History Of Mental Illness Research Articles

High psychological stress levels related to delivery can increase the occurrence of postpartum mental disorders.

The study sought to explore the relationship between high psychological stress levels related to delivery and postpartum mental disorders. A total of 284 parturients were included in the study from July 2021 to January 2022. The stress level at 1 month postpartum was assessed by the Impact of Event Scale-Revised (IES-R). Parturients with an IES-R score ≤ 9 were included in the low psychological stress level group, and those with an IES-R score > 9 were included in the high psychological stress level group. The Edinburgh Postnatal Depression Scale (EPDS), Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70), Symptom Checklist-90 (SCL-90) and Mini-International Neuropsychiatric Interview (M.I.N.I.) were conducted at 42 ± 7 days postpartum to assess the mental health of parturients.The parturients' mental health after birth was assessed by the EPDS, UPPSAQ-70, and SCL-90. Semi-structured diagnostic interviews were conducted at 42 ± 7 days postpartum by using the M.I.N.I. The incidence rate of postpartum mental disorders was 20.42% (58/284), the incidence rates of postpartum depression, anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder were 17.96% (51/284), 11.97% (34/284), 4.58% (13/284) and 1.41% (4/284), respectively, and the comorbidity rate was 58.62% (34/58). A history of mental disorders and pregnancy complications were risk factors for postpartum depression (p = 0.028, p = 0.040, respectively); a history of mental disorders, a lack of physical exercise, partner violence and pregnancy complications were risk factors for postpartum anxiety disorders (p = 0.003, p = 0.007, p = 0.031, p = 0.048, respectively); and the delivery of female infants was a risk factor for postpartum obsessive-compulsive disorder (p = 0.022).The risk of postpartum depression, anxiety disorders and obsessive-compulsive disorder was 9.125 times (95% CI = 3.900 ~ 21.349, p < 0.01), 7.310 times (95% CI = 2.588 ~ 20.649, p < 0.01) and 6.259 times (95% CI = 1.347 ~ 29.093, p < 0.01) higher in postpartum women with high psychological stress levels related to delivery than in those with low psychological stress levels, respectively. The incidence of postpartum mental disorders is high and has a positive correlation with the level of psychological stress. This may lead to a new perspective of the effect of psychological stress on postpartum mental disorders and attract more attention to other mental disorders in addition to postpartum depression.

Postoperative Cognitive Dysfunction: Mechanism and Prevention

Postoperative cognitive dysfunction (POCD) refers to a condition characterized by impaired cognitive processing and reasoning, which can negatively affect perceptual abilities and play a crucial role in overall health. Factors such as age, educational attainment, history of mental illness, and the presence of comorbid diseases can influence the occurrence of postoperative cognitive dysfunction (POCD). Strategies aimed at preventing the occurrence of postoperative cognitive dysfunction (POCD) involve both surgical interventions and addressing patient-related issues, as well as optimizing the administration of anesthetics and conducting surgery in a stress-free manner. The benefits of reducing oxidative stress and inflammation in brain cells have been demonstrated. Postoperative recovery may be extended due to postoperative cognitive dysfunction (POCD). The studies conducted showed heterogeneity in terms of patient groups, methodology used to quantify POCD, and study design, making it challenging to draw generalizable conclusions. The prevalence of postoperative cognitive dysfunction (POCD) is a widespread health concern globally.

Medical Student Syndrome in Medical University students in Jordan: A Cross-sectional Study

