Diagnosis Of Mood Disorder Research Articles

The Association Between Thyrotropin and Clinically Relevant Depression: A Retrospective Cross-Sectional Study.

Introduction: Thyroid dysfunction and mood disorders are chronic health conditions with a significant impact on quality of life. This study aimed to investigate the association between thyrotropin (TSH) and clinically relevant depression (CRD) in patients with and without mood disorders, in a population-based sample. Methods: This retrospective cross-sectional study included all consecutive adults (≥18 years) who had TSH and completed the Patient Health Questionnaire (PHQ-9) within 6 months of the index visit, between October 2016 and May 2021, at the University of Utah Health. Data on demographics, hypothyroidism diagnoses, TSH, thyroid hormone replacement (THR), PHQ-9, antidepressant (AD) medications, and mood disorder diagnoses (using the International Classification of Diseases, 10th Revision, Clinical Modification codes; Major depressive disorder single episode-F32, recurrent-F33, persistent mood disorder-F34, bipolar disorder-F30+F31, and mood disorder not otherwise specified-F39) were extracted electronically. CRD was defined as PHQ-9 ≥ 10. t-Test and chi-square test were used to compare continuous and categorical variables, respectively. Logistic regression models were formulated to evaluate the association between TSH and CRD, after adjusting for covariates. Results: The cohort included 33,138 patients, mean age 42.41 ± 16.10 years, 80.67% Caucasian, 69.10% females, and mean PHQ-9 score 10.11 ± 6.94. A total of 45.23% (n = 14,989) patients had a diagnosis of mood disorders, and 49.70% had CRD. Patients with mood disorders were more likely to be female, Caucasian, non-Hispanic/Latino, on AD, had hypothyroidism diagnoses, on thyroid medications, had higher mean PHQ-9 scores, and had CRD. TSH level was associated with an increased odds of CRD (odds ratio [OR] = 1.01, confidence interval [CI], 1.01-1.02, p < 0.009) after adjusting for age, sex, body mass index, Charlson Comorbidity Index, and use of THR and AD. Both the low TSH and high TSH groups showed increased odds of CRD, with respective ORs of 1.19 (CI: 1.04-1.37) and 1.26 (CI: 1.13-1.40). Conclusions: Thyroid dysfunction is associated with an increase in the odds of depression. Future longitudinal cohort studies are recommended to investigate the association between thyroid function and incident depression.

Increases in benzodiazepine prescribing for postpartum anxiety during COVID-19.

Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes. Little is known about how diagnosis and treatment of postpartum mood disorders changed during COVID-19. We used a retrospective pooled cross-sectional design in a sample of privately-insured postpartum women in U.S. claims data from January 1, 2016 to December 31, 2020. We measured changes in diagnoses of anxiety and depression and changes in prescription fills and days supplied of classes of medications used to treat these conditions (antidepressants, benzodiazepines, and z-drugs). We used ordinary least squares (OLS) regression for each outcome variable during the pre-pandemic period and forecast expected outcomes the observation period. Forecasted and actual values of the outcomes were then compared. Following the onset of the COVID-19 pandemic in March 2020, diagnoses of depression and anxiety were not significantly higher among privately insured postpartum women in the United States. The proportion of privately-insured postpartum women filling a benzodiazepine prescription increased by 15.2%. We find diagnosis of postpartum mood disorders did not increase after the onset of the COVID-19 pandemic, however, fills of benzodiazepines increased among privately-insured postpartum women. Given prior evidence of increased depressive and anxiety symptoms among postpartum women during COVID-19, this suggests increased barriers to appropriate diagnoses and treatment for depression during this period.

Victimisation in other- and self-directed violence as a function of ethnicity and primary diagnosis among inpatients with serious mental illness.

