Health Disorders Research Articles

Opioid use and risks in liver transplant candidates and recipients.

Opioid use is extremely prevalent among cirrhosis and liver transplant (LT) patients, despite concerns regarding opioid-related risks in this population. While there are many theoretical risks of opioids in patients with hepatic dysfunction, there is limited evidence on the effect of opioid use on clinical outcomes in cirrhosis and pre- and post-LT patients specifically. As a result there is significant center-level variability in opioid-related practice and policies. The existing data-largely based on retrospective observational studies-does suggest that opioids are associated with increased health resource utilization pre- and post-LT, and that they may precipitate hepatic encephalopathy (HE) in patients with cirrhosis and increase risk of graft loss and death post-LT. The strongest predictor of opioid use post-LT is opioid use prior to transplant; thus, a focus on safe opioid use in the pre- and peri-transplant periods is essential for minimizing opioid-related harms. We describe three strategies to guide LT providers, including: 1) Improved characterization of pain, mental health symptoms, and opioid and polysubstance use; 2) Minimization of opioid prescriptions for those at highest risk of adverse events; and 3) Safe prescribing strategies for those who do use opioids and for management of opioid use disorder (OUD). Ultimately, our goal is to improve quality of life and transplant outcomes among cirrhosis and LT patients, particularly those living with concurrent pain, mental health, and substance use disorders.

A Case-Based, Longitudinal Curriculum in Pediatric Behavioral and Mental Health.

Pediatric behavioral and mental health (BMH) disorders are increasingly common, but most pediatricians feel inadequately trained to manage them. We implemented a case-based, longitudinal curriculum in BMH within a pediatric residency program to prepare trainees to diagnose and manage these conditions. The pediatric residency program at Wright State University/Wright-Patterson Medical Center implemented a new BMH curriculum in 2020-2021. The curriculum consisted of five simulated cases involving depression, anxiety, attention deficit disorder with hyperactivity (ADHD), developmental delays, behavioral concerns, and autism. To reflect follow-up within a continuity clinic, cases included initial encounters and multiple follow-up visits. Faculty facilitators led residents in monthly small-group meetings over the academic year, with each session consisting of two to three simulated patient encounters. Residents completed pre-post surveys regarding their confidence in diagnosing and managing BMH conditions and pre- and posttests to evaluate the impact of the curriculum on knowledge gains. All 47 pediatric residents participated in the curriculum; 38 (81%) completed pre-post surveys. Upon completion of the curriculum, residents reported significantly increased confidence in managing ADHD, treating depression, creating safety plans for suicidality, recognizing autism, and counseling patients and families on special education services. Knowledge-based pre- and posttests completed by 25 residents (53%) also demonstrated significant improvement (M = 92.4, SD = 10.9, pre vs. M = 99.3, SD = 6.6, post, p = .009). This case-based, longitudinal curriculum in pediatric BMH simulating patient continuity improved residents' confidence and knowledge in diagnosing and managing common BMH conditions.

Unraveling Male Inexpressiveness : Causes, Effects and Strategies For Abrogation

Male inexpressiveness is a pervasive phenomenon across cultures, poses significant challenges to individual well-being and societal cohesion. This abstract explores the causes, effects, and potential remedies for this complex issue. Rooted in social norms dictating masculinity, the reluctance of males to express emotions stems from early socialization, where vulnerability is often equated with weakness. Consequently, men internalize these norms, leading to suppressed emotional expression as they navigate adulthood. The effects of male inexpressiveness are multifaceted and profound. At the individual level, it contributes to increased stress, mental health disorders, and strained interpersonal relationships. Societally, it perpetuates gender disparities by limiting men's access to support networks and inhibiting their ability to engage in meaningful emotional connections. To address this issue, multifaceted strategies are necessary. Educational interventions focusing on deconstructing traditional gender norms can challenge ingrained beliefs about masculinity and encourage emotional literacy from an early age. Mental health initiatives tailored to men's needs, such as male-friendly therapy spaces and support groups, can provide safe environments for emotional expression. Moreover, fostering inclusive workplaces and communities that value emotional openness and vulnerability can create conducive environments for men to express themselves authentically. In conclusion, understanding and addressing male inexpressiveness is essential for promoting holistic well-being and fostering healthier relationships and communities. By dismantling restrictive gender norms and providing avenues for emotional expression, society can move towards a more inclusive and supportive environment for all individuals.