BACKGROUND: The widely recognized phenomenon known as 'medical student syndrome' refers to the tendency of many medical students to develop fears and symptoms of illnesses they are studying. Extensive research has underscored the substantial psychological pressure that medical students endure due to factors like a demanding workload, exam-related stress, anxiety arising from new clinical experiences, and the competitive academic environment. Given its classification as a mental health issue, 'medical student syndrome' has been investigated in multiple countries. Consequently, our study aims to delve deeper into this phenomenon among medical students, considering various demographic factors. METHODS: A cross-sectional study was conducted. The survey includes sociodemographic questions and attitudes toward the syndrome, adapted from a Polish study. Data was using SPSS, with statistical tests conducted at a 95% confidence level. RESULTS: A total of 1,050 participants completed the questionnaire for this study, with 67.3% being females. The average age was 20.91 years, and the majority were unmarried (98.2%). Most participants reported a monthly income of less than 500 JDs, and only 16.2% identified as smokers. Clinical students accounted for 33.6% of the sample, while 11.2% indicated a history of mental illnesses. Additionally, 36.3% had taken previous courses related to mental illnesses, and 13.7% had sought psychiatric consultation. Furthermore, 15.6% had utilized psychiatric or psychotherapeutic counseling for other reasons, and 26.6% expressed a desire to visit a psychiatrist or psychologist due to their fear of falling ill. Mann–Whitney U and Kruskal–Wallis tests were conducted to explore potential differences in total scores based on demographic and mental background factors. Preclinical students had significantly higher mean scores compared to clinical students (41.68 vs. 39.35, p = 0.001). Respondents who had used psychiatric or psychotherapeutic counseling for reasons other than those inquired had significantly higher scores than those who did not (43.85 vs. 40.35, p &lt; 0.001). Similarly, respondents planning to visit a psychiatrist/psychologist due to their fear of falling ill scored significantly higher than those who did not share this intention (43.85 vs. 39.96, p &lt; 0.001). Multiple linear regression analysis revealed that the "year of study" variable was the only significant predictor of the total score, with a coefficient of -3.196, a t-statistic of -4.057, and a p-value &lt; 0.001. This negative coefficient suggested that as the year of study increased, the total score tended to decrease significantly. However, the model had relatively weak explanatory power, with R² indicating that it explained only about 3.5% of the variance in the dependent variable, and R²adj accounting for approximately 2.7% after adjusting for model complexity. CONCLUSION: In summary, the study included a diverse group of participants with varying demographic and mental background factors. Preclinical students tended to have higher scores, and those with a history of seeking mental health services or expressing an intention to do so had higher scores. The year of study was a significant predictor of the total score, suggesting that as students progressed in their studies, their scores tended to decrease. However, the model's overall explanatory power was relatively limited.

Grill-Related Burn Injuries: A Matched Cohort Study.

Barbequing can result in devastating burn injuries with unsafe practices. This study aims to characterize the demographics, injury characteristics, and outcomes of grill-related burns and identify ways of burn prevention. A retrospective review of patients admitted to a single-institution, metropolitan burn center from January 1, 2017, to July 1, 2023. Data included demographics, burn injury characteristics, and outcomes. Each Grill Cohort patient was matched to 3 nongrill controls by mBaux score and burn location. Of 2355 patients, 69 (2.9%) met Grill Cohort inclusion criteria. The Grill Cohort had 55 (79.7%) males and an average age of 41.7 ± 17.5 years old. In the Grill Cohort, 25 (36.2%) patients had positive blood alcohol, 8 (11.6%) tested positive for amphetamines, and 5 (7.2%) for cocaine at the time of admission. A total of 61 (88.4%) Grill Cohort burns involved the upper extremity, 43 (62.3%) the head/neck, 34 (49.3%) the lower extremity, and 30 (43.5%) the trunk. Compared with the Control Cohort, the Grill Cohort had smaller proportions of patients who were undomiciled (P < .01) or had a history of mental illness (P < .001). Grill-related burns had a greater proportion of flash/flame burns (P < .001). This study suggests that middle-aged, domiciled males without psychiatric comorbidities are more likely to make preventable grilling errors resulting in burn injuries. Prevention strategies targeting this demographic group should emphasize the risks of grilling while intoxicated, proper handling of propane tanks and lighter fluid, and the use of flash/flame-resistant gear protecting the upper extremities and head/neck.

The Psychological Impact of Isotretinoin Therapy on Acne Vulgaris Patients.

