History Of Mental Health Disorders Research Articles

Changes in Emergency Department Utilization in Vulnerable Populations After COVID-19 Shelter-in-Place Orders.

This study aims to compare emergency department (ED) utilization and admission rates for patients with a history of mental health (MH) disorders, substance use disorders (SUDs), and social determinants of health (SDOH) before and after implementing COVID-19shelter-in-place (SIP) orders. This was a retrospective, multicenter study leveraging electronic medical record (EMR) data from 20 EDs across a large Midwest integrated healthcare system from 5/2/2019 to 12/31/2019 (pre-SIP) and from 5/2/2020 to 12/31/2020 (post-SIP). Diagnoses were documented in the patient's medical records. Poisson and logistic regression models were used to evaluate ED utilization and admission rate changes. A total of 871,020 ED encounters from 487,028 unique patients were captured. Overall, 2,572 (0.53%) patients had a documented Z code for SDOH. Patients with previously diagnosed MH disorders or SUDs were more likely to seek ED care after the SIP orders were implemented (risk ratio (RR): 1.20, 95% confidence interval (CI): 1.18-1.22, p<0.001), as were patients with SDOH (RR: 2.37, 95% CI: 2.19-2.55, p<0.001). Patients with both previously diagnosed MHdisorders or SUDs and a documented SDOH had even higher ED utilization (RR: 3.31, 95% CI: 2.83-3.88, p<0.001) than those with either condition alone. Patients with MHdisorders and SUDs (OR: 0.89, 95% CI: 0.86-0.92, p<0.001) or SDOH (OR: 0.67, 95% CI: 0.54-0.83, p<0.001) were less likely to be admitted post-SIP orders, while patients with a history of diseases of physiologic systems were more likely to be admitted. Vulnerable populations with a history of MH disorders,SUDs, and SDOH experienced increased ED utilization but a lower rate of hospital admissions after the implementation of SIP orders. The findings highlight the importance of addressing these needs to mitigate the impact of public health crises on these populations.

A265 BARRIERS TO DIETARY MODIFICATION IN INFLAMMATORY BOWEL DISEASE (IBD): A MIXED-METHODS ASSESSMENT OF PATIENT PERCEPTIONS

Abstract Background Many patients living with IBD identify diet as a key factor in managing their disease, symptoms and general health, and many report implementing dietary restrictions in response to disease activity and symptoms. Despite increasing data on the role of diet, IBD patients face a variety of challenges that can compromise adherence to dietary recommendations in clinical practice. Aims To identify IBD patients’ perceptions regarding barriers to dietary modification and to understand their experiences and expectations of dietary advice from gastroenterologists (GI) or dietitians (RD). Methods A mixed-method qualitative data collection strategy with semi-structured focus group and individual one-on-one interviews moderated by a clinical psychologist over a web-based, video communication platform (Zoom). Adult IBD patients (between 18 to 75 years old) attending the McMaster University Medical Centre IBD Clinic were invited to join a focus group consisting of 2-6 individuals or a one-on-one interview. All participants were asked to complete a demographics survey (REDCap) before the session. Recorded audio files for all sessions were transcribed, de-identified and reviewed for accuracy by 2 reviewers with an independent adjudicator to resolve discrepancies followed by thematic analysis (NVIVO). Results Between May to December 2022 and May 2023, 38 of 90 invitees took part in 11 focus groups and 9 chose individual interviews. Most participants (mean age 42 years; 60% female) were Caucasian (87%); 42% had a self-reported history of mental health disorders. Mean IBD duration was 16 years (min-max: 0.5–44 years); 73% were in remission and 68% had Crohn’s disease. Thematic analysis identified 5 primary and 11 secondary barriers to dietary adoption (Table). Participants reported positive and negative experiences with dietary advice from GIs and RDs; expectations included GI referral to a specialist RD and integration of an RD into the health care team. Conclusions IBD patients report multiple, varied barriers to dietary adoption and identify a need for improved access to dietary advice and other resources, including integration of RDs into primary and IBD Clinic care teams. The identification of multiple, varied patient-reported barriers offers an opportunity to develop personalized dietary advice for IBD patients to enhance health, well-being and quality of life. Thematic map of barriers experienced by patients when adopting dietary modifications Funding Agencies Farncombe Family Digestive Health Research Institute; Douglas Family

Incidence of Suicidal Ideation in a Civil Servants Cohort During the COVID-19 Pandemic in Brazil: Insights from the ELSA-Brasil Study.

