High Prevalence Of Psychiatric Disorders Research Articles

Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients

IntroductionPsycho-oncological support (POS) and psychopharmacological interventions are effective in treating psychiatric symptoms in patients with breast cancer. However, despite high prevalences of psychiatric disorders in patients with breast cancer, a significant proportion remains untreated. MethodsData from 1062 breast cancer patients who had been diagnosed and treated at a Comprehensive Cancer Center between 2012 and 2019 were analyzed retrospectively. We descriptively evaluated the number of patients with a psychiatric diagnosis, POS and psychiatric medication. Latent class analysis was used to examine the relationship between ICD-10 coded psychiatric diagnoses, POS, psychiatric medication, and, as important prognostic factors, tumor stage and somatic comorbidity. Results31.5% of all patients had a psychiatric diagnosis, 20% received POS and up to 60% received psychiatric medication. Latent class analysis revealed three subgroups: 1) patients with a low cancer stage, low somatic comorbidity, no psychiatric diagnosis, no POS and no psychiatric medication; 2) patients with a low cancer stage, low somatic comorbidity, a psychiatric diagnosis, and a higher probability of POS and psychiatric medication than class 1 and class 3; 3) patients with advanced cancer stage, high somatic comorbidity, a higher probability of a psychiatric diagnosis and POS than class 1, and no psychiatric medication. ConclusionThis study indicated a high prevalence of psychiatric disorders among patients with breast cancer and a discrepancy between the number of patients having a psychiatric disorder and those receiving psychiatric medication. The identification of subgroups might contribute to better tailored treatment for those patients whose needs are insufficiently met.

Homelessness, psychiatric disorders, and violence in Denmark: a population-based cohort study

Homelessness is associated with adverse health and social outcomes. People experiencing homelessness have been found to have a high risk of violent crime victimisation as well as high prevalence of psychiatric disorders. It is poorly understood whether experiencing homelessness is associated with additional risks of violent offending and whether psychiatric disorders contribute to these risks. We examined the association between homelessness, psychiatric disorders, and first violence offence leading to conviction. We did a nationwide, register-based cohort study of all Danish residents who were alive at least 1 day during the study period, born between Jan 1, 1980, and Dec 31, 2006, and aged 15 years or older retrieved from the Danish Civil Registration System, which was linked to registers with information on homelessness, health care, and criminality. The exposure was any experience of homelessness, which was defined as having at least one contact with a homeless shelter during the study period. The outcome was first violent offence leading to a conviction. We calculated incidence rates per 10 000 person-years, incidence rate ratios (IRRs) using Poisson regression analysis, and probability of conviction of a violent offence using an Aalen-Johansen estimator. Analyses were stratified by sex and adjusted for calendar year of the study period, age, other sociodemographic factors, and psychiatric disorders. The study cohort included 1 786 433 Danish residents aged 15-42 years living in Denmark at some point from Jan 1, 2001, to Dec 31, 2021, contributing to 21 336 322 person-years at risk, of whom 57 084 (3·2%) individuals had their first violent offence leading to conviction during follow-up. 10 years after their first contact with a homeless shelter, 22·9% (95% CI 21·6-24·2) of men and 7·7% (6·8-8·7) of women had committed at least one violent crime leading to conviction. The fully adjusted IRRs of a violent offence leading to conviction were 4·8 (4·5-5·1) in men and 6·3 (5·6-7·2) in women experiencing homelessness compared with individuals who had not experienced homelessness. The IRR for a violent offence leading to conviction was highest in individuals experiencing homelessness and having co-occurring psychiatric disorders compared with those not experiencing homelessness and without co-occurring psychiatric disorders, especially drug use disorders (IRR in those experiencing homelessness and having a drug use disorder: 15·3 [14·1-16·7] in men and 40·1 [33·9-47·5] in women compared with individuals not experiencing homelessness and having no drug use disorder). Individuals experiencing homelessness had higher risks of a violent offence leading to conviction than those who had not experienced homelessness. In addition to preventing homelessness, public health and policy should consider how to reduce the risk of adverse outcomes in people experiencing homelessness. Lundbeck Foundation.

Psychiatric Influences on Hidradenitis Suppurativa: A Call for Help.