Among individuals with serious mental illness (SMI), victimisation has been found to increase the risk of engaging in other- and self-directed violence. However, rates of victimisation within this population have been found to vary by ethnic group and primary diagnosis. This study primarily aimed to examine the relationship between victimisation and other- and self-directed violence among a sample of inpatients with SMI during the first 3 months of admission. The role of ethnicity and primary diagnosis were also explored. This cross-sectional study utilised data from South London and Maudsley's (SLaM) anonymised database. Participants (n = 7,265) were aged over 18 upon admission, of White British, Black African, Black Caribbean or Asian ethnicity and had a primary diagnosis of major mood disorder, mania or psychosis. Among a sample of inpatients with SMI, victimisation increased the risk of other-directed violence but not self-directed violence. While Black African ethnicity was associated with an increased risk of other-directed violence, all minority ethnic groups had a decreased risk of self-directed violence compared to White British ethnicity. Those with a primary diagnosis of mania or psychosis were observed to be at increased risk of other-directed violence and decreased risk of self-directed violence compared to those with a major mood disorder. Inpatients with SMI who have experienced victimisation are at an increased risk of engaging in other-directed violence during the first 3 months of admission.

The Trifecta of Industry, Academic, and Health System Partnership to Improve Mental Health Care Through Smartphone-Based Remote Patient Monitoring: Development and Usability Study.

Mental health treatment is hindered by the limited number of mental health care providers and the infrequency of care. Digital mental health technology can help supplement treatment by remotely monitoring patient symptoms and predicting mental health crises in between clinical visits. However, the feasibility of digital mental health technologies has not yet been sufficiently explored. Rhythms, from the company Health Rhythms, is a smartphone platform that uses passively acquired smartphone data with artificial intelligence and predictive analytics to alert patients and providers to an emerging mental health crisis. The objective of this study was to test the feasibility and acceptability of Rhythms among patients attending an academic psychiatric outpatient clinic. Our group embedded Rhythms into the electronic health record of a large health system. Patients with a diagnosis of major depressive disorder, bipolar disorder, or other mood disorder were contacted online and enrolled for a 6-week trial of Rhythms. Participants provided data by completing electronic surveys as well as by active and passive use of Rhythms. Emergent and urgent alerts were monitored and managed according to passively collected data and patient self-ratings. A purposively sampled group of participants also participated in qualitative interviews about their experience with Rhythms at the end of the study. Of the 104 participants, 89 (85.6%) completed 6 weeks of monitoring. The majority of the participants were women (72/104, 69.2%), White (84/104, 80.8%), and non-Hispanic (100/104, 96.2%) and had a diagnosis of major depressive disorder (71/104, 68.3%). Two emergent alerts and 19 urgent alerts were received and managed according to protocol over 16 weeks. More than two-thirds (63/87, 72%) of those participating continued to use Rhythms after study completion. Comments from participants indicated appreciation for greater self-awareness and provider connection, while providers reported that Rhythms provided a more nuanced understanding of patient experience between clinical visits. Rhythms is a user-friendly, electronic health record-adaptable, smartphone-based tool that provides patients and providers with a greater understanding of patient mental health status. Integration of Rhythms into health systems has the potential to facilitate mental health care and improve the experience of both patients and providers.

Association between peripartum cardiomyopathy and mood disorders in a large, national U.S. cohort.

To examine the association between mood disorders in pregnancy and postpartum and peripartum cardiomyopathy (PPCM). Retrospective cohort study utilizing the National Inpatient Sample from the Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality of pregnant and postpartum patients from 2017-2019. Patients were separated into two groups based on ICD-10 coding for presence or absence of mood disorder (depression, bipolar depression, anxiety, or other mood diagnosis). The primary outcome was diagnosis of PPCM. Secondary outcomes included a composite of adverse cardiac events and maternal death. Groups were compared via t-tests, chi-squared analysis, and logistic regression that included all variables that differed between groups with p<0.05. Over 2.2 million subjects were analyzed and approximately 168,000 (7.4%) had an ICD-10 diagnosis of mood disorder. Those with mood disorders were more likely to be non-Hispanic white, obese, tobacco users, publicly insured, have comorbidities, and deliver at a large, private, non-profit hospital (all p<0.05). They were delivered at an earlier gestational age and were also more likely to undergo cesarean (37.0±4.6 vs 37.8±3.7 weeks and 35.8% vs 31.8%, respectively)., p<0.001). The primary outcome of PPCM was identified more than twice as often in those with mood disorder (0.12% vs 0.05%, p<0.001). Composite cardiac events, consisting of incidence of acute myocardial infarction, cardiac arrest, cardioversion, cardiac failure, and pulmonary edema were more frequent among patients with mood disorders (0.36% vs 0.14%, p<0.001). After controlling for confounders, PPCM remained independently associated with diagnosis of mood disorders (aOR 1.36, 95%CI 1.03-1.80) as did the composite of adverse cardiac events (aOR 1.57, 95% CI 1.37-1.81). Mood disorders in pregnancy and postpartum are associated with increased rates of PPCM and other cardiac events.

