mostly depression, but also indicate that healthy individuals may present a correlation of metabolic and mental disorders. Diabetic patients are more prone to develop psychiatric disorders, but also psychiatric patients are more commonly affected by diabetes mellitus. Moreover, those suffering from both diseases show the highest risk of overall mortality. Inflammatory pathology of both diabetes and depression, which is the most common psychiatric disorder in diabetic patients, suggests that chronic inflammation may play the main role in this relationship. Conclusion: Analyzing different risk factors of comorbidity, the significance of reversible ones is indisputable. Taking that into account, some lifestyle changes may be beneficial for metabolic and mental disorders prevention. Further studies could indicate certain pathological relationships and help understand the correlation between blood glucose and mental state in healthy individuals.

Harnessing Emotional Intelligence for Music Curation in Recommendation Systems

Abstract- When an individual decides the music he or she wants to listen to from a huge collection of already-existing options, sometimes it might get confusing. Diverse maneuvers have been executed for music, pride and food, and shopping based on user mood available, but there is no centrally managed network for all. The objective behind the technology of our music recommendation system is to give user-fitted recommendations to customers. The facial expression/user emotion analysis may a way to rectify defects in the current emotional or mental status of a user. When it comes to music and videos, this is the one area where there is a considerably large avenue for predictions based on customer tastes and previous records. This is a common thing that you've probably heard: that people often use facial expressions to be more direct about what they are really saying and the situation they are in. More than 60% of users agree with the sentiment that it will at some point become so difficult for them to determine which video they should play because quantity of videos in their library is really huge. Through the modelling of a robot dedicated to making recommendations about music to a user, it can facilitate the decision-making of which music one should be listening to and, thereby, lower the stress levels of the user. The user would not need to spend time on music searching or looking up suitable songs, as the best song paired with the user’s mood status would be successfully detected and immediately recommended to him/her by the application. The picture of the user is delivered through the camera incorporated into it. The picture of the user is taken, and then song is displayed on the screen in accordance with the mood or emotion of the user from their playlist, which matches the needs of the user.

Psychosocial factors predicting symptoms of depression and anxiety in allogeneic hematopoietic stem cell transplant recipients in Japan.

We explored whether a patient's psychosocial background before allogeneic hematopoietic stem cell transplantation (allo-HSCT) could predict the occurrence of psychiatric symptoms during treatment and after hospital discharge. Logistic regression analysis was performed using INTERMED, a scale that comprehensively evaluates psychological factors such as psychiatric history, current mental status, and coping skills, and social factors such as social participation status, relationships with others, and living environment, which were used as independent variables. The Center for Epidemiologic Studies Depression Scale was used to measure depression, while the Profile of Mood States was used to measure anxiety and other symptoms. Both measures were used as dependent variables and were administered upon clean room admission, during clean room stay, at clean room discharge, and at 3, 6, and 12months after hospital discharge. Participants included 70 patients (45 males and 25 females, mean age 53.3 ± 12.3years). Thirty-eight patients participated in the program for the entire period, up to 12months after hospital discharge. The total score on the Japanese version of the INTERMED and psychological factor scores assessed at baseline were significant predictors of depressed mood on discharge; however, there were no significant predictors of scores on the Profile of Mood States. A comprehensive pretransplant evaluation of psychosocial background can help predict the appearance of psychiatric symptoms after allo-HSCT. In patients who are expected to develop psychiatric symptoms after allo-HSCT, it is important to consider early intervention by a specialist and close monitoring by a medical team.

The Current Mental Status of Adolescent Students in High Schools in China and School Life-related Factors that Influence Their Mental Status

Suicide is an important mental-health-related problem in East Asian countries. In recent years, there is an increasing trend in this social problem in China. China has a huge number of students and fewer teaching resources, which leads to greater competitive stress. It is of our interest to see whether there is a strong relationship between the deterioration of high school students mental health status and the pressure from homework and exams.Although there has been much research on the relationship between depression and learning among college and graduate students, but there is a lack of research on adolescent high school students. Therefore, the objective of the current study was to evaluate the current mental health status of adolescents studying in high school in China and source of stress.

Development and cross-validation of a veterans mental health risk factor screen.