This study investigated the incidence of suicidal ideation and its associated risk factors in the São Paulo state of ELSA-Brasil cohort during the COVID-19 pandemic. During a pre-pandemic ELSA-Brasil onsite assessment in 2016-2018 (wave 3) and a pandemic online assessment in May-July 2020 (wave COVID), we assessed suicidal ideation using the Clinical Interview Scheduled-Revised (CIS-R). Single and multi predictor logistic regressions were performed using sociodemographic characteristics, household finance impact during pandemic, presence of previous chronic diseases, alcohol abuse, adverse childhood experiences (ACE), living alone, and previous CMD as predictors. Suicidal ideation incidence was used as outcome. Out of 4191 participants of wave 3, 2117 (50.5%) answered wave COVID. There was a threefold increase in suicide ideation, from 34 (1.8%) to 104 (5.6%).In multiple predictor models, we found that previous CMD (OR 7.17; 95% CI 4.43 - 11.58) and ACE (OR 1.72; 95% CI 1.09 - 2.72) increased the odds of incident suicidal ideation. The sociodemographic predictors female sex, younger age and low income were significant risk factors only in the single predictor model. Conclusions These findings underscore the importance of monitoring and supporting individuals who suffered ACE and have a history of mental health disorders. This is especially critical in times of heightened societal stress, such as the COVID-19 pandemic. These findings underscore the importance of monitoring and supporting individuals who suffered ACE and have a history of mental health disorders. This is especially critical in times of heightened societal stress, such as the COVID-19 pandemic.

Utilisation of specialist epilepsy services and antiseizure medication adherence rates in a cohort of people with epilepsy (PWE) accessing emergency care

BackgroundAn epilepsy-related attendance at A&E is associated an increased risk of subsequent death within 6 months. Although further work is required to provide a definitive explanation to account for these findings, in the interim it would seem reasonable that services are designed to ensure timely access and provide support at a time of greatest risk. We aim to determine the frequency of patients accessing specialist neurology services following an epilepsy-related admission/unscheduled care episode and consider ASM adherence at the point of attendance. MethodsPatients were identified retrospectively via the NHS Greater Glasgow and Clyde live integrated epilepsy Dashboard following an unscheduled epilepsy-related admission or A&E attendance between 1st January 2022 and 30th June 2022. We calculated adherence to anti-seizure medication for a period of 6 months prior to admission and defined poor medication adherence as a medication possession ratio of less than 80 %. We evaluated the rate of any outpatient neurology clinic attendance in the subsequent 3, 6 and 12 months following an epilepsy-related unscheduled care episode. Additional clinical information was identified via the electronic patient records. ResultsBetween 1st Jan 2022 and 30th June 2022, there were 266 emergency care seizure-related attendances. The mean age at attendance was 46 years (range: 16–91). Most of PWE were males (63 %) and 37 % were females.Epilepsy classification-29.3 % had GGE, 41.7% had focal epilepsy, and in 29 % of cases the epilepsy was unclassified.Of the admissions, 107/ 266 (40.2 %) generated follow-up within 6 months of attendance. Poor medication adherence was noted in 54/266 (20.3 %). 28.2 % of cases had input from on-call neurology service during admission/ED attendance, and of those 60 % had ASM adjusted.18 % of attendances had a background diagnosis of learning disability. One-third of attendances of PWE had a history of mental health disorder 35 % (93/266). 25 % of ED attendances noted an active history of alcohol consumption misuse or/and recreational drug use.14 (5.5 %) of PWE died during the period of interest (12 months following the last ED visit). In 6/14 (42.3 %) death was associated with poor medication adherence. ConclusionThis study demonstrates that a significant proportion of patients who experienced seizure-related admissions/ attendance did not access specialist neurology services in a timely manner. In addition, poor medication adherence remains a problem for a substantial number of people living with epilepsy. Early access to specialist services may go some way to improving care and reducing excessive mortality in PWE by allowing anti-seizure medication to be titrated and poor medication adherence to be addressed in those at greatest risk.