Background Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. This study aimed to assess impact of a psychiatric diagnosis on patients treated for HS. Methods Patients with HS were retrospectively identified at a single institution from 2010 to 2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. Results Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a preexisting psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1 ± 11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs. 1.5, p < 0.001), a higher median number of ED visits (1.0 vs. 0, p = 0.006), and a similar hospital length of stay ( p = 0.456). The mean COST-FACIT score of the overall study population was 19.2 ± 10.7 (grade 1 financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, p = 0.092) and reported greater financial hardship (3.3 vs. 1.7, p < 0.001). On multivariate analysis, a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. Conclusion Preexisting psychiatric conditions in patients with HS are associated with increased health care utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.

Évaluation des échanges professionnels entre médecins généralistes et psychiatres

ObjectivesThere is in France a higher prevalence of psychiatric disorders and higher than average psychotropic consumption in the general population. Considering these elements and the need to involve two complementary medical specialities to manage these disorders, general practice and psychiatry, the necessity for optimal professional exchanges is a major public health concern. In the French public health system, primary care is overseen by self-employed general practitioners. The French psychiatric public sector is said to be “sectorised”, i.e. organised in specific sectors. These sectors include in-patient care entities and out-patient services. The private sector in psychiatry is not sectorised and is mainly composed of self-employed psychiatrists and private clinics. A 2004 law designed to govern who is authorized to refer patients to specialists, stipulated that general practitioners were the only authorized referring doctors for primary care. In the meantime, the number of general practitioners being consulted for cases of depression has doubled between 2005 and 2010. Less than a quarter of these patients were referred to a psychiatrist. Our main objective is to assess the satisfaction with and the efficiency of exchanges between psychiatrists and general practitioners. We also endeavour to identify the main channels through which collaborative care involving these two specialists can be improved. Materials and methodsOur work is an observational, transverse, monocentric and descriptive study carried out using analogous feedback forms mailed by post from June to September 2016. The feedback forms were designed to be analysed both separately and comparatively. Two hundred and ninety nine self-employed general practitioners and 46 psychiatrists employed in the public sector returned the forms. The psychiatric private sector was excluded. All of these doctors worked within three specific geographical treatment zones: Saint-Étienne, Ondaine and Pays de Gier (350,000 inhabitants). The results were treated anonymously via Microsoft Excel® and IBM Corporation SPSS Statistics®. This study was approved by the ethics committee of the university hospital center (CHU) of Saint-Étienne. The doctors’ registers were retrieved via the databases of the Departmental Council of Doctors (CDOM) of the Loire and that of the CHU of Saint-Étienne. ResultsOne hundred and twenty four general practitioners and 30 psychiatrists responded to the feedback form completely. Response rates were 41.4 % for the family physicians and 65.2 % for the psychiatrists. Respectively, 57 % and 70 % knew the identity of their counterpart. A public sector psychiatrist saw 91.9 % of the patients also treated by general practitioners. Of the attending doctors, 79.8 % reported a one third or less return rate of follow-up information from the psychiatrist for the patients they treated together. Similarly, 76.7 % of the psychiatrists reported a return rate of one third or less. One hundred percent (p<0.05) of the general practitioners who did not know the psychiatrists were dissatisfied with their collaboration. Likewise, 98.9% (p<0.05) of the general practitioners who rarely or never received correspondence from the psychiatrists were dissatisfied. Respectively, 77.7% (p>0.05) and 69.5% (p>0.05) of the psychiatrists were dissatisfied. In favor of participating in a standard addressing and return letter process, were 53.4% of the psychiatrists. On the contrary, 64.9% of the general practitioners were against such a process. Willing to receive additional medical training in the psychiatric field were 74.5 % of the family physicians. One out of five psychiatrists considered it a high priority for general practitioners to receive additional training in the psychiatric field. Sharing hospitalisation and consultation reports, along with general practitioners continuous medical training, were considered to be the top priorities for any approach for improving communication. ConclusionsWe observed a high level of dissatisfaction among the participants as a result of the lack of communication. As mentioned above, the field of psychiatry is compartmentalised, psychiatrists are less available for general practitioners. General practitioners are not sufficiently trained but are willing to take more training to improve their practice in the psychiatric field. The results of this study show that first and foremost there is a need to systematise mailings, to simplify phone-based opinion sharing, and to increase the frequency of cross-field training among general practitioners. All of the above could improve exchanges and the management of patients suffering from psychiatric disorders.