VA primary care patients are routinely screened for current symptoms of PTSD, depression, and alcohol disorders, but many who screen positive do not engage in care. In addition to stigma about mental disorders and a high value on autonomy, some veterans may not seek care because of uncertainty about whether they need treatment to recover. A screen for mental health risk could provide an alternative motivation for patients to engage in care. Data from samples of veterans and traumatic injury survivors were analyzed to identify mental health risk factors that are characteristics of individuals or stressors or of post-trauma, post-deployment, or post-military service resources, experiences, or responses. Twelve risk factors were strongly related to PTSD (r > .50): current PTSD, depression, dissociation, negative thinking, and emotional lability symptoms, life stress, relationship stress, social constraints, and deployment experiences of a difficult environment, concerns about life and family, perceived threat, and moral injury. Items assessing each of these risk factors were selected and their validity to prospectively predict PTSD and/or depression 6 months later was assessed in a new sample of 232 VA primary care patients. Twelve items assessing dissociation, emotional lability, life stress, and moral injury correctly classified 86% of those who later had elevated PTSD and/or depression symptoms (sensitivity) and 75% of those whose later symptoms were not elevated (specificity). Performance was also very good for 110 veterans who identified as members of ethnic/racial minorities. Mental health status was prospectively predicted in VA primary care patients with high accuracy using a screen that is brief, easy to administer, score, and interpret, and fits well into VA's integrated primary care. When care is readily accessible, appealing to veterans, and not perceived as stigmatizing, information about mental health risk may result in higher rates of engagement than information about current mental disorder status.

Current mental status and burnout level among ophthalmologists in Riyadh, Saudi Arabia: a cross-sectional study

Background: The World Health Organization's recent recognition of burnout as an "occupational phenomenon" underscores its significance in healthcare settings. Ophthalmologists, in particular, face a heightened risk of burnout, which can have grave implications for patients, healthcare peers, and organizations. This study investigates the mental health and burnout levels of ophthalmologists in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted in Riyadh's multiple hospitals, utilizing a questionnaire with three sections: demographics, mental health assessment (using depression anxiety stress scales-21), and burnout evaluation (using Maslach Burnout Inventory-Human Services Survey). Data were analyzed using Statistical Package for the Social Sciences. Results: Mental health assessments revealed varying degrees of depression (40.0% no depression, 17.5% mild, 23.8% moderate, and 18.8% severe), anxiety (31.9% no anxiety, 10.6% mild, 21.9% moderate, and 35.6% severe), and stress (15.0% mild, 14.4% moderate, and 10.0% severe). Burnout levels indicated 43.8% with low depersonalization, 17.5% with moderate, and 38.8% with high levels. The overall burnout prevalence was 32.5%, with 67.5% not experiencing burnout. Burnout was more prevalent among ophthalmologists with 6-10 years' of experience compared to those with ≤5 years. On-call duties did not significantly impact burnout prevalence. Conclusion: This study underscores the pressing issue of mental health and burnout among ophthalmologists in Riyadh, Saudi Arabia. The findings emphasize the urgent need for tailored interventions and support systems to address the considerable psychological distress and burnout within this workforce. Future research should explore longitudinal designs to gain a deeper understanding of the evolving mental well-being of ophthalmologists over time.

Differences in prescription patterns between real-world outpatients with bipolar I and II disorders in the MUSUBI survey.

There is limited information available on the prescription of psychotropic agents to patients with bipolar I (BD-I) and bipolar II disorder (BD-II). The purpose of this study was to investigate the characteristics of drug therapy in BD-I and BD-II outpatients, particularly with regard to antidepressants. In 2017, the MUlticenter treatment SUrvey for BIpolar disorder in Japanese psychiatric clinics (MUSUBI) study collected data on current mental status, medications, and other factors from 2774 outpatients with BD-I or BD-II. There were significant differences in the rates of prescriptions for mood stabilizers, antipsychotics and antidepressants. Mood stabilizers and antipsychotics were prescribed at higher rates to patients with BD-I (mood stabilizers; BD-I 86.0%, BD-II 80.8%, p<0.001; antipsychotics; BD-I 61.5%, BD-II 47.8%, p<0.001), and antidepressants were prescribed at higher rates to patients with BD-II (BD-I 32.1%, BD-II 46.4%, p<0.001). The most commonly prescribed antidepressants were escitalopram for patients with BD-I and duloxetine for patients with BD-II. Selective serotonin reuptake inhibitors (SSRIs) were the most common class of antidepressants prescribed to patients with BD. With regard to combination therapy, combinations containing antidepressants were often prescribed to patients with BD-II. There was a difference in the prescription of psychotropic agents between patients with BD-I and BD-II. The outpatient prescriptions for BD in Japan were mood stabilizers and antipsychotics, which generally followed the guidelines. There is insufficient evidence regarding the effects of the prescribed antidepressants and the risk of manic episodes, and further evidence needs to be collected.