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.

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.

POSTPARTUM DEPRESSION AND ANXIETY: A COMMUNITY-BASED STUDY ON RISK FACTORS BEFORE, DURING AND AFTER PREGNANCY

Postpartum anxiety and depression are a significant public health concern as it is the leading cause of maternal morbidity. It is associated with adverse effects on the cognitive and social development of the infant. The primary aim of the study is to find postpartum depression and anxiety as a community-based study on risk factors before, during, and after pregnancy. The prospective cohort study was conducted in Khyber Teaching Hospital Peshawar from April 2023 to July 2023. A total of 320 pregnant women were recruited for this study. Participants were enrolled during their antenatal visits to healthcare facilities within the community, ensuring representation across diverse demographic and socio-economic backgrounds. Data collection for this community-based study on postpartum depression and anxiety was executed meticulously across three distinct phases: before, during, and after pregnancy. Data was collected from 320 pregnant females. The mean age of participants was 28.5±4.2 years. Most participants had at least a high school education (65%) and reported a moderate household income (55%). 18% of participants had a history of previous episodes of depression or anxiety. 35% reported experiencing significant life stressors before pregnancy, with financial concerns being the most common (62%). 24% had a family history of mental health disorders. It is concluded that this study has revealed a significant prevalence of postpartum depression (22%) and anxiety (18%) among participants. The identified risk factors, including prior mental health history and high prenatal stress, emphasize the need for early intervention and targeted support systems during the perinatal period.

Abstract 12291: Impact of History of Mental Health Disorder on In-Hospital Mortality in Patients With Heart Failure. A Population-Based Cohort Study

Introduction: Mental health disorders are associated with lower life expectancy and patients with mental disorders are at an increased risk of heart failure. Data on the prognostic impact of mental disorders on heart failure outcomes is limited and inconclusive. Hypothesis: Mental health disorders are associated with increased risk of in-hospital mortality in patients with heart failure. Methods: The study population were patients aged ≥18 years in acute care hospitals with heart failure as principal diagnosis in Texas for years 2016 through 2021. Three prespecified models were applied to estimate the association between mental disorders and in-hospital mortality. Multilevel, multivariable logistic regression with propensity adjustment was the primary analysis approach with propensity score matching and multivariable logistic regression without propensity adjustment applied as alternative analyses. Additional analyses were completed for patient subgroups, categories of mental disorders, and classifications of heart failures. Results: Out of 513,565 heart failure hospitalizations, 103,675 (20.2%) had mental disorders. Heart failure hospitalizations with vs without mental disorders were more commonly female (61.3% vs 46.0%), white (55.3% vs 46.9%), and obese (31.6% vs 26.4%), but had less frequent need for mechanical ventilation (1.8% vs 2.1%); p &lt; 0.0001 for each. Unadjusted in-hospital mortality among heart failure hospitalizations with and without mental disorders was 1.7% vs 2.2%. On adjusted analyses, mental disorders remained associated with lower odds of in-hospital mortality (adjusted odds ratio 0.8650 [95% CI 0.8149-0.9183]). The results were similar for the alternative modeling approaches, subgroup analyses, and classifications of heart failure. Conclusion: Mental disorders were associated with substantially lower risk of in-hospital mortality for patients with a principal diagnosis of heart failure.

Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario

Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.