Keratinocyte-Derived Cytokine in the Hippocampus Disrupts Extinction of Conditioned Fear Memory in Tumor-Bearing Mice.

While patients with cancer show a higher prevalence of psychiatric disorders than the general population, the mechanism underlying this interaction remains unclear. The present study examined whether tumor-bearing (TB) mice show psychological changes using the conditioned fear paradigm and the role of cytokines in these changes. TB mice were established by transplantation with mouse osteosarcoma AXT cells. These TB mice were then found to exhibit disruption in extinction of conditioned fear memory. Eighteen cytokines in serum were increased in TB mice, among which i.c.v. injection of interleukin (IL)-1β and IL-6 strengthened fear memory in normal mice. Contents of IL-17 and keratinocyte-derived cytokine (KC) in the amygdala and KC in the hippocampus were increased in TB mice. KC mRNA in both the amygdala and hippocampus was also increased in TB mice, and i.c.v. injection of KC dose-dependently strengthened fear memory in normal mice. In addition, injection of IL-1β, but not IL-6, increased KC mRNA in the amygdala and hippocampus. In TB mice KC mRNA was increased in both astrocytes and microglia of the amygdala and hippocampus. The microglia inhibitor minocycline, but not the astrocyte inhibitor fluorocitrate, alleviated disruption in extinction of conditioned fear memory in TB mice. Microinjection of KC into the hippocampus, but not into the amygdala, increased fear memory in normal mice. These findings indicate that TB mice show an increase in serum cytokines, including IL-1β, that increases KC production in microglia of the hippocampus, which then disrupts extinction of fear memory.

Prévalence des troubles psychiatriques en population carcérale française : une revue systématique de la littérature

IntroductionThe prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. MethodThe reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry (“mental health”, psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. ResultsAmong 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4–44.4% for anxiety disorders, 5–14.2% for PTSD, 28–31.2% for mood disorders, 6.9–17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. ConclusionThis systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.

A survey of Psychiatric Disorders and Their Comorbidities in Children and Adolescents

Background: This community-based study aimed to investigate the psychiatric disorders and their comorbidities according to the kind of psychiatric disorders. Frequency of demographic factors and the prevalence of total psychiatric disorders in term of demographic charactheristics were obtained too. Materials and Methods: The present study focused on 1028 children and adolescent aged 6 to 18 years old across the Razavi Khorasan province by random sampling. The subjects included 496 boys and 532 girls from three age groups (6-9 years, 10-14 years and 15-18 years). Eight clinical psychologists trained to complete the Persian version of K-SADS-PL (Kiddie-SADS present and life time version). This scale measures five diagnostic appendixes of psychiatric disorders. Demographic data of participants were collected too. The data were recorded into the SPSS version 16. The relationship between psychiatric disorders and demographic factors deliberate by descriptive analysis and 95% confidence interval. Results: The total rate of psychiatric disorders among children and adolescent was estimated as 20.5%, elimination disorders with a rate of 12.9% was the most prevalent disorder in the subjects. The lowest prevalence belongs to psychotic disorder and bulimia nervosa (0.1%). Of participants with mood disorders about 71.4% have behavioral disorders too. Anxiety disorders also commonly occurred in person with mood disorders. The comparison of ORs and their 95% confidence interval revealed that there is a significant difference for total psychiatric disorder among boys and girls (OR=0.6 for girls; 95% CI: 0.44-0.82). The rate of total psychiatric disorders in rural and urban areas was 14.9% and 21.1% respectively. Conclusion: With attention to the high prevalence of psychiatric disorders among children and adolescents, it’s necessary that healthcare officials pay more attention to reinforcement of mental health care. [GMJ.2020;9:e1714]

Community prevalence of psychiatric disorders: Findings from a nationwide survey in Bangladesh