Hierarchical Regression of Wellbeing and Self-Rated Health among Older Adults in Abu Dhabi.

This study investigates the wellbeing factors related to self-rated health for older adults in Abu Dhabi (≥55 years). The purpose is to provide a comprehensive analysis of the determinants of self-rated health, considering various wellbeing factors, controlling for factors such as gender, nationality and long-standing illness if present. This research drew from a sample of 2375 older adults who participated in the Abu Dhabi Quality-of-Life Survey (QoL) conducted in 2018. Hierarchical multiple regression analysis was employed where the first two models corresponded to gender, nationality and having a long-standing illness or not. The third model focused on the wellbeing factors of Abu Dhabi citizens (i.e., social networks and connection, income and housing, sports and activities, mental feelings). The analysis revealed the insignificance of gender and nationality as controlled variables while having a long-standing illness showed significant adverse effects. The most significant variables were social support networks, family and social arrangements and connections. Other variables of significance included housing satisfaction, household income satisfaction, frequency of practicing sports, current mental status and life satisfaction. Policymakers could use the outcomes as insider intelligence for policymakers and social work professionals to create policies, programs and services to enhance the lives of older people in Abu Dhabi.

SARS – CoV 2 imapct’s on menthal health. Case study, psychiatric hospitals “Ali Mihali”, Vlorë

IntroductionThe aim of this paper is to analyse the impact of SARS – CoV 2 on Menthal Health. Based on the studies pacients infected with COVID-19 manifest severe menthal health problems during or after infection.ObjectivesHow do different people face the acute phase of SARS-CoV-2 infection? How do menthal health problems influence the disease’s trajectory? What kind of the menthal health disorder occur in people status post Covid?MethodsWe have used a regular, clinical strategy involving adults aged 21-61 years infected with SARS-CoV-2. The research was conducted over the period July-December 2020, in 5 patients (3 males and 2 females) hospitalized in the Psychiatric Hospital “Ali Mihali” Vlora. The assessment on the diagnosis was made conforming to the diagnostic criteria of DSM-5 based on structured clinical interview (information from family, friends, etc.) and examination of mental statusResultsAccording to the studies SARS CoV2 affects with serious problems the Menthal Health. Some of them are: Sleep disorder. Anxiety disorder. Major Depressive Disorder. Bipolar disorder Psychotic disorderConclusionsPatients infected with SARS-CoV-2 must be provided with a family physician psychological evaluation during the acute and post-COVID-19 phase. All individs status post COVID-19 who have lost their daily functioning and pose a risk to themselves and others must be recommended to CMHC for multidisciplinary treatment All COVID hospitals and wards must be equipped with multidisciplinary teams (psychiatrist, psychologist, social worker, mental health nurse) and each clinical record must have current mental status assessment and follow-up in case dynamics.DisclosureNo significant relationships.

Associated factors of REM sleep without atonia in younger (\u2264 50\u2009years) hospitalized psychiatric patients

BackgroundIsolated REM sleep without atonia (RSWA) as a main polysomnograhic feature of REM sleep behaviour disorder (RBD) is thought to be a prodromal or subclinical state of the disease. RSWA/RBD occurence in psychiatric population is much more frequent than in general population but its associated factors are still not known.MethodsWe invited 88 psychiatry in-patients to undervent video-polysomnography. The visual scoring was focused on RSWA in submentales and flexores digitales superficiales muscles. This parametr was subsequently correlated mainly with age/gender, their medication and mental status.ResultsThe RWSA was mostly still in normal range despite the fact, that selected psychiatry patients (≤ 50 years) were taking several classes of psychoactive medication. 3,6% had convincingly RBD, although 35.7% reported rare lifetime occurence of dream-enacting behaviour and 62.8% sporadic nightmares. We found correlation between RSWA and SNRI medication class (p = 0.015), specifically venlafaxine (p = 0.029) as well as quetiapine (p = 0.030). Another significant associated factors were current anxiety (p < 0.001) and depressive symptoms (p = 0.05), but we found no relation between RSWA and given diagnosis.ConlucionsIsolated RSWA in younger psychiatry patients might be a result of multiple factors, including medication and current mental status but these factors are in most cases not sufficient to manifest RBD.

