Mental Ill-health Research Articles

The era of digital mental health interventions: we know they can be effective but are they also safe?

Over the past two decades, digital mental health interventions (DMHIs) have seen a surge in studies with people experiencing mental ill-health, whether this be via web-based platforms, smartphone applications, text messages or other digital devices. Although DMHIs already demonstrate evidence of their acceptability and some of their effectiveness among different populations, the information about their safety is less clear. This Editorial reflects on a Delphi study by Taher and colleagues that explored the regulation of DMHIs and generated ten safety recommendations. We discuss these recommendations in the context of existing relevant literature and provide suggestions for further steps to advance research and policy on DMHIs in the UK and globally. Further dialog is needed, including the views and experiences of all key stakeholders, and particularly of people with lived experience, to ensure DMHIs are not only an acceptable and potentially effective treatment approach, but also safe for those that use them.

A population-based cohort study of mitochondrial disease and mental health conditions in Ontario, Canada

BackgroundMitochondrial disease has been linked to mental health disorder in clinical cohorts and post-mortem studies. However, a lack of population-level studies examining the relationship between mitochondrial disease and mental health has resulted in an evidence gap and creates a challenge for identifying and addressing care needs for the mitochondrial disease population. Using multiple linked population health databases in a single-payer health system that covers the full population, this study aimed to investigate the prevalence of mood disorders and other mental health conditions in patients with mitochondrial disease and to examine the joint impact of mitochondrial disease and mental health conditions on healthcare use and health system costs. To contextualize these findings, a clinical comparator cohort of multiple sclerosis (MS) patients was analyzed.ResultsOverall, co-prevalent mental health conditions are common in the mitochondrial population. Double the proportion of patients in the mitochondrial disease cohort had a co-prevalent mental health illness as compared to the MS population (18% vs 9%). Healthcare utilization was highest among patients with co-prevalent mitochondrial disease and mental illness, with 49% hospitalized within 1 year prior to cohort entry (compared to 12% of MS patients with no mental health condition). Costs were likewise highest among mitochondrial disease patients with mental health conditions.ConclusionsThis study presents the first comprehensive, population-wide cohort study of mitochondrial disease and co-prevalent mental health conditions. Our findings demonstrate a high burden of mental health conditions among mitochondrial disease patients, with high associated health care needs. We also find that patients with concurrent mental illness and mitochondrial disease represent a high-burden, high-cost population in a single-payer health insurance setting.

Smoking and e-cigarette use in young adults with disabilities

BackgroundTobacco use is closely linked to social and health inequalities, including economic vulnerability, morbidity, and premature death. Young adults with disabilities experience significant social and material hardships, which may be exacerbated by tobacco use. Limited research exists on smoking and e-cigarette use in this population. This study examines the prevalence of disability among young adults in Ireland, compares smoking and e-cigarette use between those with and without disabilities, identifies protective and risk factors, explores shared risk factors, and evaluates disability as an independent risk factor for smoking and e-cigarette use.MethodsWe analysed weighted data from 4,729 20-year-olds in the Growing Up in Ireland Cohort ’98 study who were present in Waves 1 (2008), 3 (2016), and 4 (2019). Current smoking, e-cigarette use, disability (excluding mental ill-health) and all other variables were assessed at Wave 4, while peer smoking data were drawn from Wave 3. Analyses were conducted using SPSS version 27.Results18.1% of participants reported a disability, which was associated with significantly higher smoking (41.8% vs. 36.7%) and e-cigarette use (16.1% vs. 12.9%). Protective factors against both behaviours included being female (OR 0.87 for smoking, OR 0.57 for e-cigarettes), later smoking initiation (OR 0.35, OR 0.62), living in two-parent families (OR 0.83, OR 0.70), and physical activity (smoking only). Risk factors included having peers who smoked (OR 3.67 for smoking; OR 2.36 for e-cigarette use) and caregivers who smoked (OR 1.48, OR 1.48), being employed at age 20 (OR 1.58, OR 1.48), and social media engagement (smoking only). Young adults with disabilities were significantly more likely to experience risk factors (e.g., earlier smoking initiation, caregivers who smoked, one-parent families, employment) but were less likely to have peers who smoked or engage with social media. Disability was independently associated with a higher likelihood of smoking (by 54%) and e-cigarette use (by 36%) after adjusting for protective and risk factors.ConclusionHigher smoking and e-cigarette use in 20-year-olds with disabilities adds further inequality to their lives. Increased awareness, targeted surveys and focused prevention and therapeutic interventions are required to reduce inequalities in this population and hasten the tobacco endgame.