ObjectiveTo determine the community prevalence of psychiatric disorders in adult population and describe the prevalence by age, men-women, urban-rural strata. MethodsA nationwide household survey was conducted in 2019 where adults aged 18 years and above were selected by a multicentric, stratified, systematic random approach. The Self-Reporting Questionnaire (SRQ) was used for screening purpose and screened positive individuals were interviewed by research psychiatrists and diagnosed according the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. ResultsOverall adult response rate for this survey was 90.4%. In total, of the 7270 adults, 1570 (21.6%) came positive on the SRQ. Overall prevalence of mental disorders found was 18.7% ((95% CI: 17.4%−20.0%). Women reported higher prevalence of psychiatric disorders than men (21.5% vs 15.7%). No significant difference was observed between urban and rural residents (18.9% vs 18.7%). Most common psychiatric disorders found were depressive disorders (6.7%), anxiety disorders (4.7%), somatic symptom and related disorders (2.3%), sleep-wake disorders (1%) and schizophrenia spectrum disorders (1%). ConclusionsThe study revealed that a substatial proportion of adults received diagnoses for psychiatric disorders. Once again, our findings emphasize the need for development of comprehensive mental healthcare services.

Sibling complexity and psychiatric disorders in late adolescence among the Finnish 2000 birth cohort

Abstract Background Due to the increasing family instability and multipartner fertility in Western countries, more children have half- and stepsiblings. While numerous studies link family instability and complexity with mental health problems, the focus has typically been on the parents while a small but growing literature suggest that sibling constellations with half- and stepsiblings may also be important for adolescent mental health. Methods This study is based on administrative register data of all children born in Finland in 2000 and residing there at ages 0 − 15 (n = 56,372). We identified the biological parents, their cohabiting partners, and any full, half and step siblings that the index child has from birth to age 15. We used Cox proportional-hazards models to compare differences in psychiatric disorders from age 16 to 19 for boys and girls by different sibling constellations. Psychiatric disorders were identified as any disorders treated in specialized outpatient or hospital care (n = 7,999). Results Almost one in five children in the birth cohort had a cohabiting half sibling and almost 4% had a step sibling. Psychiatric disorders in late adolescence were more prevalent among children in different sibling compositions with half or step siblings. For example, the preliminary results show that adjusting for confounders such as socioeconomic status and living with both biological parents or not, boys and girls with an older half sibling had a 44% (95% confidence interval 34-55) higher risk of psychiatric disorders when compared to children with biological siblings only. The corresponding difference in risk for those with younger half siblings was 24% (11-55). Conclusions Psychiatric disorders were more prevalent in late adolescence among children with half and/or step siblings. Future studies on family complexity are likely to benefit from including information on sibling characteristics in addition to those of the parents. Key messages • Adolescents growing up with half or stepsiblings had a higher prevalence of psychiatric disorders in late adolescence. • More studies on sibling composition and adolescent psychiatric disorders are needed to inform the type of supportive measures that may benefit children living with half and stepsiblings.

Psychiatric disorders are associated with high mortality rates: somatic comorbidity and mortality in autism spectrum disorder and schizophrenia

A significant proportion of the high mortality associated with psychiatric illness is due to premature death in comorbidity with somatic illness, and to a lesser extent suicide and accidents. In our literature review, we demonstrate that the risk of mortality for individuals diagnosed with autism spectrum disorder and schizophrenia is more than twice of that of controls. With respect to schizophrenia diagnosis, national data from Hungary are available, and consistent with the international data show an increased risk of mortality. In Hungary, the mortality risk of persons with a diagnosis of schizophrenia is about 2.4 times higher than that of controls matched by age, sex and postcode. In particular, the risk of dying from schizophrenia is increased among young people (7-10 times) and we highlight that although the risk of death in schizophrenia is higher for men than for women, the risk of dying from schizophrenia for women diagnosed with schizophrenia is higher than for men compared to the female control group (relative risk). Considering the high prevalence of psychiatric disorders, an important prerequisite for improving the national mortality rates recorded for somatic illnesses is the early diagnosis and treatment of psychiatric illnesses comorbid with somatic illnesses. The data presented here can help to support the reforms needed in medical education and training and in the organization of health care to reduce mortality. Orv Hetil. 2023; 164(33): 1287-1293.