Mental health literacy of undergraduate radiography students in Zimbabwe

IntroductionL'évaluation de la connaissance de la santé mentale (CSM) des étudiants est cruciale pour comprendre les lacunes en matière de connaissances sur la santé mentale, la stigmatisation, les croyances erronées, les facteurs de risque et les comportements de recherche de traitement. L'objectif de cette étude était d'utiliser une échelle validée pour examiner la CSM des étudiants en radiographie dans un établissement d'enseignement supérieur à Harare, au Zimbabwe. MéthodologieUne enquête descriptive transversale a été menée pour évaluer la CSM des étudiants en radiographie dans un établissement tertiaire de Harare, au Zimbabwe, à l'aide d'une échelle CSM validée. Des tests t individuels et des analyses de variance (ANOVA) ont été effectués pour chaque variable afin d'examiner les différences entre les groupes censés différer dans leur CSM. RésultatsLe score moyen global de CSM était de 96,62 (écart-type 9,55), les étudiants étant moins bien informés sur les facteurs environnementaux, sociaux, familiaux ou biologiques qui augmentent le risque de développer une maladie mentale. Le sexe n'a pas eu d'effet statistiquement significatif sur le score global, t(83) = -0,81, p = 0,42 [M Hommes = 95,64, ET Hommes = 10,14; M Femmes = 97,35, ET Femmes = 9,12]. Cependant, il y avait une différence significative dans la connaissance de la phobie sociale en fonction du sexe, t(87) = -1,95, p = 0,05, les étudiantes (M = 3,33, ET = 0,62) obtenant un score plus élevé que les étudiants (M = 3,05, ET = 0,73). En ce qui concerne la reconnaissance des troubles de la personnalité, les étudiants ayant des antécédents de troubles mentaux ont obtenu des scores plus élevés (M = 3,5, ET = 0,53) que ceux qui n'avaient pas d'antécédents (M = 2,90, ET = 0,78). ConclusionLe programme d'études devrait être développé pour aider les étudiants en radiographie de premier cycle à être plus conscients de la santé mentale et à chercher du soutien.

The Differential Effect of Oxytocin on Mindfulness in People with Different Resilience Level

ObjectivesMindfulness skills have been shown to be an important attribute for mental and general well-being. The neurohormone oxytocin and resilience are established biological and psychological factors that are associated with mindfulness. This study aimed to elucidate the interaction of resilience and oxytocin levels as independent variables to predict mindfulness facets in university students.MethodParticipants (n = 96) were university students in Hong Kong who previously participated in a resilience study with no history of mental health disorders or substance abuse. Mindfulness and resilience were measured using the Chinese versions of the Five Facet Mindfulness Questionnaire and the Connor-Davidson Resilience Scale, respectively. Saliva samples were collected to measure oxytocin levels using an enzyme-linked immunosorbent assay kit. A moderator analysis was conducted to assess the associations between oxytocin levels (predictor) and the five facets of mindfulness (outcomes) under the moderation effect of resilience (moderator).ResultsThe interaction between oxytocin and resilience levels predicted the nonreactivity facet of mindfulness. Specifically, oxytocin levels significantly and positively predicted nonreactivity in participants with low or moderate resilience levels, but not in those with high resilience.ConclusionThis study showed the influence of oxytocin levels on mindfulness was significant only in participants with low or moderate resilience, suggesting that oxytocin might act on other factors instead of influencing mindfulness in individuals with high levels of resilience.Pre-registrationThis study is not pre-registered.

The Association of Perceived Labor Agentry and Depression and/or Anxiety.

Pregnancies complicated by perinatal mood disorders or a history of mental health disorder are at increased risk for complications including postpartum depression/anxiety. Patients' perceived control over childbirth is known to be an important factor for development of postpartum depression/anxiety. It is unclear whether women with preexisting and/or current depression and/or anxiety have different perceptions of control during childbirth compared with those without these comorbidities. This study aimed to evaluate the association between a current and/or prior diagnosis of depression and/or anxiety and scores on the Labour Agentry Scale (LAS), a validated tool evaluating patient's experience of control over their labor and delivery. This is a cross-sectional study of nulliparous patients admitted at term to a single center. Participants completed the LAS after delivery. A trained researcher performed detailed chart reviews for all participants. Participants were identified as having a current or historical diagnosis of depression/anxiety by self-report confirmed by chart review. Scores on the LAS were compared between those with versus without a diagnosis of depression/anxiety prior to admission for delivery. A total of 73 (44.8%) of the 149 participants held a current and/or prior diagnosis of depression and/or anxiety. Baseline demographics were similar between those with and without depression/anxiety. Mean scores on the LAS (range: 91-201) were significantly lower for those with depression/anxiety than those without a prior diagnosis (150.0 vs. 160.5, p < 0.01). Even after controlling for mode of delivery, admission indication, anesthesia, and Foley balloon usage, participants with anxiety and depression had scores that were on average 10.4 points lower on the LAS (95% confidence interval: -19.25, -1.62). Participants with a current and/or prior diagnosis of depression and/or anxiety scored lower on the LAS as compared with those without psychiatric diagnoses. Patients with psychiatric diagnoses may benefit from increased education and support during childbirth. · Control over childbirth is an important factor in the development of postpartum depression/anxiety.. · Patients with a prior or current diagnosis of anxiety and depression have lower labor agentry scores.. · These differences remained significant even when controlling for confounders such as delivery mode..