Adult and late adolescent complications of pediatric solid organ transplantation.

There have been over 51 000 pediatric solid organ transplants since 1988 in the United States alone, leading to a growing population of long-term survivors who face complications of childhood organ failure and long-term immunosuppression. This is an educational review of existing literature. Pediatric solid organ transplant recipients are at increased risk for risk for cardiovascular and kidney disease, skin cancers, and growth problems, though the severity of impact may vary by organ type. Pediatric recipients often are able to complete schooling, maintain a job, and form family and social networks in adulthood, though at somewhat lower rates than the general population, but face additional challenges related to neurocognitive deficits, mental health disorders, and discrimination. Transplant centers and research programs should expand their focus to include long-term well-being. Increased collaboration between pediatric and adult transplant specialists will be necessary to better understand and manage long-term complications.

Trends in the mental health in children and adolescents in Russia

Introduction. Mental health disorders in the world and the Russian Federation pose a serious problem, and their increase in childhood and adolescence is a determining factor in the development of diseases in later life. The purpose of the study is to analyze the follow up data of official sources on the specifics of the incidence of mental disorders in Russia of a children 0–17 year contingent with a differentiation of 0–14 and 15–17 years. Materials and methods. Materials from official statistics of the Ministry of Health of Russia and Rosstat were used in dynamics for various sections of the study as a whole for the 7-year period over 2015–2021, highlighting the years 2019–2021 to potentially identify the impact of COVID-19 on mental health. The analysis was carried out using statistical, analytical, and other methods. Results. The terminology on the problem was discussed. According to the analysis materials, among the reasons for taking in the Russian Federation under observation with a diagnosis for the first time in life (per 100 thousand population) in the “Mental and behavioural disorders” class. The leading reason for the entire population was “psychosis and dementia” — 55.1%; in children (0–14 years old) and in children, especially adolescents — “non-psychotic mental disorders” — 38.5% and 50.2%, respectively. An increase in childhood disability was revealed, both in general and for the studied reasons. Recommendations substantiated. Research limitations. The research materials are limited to the results of the analysis of official statistical information (indicators of morbidity, disability of the population) for the period of 2015–2021. Conclusion. Based on the research materials, we can conclude that the presented characteristics of the incidence of mental disorders and behavioural disorders in the population of Russia, certain negative trends cannot but cause concern, indicating the need for adequate decisions to be made by all levels of the organization and management to provide effective medical care with preventive measures for the adult and child population in Russia.

Relationship Between Childhood Maltreatment With Levels of Depression On Street Children in Surabaya

Introductions: Childhood maltreatment is any form of violence or neglect that occurs against children under the age of 18. Street children are a group that is vulnerable to violence because their activities, for which they spend a lot of time on the streets, make it easier for them to experience violence from both adults and fellow students. One of the impacts can cause mental health disorders, one of which is depression. Objective: Analyze the relationship between childhood maltreatment and levels of depression in street children in Surabaya. Methods: A cross-sectional analytical study was conducted on 43 street children from Surabaya City, East Java, Indonesia. Subjects were selected through two stages, namely using the Children’s Depression Inventory (CDI) and the International Child Abuse Screening Tool for Children (ICAST-C) to assess depression and childhood maltreatment. Data analysis using chi-square. Results: The results of the study showed that of the 43 respondents, 18 children experienced childhood maltreatment and 31 children experienced moderate depression. The results of the analysis of the relationship between childhood maltreatment and depression levels showed a p-value of 0.481. Conclusion: Childhood maltreatment is not related to the level of depression in street children in Surabaya.

Path to adventure: a qualitative exploration of provider training for adventure-based prevention practice

ABSTRACT Despite the utilization of adventure therapy techniques in behavioral health disorder prevention programming, little is known about how providers become trained in adventure-based prevention practice. Additionally, limited literature examines how adventure therapy providers are trained. This exploratory qualitative study provides a starting point for understanding the education and lived experiences that prepared providers of adventure-based prevention for professional practice. A purposive sample of 23 clinicians and administrators participated in semi-structured interviews with the first author. Interviews were transcribed and analyzed using thematic analysis with first-cycle coding, second-cycle coding, and in-vivo coding. Strategies to ensure the trustworthiness of the data were utilized including researcher reflexivity, memoing, intercoder reliability, triangulation, in-vivo coding, and member checking. Primary themes were providers’ lived experiences leading to adventure-based work, education & training, and mentorship. Discussion of new findings about preparation and education for adventure-based prevention are offered. Implications are described for practice, policy, research, and education.

Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research.

Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China. The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results. A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant. Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.

Effectiveness of Blended Internet-based Self-help and Face-to-face Intervention for Depression: A Pilot Study from India

Background: Depression is a common mental health disorder with a wide treatment gap despite the availability of a number of effective treatment options. Blended interventions adopt a novel approach in combining internet-based self-help with brief face-to-face sessions thereby combining the advantages of both approaches and offering scope to address the treatment gap. The present study examined the effectiveness of a blended intervention combining the use of guided internet-based self-help with four to six face-to-face sessions in the treatment of mild to moderate depression. Method: A single group, open-label design was adopted with baseline, postintervention, and three-month follow-up assessments. The sample comprised 60 individuals with a primary diagnosis of major depressive disorder, dysthymia, or recurrent depressive disorder of mild or moderate severity meeting eligibility criteria. Standardized measures (self-report and clinician-rated) were used to examine the effectiveness of the intervention in reducing depression, improving functioning, self-esteem, and psychological recovery. A total of 40 participants completed the intervention and follow-up assessments. Results: Significant improvements were noted from baseline to post-assessment for both completers’ and intent-to-treat samples, with medium to large effect size on most outcome measures and maintenance of gains at follow-up. Eighty-five percent of the completers showed clinically significant improvement. Subgroups of blended intervention participants with and without pharmacotherapy showed similar outcomes. Completers were higher on interest in learning self-help skills and on the Growth subscale of psychological recovery, compared to the dropouts at baseline. Conclusion: The blended intervention demonstrated effectiveness in reducing depression and improving self-esteem, and functional and psychological recovery.

Effects of Inpatient Occupational Rehabilitation vs. Outpatient Acceptance and Commitment Therapy on Sick Leave and Cost of Lost Production: 7-Year Follow-Up of a Randomized Controlled Trial.

Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production. We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production. Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI -264 to 104), with an adjusted difference of 114 fewer days (95% CI -298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI -35,009 to 89,104). I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.

Application of Narrative Therapy in a Social Work Group of Caregivers with Mental Health Disorders

Social workers from China found in their community service and interview: Caregivers of individuals with people with mental disorders Lack of sense of meaning in life. They showed simple narration content, narration style, pessimism, low identity recognition. Caregivers think Causing their life stress, family economic difficulties. the psychological pressure is because of their have a mental illness person in. family. Social workers follow the concept of helping people to help themselves, hoping to improve the sense of meaning of life for these caregivers and change their perception. Thirty family carers of the mentally disabled have been chosen to receive life narration treatment in a social work group. this is the main content of social work practice research. In practice, Social worker which has adopted various kinds of narration methods such as life narration, sand table narration, story narration, drawing narration, etc. The practice of This social work group helps carers discover their life meaning from the experiences of care mental illness. this is a valuable practice of social work service for families with mental disorder. This is done with application value of promotion.

In Case You Haven't Heard…

Yet another official charged with misconduct has blamed it on alcohol use disorder. The former prosecutor for Hocking County, Ohio, resigned this month after a complaint was filed against him for creating a hostile work environment, commenting on female clothing in a sexual manner, sending unsolicited photos of himself to a female subordinate, and having a sexual relationship with the county commissioner whom he would be representing as the county's prosecutor. Ryan Black, 41, responded to the complaint, which was filed with the board that oversees the discipline of attorneys in the state through his attorney, Alvin Mathews, last week, saying that he “suffered from a mental health disorder and an alcohol use disorder,” adding that he is “seeking ongoing treatment.” The disorders “contributed to cause any conduct for which (Black) is responsible,” the response said, according to an April 23 article in the Columbus Dispatch. Potential discipline by a panel consisting of three attorneys or judges who do not reside in the area where Black practices law could involve the suspension of his law license or disbarment. First of all, ADAW hopes he gets the help he said he needs. But it's too bad he didn't get it before he got into trouble. It should be much easier for public officials to get that kind of help before they destroy their careers.

Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database.