The Frequency and Determinants of Positive and Negative Officiating Interactions and the Relationships with Mental Ill-Health Symptoms in Sports Officials.

Concerns exist about the prevalence of abuse directed towards sports officials and its impact on their mental health; however, sports officiating can also be a rewarding experience. The present study aimed to identify the frequency and determinants of both positive (e.g. praise, appreciation, apologies) and negative (e.g. verbal abuse, physical abuse, social media abuse) officiating interactions and to examine their independent contributions to mental ill-health symptoms. An online, cross-sectional survey was distributed to current or former sports officials operating on a voluntary or paid basis in the UnitedKingdom (UK). Participants completed validated measures of mental ill-health symptoms (Depression, Anxiety, Stress Scale) and daily hassles (LIVES-Daily Hassles Scale) and reported the frequency with which they experienced positive and negative officiating interactions. A total of 320 sports officials (73.8% male; mean age ± standard deviation (SD) = 49.99 ± 15.86years) completed the survey with the most represented sports including cricket (30.3%), rugby union (24.4%) and football (soccer) [16.9%]. Regular positive officiating interactions were experienced by 90.0% of sports officials and regular negative officiating interactions by 22.2%. Logistic regression analyses revealed that male sports officials (odds ratio (OR) = 3.95; 95% confidence interval (CI) = 1.34, 11.65) were significantly more likely to experience regular positive interactions, while football officials (OR = 7.33; 95% CI = 1.38, 38.90) were significantly more likely to experience regular negative interactions. When controlling for daily hassles, age and sex, regular positive interactions were independently associated with lower odds of depression (OR = 0.38; 95% CI = 0.15, 0.92) and anxiety (OR = 0.33; 95% CI = 0.13, 0.82) symptoms. However, regular negative officiating interactions were not independently associated with mental ill-health symptoms. Positive officiating interactions were commonly experienced and independently predicted lower odds of mental ill-health symptoms. Approximately one fifth of officials reported regular negative interactions, although this was notably higher among football officials. No independent association existed between negative interactions and mental ill-health symptoms, and future research should determine if positive interactions help to offset the impact of negative ones for sports officials.

Adverse Cardiovascular Effects of Psychotropic Medications

Cardiovascular disease is the leading cause of death in people with serious mental health illnesses, including schizophrenia, major depression and bipolar disorder. The adverse cardiac risk profile of this population is related to the complex interplay between biological, patient-specific and healthcare system factors. A variety of psychotropic medications used to treat these conditions can in themselves produce cardiovascular side effects. This includes autonomic dysfunction, malignant ventricular arrhythmias, heart muscle disorders and vascular thromboembolic events, some of which have been linked with sudden cardiac death. As a result, there is a pressing need for physicians to be aware of the cardio-toxicity associated with psychotropic medication use. In this review, we summarise the main effects of psychotropic drugs on the cardiovascular system and the current recommendations for evaluation and continual monitoring of the many and rapidly increasing number of patients receiving psychotropic pharmacotherapy.