Introduction Acne vulgaris is a dermatologic condition that affects the pilosebaceous unit. It is the most common skin disorder worldwide, and it is most prevalent during puberty. For patients with moderate to severe acne that is unresponsive to antibiotic treatment, the main treatment is oral isotretinoin. The objective of this study was to define the impact of isotretinoin and its well-established adverse effects on the psychological status of acne patients during treatment. Methods The sample cohort included 80 patients with acne vulgaris who were treated with isotretinoin. The sample size was calculated using the Raosoft [Raosoft.com (2015) Sample Size Calculator by Raosoft, Inc.] sample size calculator to maintain a confidence interval of 95% and a margin of error of 5%. The participants were assessed using the Depression and Anxiety Stress Scale-21 (DASS-21). The DASS-21 is a self-reporting scale used to measure the emotional states of depression, anxiety, and stress. This study was a cross-sectional survey conducted at the dermatology outpatient clinic at King Abdulaziz Medical City, Jeddah, Saudi Arabia. All patients diagnosed with acne vulgaris between January and April 2020 were included in the study. A multivariate regression analysis was also conducted to determine the presence of any significant independent factors associated with depression, anxiety, and stress. A P-value of ≤0.05 was considered statistically significant. Results We observed that the most prevalent psychiatric disorder among acne patients on isotretinoin therapy was anxiety. Our results also indicate that a history of mental illness is an independent risk factor for developing depression when isotretinoin is used. In addition, known adverse physical effects of isotretinoin treatment, including muscle pain, arthralgia, and headaches significantly increase the likelihood of patients developing psychiatric morbidity during therapy. Conclusion Isotretinoin is a highly potent therapy for acne. Overall, the physical side effects profile is well acknowledged, yet the exact psychological impact the treatment predisposes the patients to is yet to be determined.

Stress exposure in at-risk, depressed, and suicidal adolescents.

Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China

Background Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students. Method The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students’ basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression. Results Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population. Conclusion The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.

Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature.

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Gaze measurements during viewing human dialogue scenes in adults with ADHD: Preliminary findings.

Eye gaze measurement to human dialogue scenes in adults with attention deficit hyperactivity disorder (ADHD) was investigated. We examined whether eye gaze measurement might be a biological marker of ADHD. Twenty-two individuals with ADHD (mean age, 34.5 years) attending the outpatient clinic of Showa University Karasuyama Hospital were included in the study, and 26 healthy individuals (mean age, 32.6 years) with no history of mental disorders were used as the control group. For the participants, intellectual functioning was estimated using the Japanese Adult Reading Test, and mental symptoms were assessed using the Autism Spectrum Quotient and Conner's Adult ADHD Rating Scale. We extracted human dialogue scenes from two classic movies as visual stimuli and recorded the participant's gaze while watching these scenes using Tobii's eye tracker. For gazing time, repeated measures analysis of variance showed no significant main effect of "group" and no significant interaction effect between "group" and areas of interest "(AOI)." In the normal group, gazing time at the eyes was significantly longer than those at the mouth, body, and background; in the ADHD group, gazing time at the eyes was significantly longer than only that at the background. Given the different results obtained in the past in ASD, these results suggest that it would be necessary to directly compare the two groups to determine whether the gaze measurement shows significant differences in ASD and ADHD.

The correlation between bipolar disorder not otherwise specified progression with patients’ clinical and demographic characteristics

Introduction: Bipolar disorder not otherwise specified is a complex condition characterized by unusual shifts in mood, energy levels, and behavior. Objectives: This study aimed to investigate the relationship between bipolar disorder not otherwise specified progression and patients’ clinical and demographic characteristics. Patients and Methods: Data for this study was obtained from a cross-sectional study conducted between the years 2008-2021. The study investigated 171 patients with bipolar disorder not otherwise specified. The data collection tool was the content of the file registered in the psychiatry department of the hospital, which was based on the physician’s interview with the patient. Data analysis was conducted using statistical tests in SPSS version 26 software. Results: Out of 171 patients, 80 (46.8%) were men with a mean age of 39.5 ± 12.2 years. The results found that the duration of symptoms onset to hospitalization in patients with mania symptoms was related to gender, family history of mental illness, and history of opium abuse. On the other hand, the duration of symptoms onset to hospitalization in patients with major depressive episodes (MDEs) was related to education level, marital status, and family history of mental illness (P&lt;0.05). In the patients with both Mania and MDEs’ symptoms, no statistically significant correlation was found between patients’ characteristics with the duration of symptoms onset to their hospitalization (P&gt;0.05). Conclusion: Identification of related risk factors and early treatment of bipolar disorder not otherwise specified, along with addressing potential comorbidities such as family heredity and opium abuse, can help improve patients’ outcomes and quality of life. Clinicians should consider these factors when assessing these patients to provide appropriate treatment and support.