Factors influencing social media addiction among Vietnamese adolescents

Social media is integral to modern life, particularly for adolescents who spend considerable time online. However, excessive use poses significant risks to well-being, especially among adolescents who are vulnerable to compulsive social media usage. This study examines factors contributing to social media addiction among Vietnamese adolescents using the Bergen Social Media Addiction Scale (BSMAS) and the Online Fear of Missing Out Inventory (On-FoMO). A cross-sectional study was conducted in Vietnam with participants aged 13 to under 18. Snowball sampling was used to ensure a diverse participant pool. The study excluded individuals with diagnosed mood disorders to maintain population homogeneity. BSMAS, On-FoMO, demographic data, and informed consent were collected via an online survey. The study found a high prevalence of social media addiction among Vietnamese adolescents, with females being more susceptible than males. Vietnamese adolescents struggled to reduce social media usage and felt distressed when restricted. They did not necessarily feel envious or sad when seeing others' happiness online, nor did they seek validation through likes or comments. However, Vietnamese adolescents reported forgetting problems or being late due to SM use. The study results indicate that improving 17 emotional intelligence scales may reduce the extent of SMA among Vietnamese adolescents. The study results also suggest that interventions for social media addiction need to be developed in different fields.

Associations between adolescent psychiatric disorders and adulthood payment problems: a Norwegian register study of complete birth cohorts of 1995–1997

BackgroundPsychiatric disorder diagnoses are linked to long-term socioeconomic ‘shadows’ into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway and whether these...

Prevalence and Clinical Correlates of Suicidal Ideation and Attempts in Individuals at Clinical High Risk for Psychosis.

Individuals with psychosis symptoms are at high risk for suicidal ideation and attempts. The prevalence and correlates of suicidal ideation and attempts in clinical high risk for psychosis (CHR-P) have yet to be clarified. This study reports on the prevalence and clinical correlates of suicidal ideation and attempts in a clinical CHR-P sample. Participants (n = 135) included CHR-P clients at a CHR-P community specialty clinic, who participated in a clinical assessment between 2017 and 2022. Assessments measured attenuated psychosis symptoms, suicidal ideation and attempts, clinical covariates, and functioning. Frequency analyses assessed the prevalence of lifetime suicidal ideation and attempts and t-test and Chi-square identified clinical correlates. Logistic regression assessed the relationship between significant clinical correlates and lifetime suicide attempts. Sixty-five percent of participants at CHR-P endorsed lifetime suicidal ideation, while 22.2% reported at least one lifetime attempt. Correlates for lifetime suicidal ideation included self-reported gender expansive identity, hopelessness, depression, trauma, obsessive compulsive symptoms, insight: reflectiveness, trauma diagnoses, mood disorder diagnoses, and perceptual abnormalities/hallucinations. Significant correlates for lifetime suicide attempts included self-reported hopelessness, depression, trauma diagnosis and mood disorder diagnosis. CHR-P clients are at a higher risk for suicidal ideation and attempts compared to the general population. Correlates of suicidal ideation and attempts may be diagnostically heterogeneous and therefore interventions should be tailored to specific clinical needs. Clients with trauma-disorder diagnoses may be at highest risk for suicidal ideation and attempts. Continued intervention and longitudinal research is needed to clarify causal risk factors and establish evidence-based treatments for suicidal ideation and attempts in CHR-P.

Variables Associated with the Use of Psychotropic Medications by Brazilian University Students.