The study aimed to conduct a multidimensional evaluation of potential adverse events (AEs) of escitalopram oxalate based on the FDA adverse event reporting system (FAERS) database. This study utilized the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma-poisson shrinker (MGPS) to mine and analyze data from the FAERS database from the first quarter of 2004 to the second quarter of 2023. There was a total of 19,854 AE reports related to escitalopram oxalate, extracting 625 preferred terms (PTs), and covering 27 system organ classes (SOCs). The results showed that the number of reports by females was significantly higher than males, accounting for 57.68%. The reporting number was higher in 2018 and 2019, accounting for 9.50% and 10.18% of the total reports, respectively. The main reporters were consumers and other health professionals, accounting for 26.99% and 26.75% respectively. The majority of the reports were primarily from the United States. Newly emerging AE signals such as intentional overdose (n = 691, ROR 8.51, PRR 8.45, IC 3.05, Empirical Bayesian Geometric Mean (EBGM) 8.35), suicide attempt (n = 665, ROR 8.58, PRR 8.52, IC 3.06, EBGM 8.42), serum serotonin (n = 5, ROR 1044.78, PRR 1044.71, IC 2.56, EBGM 392.39), anti-actin antibody positive (n = 5, ROR 626.87, PRR 626.83, IC 2.56, EBGM 313.91), among others, were not mentioned in the drug's label. While escitalopram oxalate has clear benefits in the treatment of depression and other mental health disorders, the presence of AEs also suggests risks associated with its use. Particularly concerning are risks of suicide and changes in serum serotonin levels.

Dorsal dentate gyrus mediated enriched environment-induced anxiolytic and antidepressant effects in cortical infarcted mice

Anxiety and depression are the most common mental health disorders worldwide, each affecting around 30% stroke survivors. These complications not only affect the functional recovery and quality of life in stroke patients, but also are distressing for caregivers. However, effective treatments are still lacking. Enriched environment (EE), characterized with novel and multi-dimensional stimulation, has been reported to exert therapeutic effects on physical and cognitive function. In addition, EE also had potential positive effects on emotional disorders after ischemic stroke; however, the underling mechanisms have not been well elucidated. This study aimed to explore the effectiveness of EE on emotional disorders after cerebral ischemia and its underling mechanism. Sensorimotor cortical infarction was induced by photothrombosis with stable infarct location and volume, resulting in motor dysfunction, anxiety and depression-like behaviors in mice, with decreased ALFF and ReHo values and decreased c-fos expression in the infarction area and adjacent regions. Seven days' EE treatment significantly improved motor function of contralateral forelimb and exhibited anxiolytic and antidepressant effects in infarcted mice. Compared to the mice housing in a standard environment, those subjected to acute EE stimulation had significantly increased ALFF and ReHo values in the bilateral somatosensory cortex (S1, S2), dorsal dentate gyrus (dDG), dorsal CA1 of hippocampus (dCA1), lateral habenular nucleus (LHb), periaqueductal gray (PAG), ipsilateral primary motor cortex (M1), retrosplenial cortex (RSC), parietal association cortex (PtA), dorsal CA3 of hippocampus (dCA3), claustrum (Cl), ventral pallidum (VP), amygdala (Amy), and contralateral auditory cortex (Au). Some of, but not all, the ipsilateral brain regions mentioned above showed accompanying increases in c-fos expression with the most significant changes in the dDG. The number of FosB positive cells in the dDG, decreased in infarcted mice, was significantly increased after chronic EE treatment. Chemogenetic activation of dDG neurons reduced anxiety and depressive-like behaviors in infarcted mice, while neuronal inhibition resulted in void of the anxiolytic and antidepressant effects of EE. Altogether, these findings indicated that dDG neurons may mediate EE-triggered anxiolytic and antidepressant effects in cortical infarcted mice.

Disease burden and healthcare utilization in pediatric low-grade glioma: a United States retrospective study of linked claims and electronic health records

Abstract Background Despite high long-term survival rates, pediatric low-grade gliomas (pLGGs) are linked with significant tumor- and treatment-associated morbidities that may persist throughout life. The aims of this descriptive cross-sectional pilot study were to characterize health conditions among a cohort of patients with pLGG and explore the feasibility of quantifying disease burden and healthcare resource utilization (HRU). Methods Optum® Market Clarity Data were used to identify patients aged ≤18 years with an ICD-10 code for brain neoplasm, ≥1 physician notes, and with evidence of pLGG recorded between January 1, 2017 – June 30, 2018. Outcomes including health characteristics, HRU, medications, and procedures were assessed at six-month intervals over 36 months. Results 154 patients were identified with pLGG and over half experienced headache/migraine, respiratory infection, pain, or behavioral issues during the 36-month study period. The most common comorbidities were ocular/visual (including blindness), mental health disorders, seizure, and behavioral/cognition disorders. Most symptoms and comorbidities persisted or increased during the study period, indicating long-term health deficits. HRU, including specialty care visits, filled prescriptions, and administered medications, was common; 74% of patients had prescriptions for anti-infectives, 56% antiemetics, and 52% requiring pain or fever relief. Sixty-five percent of patients underwent treatment to control their pLGG, the most common being brain surgery. Little decline was observed in medication use during the study period. Conclusions Patients with pLGG have complex healthcare needs requiring high HRU, often over a long time. Patients need to be optimally managed to minimize disease- and treatment-related burden and HRU.