Factors associated with common mental disorders among breastfeeding mothers in tertiary hospital nurseries in Nigeria.

Several studies have shown that the impact of maternal mental health disorders on newborns' well-being in low and middle-income countries (LMIC) are underreported, multi-dimensional and varies over time and differs from what is reported in high-income countries. We present the prevalence and risk factors associated with common mental disorders (CMDs) among breastfeeding mothers whose infants were admitted to Nigerian tertiary care facilities. This was a national cross-sectional study involving mothers of hospitalised babies from eleven Nigerian tertiary hospitals. We used the WHO self-reporting Questionnaire 20 and an adapted WHO/UNICEF ten-step breastfeeding support package to assess mothers' mental health and breastfeeding support. Only 895 of the 1,120 mothers recruited from eleven tertiary healthcare nurseries in six geopolitical zones of Nigeria had complete datasets for analysis. The participants' mean age was 29.9 ± 6.2 years. One in four had CMDs; 24.0% (95% CI: 21.235, 26.937%). The ages of mothers, parity, gestational age at delivery, and length of hospital stay were comparable between mothers with and those without CMDs. Antenatal care at primary healthcare facilities (adjusted odds ratio [aOR:13], primary education [aOR:3.255] living in the south-southern region of the country [aOR 2.207], poor breastfeeding support [aOR:1.467], polygamous family settings [aOR:2.182], and a previous history of mental health disorders [aOR:4.684] were significantly associated with CMDs. In contrast, those from the middle and lower socioeconomic classes were less likely to develop CMDs, with [aOR:0.532] and [aOR:0.493], respectively. In Nigeria, the prevalence of CMDs is relatively high among breastfeeding mothers with infants admitted to a tertiary care facility. Prior history of mental illness, polygamous households, mothers living in the southern region and low or no educational attainment have a greater risk of developing CMDs. This study provides evidence for assessing and tailoring interventions to CMDs among breastfeeding mothers in neonatal nurseries in LMIC.

Suicidal ideation following self-reported COVID-19-like symptoms or serology-confirmed SARS-CoV-2 infection in France: A propensity score weighted analysis from a cohort study.