Neural emotion regulation during pregnancy: An fMRI study investigating a transdiagnostic mental health factor in healthy first-time pregnant women

Abstract Pregnancy is a psycho-neuro-endocrinological transition phase presenting a window of vulnerability for mental health. Emotion regulation, a transdiagnostic factor for psychopathology, is influenced by estradiol across the menstrual cycle on the behavioral and neural level. Whether this is also the case in the antepartum period remains unknown. For the first time, behavioral and neural emotion regulation were investigated in healthy pregnant females with extremely high estradiol levels during the second trimester (N = 15) using a functional magnetic resonance imaging (fMRI) paradigm. Results were compared with naturally cycling females with high (N = 16) and low estradiol levels (N = 16). Although pregnant females reported the lowest trait use of cognitive reappraisal, all participants successfully regulated their emotions by applying cognitive reappraisal in the scanner. During downregulation of negative emotions, all females had increased activity in the left middle frontal gyrus. Pregnant females showed no significant differences in functional connectivity (psychophysiological interaction, resting-state) related to emotion regulation compared with the nonpregnant groups. However, group differences emerged for amygdala activation. In pregnant females, increased amygdala activity predicted reduced regulation success and was positively associated with depression scores. This first fMRI study during pregnancy indicates that depression scores are reflected in heightened amygdala activity already observable in the antepartum period. Thus, through its association with reduced regulation success, increased amygdala activity suggests a neural risk marker for peripartum mental health. The findings highlight the importance of investigating neural and behavioral emotion regulation in the ante- and postpartum period, eventually allowing enhanced identification, prevention, and treatment of peripartum mental ill-health.

Youth Mental Health Help-Seeking Behaviour: A Systematic Literature Review

Research shown that the prevalence of mental illness among youth is dramatically higher than other age groups but they have reported reluctance to seek help for mental illness and psychological suffering. The present review tends to provide an update of the literature and expand the understanding on facilitators and barriers of youth mental health help-seeking behavior as well as the influence of socio-demographic factors. The most mentioned facilitators are associated with mental health knowledge and attitude, while main barriers were stigma and shame. Gender difference, living areas and ethnic were the main socio-demographic influencing factors. The findings contribute to the current knowledge related to mental health help-seeking among youth. This has implications for psychology practitioners and schools in developing targeted interventions towards improving mental health literacy as well as organizing school or public awareness campaigns to diminish the stigma of mental health illness.

Examining the barriers and facilitators to mental health service provision for autistic people in Ireland: a survey of psychiatrists

Abstract Background: Autistic people have high levels of mental ill-health and an increased risk of suicide across the lifespan. Yet autistic people report difficulties communicating with healthcare professionals and accessing a range of healthcare services. At the same time, mental healthcare workers in other countries are reporting links between confidence when working with autistic patients and the degree of autism knowledge and training they can access. Methods: We sought to examine what factors helped or hindered Irish mental healthcare colleagues when working with autistic healthcare service users. An online survey using quantitative and qualitative metrics was circulated among psychiatrists who are members of the College of Psychiatrists of Ireland, both in training and at consultant level, from April 2021 to April 2022. Results: Knowledge of autism was high among psychiatrists (n = 140), but self-efficacy scores were variable, particularly in relation to care pathways. Self-efficacy was better among psychiatrists with caseloads of children and youth or individuals with co-occurring intellectual disabilities. Three key qualitative themes emerged relating to capacity and training of mental health professionals, ways to improve mental health services provision for autistic individuals and also the critical need for co-creation and neurodiversity affirmative care. Conclusions: The study highlighted critical systemic and professional challenges in providing mental health care to autistic people in Ireland. We provide recommendations for reducing these challenges and for enabling the development of inclusive, evidenced-based care to autistic individuals.

An enhanced CNN-Bi-transformer based framework for detection of neurological illnesses through neurocardiac data fusion

Classical approaches to diagnosis frequently rely on self-reported symptoms or clinician observations, which can make it difficult to examine mental health illnesses due to their subjective and complicated nature. In this work, we offer an innovative methodology for predicting mental illnesses such as epilepsy, sleep disorders, bipolar disorder, eating disorders, and depression using a multimodal deep learning framework that integrates neurocardiac data fusion. The proposed framework combines MEG, EEG, and ECG signals to create a more comprehensive understanding of brain and cardiac function in individuals with mental disorders. The multimodal deep learning approach uses an integrated CNN-Bi-Transformer, i.e., CardioNeuroFusionNet, which can process multiple types of inputs simultaneously, allowing for the fusion of various modalities and improving the performance of the predictive representation. The proposed framework has undergone testing on data from the Deep BCI Scalp Database and was further validated on the Kymata Atlas dataset to assess its generalizability. The model achieved promising results with high accuracy (98.54%) and sensitivity (97.77%) in predicting mental problems, including neurological and psychiatric conditions. The neurocardiac data fusion has been found to provide additional insights into the relationship between brain and cardiac function in neurological conditions, which could potentially lead to more accurate diagnosis and personalized treatment options. The suggested method overcomes the shortcomings of earlier studies, which tended to concentrate on single-modality data, lacked thorough neurocardiac data fusion, and made use of less advanced machine learning algorithms. The comprehensive experimental findings, which provide an average improvement in accuracy of 2.72%, demonstrate that the suggested work performs better than other cutting-edge AI techniques and generalizes effectively across diverse datasets.