Association between maternal benzodiazepine or Z-hypnotic use in early pregnancy and the risk of stillbirth, preterm birth, and small for gestational age: a nationwide, population-based cohort study in Taiwan

Benzodiazepines and Z-hypnotics are commonly prescribed for anxiety and insomnia during pregnancy, but the evidence regarding potential adverse neonatal outcomes is insufficient because of poor control for confounding factors in previous studies. We therefore aimed to evaluate the association between the use of benzodiazepines or Z-hypnotics during early pregnancy and adverse neonatal outcomes (stillbirth, preterm birth, and small for gestational age). We did a nationwide, population-based cohort study in Taiwan using three data sources: Taiwan's National Birth Certificate Application database, the National Health Insurance database, and the Maternal and Child Health Database. The study cohort included all singleton pregnancies of females aged 15-50 years who gave birth between Jan 1, 2004, and Dec 31, 2018. Pregnancies without valid information were excluded. Benzodiazepine and Z-hypnotic use was defined as at least one benzodiazepine or Z-hypnotic prescription during early pregnancy (the first 20 weeks of pregnancy). The primary outcomes were stillbirth (fetal death at or after 20 weeks' gestation), preterm birth (<37 weeks' gestation), and small for gestational age (birthweight below the 10th percentile for gestational age by sex). Logistic regression models with propensity score fine stratification weighting were used to control for potential confounders and examine the association between benzodiazepines or Z-hypnotics use during early pregnancy and the risk of adverse neonatal outcomes. Odds ratios (ORs) and 95% CIs were reported. We used confounding by indication control analyses, a sibling control study, and a paternal negative control design to account for unmeasured confounders. The risk associated with exposure during late pregnancy was also assessed. Between Oct 7, 2021, and June 10, 2022, we analysed the study data. The cohort included 2 882 292 singleton pregnancies; of which, 75 655 (2·6%) of the mothers were dispensed one or more benzodiazepines or Z-hypnotics during early pregnancy. Women exposed during pregnancy were older (mean age at delivery was 31·0 years [SD 5·3] for exposed women vs 30·6 years [4·9] for unexposed women), had a higher prevalence of psychiatric disorders, and were more likely to have unhealthy lifestyle behaviours than unexposed women. Information about ethnicity was not available. Early pregnancy exposure was associated with adverse neonatal outcomes compared with non-exposure. The propensity score-weighted OR was 1·19 (95% CI 1·10-1·28) for stillbirth, 1·19 (1·16-1·23) for preterm birth, and 1·16 (1·13-1·19) for small for gestational age. After controlling for confounding by indication, there was no significant association between drug exposure and stillbirth risk; however, this attenuation was not observed for preterm birth and small for gestational age. In models with sibling controls that accounted for familial confounding and genetic factors, early exposure to benzodiazepines or Z-hypnotics was not associated with an increased risk of stillbirth and preterm birth, but it remained significantly associated with small for gestational age. The paternal negative control analyses with point estimates close to the null indicated no strong evidence of unmeasured confounding shared by the mother and the father. Substantially increased risks of stillbirth and preterm birth were observed for late pregnancy exposure. Benzodiazepine or Z-hypnotic use in early pregnancy is not associated with a substantial increase in the risk of stillbirth and preterm birth after accounting for unmeasured confounding factors. Clinicians should be aware of the increased risk of small for gestational age and caution should be taken when prescribing these medications during late pregnancy. National Science and Technology Council, Taiwan. For the Taiwanese translation of the abstract see Supplementary Materials section.

Trauma and mental health in young adults who arrived in France as unaccompanied and separated migrant children