A higher risk of suicidal ideation associated with self-report of Coronavirus Disease 2019 (COVID-19)-like symptoms or COVID-19 infection has been observed in cross-sectional studies, but evidence from longitudinal studies remains limited. The aims of this study were 2-fold: (1) to explore if self-reported COVID-19-like symptoms in 2020 were associated with suicidal ideation in 2021; (2) to explore if the association also existed when using a biological marker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in 2020. A total of 52,050 participants from the French EpiCov cohort were included (median follow-up time = 13.7 months). In terms of demographics, 53.84% were women, 60.92% were over 45 years old, 82.01% were born in mainland France from parents born in mainland France, and 59.38% completed high school. COVID-19-like symptoms were defined as participant report of a sudden loss of taste/smell or fever alongside cough, shortness of breath, or chest oppression, between February and November 2020. Symptoms were self-reported at baseline in May 2020 and at the first follow-up in Autumn 2020. Serology-confirmed SARS-CoV-2 infection in 2020 was derived from Spike protein ELISA test screening in dried-blood-spot samples. Samples were collected from October 2020 to March 2021, with 94.4% collected in 2020. Suicidal ideation since December 2020 was self-reported at the second follow-up in Summer 2021. Associations of self-reported COVID-19-like symptoms and serology-confirmed SARS-CoV-2 infection in 2020 with suicidal ideation in 2021 were ascertained using modified Poisson regression models, weighted by inverse probability weights computed from propensity scores. Among the 52,050 participants, 1.68% [1.54% to 1.82%] reported suicidal ideation in 2021, 9.57% [9.24% to 9.90%] had a serology-confirmed SARS-CoV-2 infection in 2020, and 13.23% [12.86% to 13.61%] reported COVID-19-like symptoms in 2020. Self-reported COVID-19-like symptoms in 2020 were associated with higher risks of later suicidal ideation in 2021 (Relative Riskipw [95% CI] = 1.43 [1.20 to 1.69]), while serology-confirmed SARS-CoV-2 infection in 2020 was not (RRipw = 0.89 [0.70 to 1.13]). Limitations of this study include the use of a single question to assess suicidal ideation, the use of self-reported history of mental health disorders, and limited generalizability due to attrition bias. Self-reported COVID-19-like symptoms in 2020, but not serology-confirmed SARS-CoV-2 infection in 2020, were associated with a higher risk of subsequent suicidal ideation in 2021. The exact role of SARS-CoV-2 infection with respect to suicide risk has yet to be clarified. Including mental health resources in COVID-19-related settings could encourage symptomatic individuals to care for their mental health and limit suicidal ideation to emerge or worsen.

Identification of risk factors for post-intensive care syndrome in family members (PICS-F) among adult patients: a systematic review.

Relatives of critically ill patients who either die or survive the intensive care unit (ICU) may develop substantial mental health problems that are collectively defined as post-intensive care syndrome in family (PICS-F). By using a systematised search strategy we included studies that focused on PICS-F in relatives of adult ICU patients and reported the risk factors associated with its development. The search was conducted within PubMed, Embase, SCOPUS, clinicaltrials.gov, and Cochrane Library on the 23 August 2022. PRISMA 2020 guidelines were implemented for appropriate reporting. The objective was to document all possible risk factors associated with the development of PICS-F. We included 51 papers covering 9302 relatives. The frequency of PICS-F varied between 2.5 and 69%. We identified 51 different risk factors of PICS-F, among which we distinguished patient-related ( n = 16), relative-related ( n = 27), and medical staff-related ( n = 8) risk factors. Among 21 studies of the highest quality, we identified the 33 variables associated with the development of PICS-F, of which younger age of a patient, death of a patient, depression in relatives during the ICU stay, history of mental disorders in relatives, being a female relative, being a spouse, and having low satisfaction with communication and care in the ICU were the most commonly reported risk factors. PICS-F is a highly frequent phenomenon that can be exacerbated by several risk factors. Special attention should be paid to relatives of younger patients with worse prognosis and with the following relative-related risk factors: female sex, being a spouse, and history of mental health disorders. Finally, the medical staff play a role in preventing the PICS-F development, not only by maintenance of proper communication, but also by early identification of relatives prone to PICS-F.

Social Support and Mental Health in the Postpartum Period in Times of SARS-CoV-2 Pandemic: Spanish Multicentre Cohort Study

To explore the depression and anxiety symptoms in the postpartum period during the SARS-CoV-2 pandemic and to identify potential risk factors. A multicentre observational cohort study including 536 women was performed at three hospitals in Spain. The Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Postpartum Bonding Questionnaire (PBQ) were assessed after birth. Depression (EPDS) and anxiety (STAI) symptoms were measured, and the cut-off scores were set at 10 and 13 for EPDS, and at 40 for STAI. Regarding EPDS, 32.3% (95% CI, 28% to 36.5%) of women had a score ≥ 10, and 17.3% (95% CI, 13.9% to 20.7%) had a score ≥ 13. Women with an STAI score ≥ 40 accounted for 46.8% (95% CI, 42.3% to 51.2%). A lower level of social support (MOS-SSS), a fetal malformation diagnosis and a history of depression (p = 0.000, p = 0.019 and p = 0.043) were independent risk factors for postpartum depression. A lower level of social support and a history of mental health disorders (p = 0.000, p = 0.003) were independent risk factors for postpartum anxiety. During the SARS-CoV-2 pandemic, an increase in symptoms of anxiety and depression were observed during the postpartum period.