Impacto de la COVID-19 en la salud mental de la población: estudio en atención primaria

ObjectiveTo determine the prevalence of COVID-19 and the characteristics of infected patients, as well as the prevalence of mental disorders associated with the infection and the associated risk factors. Secondary: to know the prevalence of the long COVID syndrome and the characteristics of this cohort. DesignIncidence study of mental disorder in patients diagnosed with COVID-19 and case-control study of long COVID syndrome in the subsample of patients diagnosed with COVID-19 without a history of mental disorder. SitePrimary care setting in Lleida. ParticipantsThe 46,258 patients diagnosed of COVID-19 without a history of mental disorder were followed for 2 years. Main measurementsThe dependent variable was the mental disorder in the period 03/11/2020 to 03/11/2022; and the independent variables were clinical and social variables. Its association with mental disorder was analyzed by calculating the adjusted hazard ratio using a logistic regression model. ResultsThe average age of 46,258 patients at the beginning of the study was 43±17.9 years. 47% were women. The mental disorder rate for all period was 3.46% (59.20% anxiety). A predictive score was elaborated. The long COVID syndrome was more common in older women, without toxic habits, with obesity and associated comorbidity. ConclusionsCOVID-19 has had an impact on the mental health of patients. Knowing the risk factors for developing these mental disorders and the long COVID syndrome would allow the clinician to be able to identify patients at risk in order to establish preventive measures and avoid their appearance.

Predictors of COVID-19-related posttraumatic stress and anxiety symptoms in high school students in China

Youth may be particularly vulnerable to negative consequences of the COVID-19 pandemic due to acute and chronic stressors (e.g., social distancing) during a critical period of development. The present study examined factors associated with COVID-19-related posttraumatic stress and anxiety in high school students in China (N = 294) during May 2020. Logistic and zero-inflated negative binomial regression were used to evaluate the effects of self-reported prior mental health concerns, duration of isolation/quarantine measures, impact from the pandemic, behaviors changed during COVID-19, and attitudes surrounding the pandemic on self-reported anxiety and pandemic-related posttraumatic stress. Self-reported history of mental health concerns significantly predicted anxiety and pandemic-related posttraumatic stress. While timing likely contributed to lower rates of clinically significant outcomes than have been reported in other studies, some students exhibited signs of enduring distress. History of mental illness may be a sign of negative psychological outcomes in adolescents and should prompt further screening.

Prevalence and Risk Factors for Suicidal Ideation Following the COVID-19 Pandemic in Kerman Province: A Cross-Sectional Study.

Suicidal ideation (SI) serves as an important predictor of suicide. The prevalence of SI has increased following the COVID-19 pandemic. This study aims to investigate the prevalence and risk factors associated with SI after the pandemic in the Kerman province. This cross-sectional study was conducted in 23 counties of the Kerman province between 2021 and 2022. The Beck Scale for Suicidal Ideation (BSSI) was utilized to estimate SI, while multiple logistic regression analysis was employed to examine the impact of various variables on SI. A total of 1421 individuals (47.7% men, 50.0% women and 2.3% unknown) with an average age of 35.17±9.47 years participated in this study. The estimated prevalence rate of SI was 9.2%, with variations ranging from 0% to 42% across different counties. Individuals with SI exhibited a significantly younger mean age and fewer family members. Furthermore, SI was significantly more prevalent among single participants, unemployed individuals, students, those with a history of mental illness, prior psychiatric medication use, and previous SI. Employed individuals had 87% lower odds of experiencing SI compared to the unemployed. Individuals with a history of prior SI had 239 times higher odds of SI than those without such a history. Additionally, each year increase in age corresponded to an 8.8% decrease in the odds of SI. The high prevalence of SI is concerning, and it is essential to remain vigilant regarding its health and social consequences as the pandemic continues. Therefore, it is imperative to provide enhanced mental health services, particularly targeting at-risk groups.

The Thai version of difficulties in emotion regulation scale-short form: Validation among undergraduate students

BackgroundEmotion regulation plays an important role in an individual's psychological and social functions. The Difficulties in Emotion Regulation Scale – Short Form (DERS-SF) has been chosen to investigate its psychometric properties. ObjectiveTo develop the Thai version of the scale and examine construct validity, internal consistency, concurrent validity, criterion-related validity, and floor and ceiling effects of the scale. DesignA cross-sectional survey design Participants400 undergraduate students were recruited and completed a self-report online questionnaire including a demographic form, the Thai version of DERS-SF, and The Depression Anxiety Stress Scale. MethodsThe Thai version of DERS-SF was developed following the Beaton translation process. Confirmatory factor analyses, Cronbach's alpha, Pearson's correlations, and T-test were used. ResultsThe Thai version of the DERS-SF without Awareness provided a good fit with good internal consistency (Cronbach's α = 0.88). The scale presented a moderate correlation with depression (r =0.58), anxiety (r = 0.57), and stress (r = 0.67) (all p < .05). Students who reported higher scores on the scale tended to experience inadequate income (t-test = 2.82 p < .01), mental illness history (t-test = -2.73 p < .05), and stressful life-event in the past six months (t-test = -3.95 p < .001). Eight items of the scale presented the floor effect while one item had a ceiling effect. ConclusionThe Thai version of the DERS-SF without Awareness exhibited good psychometric properties. The scale would be useful for future research and clinical work to assess emotion regulation among Thai university students.