Pain Catastrophizing: How Far Have We Come

The perception of pain is strongly influenced by various social, emotional, and cognitive factors. A psychological variable which has consistently been shown to exert its influence on pain is a cognitive process referred to as pain catastrophizing. Numerous studies have found it to be a strong predictor of pain intensity and disability across different clinical populations. It signifies a maladaptive response to pain marked by an exaggerated negative assessment, magnification of symptoms related to pain, and, in general, a tendency to experience marked pain-related worry, as well as experiencing feelings of helplessness when it comes to dealing with pain. Pain catastrophizing has been correlated to many adverse pain-related outcomes, including poor treatment response, unsatisfactory quality of life, and high disability related to both acute and chronic pain. Furthermore, there has been consistent evidence in support of a correlation between pain catastrophizing and mental health disorders, such as anxiety and depression. In this review, we aim to provide a comprehensive overview of the current state of knowledge regarding pain catastrophizing, with special emphasis on its clinical significance, and emerging treatment modalities which target it.

Empathy and mental health in veterinary medicine.

In veterinary medicine, the relationship between empathy and mental health presents a complex and important aspect of professional well-being. Veterinarians are frequently exposed to numerous work-related stressors and are therefore more likely to experience mental health disorders and commit suicide. Due to the specific nature of the profession, veterinarians deal with negative patient outcomes, inform owners of unfavourable news, handle heavy workloads, and professional isolation. Psychological stress is a result of all these factors coming together, and it can lead to anxiety, depression, burnout, and even frequently reported suicide. Animal euthanasia has been recognised as a unique professional risk factor that can have harmful psychological effects on veterinary professionals.This paper explores the role of empathy in the mental health of veterinarians and other veterinary staff, and how this might contribute to their vulnerability to psychological stress and suicidal ideation. Empathy plays an important role in interpersonal interactions, while also influencing human-animal relationships, which adds a whole new level of complexity to the doctor-patient dynamic in this field. Veterinarians are responsible for providing compassionate care for both the animals they treat and their owners. They must manage the emotionally demanding work while preserving their mental health by balancing between providing empathetic care and sustaining their own emotional boundaries. To alleviate the negative effects of psychological stress, veterinary professionals require interventions such as peer support groups, stress management training, and mental health support programmes.

Obstructive Sleep Apnea and Mental Health Disorders in the Pediatric Population: A Retrospective Population-based Cohort Study.

Information is limited about the association between obstructive sleep apnea (OSA) and mental disorders in children. In children, (1) to evaluate the association between OSA and new mental healthcare encounters; (2) to compare mental healthcare encounters two years post- to pre-OSA treatment initiation. We conducted a retrospective longitudinal cohort study using Ontario health administrative data (Canada). Children (0-18 years) who underwent diagnostic polysomnography (PSG) 2009-2016 and met criteria for definition of moderate-severe OSA (PSG-OSA) were propensity score weighted by baseline characteristics and compared to children who underwent a PSG in the same period but did not meet the OSA definition (PSG-No-OSA). Children were followed until March 2021. Weighted cause-specific Cox Proportional Hazards and Modified Poisson regression models were used to compare time from PSG to first mental healthcare encounter and frequency of new mental healthcare encounters per person time, respectively. Among those who underwent adenotonsillectomy (AT) or were prescribed and claimed positive airway pressure therapy (PAP), we used age-adjusted conditional logistic regression models to compare two years post- to pre-treatment odds of mental healthcare encounters. Of 32,791 children analyzed, 7,724 (23.6%) children met criteria for moderate-severe OSA. In PSG-OSA group, 7,080 (91.7%) were treated (AT or PAP). Compared to PSG-No-OSA, the PSG-OSA group had a shorter time from PSG to first mental healthcare encounter (HR: 1.08; 95%CI: 1.05-1.12), but less frequent mental healthcare encounters in follow-up (RR: 0.92; 95% CI: 0.87-0.97). OSA treatment (AT or PAP) was associated with lower odds of mental healthcare encounters two years post-treatment initiation compared to two years prior (OR: 0.69; 95% CI: 0.65-0.74). In this large population-based study of children who underwent PSG for sleep disorder assessment, OSA diagnosis/treatment was associated with an improvement in some mental health indicators, such as fewer new mental healthcare encounters compared to no OSA, and lower odds of mental healthcare encounters compared to pre-OSA treatment.