NCOG-12. IMPACT OF TUMOR-RELATED SEIZURES ON MENTAL HEALTH DISORDER ORDER IN LOW-GRADE GLIOMA

Abstract INTRODUCTION Majority of LGG patients experience seizures during their disease course, requiring anti-epileptic drugs (AEDs). Frequent seizures negatively impact health-related quality of life (HRQoL). AEDs, moreover, are hypothesized to have mood-modulating effects. As survival for LGG patients has been improving, it is essential that the impact of seizure burden and AEDs on mental health disorders (MHD) be considered. The objective was to measure an association of tumor-related seizures with MHD onset among LGG patients. METHODS This retrospective cohort study queried data from the IBM Watson Health MarketScan® Claims and Encounters Database (2005-2014) to identify LGG patients without prior MHD history who experienced glioma-related seizures. Presence of seizures was determined by anti-epileptic drug fills within one year following LGG diagnosis. Patients with new onset of MHDs were identified using ICD-9 codes for MHDs and psychotropic drug fills in the 12 months post-LGG diagnosis period. Unadjusted odds ratios measured associations between seizures and MHD prevalence. RESULTS 11,458 LGG patients with no history of MHD were included; 1,799 (15.7%) experienced seizures within 12 months of LGG diagnosis. Among them, 494 (27.5%) developed MHD in the post-LGG diagnosis period. Patients who experienced seizures were more likely to develop an MHD compared to patients who did not (OR, 2.19, 95% CI, 1.95–2.47). MHD incidence was significantly associated with female gender (OR, 1.14, 95%, 1.03–1.26) and age range of 35–44 (OR, 1.20, 95%, 1.03–1.39) compared to 18–34. CONCLUSION These findings demonstrated that tumor-related seizures were associated with MHD onset. This highlights the burden of seizures and regular AED use on mental health. The psychosocial and neurological aspects related to seizures and AEDs likely contribute to the multifaceted mental health disorder onset seen among these LGG patients. Proactive counseling, diagnosis, and management of MHDs in LGGs, particularly those with seizures, is warranted.

Residential parenting services: An integrative literature review of characteristics, service usage and parent and staff perspectives.

The primary aim of the review was to provide an overall assessment of residential parenting services in Australia, by describing the characteristics of infants and parents using residential parenting services, their prior service use and reasons for admission, referral pathways for access and parenting and infant outcomes. The secondary aims were to explore parent and staff perception of the programmes. An integrative literature review. A systematic and comprehensive search of health and social sciences databases was conducted for studies related to residential parenting services (published between 1st January 1990-31st December 2019). Six hundred and eleven peer-reviewed papers were identified, after which 301 duplicates were removed and an additional 256 papers excluded after titles/abstracts were read. Of the remaining 54 abstracts/papers, a further 14 were omitted as not relevant. Forty papers were independently reviewed by four authors. ENTREQ and MOOSE checklists were applied. Thirty studies were quantitative, nine were qualitative, and one was mixed methods. All studies originated from in Australia. Women and babies admitted to residential parenting services were found more likely to be: older, Australian born, from higher socio-economic groups, and first-time mothers, and having labour and birth interventions and a history of mental health disorders. The babies were more likely to be twins, male and admitted with sleep disorders and dysregulated behaviour. Studies reporting postintervention outcomes demonstrated improvements to maternal mental health, breastfeeding, parenting confidence and sleep quality, and infant sleeping and behaviour.

Telephone-based cognitive behavioural therapy for patients with postoperative bariatric surgery to manage COVID-19 pandemic-related mental health issues and distress (TELE-BARICARE): a protocol for a randomised controlled trial

IntroductionBariatric surgery is currently the most effective treatment for obesity, and is performed yearly in over 8000 patients in Canada. Over 50% of those who live with obesity also have...

Why is it so hard to do the right thing? Reflections on the fourth trimester

Why is it so hard to do the right thing? Reflections on the fourth trimester