Preoperative low scores of Life Satisfaction Rating predicts poor outcomes after total knee arthroplasty: a prospective observational study

BackgroundDespite the continued improvement in the surgical techniques during primary total knee arthroplasty (TKA), literatures indicate that up to 10 to 20% patients are not satisfied with their outcomes. Psychological factors in this dissatisfaction are yet to be clearly identified. The aim of this study is to develop a method to assess whether the patient’s current mental state is suitable enough to accept a TKA surgery.MethodsPreoperative demographic and clinical data of 532 patients who underwent TKA were prospectively obtained from January 2012 until December 2016. We recorded the scores evaluated by SF-36 questionnaire and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively and 1 year postoperatively. Preoperative Life Satisfaction Rating (LSR) is emphatically evaluated.ResultsPoor preoperative score of LSR was a significant predictor of dissatisfaction after TKA. Patients with low LSR reported significant pain and stiffness, although there was no remarkable effect on functionality of the replaced joint. The results also showed that age and BMI were not strong predictors of satisfaction in TKA.ConclusionOur outcomes can help clinicians evaluate whether a patient’s current mental status is favorable for TKA. If patients have extreme low scores of LSR (less than 10), a psychological intervention should be recommended for better satisfaction following a TKA surgery. This would also allow surgeons to individually assess the risks and benefits of surgery.

Genel Halkın COVID-19 Anlayışı: İnternet Üzerinden Kesitsel Bir Araştırma ve Nitel Sunum

Objective: To identify general people's actual knowledge, awareness, and perception about COVID-19 and to facilitate healthcare organizations, responsible authority, and general people. Material and Methods: Cross sectional online survey. Necessary data have been collected from the responses of questionnaires and the questionnaires have been developed utilizing Google form. The study covered 50 participants from various countries from the author's network. We considered a systematic flow diagram from March 25 to March 31, 2020 including demographic information of participants. Results: Almost 74% of the participants clearly describe and explain all the questions and still, 26% of the participants are not clear about their idea regarding COVID-19 disease. Moreover, the perceptions provided by the participants are also close to the guidelines of WHO and National Health Commission of the People's Republic of China regarding COVID-19. Only few participants' understandings are not fully completed compared to their guidelines. The current mental status was also analyzed in this study wherein 51% participants stated that they are suffering from mental stress and depression due to this virus. Conclusion: It is necessary to identify and improve the actual knowledge, awareness, and perception to control the spread of COVID-19. More awareness activities from responsible authority are required. Moreover, this survey will facilitate healthcare organizations and responsible authority to design their awareness activities in this critical moment. Additionally, general people will get benefited and prepared themselves to read the perceptions of the individual participator.

Long-Term Mental Health Effects of Exposure to Earthquake-Related Prenatal Maternal Stress

ABSTRACT Background: Many studies involving human subjects have shown that exposure to negative factors during pregnancy can have both short- and long-term effects. This study aims to examine the effects on the mental health of the adolescent children of mothers exposed to prenatal maternal stress during earthquakes. Method: The sample consisted of 407 adolescents aged 17 years at the time the study was conducted, as well as their mothers, who were pregnant during the earthquake of August 17, 1999 in Turkey. The mothers’ mental state were evaluated using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Traumatic Stress Symptom Checklist (TSSC). The evaluations of the mental status of the mother following earthquake exposure in pregnancy were conducted retrospectively using self-reported depression, anxiety and trauma scales. The mothers were asked to fill out the BDI and BAI questionnaires based on their mental state in the week following the earthquake, while for the TSSC they were asked to select the statements that best described their status in the 6 months following the earthquake. The adolescents’ current depression, anxiety and Attention Deficit Hyperactivity Disorder (ADHD) symptoms were evaluated with the BDI, BAI and the Wender Utah Rating Scale. Given the contribution of stressful events to their current mental status and to the long-term effects of perinatal stress, the Traumatic Experiences List (TEL) was also administered. The presence of depression, anxiety and ADHD among adolescents and the link to the mother’s mental status, and the factors predicting depression, anxiety and ADHD were analyzed. Results: The adolescents whose mothers had mental complaints during pregnancy were found to have significantly higher levels of depression and mental complaints than those whose mothers had no mental complaints in their case histories (p

Diagnose, indicate, and treat severe mental illness (DITSMI) as appropriate care: A three-year follow-up study in long-term residential psychiatric patients on the effects of re-diagnosis on medication prescription, patient functioning, and hospital bed utilization.