ObjectivesThe mental health of unaccompanied and separated minors (UASC) has been widely studied but not their first years of adulthood, often characterised by uncertainty after leaving child protection. The aim of this study was to estimate the prevalence of psychiatric disorders using standardised and validated research instruments and examine the effect of exposure to trauma. MethodsOne hundred and ten youth (92.7% male, median age 19.7 [18.1–22.8]) from Chambery, Montpellier and La Rochelle were recruited to a cross-sectional exploratory study. During a face-to-face interview, somatoform disorder, anxiety, and depression were assessed using the Patient Health Questionnaire (score≥10) and post-traumatic stress disorder (PTSD) with the PTSD Checklist for DSM-5 (score≥33). Traumatic life events were assessed using the Life Events Checklist. ResultsOf the youth, 19.3% had a probable somatoform disorder, 17.6% anxiety, 28.7% depression, and 20% PTSD. The number of traumatic life events increased the risk of depression (multi-adjusted OR (95%CI): 1.56 (1.25–1.96)), PTSD (1.60 (1.23–2.08)), somatoform disorder (1.41 (1.10–1.82), and anxiety (1.33 (1.02–1.72)). Physical assault was the type of event positively associated with the most disorders (P≤0.01, except for anxiety), followed by witnessing sudden and violent death (P≤0.01 for depression and PTSD) and sexual assault (P=0.002 for PTSD). ConclusionOur study highlights the high prevalence of psychiatric disorders in young adults who arrived as UASC and the impact on their mental health of cumulative trauma and exposure to interpersonal and violent traumatic life events. A greater focus on their mental health with regular assessments is needed in order to provide rapid and adapted care.

Disclosure of suicidal ideation and behaviours: A systematic review and meta-analysis of prevalence.

Disclosure of suicidal ideation and behaviours, defined as thoughts, plans, or attempts, to other people provides opportunity for intervention and prevention. This study is the first to meta-analyze all available studies to estimate the prevalence of disclosure, to whom people disclose, and examine factors that influence disclosure. Databases were searched for studies reporting samples of people who had experienced suicidal ideation or behaviours (including those who had died by suicide) and whether they had disclosed this. Almost 100 studies (k=94, N participants=1,044,629) were included in the overall prevalance analysis. The results showed less than half of people disclosed suicidal ideation or behaviour: 45.9% (95%CI 41.9-49.9%, PI 12.3-81.8%; k=94). High heterogeneity, common to prevalence studies, was found (Q[93]=130,584, p<.001; I2=99.9%). No publication bias was detected. Removing outliers did not change the prevalence estimate, but provided tighter prediction intervals: 45.6% (95%CI 43.4-47.9%, PI 35.8-55.7%; k=33). Disclosure was related to higher prevalence of psychiatric disorders, female gender, and a longer timeframe of suicidal ideation or behaviour. Prevalence of disclosure was lower among people who died by suicide, relative to community samples, and lower when reported verbally rather than written online. Disclosure, and proportions of disclosures, to family members, was numerically higher than to friends or professionals, but could not be directly compared. In conclusion, between 50 and 60% of people do not disclose their suicidal ideation and behaviours to other people, and therefore remain unidentified and potentially untreated.

Specific cognitive dysfunctioning and vulnerability to specific psychopathology: A descriptive study on intellectual developmental disorder (intellectual disability)

IntroductionIntellectual Developmental Disorder (IDD) is diagnosed with cognitive and adaptive behaviour evaluations. There is increasing evidence of a high prevalence of psychiatric disorders comorbid with IDD. The relationship between specific cognitive dysfunctions and psychiatric vulnerability may provide the basis for a paradigm shift from “intellectually below average IQ” to “neuropsychological characterization”.Objectives1) reassessing an IDD sample in cognitive profile and psychiatric comorbidities 2) investigating the correlations between specific cognitive dysfunctions and specific psychiatric diagnoses in IDD.Methods120 individuals with IDD from 3 Italian facilities were consecutively evaluated, one group with mild IDD, using WAIS-IV or Leiter-3, TMT, Stroop and TOL tests, after which a professional caregiver did individual interviews (Vineland Adaptive Behavior Scale-II, SPAIDD-G, and STA-DI) to evaluate the patient adaptive behaviour, psychiatric comorbidities and presence of ASD. The second group (more severe IDD), was evaluated only with professional caregiver assessment tools.Results90 males and 30 females, mean age 57 years, institutionalized for a mean period of 36.44 years. 52% had no education, 19% a middle school diploma. IDD diagnoses: borderline 3%, mild 16%, moderate 11%, moderate-severe 4%, severe 59%, profound 0%.11% comorbid ASD diagnosis, 29% with ASD after diagnostic re-assessment (STA-DI). 89% physical comorbidities, 58% psychiatric comorbidities, 56% psychoses (Fig. 1). Psychiatric comorbidities re-assessment (SPAIDD-G) identified a significant number of disorders (Fig. 2), despite the medical records showed a low prevalence of psychiatric diagnoses. The consistent quantity of psychotropic drugs prescribed in the sample, possibly reflects the real prevalence of psychopathology. Pearson correlations (p&lt;0.05). WAIS-IV and SPAIDD-G (N=29): Verbal Comprehension Index correlates with anxiety disorder and impulse control disorder; Perceptual Reasoning Index correlates with nutrition/feeding disorder; Processing Speed Index correlates with nutrition/feeding disorder and sexual disorder; IQ correlates with ASD, nutrition/feeding, anxiety, sexual disorders. Leiter-3 and SPAIDD-G (N=14): Form Completion and non-verbal IQ correlate with OCD negatively.Image:Image 2:ConclusionsIn conclusion, the SPAIDD-G evaluations revealed a greater prevalence of psychopathology than reported in the medical records. Using psychopathological screening tools can improve the diagnostic process in residential facilities for IDD cases. Pearson’s analyses revealed the need to further investigate the correlation between cognitive dysfunctions and psychopathological vulnerability, studying intelligence as a multi-component model and identifying specific behavioural and cognitive phenotypes in IDD cases.Disclosure of InterestNone Declared