University life is a phase of developing personal and professional skills, but it brings challenges such as distancing from family and supporting networks, difficulties with academic tasks, loneliness, new relationships, competitiveness, and social, socioeconomic, and psychological vulnerability, among others. These conditions can lead to the development of illnesses such as anxiety, depression, sleeping disorders, suicide, self-harming, and excessive drug use, including psychotropic medications. Therefore, this study aimed to evaluate the use of psychotropic medications and its association with sociodemographic, academic, behavioral, and health variables in Brazilian university students. A cross-sectional, quantitative research, with a sampling of 524 students from a Brazilian public Higher Education Institution (Federal University of Mato Grosso - UFMT). The collection took place from October 10th to December 30th, 2022. An online questionnaire was applied with sociodemographic and clinical questions-the General Anxiety Disorder Questionnaire-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). The data were descriptively and inferentially analyzed; in the descriptive analysis, the absolute (FA) and relative (FR) frequencies of each category investigated were presented; and for bi- and multivariate analyses, Poisson regression with robust estimation was used. The participants were at the median age of 22 years old, the majority were female (69.7%), heterosexual (68.1%), with medium/high subjective social status (82.4%) and without being involved in a romantic relationship (54%). The prevalence of psychotropic medication use was 26.1%, considering that 17.5% was not prescribed by a medical professional. The most used class of medications was antidepressants (91 participants), followed by natural medicines (38 participants). Among the segments associated with the use of psychotropic drugs were female individuals, romantic relationships, perception of academic performance by postgraduate students, and previous diagnoses of mental or mood disorders (depression and anxiety). The results obtained highlight the importance of research on mental health among university students, especially regarding the use of psychotropic drugs, which must be monitored by a qualified professional. At the university, these data can be important for the development of policies aimed at health and life quality, in addition to contributing to the strengthening of national and international partnerships, and promoting the scientific production in the area.

A passive electronic medical record‐based cognitive risk calculator predicts neuropsychological performance in older adults

AbstractBackgroundStratifying risk of cognitive decline for an individual patient can be difficult in primary care settings where advanced biomarkers are usually not available. Passive risk calculators that capitalize on existing information contained in the electronic medical record (EMR) hold promise, but most are developed using EMR documentation of cognitive decline which is highly unreliable. This prospective study used objective cognitive testing to build a multivariable cognitive risk model based on EMR records.Methods338 primary care patients aged 60 and older who had at least two visits over the previous 5 years completed brief neuropsychological testing to establish current cognitive function and consented to access to their medical records. Records from the preceding 5 years were mined for health status indicators (e.g., BMI, pulse, blood pressure), diagnoses, medications, demographic, and socioeconomic information and entered into a multivariable logistic regression model using Harrell’s step‐down selection. To account for changes in variable values from visit to visit, binary variables (e.g. medications, diagnoses, smoking status) were classified as absent or ever‐present during patient follow‐up, while first, last, and “worst” values were retained for continuous variables (e.g. blood pressure, pulse). Bootstrap resampling was used for internal validation. Model was adjusted for optimism and fit evaluated using calibration curves.ResultsThe sample was 59% female and 80% white, with a mean age of 72.5 (SD 7.0) and 15.5 years of education (SD 2.6)). Eighty patients (24%) were cognitively impaired. The model that best identified impairment included age, most recent pulse, race, presence of mood disorder diagnosis, family history of neurological diagnosis, NSAID use, and most recent systolic blood pressure. After adjusting for optimism, the discrimination index was 0.71, indicating good discrimination. Results from the model were transformed to yield patient‐specific probability scores used to trigger risk flag in the patient’s medical record.ConclusionsAn EMR‐based risk calculator successfully discriminated between patients with and without cognitive impairment. Strategies for implementing the cognitive risk flag into clinical practice are discussed.

Suicidal behavior among forensic psychiatric patients in Japan: Risk factors and implications for treatment.