While polypharmacy is common in long-term residential psychiatric patients, prescription combinations may, from an evidence-based perspective, be irrational. Potentially, many psychiatric patients are treated on the basis of a poor diagnosis. We therefore evaluated the DITSMI model (i.e., Diagnose, Indicate, and Treat Severe Mental Illness), an intervention that involves diagnosis (or re-diagnosis) and appropriate treatment for severely mentally ill long-term residential psychiatric patients. Our main objective was to determine whether DITSMI affected changes over time regarding diagnoses, pharmacological treatment, psychosocial functioning, and bed utilization. DITSMI was implemented in a consecutive patient sample of 94 long-term residential psychiatric patients during a longitudinal cohort study without a control group. The cohort was followed for three calendar years. Data were extracted from electronic medical charts. As well as diagnoses, medication use and current mental status, we assessed psychosocial functioning using the Health of the Nations Outcome Scale (HoNOS). Bed utilization was assessed according to length of stay (LOS). Change was analyzed by comparing proportions of these data and testing them with chi-square calculations. We compared the numbers of diagnoses and medication changes, the proportions of HoNOS scores below cut-off, and the proportions of LOS before and after provision of the protocol. Implementation of the DITSMI model was followed by different diagnoses in 49% of patients, different medication in 67%, some improvement in psychosocial functioning, and a 40% decrease in bed utilization. Our results suggest that DITSMI can be recommended as an appropriate care for all long-term residential psychiatric patients.

PSYCHIATRIC INTERVIEW OF PATIENTS WITH CANCER

Background. Psychiatrists providing consultation in cancer centers need to understand the patient’s mental health without possibility of collecting data on the objective case history and follow-up.Purpose: to analyze the modern methods of assessment of psychopathological disorders in cancer patients.Material and Methods. Publications indexed in PubMed and devoted to the analysis of defense mechanisms, strategies for overcoming challenges, responses to acute and chronic stress, and support for family members of cancer patients were analyzed.Results. Modified psychosomatic interviews used for cancer patients, attachment styles, coping strategies, and defense mechanisms were described. The taxonomic system of the most common mental disorders in modern psycho-oncology was presented.Conclusion. The modified psychiatric interview, during which the defense mechanisms, coping styles, coping reactions with acute and chronic stress, methods of functioning of cancer patient’s family are assessed, allows a psychiatrist to obtain essential information about psychopathological status of a patient within the first (and often the only) appointment. A multidimensional diagnostic approach helps to assess the involvement of various damaging factors in a patient’s current mental status. Conclusion made by a psychiatrist in terms of the taxonomic systems of the International Statistical Classification of Diseases and Health Related Problems (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM) allows him to provide information to an oncologist in a uniquely interpretable (standardized) form.

Readiness to change and barriers to treatment seeking in college students with a mental disorder

BackgroundCollege students have high prevalence of mental disorders and suicidal thoughts and behaviours, and low rates of treatment uptake. This study assesses treatment access, intentions to seek help, and perceived barriers to help-seeking, considering gender and suicidal thoughts or behaviours (STBs) as predictors. MethodsData is from the Ulster University Student Wellbeing study (2015) conducted in Northern Ireland (NI), as part of the WHO World Mental Health Surveys International College Student Project. Participants are 392 new college entrants (162 males (41.3%)/230 females (58.7%)), who all reported some lifetime mental disorder or STBs. ResultsReceipt of treatment was low (37.8%), particularly among males and those with no STBs. Males were less likely to intend to access external professional services and were less likely than females to rate embarrassment (OR = 0.60) or worry about being treated differently (OR = 0.63) as important reasons for not seeking treatment. Those with STBs rated wanting to handle things on their own as a more important barrier those with no STBs (OR = 0.55 for non STBs group) and rated being unsure where to go as a less important barrier than those with no STBs (OR = 1.80 for non STBs group). LimitationsData is correlational and concerns lifetime criteria for mental disorder, with no consideration of current mental status nor disorder type. ConclusionsThese findings have implications for the active screening and intervention for vulnerable college students, particularly males and those with mental disorders but no STBs.