From Evidence to Practice: A Comprehensive Analysis of Side Effects in Synthetic Anti-Depressant Therapy.

Depression, a pervasive mental health disorder, affects millions worldwide, necessitating the widespread use of synthetic anti-depressant medications. While these pharmaceutical interventions have demonstrated efficacy in alleviating depressive symptoms, they are not without their associated side effects. This review provides a comprehensive overview of the side effects of synthetic anti-depressants, aiming to enhance the understanding of their clinical implications. Common side effects explored include gastrointestinal disturbances, sexual dysfunction, insomnia, weight gain, and cognitive impairments. Additionally, this review delves into less frequent but potentially severe adverse events, such as serotonin syndrome, hyponatremia, and cardiac complications associated with specific classes of synthetic anti-depressants. Moreover, the review examines the interplay between side effects and treatment adherence, emphasizing the importance of monitoring and managing these effects in clinical practice. It also discusses strategies to mitigate side effects, including dose adjustments, combination therapy, and alternative treatment approaches. In conclusion, this comprehensive review sheds light on the multifaceted landscape of side effects associated with synthetic anti-depressants. By providing clinicians with a nuanced understanding of these effects, it aims to facilitate informed decision-making, personalized treatment plans, and improved patient outcomes in managing depression.

The revision and factor analytic evaluation of the German version of the depression literacy scale (D-Lit-R German)

BackgroundDepression is a common mental health disorder and the second leading cause of disability worldwide. In people with depression, low depression literacy, which could be characterized by a poor recognition of depressive symptoms and less knowledge about the availability of treatment options, can hinder adequate therapy for depression. Nevertheless, questionnaires measuring depression literacy in Germany are rare. Consequently, for the present study, the German Depression Literacy Scale (D-Lit) has been revised and evaluated.MethodsFirst, a team of clinical psychologists revised the D-Lit German scale. Next, cognitive interviews were conducted with patients with depression to improve the comprehensibility of the scale items. Our revision of the D-Lit-R German scale was then subjected to an anonymous online study. Finally, the data went through an exploratory factor analysis, and sociodemographic subgroup analyses were performed.ResultsN = 524 individuals (age 18–80) completed the D-Lit-R German scale and a questionnaire on their sociodemographic data. Cronbach´s alpha was estimated as α = .72, and McDonald's Omega (categorical) was estimated as ω = .77. The mean Item difficulty was M = .75 (SD = .15). An EFA was performed for a unidimensional model, a 5-factor-model and at last a 3-factor-model. The 5-factorial model showed a good model fit (χ2emp,WLSMV(131) = 92.424, p > .05; CFI = 1, RMSEA = 0, SRMR = .07) but was rejected since the content of the potential 5 factors could not be determined. The 3-factor model showed an arguable model fit. The Chi2 test was significant (χ2emp,WLSMV(168) = 199.912, p < .05), but the CFI and the RMSEA met an acceptable model fit (CFI = .990, RMSEA of .019, 90% CI[.003, .029]). Substantively, the three factors were defined as (1) Distractors and other symptoms, (2) Depressive symptoms, and (3) Pharmacological and psychotherapeutic depression treatment. Furthermore, there were significant differences in sum scores regarding the subgroup's gender, treatment for mental health problems, depression treatment, experience with depression, and different career fields.ConclusionsThe D-Lit-R German scale is a time-efficient scale to assess some aspects of the depression literacy construct that can be easily applied. Since there was no perfect model fit, it is recommended to continue to revise the scale. Further evaluation studies could ask for knowledge of the etiological factors of depression. Future studies could then use this instrument to convey depression literacy. This instrument could assess the growth of knowledge after psychoeducational interventions in different settings.Trial registrationThis trial was preregistered at the platform osf.io (https://osf.io/49xdh).Registration number: https://doi.org/10.17605/OSF.IO/49XDHDate of registration: 28 April 2022.