In Japan, the Medical Treatment and Supervision Act (MTSA) was enacted in 2005 to provide intensive interventions aimed at reintegrating forensic psychiatric patients into society. However, these individuals face challenges with social reintegration and have an elevated risk of suicide. Therefore, identifying the risk factors for suicide among forensic psychiatric patients is essential. We compiled an extensive database spanning 12 years of data on Japanese forensic outpatients. Using a generalized linear model (GLM), we explored the relationship between suicidal behaviors-both attempted and completed suicides-and several variables, including outpatient pathways defined by law, histories of psychiatric outpatient/inpatient treatment, diagnoses of schizophrenia or mood disorders, types of crimes committed, and the types of victims involved. Our analysis included data from 2,263 Japanese forensic outpatients. Suicidal behaviors were observed in 6.9% of patients, with 1.5% completing suicide. Risk factors for suicidal behavior included being a direct outpatient (odds ratio [OR] = 1.63, 95% confidence interval [CI]: 1.14-2.34), having a history of outpatient treatment (OR = 1.92, 95% CI: 1.07-3.48), and being arrested for arson (OR = 2.24, 95% CI: 1.33-3.76). Conversely, a diagnosis of schizophrenia was associated with a reduced risk of suicidal behavior (OR = 0.61, 95% CI: 0.39-0.95). Forensic psychiatric patients are at a higher risk of suicide compared to the general population. It is essential to account for both risk and protective factors when planning interventions for these individuals.

Incremental learning and granular computing from evolving data streams: An application to speech-based bipolar disorder diagnosis

We apply an evolving granular-computing modeling approach, called evolving Optimal Granular System (eOGS), to bipolar mood disorder (BD) diagnosis based on speech data streams. The eOGS online learning algorithm reveals information granules in the flow and design the structure and parameters of a granular rule-based model with a certain degree of interpretability based on acoustic attributes obtained from phone calls made over 7 months to the Psychiatry department of a hospital. A multi-objective programming problem that trades-off information specificity, model compactness, and numerical and granular error indices is presented. Spectral and prosodic attributes are ranked and selected based on a hybrid Pearson-Spearman correlation coefficient. Low attribute-class correlation, ranging from 0.03 to 0.07, is observed, as well as high class overlap, which is typical in the psychiatric field. eOGS models for BD recognition overcome alternative computational-intelligence models, namely, Dynamic Evolving Neural-Fuzzy Inference System (DENFIS) and Fuzzy-set-Based evolving Modeling (FBeM-Gauss), by a small margin in both best and average cases; followed by eXtended Takagi-Sugeno (xTS) and evolving Takagi Sugeno (eTS) types of models. The proposed eOGS model using only 8 of the original acoustic attributes, and about 15 ‘If-Then’ inference rules, has exhibited the best root mean square error, 0.1361, and 91.8% accuracy in sharp BD class estimates. Granules associated to linguistic labels and a granular input-output map offer human understandability with relation to the inherent process of generating class estimates. Linguistically readable eOGS rules may assist physicians in explaining symptoms and making a diagnosis.

Intergenerational transmission of childhood trauma in youths with mood disorders and their parents

ObjectiveChildhood trauma is a significant environmental stressor linked to mood disorder. It can affect not only the individuals directly involved but also the next generation through the intergenerational transmission of trauma. This study aimed to investigate, for the first time, the co-occurrence of childhood trauma in youths with mood disorders and their parents. MethodsWe assessed 443 individuals, 100 youths with DSM-5 mood disorders, 100 youths healthy controls (HCs), 92 s' parents and 161 adult HCs. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). The distribution patterns of childhood trauma subtypes was estimated through a multivariate model. Intraclass correlations (ICC) were calculated to account for the familial clustering of the sample. ResultsWe found significantly higher scores for Patients as compared to Young-HC in all the subtypes of childhood trauma (p < 0.05). Considering Parents and Adult-HC groups, Physical abuse (p = 0.001) and Emotional neglect showed higher scores in Parents (p < 0.001). Regarding the familial clustering of the sample, emotional (p < 0.001) and sexual abuse (p = 0.001), and emotional (p = 0.3) and physical neglect (p = 0.003) showed statistical significance, but only emotional abuse reveled a medium level ICC (0.25). ConclusionsOur study highlights the effect of intergenerational transmission of childhood trauma on the diagnosis of mood disorders in youths. Our findings underscore the significance of systematically assessing childhood trauma, in particular emotional abuse, in youths with mood disorders and their parents. Additionally, there is urgent need for evidence-based preventive measures aimed at promoting positive parenting strategies and emotionally supportive environments for children.