Mental Health Illness

The necessity for efficient medical care and the rise of mental health issues have resulted in an investigation of machine learning that can be applied in mental health problems. This paper presents a recent comprehensive analysis of machine learning techniques for mental health issue prediction. We have collected research articles and studies that are related to the machine learning approaches in predicting mental health problems by searching reliable databases. We include a total of 06 research articles in this review after the screening and identification processes. Then, we categorize the collected research articles based on the mental health problems such as bipolar disorder, sadness and anxiety, and children's mental health issues. In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults. Keywords Mental health disorder,suicide prevention ,adolescent mental health ,depression and anxiety,psychological well being, unicef mental health report

Tackling Loneliness, Ineffective Social Support, and Mental Ill-Health Among People With Higher Weight.

People with higher weight are at greater risk of experiencing loneliness and mental ill-health, in part due to challenging social networks that can be unsupportive of efforts to engage in positive health behaviours and a source of weight-based stigma and discrimination. Targeting this issue is a manualised intervention, Groups 4 Health (G4H), that helps people to optimise social connectedness and group-based belonging for effective support to reduce loneliness and mental ill-health. We evaluated the efficacy of this program for people with higher weight. We conducted a matched controlled trial (non-randomised) with 98 Australian adults with a body mass index (BMI) ≥ 30 kg/m2 (n = 49 in the intervention group). Retention rates at T2 were comparable to previous trials: intervention group n = 33 (67.3%); matched control group n = 36 (73.5%). Loneliness, well-being, weight-related social support, depression, and eating disorder symptoms were assessed pre-intervention (T0), post-intervention (T1), and at 4-month follow-up (T2). Among the intervention group, loneliness (d = -0.66, p < 0.001), depression (d = -0.58, p < 0.001), and eating disorder symptoms (d = -0.77, p < 0.001) all significantly decreased from T0 to T2. Similarly, well-being (d = 0.80, p < 0.001) and experiences of effective weight-related social support (d = 0.68, p < 0.001) significantly increased from T0 to T2. These positive changes were not observed in the matched control group. The findings provide strong preliminary support for the efficacy of G4H among people with higher weight to address loneliness and challenging social networks, which pose key psychosocial barriers to health. The Groups 4 Health program has previously undergone a published codesign and consumer feedback process. The materials for this study were co-produced with a member of the research team with lived experience to ensure that the content was non-stigmatising and relevant to the population of the study. The research team member is a representative of a consumer advocacy association, and contributed to the study design, data collection, interpretation of results, and manuscript revisions.

"Understanding the association between household food insecurity and diet quality: The role of psychological distress, food choice motives and meal patterning".

"Understanding the association between household food insecurity and diet quality: The role of psychological distress, food choice motives and meal patterning".

Implementation of Transdiagnostic Psychosocial Group Interventions and a Novel Peer Work Role in a Community Youth Mental Health Setting.