Legalization of cannabis for medical and recreational use

AbstractSince 1996, 39 of the 50 US states have enacted medical cannabis laws (MCL) and since 2012, 21 states and Washington D.C. (DC) enacted recreational cannabis laws (RCL). Many individuals can use cannabis without harm, and legalization helps achieve social justice and financial aims. However, 20%-33% of cannabis users develop cannabis use disorder (CUD), which is associated with impaired functioning, psychosocial, physical and psychiatric problems. Despite these risks, Americans increasingly see cannabis use as harmless or even beneficial in treating or preventing health problems. The prevalence of frequent cannabis use and CUD has increased in US adults in recent years. Studying the role of MCL and RCL in these nationally increasing prevalences is challenging due to staggered-adoption dates of state legalizations, few years of data available to study RCL, and other potential influences on cannabis use and CUD. Using self-report data from US national surveys, MCL have been shown to have little influence on adolescent cannabis use, but increase adult illicit cannabis use and CUD. Fewer studies have examined RCL; in these, RCL increases adult use and CUD. However, studies are needed in national patient populations with multiple risk factors for CUD, including painful medical conditions and a high prevalence of psychiatric disorders. We used data from the electronic health records (EHR) database of the US Veterans Health Administration (VHA), the largest integrated healthcare system in the US, to examine trends in provider-diagnosed ICD-9-CM and ICD-10-CM CUD over time, differences in these trends by patient characteristics, and the role of MCL and RCL in the trends. CUD diagnoses more than doubled overall in the VHA, from 0.85% in 2005 to 1.92% in 2019. Increases were found across age, sex, and racial/ethnic subgroups of patients, with greater rates and increases among patients with chronic pain and with psychiatric disorders. Among patients living in MCL and RCL states, increases in CUD were larger than among patients in other states, although the size of legalization effects suggested that other factors are important in driving up prevalence, e.g., online commercialized information and other forms of advertising. The tensions between public health aims, social justice and financial gain will be discussed.Disclosure of InterestNone Declared

Nursing students' perceptions of how the COVID-19 pandemic impacts mental well-being and educational environment

BackgroundChallenging work conditions put over 20 million U.S. health workers, including nurses, at risk for mental health problems. Mental health concerns among nurses and nursing students include anxiety, burnout, and stress which can lead to substance abuse and suicidal behavior. Nursing students practice in environments where they are exposed to complex challenges and high-stress situations that can lead to a higher prevalence of psychiatric disorders. As nursing students attempt to adapt to a post-pandemic educational environment, it is important to identify perceptions of nursing students' mental well-being. MethodsA qualitative design was utilized using a descriptive method. Semi-structured interviews were conducted with a purposeful sample of BSN students (n = 11) from the southeastern U.S. Content analysis and coding were utilized in the study. ResultsCoping strategies and coping skills are imperative for nursing students to thrive in the educational environment, which includes a multitude of stressors that can negatively impact academic success. The rigorous workload of nursing schools, lack of support, financial challenges, and lack of experience are contributing factors that lead to decreased mental well-being among nursing students. ConclusionInterventions that aid in recognizing students at high risk for negative mental health outcomes must be implemented to ensure academic success. Implementing interventions to support healthy mental well-being among nursing students can also create an educational environment that prepares students to provide high-quality, safe, and effective patient care.