Identification of Mood Disorders in Self-Reported Versus Health Administrative Data.

Producing relevant knowledge on the prevalence of mood disorders (MDs) requires a clear identification of people living with the condition. Analyzing this multifaceted disease from the perspective of health administrative data and population-based surveys could contribute to document inconsistencies between these data sources and highlight the strengths and limitations of each methodological approaches. The aim of this study was to estimate the prevalence of MD disease, assess concordance of MD patterns in population-based surveys versus health administrative data, and investigate statistical differences in characteristics between individuals presenting the disease in each data sources. This study used the Care Trajectories-Enriched Data (TorSaDE) cohort. The TorSaDE cohort is built by merging five waves of the Canadian Community Health Survey (CCHS) with health administrative data of the province of Quebec, Canada. The sample includes individuals who participated in at least one round of CCHS and for whom evidence of use of health services in the year of CCHS completion and the year before were present in health administrative data. The cohort was split into four groups based on the presence and absence of MD in self-reported versus health administrative data. Groups' characteristics were compared using chi-square tests and ANOVA. The study cohort was composed of 96,079 individuals, of which 10,418 (10.8%) had MD, regardless of the data sources. Self-reported prevalence of MD was 6.03%, while the prevalence from health administrative data was about 7.79%. Estimates showed a low level of concordance between the two measures, as only 27.4% of people presenting this medical condition were identified in both data sources. Furthermore, individuals identified with MD only in survey data had poorer socioeconomic outcomes but better health outcomes than those from the concordant group (i.e., identified in both data sources). In addition, people presenting MD in health administrative data only had better socioeconomic and health outcomes than those who reported MD diagnosis only in survey data. Findings suggest that each measure capture different specific subpopulations. Estimates obtained from each source should thus be contextualized and interpreted with caution.

The association between systemic lupus erythematosus (SLE) and early psychiatric background

BackgroundThe etiology of Systemic Lupus Erythematosus (SLE) remains elusive.Research has established links between SLE and various mental health issues, including associations with psychiatric illness, unique symptomatology in SLE, a relationship between stress and disease exacerbation, and improvement in SLE patients after psychiatric and psychological treatment. However, the hypothesis that psychiatric conditions might precede SLE onset by long periods has not been empirically established. This study aims to address this gap. MethodsThis matched cohort study conducted a retrospective analysis using the electronic database of Clalit Health Services (CHS), Israel's largest HMO, comparing 2786 individuals diagnosed with SLE with 8358 non-SLE matched controls. ResultsTwo logistic regression analysis tests revealed significant associations between SLE diagnosis and prior psychiatric conditions.the first (p < 0.001) showed a 120% higher likelihood of psychiatric history among those diagnosed at least 10 years later with SLE compared to controls, and the second (p = 0.008) showed a 61% greater likelihood of a psychiatric history among those diagnosed at least 15 years with SLE. Investigation into the association between specific psychiatric indices and the later development of SLE found significant correlations between an SLE diagnosis and four psychiatric indices 10 years prior: dispensing of antipsychotics, anxiolytics, hypnotics, and sedatives; dispensing of antidepressants, psychostimulants, ADHD agents, and nootropics; diagnosis of mood disorders; and phobic and anxiety disorders. ConclusionsThe increased probability of pre-existing mental health issues preceding SLE onset by extended durations suggests a potential etiological role in SLE development.

Psychiatric hospitalizations among adolescents during the pandemic in Italy: a retrospective study.