Group interventions can be an appropriate care option for young people with mental ill-health, yet there is a lack of research on their implementation within real-world settings. This paper aimed to explore the feasibility and acceptability of group interventions and a Group Coordinator peer work role in a community mental health service and the perspectives of young people, carers and staff on implementation. A retrospective chart audit of 121 referrals to group interventions from January 2022 to June 2023 was conducted. Education, demographic and administrative data were collected to explore feasibility and acceptability. Survey data from 44 young people who participated was also used to explore acceptability. Semi-structured interviews (8 young people, 7 carers and 11 staff) explored perspectives on implementation, mapping barriers and facilitators to domains of the Comprehensive Framework for Implementation Research. Referrals made before the young person was involved in mental health treatment (i.e., at the stage of assessment) were less likely to result in engagement in a group, suggesting limited feasibility as a standalone care option. Young people reported overall positive experiences of group interventions, though attrition rates and qualitative interviews indicate they are perceived as less acceptable than individual options. The Group Coordinator role was viewed by staff as key to sustainability, with multiple benefits. The current paper contributes to the scant literature on the implementation of group interventions with several practical implications for service planning. Further studies are needed to examine the implementation in other contexts, explore within-treatment variables and incorporate clinical outcomes.

EMOTIONAL BURNOUT AMONG MENTAL HEALTH PROFESSIONALS IN WARTIME — CLINICAL AND SOCIAL ASPECTS AND WAYS TO OVERCOME IT (LITERATURE REVIEW)

The problem of emotional burnout is becoming increasingly important due to the increase in socio-economic and political challenges of our time. An analysis of the literature on the clinical and social aspects of professional burnout and the mechanisms developed to overcome this problem have been conducted. Clinical symptoms include physical, psychopathological and social. Psychopathological symptoms are most often manifested in emotional, behavioral and cognitive, physical — in various somato-vegetative symptoms, social are considered through the problems of medical workers, the impact on patients and the healthcare industry as a whole. A promising direction for further research may be the analysis of emotional burnout of specialists in the field of mental ill-health in the harsh conditions of war. It is necessary to continue research into the positive and negative effects of professional activity and other circumstances on the emotional state of specialists and to identify risk and anti-risk factors of professional burnout from the point of view of distinguishing between fruitful and inspired work, as an adaptive resource in complex macro-social conditions, and excessive immersion and overload, as a potential factor that can cause psychological, emotional and physical problems and develop mechanisms for overcoming them at the organizational, interpersonal and individual levels.

RELEVANCE OF BIO-PSYCHOSOCIAL AND PSYCHO-DIAGNOSTIC MODELS ON THE EVALUATION OF INDIVIDUAL’S MENTAL HEALTH

This paper sightsees the relevance and significance of the biopsychosocial and psychodiagnostic models in comprehensively assessing individual mental health. The biopsychosocial model emphasizes the intricate interplay between biological, psychological, and social factors in understanding and treating mental health conditions. It acknowledges the interconnectedness of these domains, recognizing that a holistic approach is essential for effective intervention. In contrast, psychodiagnostic models focus on identifying specific patterns of symptoms and behaviors to diagnose mental disorders. While these models provide a structured framework for classification, their limitations in capturing the hints of individual experiences and the broader context of mental health issues are discussed. By integrating the strengths of both models, mental health professionals can gain a deeper understanding of individuals' mental well-being, leading to more tailored and effective treatment plans. In conclusion, the relevance of the lay knowledge in understanding the phenomena of mental health and mental illness, there is need for a common link or thread that bridges all these gaps and helps Bio-psycho-social Model and psychodiagonstic model to look into the issues that needs to be addressed. Therefore, it cannot be concluded that any specific model is better than the other rather; an eclectic view is desirable that incorporates, features from different models that best suits the nature of intervention. Therefore, it is recommended that, Clinical Settings, Clinical Psychologists and other health professionals should embraced used of bio-psychosocial skills and psycho-diagnostic evaluation as a key approach to mental health of an individual because, there is no doubt that this method of thinking is a useful skill in itself and one that can prove essential in later clinical practice.

Understanding Mental Pressure in Older Adults: A Public Health Perspective

The health and well-being of older persons are significantly impacted by mental pressure, which includes stress and worry. Many stressors, such as chronic illnesses, bereavement, and social isolation, are linked to ageing and have a major role in mental health disorders. In older adults, depression and anxiety are prevalent and can exacerbate physical health issues including heart disease and cognitive loss. Health hazards are further exacerbated by the reciprocal association between mental health and chronic illness. A lack of support systems and unstable finances are two examples of social variables that significantly influence mental health outcomes. Improving elderly health requires addressing mental pressure through lifestyle changes, mental health treatments, and community involvement. Improving older individuals' quality of life requires a multidisciplinary strategy that include psychological therapies, stress management, and early diagnosis. This message emphasises the critical necessity for all-encompassing approaches to reduce mental stress in this susceptible group.