Epidemiology and Psychiatric Correlates of Cancer among Homeless and Unstably Housed Veterans in the VA Health Care System.

This study examined the incidence and correlates of cancer among homeless and unstably housed (HUH) veterans as compared with stably housed (SH) veterans. Using Veterans Affairs (VA) administrative data from 564,563 HUH and 5,213,820 SH veterans in 2013 and 2014, we examined the types and stages of 69 different types of cancer diagnosed among HUH and SH veterans. Sociodemographic and psychiatric characteristics associated with cancer were also examined. The 1-year incidence rate of cancer was 21.5% lower among HUH veterans than SH veterans (0.68% and 0.86%, respectively). There was no difference in the most common stages and types of cancer among HUH and SH veterans. The most common primary sites of cancer were in the prostate, lung, and bronchus. HUH veterans were more likely than SH veterans to have cancer of the liver and intrahepatic bile ducts (∆4.79%). Among HUH veterans, older age and alcohol use disorder were associated with greater risk for any incident cancer while suicidal ideation/behaviors were associated with lower risk. Psychiatric conditions were often diagnosed before cancer diagnosis for SH and HUH veterans; rates of substance use disorders and suicidal ideation/behaviors decreased in HUH veterans after cancer diagnosis. The VA health care system serves many HUH veterans with cancer. Mental health and substance use disorders are important to treat in veterans at risk of cancer and as potential sequalae of cancer. The high prevalence of psychiatric disorders in HUH populations is important to consider in the diagnosis and treatment of cancer in these populations.

Substance Use Disorders Are Prevalent in Adults With Congenital Heart Disease and Are Associated With Increased Healthcare Use

Adults with congenital heart disease (CHD) represent a heterogeneous group with significant long-term health risks. Previous studies have demonstrated a high prevalence of psychiatric disorders among adults with CHD; however, little is known about the frequency of co-morbid substance use disorders (SUDs) in patients with CHD. The Oregon All Payer All Claims (APAC) database for the years 2014 to 2017 was queried for adults aged 18 to 65years with International Classification of Diseases, Ninth or Tenth Revision codes consistent with CHD. Alcohol and substance use were identified by International Classification of Diseases codes for use or dependence and classified in mutually exclusive categories of none, alcohol only, and other drugs (with or without alcohol). Descriptive statistics were used to characterize prevalence and chi-square tests were used to test for associations between variables. A total of 12,366 adults with CHD were identified. The prevalence of substance use was 15.7%. The prevalence of isolated alcohol use was 3.9%. A total of 19% of patients used tobacco. Insurance type, presence of a concurrent mental health diagnosis, and age were associated with substance use, whereas CHD complexity was not. Cardiovascular co-morbidities were more common in patients with reported substance use. Inpatient and emergency care use were higher in those with SUD. In conclusion, this study of substance and alcohol use among adults with CHD demonstrates high rates of co-morbid SUD, particularly among patients with mental health disorders and Medicaid insurance, associated with increased healthcare utilization. We identify a population in need of targeted interventions to improve long-term health.

Some people living with HIV might need to pay attention to their mental health during the COVID-19 two years pandemic in Tokyo until the Omicron variant occur.

People living with HIV (PLWH) have a higher prevalence of psychiatric disorders than the general population. We retrospectively examined the medical records of PLWH who underwent the Kessler Psychological Distress Scale-10, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 at an HIV referral hospital during the COVID-19 pandemic. Some PLWH who were unemployed with a history of psychiatric visits may remain in poor mental health during the prolonged COVID-19 pandemic until the Omicron variant occurs, so they may need to pay attention to their mental health.

Tough times never last too long: the future of psychopharmacology.

Tough times never last too long: the future of psychopharmacology.