The COVID-19 pandemic has negatively impacted child and adolescent mental health. The study outcome was the evaluation of the pandemic impact on adolescents' hospitalizations in an acute psychiatric ward. With an observational and retrospective design,we collected selected variables among adolescents hospitalized in an acute psychiatric ward from 01/07/2017 to 30/06/2022. Data were statistically processed. Our sample consisted of 118minors with an average age of 15.7±1.2 SD, mostly represented by females (61 %) and Italians (60.2 %), who made 204 hospitalizations inthe study period. The admissions by years drastically decreased in 2020 concomitantly with the lockdown and increased in the first half of 2022. The admission rate was higher in winter and spring, except in 2020 when all admissions decreased (p=0.000). Females more frequently were hospitalized for suicidal behavior and acute anxiety (p=0.000) and were discharged with acute stress reactions, eating disorders, and mood disorder diagnoses (p=0.000). Differently, males more frequently were hospitalized for aggressive behavior (p=0.000) and discharged with ADHD diagnosis (p=0.000). At multiple linear regression, the duration of hospitalization (dependent variable) was negatively associated with "the pandemic period" (p=0.017) and "absent aggressive behavior" (p=0.003), and positively with "autism" diagnosis (p=0.000). We highlighted the more stressful impact of COVID-19 pandemic on female adolescents, who required more frequently psychiatric hospitalizations due to suicidal behavior, anxiety and mood disorders.

Unlocking the potential of wearable device wear time to enhance postpartum depression screening and detection.

Postpartum depression (PPD) is a mood disorder affecting one in seven women after childbirth that is often under-screened and under-detected. If not diagnosed and treated, PPD is associated with long-term developmental challenges in the child and maternal morbidity. Wearable technologies, such as smartwatches and fitness trackers (e.g., Fitbit), offer continuous and longitudinal digital phenotyping for mood disorder diagnosis and monitoring, with device wear time being an important yet understudied aspect. Using the All of Us Research Program (AoURP) dataset, we assessed the percentage of days women with PPD wore Fitbit devices across pre-pregnancy, pregnancy, postpartum, and PPD periods, as determined by electronic health records. Wear time was compared in women with and without PPD using linear regression models. Results showed a strong trend that women in the PPD cohort wore their Fitbits more those without PPD during the postpartum (PPD: mean=72.9%, SE=13.8%; non-PPD: mean=58.9%, SE=12.2%, P-value=0.09) and PPD time periods (PPD: mean=70.7%, SE=14.5%; non-PPD: mean=55.6%, SE=12.9%, P-value=0.08). We hypothesize this may be attributed to hypervigilance, given the common co-occurrence of anxiety symptoms among women with PPD. Future studies should assess the link between PPD, hypervigilance, and wear time patterns. We envision that device wear patterns with digital biomarkers like sleep and physical activity could enhance early PPD detection using machine learning by alerting clinicians to potential concerns facilitating timely screenings, which may have implications for other mental health disorders.

The relationship between prodromal symptom levels and affective temperament features and emotional dysregulation in patients diagnosed with bipolar disorder and their first-degree relatives: A controlled study

BackgroundThe frequency of developing psychiatric symptoms is higher in the first-degree relatives of bipolar patients compared to the healthy population. This study aims to determine the possible diagnosis of bipolarity by revealing the bipolar prodromal features, temperament changes, and emotional disregulation in the first-degree relatives of bipolar patients and their interrelationships. MethodsA total of 150 patients, including bipolar disorder patients, their first-degree relatives, and a healthy control group, aged 18–65 who met the study inclusion criteria, were included in the study. Sociodemographic data form, Bipolar Prodromal Symptom Scale (BPSS), Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A), and Difficulty in Emotion Regulation Scale (DERS) were administered to all participants. ResultsSignificant differences were found between the BPSS, TEMPS-A, and DERS total and subscale scores of the bipolar patient group, first-degree relatives, and healthy control group (p < 0.001). There were significant differences in BPSS frequency and severity subscale scores, TEMPS-A hyperthymic and cyclothymic subscale scores, and DERS strategy, goal-oriented, and awareness subscale scores between patients and their first-degree relatives (p < 0.001). Additionally, all scale scores of the patient relatives were significantly different from the healthy control group (p < 0.001). A significant relationship was found between the prodromal scores and temperament scores of the patient relatives, and between the temperament scores and DERS scores (p < 0.001). ConclusionIt has been observed that the severity and frequency of bipolar prodromal symptoms, temperament changes, and difficulty in mood regulation are higher in bipolar patients and their first-degree relatives compared to the healthy population. Differences were found in hyperthymic and cyclothymic temperament features and difficulty in mood regulation scores between bipolar patients and their first-degree relatives. Patient relatives showed significant changes in all parameters compared to the healthy group. The severity of bipolar prodromal symptoms in patient relatives was associated with cyclothymic and anxious temperament features, while the frequency of bipolar symptoms was associated with anxious temperament. Relationships were found between some temperament and mood regulation difficulty sub-scores. In light of these findings, evaluating clinical variables such as the frequency and severity of prodromal symptoms, temperament features, and difficulty in mood regulation in the first-degree relatives of bipolar patients may be an appropriate approach for diagnosing mood disorders.