Obstetric and psychiatric history as predictors for psychosomatic symptoms among Korean perimenopausal women.

Menopause presents various physical and psychological disturbances for women and comes at a high financial cost. Therefore, this study aimed to identify factors influencing menopause symptoms. Data of Korean perimenopausal women aged 40-60 (n=1060; mean age, 46.03±4.08) were collected by a research company. Participants were classified into a "functional" group (n=716) or a "dysfunctional" group (n=344) according to the severity of their perimenopausal psychosomatic symptoms. To investigate the association of obstetric and psychiatric history with membership of the "dysfunctional" group, a hierarchical logistic regression analysis was conducted. The outcomes of all three hierarchical logistic regression models presented significant overall model fit. Among the independent variables, family history of menopausal symptoms, menarcheal age, number of pregnancies, history of postpartum depression, postpartum psychosis, and other psychiatric disorders were positively associated with being in the "dysfunctional" group, whereas age and number of deliveries were negatively associated with being in the "dysfunctional" group. A short reproductive period and short exposure to estrogen due to late menarche and early menopausal transition may be related to severe perimenopausal symptoms. The relationship between the history of postpartum mental illness and severe perimenopausal symptoms may be associated with heightened sensitivity to hormonal triggers when a woman is exposed to fluctuating ovarian sex steroid levels. The relationship between parity or gravidity and the severity of menopausal symptoms in Korean women differed from that in studies conducted in other countries, possibly due to the low birth rate in Korea.

Identifying Patient Characteristics Associated With Opioid Use to Inform Surgical Pain Management.

Balancing surgical pain management and opioid stewardship is complex. Identifying patient-level variables associated with low or no use can inform tailored prescribing. A prospective, observational study investigating surgical procedures, prescription data, and patient-reported outcomes at an academic health system in Pennsylvania. Surgical patients were consented following surgery, and prospective data were captured using automated text messaging (May 1, 2021-February 29, 2022). The primary outcome was opioid use. Three thousand six hundred three (30.2%) patients consented. Variation in patient reported used included 28.1% of men reported zero use versus 24.3% of women, 20.5% of Black patients reported zero use versus 27.2% of white patients. Opioid-naïve patients reported more zero use as compared with chronic use (29.7% vs 9.8%). Patients reporting higher use had more telephone calls and office visits within 30 days but no change in emergency department utilization or admissions. Higher discharge pain score was associated with higher use. In the adjusted analysis, opioid use relative to the guideline, higher use was associated with age, male sex, obesity, discharge pain score, and history of mental health disorder. In the adjusted model, younger age and being opioid-naïve to be associated with low to zero use across procedures. Younger age, being opioid-naïve, and lower discharge pain score are associated with low or no postoperative opioid use. These characteristics can be used by clinicians to help tailor opioid prescribing to specific patients to reduce the risk of prolonged exposure and unused `ts in the community.

#229 : The Impact of Menopausal Phase to Depression

Background and Aims: In premenopausal and menopause women, a woman will start to experience mood problem and in more severe cases can cause depression. Researchers have connected the relation between hormonal changes that occur with the emersion of the symptom. In Indonesia, the awareness of the community to check themselves due to mental disorders is still quite low. This leaves many cases of depression have not been revealed. The main objective of this study was to find out the relation of menopause and depression by evaluating the subjects result of Hamilton Depression Rating Scale (HAM-D). Method: This research used thematic analysis of semi-structured interview based on Hamilton Depression Rating Scale (HAM-D). The collected data were analysed using IBM SPSS Statistic 23.0 for windows. The populations in this study are all women aged between 40-60 years, totaling 60 people. The choosing of the patients based on some criteria: 1) the data was taken from women aged 40 and above; 2) showing symptoms of premenopausal or menopause; 3) The researcher did not consider patient’s history of depression and other mental disorder; 4) That person have agreed to the informed consent. Results: Measurements Hamilton Depression Rating Scale (HAM-D) classified someone as suffering severe depression disorder if the test score is 24 and above, moderate depression if the score between 17-23, mild depression score is 8-16, and normal if the score is below 8. The statistically significant score is set up at p &lt;0.05 if there is correlation between menopausal and depression. Women experiencing menopause tend to tend to experience depression; (Correlation Coefficient = 0.176); (p=0.179 or p&gt;0.05) compared to those of women without menopause or premenopausal. Conclusion: The changes into menopausal phase increase the risk of being depressed even though it is low.