Day-to-day fluctuations in motivation drive effort-based decision-making

Internal states like motivation fluctuate substantially over time. However, studies of the neurocomputational mechanims of motivated behavior have failed to capture this. Here, we examined how naturalistic ups and downs in state motivation influence the subjective value of reward and effort. In a microlongitudinal design (N = 155, state timepoints = 3,344, decision-making tasks = 845), we captured fluctuations in state and effort-based decision-making using smartphone-based momentary assessments as people went about their daily lives. We found that both state and trait have independent and multiplicative effects on decision-making. State-behavior coupling was particularly pronounced in individuals with higher trait apathy, meaning that their choices were even more state dependent. Using computational modeling, we demonstrate that state motivation prospectively boosted reward sensitivity, making people more willing to exert effort in future. Our results show that day-to-day fluctuations in state and cognition are tightly linked and critical for understanding fundamental human behaviors and mental ill-health.

Emotion Detection of Mental Health Illnesses Using Physiological Data and Machine Learning Models

Emotion Detection of Mental Health Illnesses Using Physiological Data and Machine Learning Models

The destructive effects of gender-based violence against men in South Africa: stigmatizing the victim

Gender-based violence (GBV) is increasingly gaining local and international attention. South Africa has been experiencing high volume of GBV cases. Men are unable to report gender-based violence cases because of fears for discrimination, labelling and cultural norms. Traditionally, men are expected to be strong despite the difficulties experienced. Although there is high unequal implementation of programs and policies that caters for GBV, male victims continue to suffer because the societal perception, stigmatization, and discrimination. Notwithstanding the existing policies, men continue to become victims of gender-based violence at an alarming rate. Gender-based violence against men has disturbing effects which includes physical effects, mental health illness, sexual dysfunctionality suicide and femicide. Men significantly suffer gender-based violence which this leads to lack of self-expression due to societal expectations and finding it difficult to seek help and report about the abuse. This mostly results to divorce, homicides and other mental related problems. The purpose of the study was to explore the destructive effects of gender-based violence against men in South Africa. The study employed the qualitative research approach with exploratory research design adopted. A sample of 14 male victims of gender-based violence was chosen for the purpose of the study. The study used interviews with semi-structured interview schedule used to guide the session. Purposive sampling technique was used with thematic content used for data analysis process. Among the many effects experienced, the study established the physical, mental health problems, sexual dysfunctionality, suicide and homicide to be the main effects of gender-based violence against men. Family systems theory was found to be relevant in the study to understand the dynamics of gender-based violence.

The complete mental health of Australia's adolescents and emerging adults: distress and wellbeing across 3 nationally representative community samples.

The high level of psychological distress in young people is a growing concern. However, there are few national surveys that describe the trajectories of mental health and wellbeing through adolescence into early adulthood. Further, existing research has largely focused exclusively on mental ill-health, with little focus on positive mental health. This study provides the first national profile of the mental health and wellbeing of Australians aged 12-25years. Participants completed the National Youth Mental Health survey in 2018 (n1=3832), 2020 (n2=974) or 2022 (n3=961). We applied Keyes' Complete Mental Health (CMH) framework to derive categories of mental health and wellbeing, and examine rates of CMH over time, by age and gender. While approximately half of those surveyed reported flourishing (high wellbeing without mental illness), rates of flourishing declined between 2018 and 2022. Rates of flourishing generally decreased with age, and flourishing was more prevalent amongst males than females. The findings provide a unique contrast of youth mental health pre-, during and post- the COVID-19 pandemic. While rates of psychological distress are consistently high, the proportion of youth reporting flourishing highlights the need to consider all aspects of psychological functioning to accurately understand and respond to the mental health needs of young people.