Determination of Increased Mental Workload Condition From EEG by the Use of Classification Techniques

Extraction of the information hidden in the brain electrical signal enhance the classification of the current mental status. In this study, 16 channel EEG data were collected from 15 volunteers under three conditions. Participants were asked to rest with eyes open and eyes closed states each with a duration of three minutes. Finally, a task has been imposed to increase mental workload. EEG data were epoched with a duration of one second and power spectrum was computed for each time window. The power spectral features of all channels in traditional bands were calculated for all subjects and the results were concatanated to form the input data to be used in classification. Decision tree, K-nearest neighbor and Support Vector Machine techniques were implemented in order to classify the one second epochs. The accuracy value obtained from KNN was found to be 0.94 while it was 0.88 for decision tree and SVM. KNN was found to outperform the two methods when all channel and power spectral features were used. In can be concluded that, even with the use of input features formed by concatanating all subject’s data, high classification accuracies can be obtained in the determination of the increased mental workload state.

Integrating mental health professionals into the care team to better recognize and manage delirium in hospitalized oncology patients.

83 Background: Delirium is a common neuropsychiatric condition associated with increased morbidity and mortality, length of hospitalization, and distress. The prevalence of delirium in cancer ranges from 10% to 30% in hospitalized patients and up to 85% in terminally ill cancer patients. Rates of delirium on Cleveland Clinic’s inpatient oncology units were lower than expected. Our goal was to integrate mental health professionals into the care team to assist with better recognition and management of delirium. Methods: Education was developed for a range of caregivers, including physicians, nurses, and advanced practice providers. It was facilitated by a psychiatrist, psychologist, and clinical social workers, and included proper identification of both hyper- and hypoactive delirium through use of the Brief Confusion Assessment Method (bCAM) and use of a delirium order set to treat and manage patients identified as positive for delirium. An important component of this education included a proper assessment and comparison of patients’ current mental status compared to their true baseline prior to hospitalization. Additional integration directly into the care team included participation of the psychiatrist, psychologist, and clinical social workers into each team’s multidisciplinary rounds to facilitate discussions around delirium and its appropriate management, and separate targeted rounding which included one-to-one education with front-line caregivers. Results: During the first year of integration, substantial improvements were noted. The percentage of patients identified as positive for delirium through bCAM screening increased from 3.4% to 15.8% after 12 months, and utilization of the delirium order set increased from 11.1% to 58.3%. Additionally, the average nursing unit length of stay (LOS) for delirium-positive patients decreased by more than 2 days compared to baseline. Conclusions: Integration of mental health providers into the care team to assist with recognizing and managing patients with delirium and to provide direct education to front-line caregivers has helped to rapidly improve delirium identification and management for oncology inpatients.

History of co-occurring disorders and current mental health status among homeless veterans

BackgroundHomeless veterans are at high risk for co-occurring disorders (COD), defined as mental illnesses that include at least one alcohol or other drug use disorder and at least one non-drug related mental disorder. However, epidemiological studies examining the prevalence of COD and associated mental health status in this population are limited. The objectives of the study were: (1) to describe a history of diagnosed mental disorders among homeless veterans admitted to a transitional housing program, and (2) to examine the associations of the prior diagnosed COD and other mental disorders with current mental health status.MethodsStudy participants were male homeless veterans admitted to a transitional housing program from July 2015 to September 2017 in a large municipal area in Northeast Ohio, the United States. Cross-sectional, self-reported data from the admission assessment were included and analyzed. History of mental disorder diagnoses were aggregated into five categories for the purpose of this study: no mental disorders, only alcohol or other drug use disorder(s), one non-drug related mental disorder, two or more non-drug related mental disorders, and COD. Current mental status were measured as empowerment, mental component summary score (MCS) and physical component summary score (PCS) of health related quality of life (VR-12), and perceived overall well-being. Sample distribution of the five categories and their associations with current mental status were examined using Generalized Linear Model test.ResultsOf all participants, 76.7% had at least one prior diagnosed mental disorder, including 47.4% with any drug-related disorders. Over one-third (37.2%) reported having COD. Compared to those with no mental disorder history, those with COD scored significantly lower on MCS and empowerment scores; those with any prior diagnosed non-drug related mental disorders also scored significantly lower on MCS. No significant differences, however, were found in current mental health status between those with COD and those with mental disorders but not COD.ConclusionsCOD prevalence among homeless veterans was within the parameter of other literature reports. Veterans with COD compared to veterans with no history of mental disorders tended to have lower MCS and empowerment scores. Veterans with COD had the same mental health status as those with other mental disorders.