Qualitative Study of Perinatal Mental Health Services: Experiences and Perspectives of Health Workers and Patients

The perinatal period is a transitional period that is vulnerable to changes in women's relationships with partners, family, friends, and wider social networks. This study aims to determine how perinatal mental health services are based on the experiences of health workers and patients. This research is qualitative research with a case study design. The informants in this study were 6 informants, namely 2 health workers and 4 patients with a history of perinatal mental health disorders. The instruments used in this study were structured interview guidelines, interviews were conducted in health facilities and patients' homes. Thematic data analysis using the Collaizi protocol. Qualitative data from this study raised six themes, namely "symptoms of perinatal mental health disorders", "causes of perinatal mental health disorders", "management of mental health disorders", "prevention of perinatal mental health disorders", "barriers to perinatal mental health services", and "support". Pregnant, maternity and postpartum women are vulnerable to mental health problems, especially if a woman is faced with family neglect and lack of husband's support during pregnancy. It is important for health workers, especially midwives, to examine women's problems more comprehensively during antenatal care.

Improving the Management of Maternal Mental Health with Digital Health Care.

Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among peripartum people with a history of mental health disorders and determine which components of utilization associate with maternal mental health outcomes. Participants in this retrospective cohort analysis (n=1561) accessed Maven as an employer-sponsored health benefit and enrolled during their pregnancy and delivered from January 2020 through September 2022. Participants completed health surveys at enrollment, including history of a mood disorder, and post-delivery. Maven includes online articles, asynchronous and synchronous virtual classes, app-based mental health screenings, access to allied health professional and maternity care providers via messaging and telehealth appointments. Quantile g-computation was used to estimate the effects of multi-utilization exposures on reports of postpartum depression (PPD) and management of mental health. Multi-utilization exposure mixture models demonstrated that increasing use of digital resources by one quartile is associated with an increased odds of reporting that Maven helped users manage their mental health (aOR: 12.58 [95% CI: 6.74, 23.48]) and was not associated with self-reported incidence of PPD (aOR: 1.30 [95% CI: 0.52, 3.27]). Care advocate appointments, provider messages, and article reads were positively associated with improved mental health management. Digital health platforms, such as Maven, may play an important role in managing maternal mental health conditions among pregnant and postpartum people at high risk for PPD.

Investigating the relationship between hepatitis B virus infection and postpartum depression in Chinese women: a retrospective cohort study.

Postpartum depression (PPD) is associated with several psychological and obstetric factors. Hepatitis B virus (HBV) infection has been linked with a high risk of depression, but little is known about the relationship between maternal HBV infection and PPD. We aimed to investigate the association between HBV infection and PPD. This retrospective cohort study included 3,808 mothers who gave birth in a hospital in southern China. Self-reported Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Multivariate logistic regression was used to determine whether maternal HBV infection was associated with PPD risk. Of the 3,808 participants, 11.9% of mothers had PPD at 6 weeks postpartum. Two hundred and seventy-eight (7.3%) and 3,530 (92.7%) were in the HBV and control groups, respectively. Women with HBV infection were more likely to test positive for PPD (14.7 vs.11.7%). The multivariate logistic regression analysis showed that HBV-infected women did not have a significantly higher incidence of PPD (OR = 1.23; 95% CI, 0.82-1.84) than those without HBV infection in the study cohort. Parity and postpartum hemorrhage were found to be associated with PPD. In addition, our study showed that e antigen positivity was not associated with PPD risk (OR = 0.56, 95% CI 0.19-1.63). To our knowledge, this is the first investigation of the relationship between maternal HBV infection and PPD. In a cohort of women without prior history or family history of mental illness, having HBV infection was not significantly associated with self-reporting of PPD compared to not having HBV infection.