Understanding experiences of non-physical maltreatment in childhood in Canada: What is the relationship with suicidal ideation and mental health disorders?

Physical and sexual childhood abuse are associated with suicidal ideation and mental health disorders. However, less is known about non-physical types of maltreatment. This study examined associations between non-physical types of child maltreatment (e.g., emotional abuse, interpersonal aggression, exposure to physical intimate partner violence, emotional and physical neglect) and suicidal ideation, and mental health disorders. Data from the 2018 Survey of Safety in Public and Private Spaces were used to estimate the proportion of individuals 15 years and older in Canada who experienced non-physical maltreatment during childhood. Multivariable regression analyses were used to examine associations between five types of non-physical child maltreatment and suicidal ideation, and mental health disorders. Overall, interpersonal aggression was the most common (45.7%), followed by emotional abuse (40.4%) and emotional neglect (20.0%). Individuals who experienced any type of non-physical maltreatment in childhood had a higher probability of lifetime suicidal ideation than those who never experienced the maltreatment examined. Mood disorder diagnoses were more likely among those who experienced emotional abuse, interpersonal aggression, and emotional neglect than among those who never experienced these types of maltreatment. Compared with those who never experienced the maltreatment examined, individuals who experienced emotional abuse, interpersonal aggression, emotional neglect, or physical neglect were more likely to be diagnosed with an anxiety disorder. Diagnoses of post-traumatic stress disorder were more likely among those who experienced emotional and physical neglect than among those who never experienced these types of maltreatment. Non-physical child maltreatment is associated with suicidal ideation and mental health disorders. The findings highlight the importance of including non-physical types of child maltreatment on population-based surveys to differentiate associations with mental health outcomes to better align interventions and policies.

Psychiatric follow-up and repeated hospital presentation of DSH: A national study on young adults

IntroductionPsychiatric care following discharge from general hospital treatment of deliberate self-harm (DSH) is important to reduce patients´ risk of relapse. Whether such follow-up is associated with DSH repetition in young adults is not sufficiently understood. This study examined the association between psychiatric service attendance within seven days of discharge and repeated hospital-presented DSH within 3, 6, and 12 months in patients aged 18–35 years. MethodsIncident episodes of hospital-presented DSH from 2010 to 2017 were identified from the Norwegian Patient Register. Those already psychiatrically admitted or who died during the general hospital or in the seven days after discharge were excluded. Psychiatric service attendance was categorized as ‘no attendance’, ‘outpatient attendance’, and ‘inpatient admissions.’ The association between psychiatric service attendance and subsequent DSH repetition was examined with an Inverse Probability of Treatment Weighted logistic regression model. ResultsOf the 11,308 patients identified, 17.3 % had a psychiatric outpatient attendance, and 19.9 % had an inpatient admission. Outpatient attendance was not associated with a reduced risk of repeated DSH and inpatient admissions were associated with an increased risk in certain subgroups, notably patients: aged 18–24 years; without a recorded mood disorder diagnosis; or no history of hospital-treated DSH. LimitationsOur data did not contain all relevant confounders. Unmeasured confounding is therefore likely to influence the results. ConclusionAlthough no conclusions regarding treatment effectiveness can be drawn from these findings, the study highlights that patients with the most severe psychiatric symptoms and at the highest risk of DSH relapse received follow-up.