Integrated Care Approach Research Articles

Understanding Major Depressive Disorder in Singapore: Insights from the second Singapore Mental Health Study (SMHS 2016)

BackgroundMajor Depressive Disorder (MDD) poses significant public health challenges globally and in Southeast Asia, with substantial impairment and disease burden. Understanding its prevalence and associated risk factors is crucial for effective intervention. MethodsThis study aims to describe the prevalence shifts, correlates, and comorbidities of MDD in Singapore. Data were collected from the second Singapore Mental Health Study (SMHS 2016), a national cross-sectional survey comprising 6126 adult residents. The WHO Composite International Diagnostic Interview assessed MDD and comorbidities. Statistical analyses, including logistic regression, were conducted to examine the associations and trends. ResultsThe lifetime weighted prevalence of MDD in SMHS 2016 was 6.2 %, with an overall increase from 5.8 % in 2010. Significant associations were found between MDD and age, marital status, and comorbid physical disorders. Young adults and divorced/separated individuals exhibited higher MDD prevalence. Chronic pain was significantly associated with MDD. LimitationsThe study's cross-sectional design limits causal inference, and selective non-response might affect prevalence estimates. However, the study benefits from a large, nationally representative sample and standardized methodologies. ConclusionsYoung and middle-aged adults, and divorced/separated individuals demonstrate elevated MDD prevalence, warranting targeted interventions. Individuals with comorbidities, particularly chronic pain, constitute a high-risk and vulnerable population. Comprehensive assessment and treatment plans should involve multidisciplinary teams and integrated care approaches to better address the complex needs of these individuals. Our study also highlights specific interventions for schools, families, communities, and workplaces. Despite Singapore's relatively low prevalence compared to Western nations, MDD remains cross-culturally valid emphasizing the need for early intervention and preventive public health measures.

Assessing the Burden of Anemia in Non-Communicable Diseases at a Tertiary Care Center: A Cross-Sectional Study

Background: Anemia is a prevalent global health issue, significantly affecting patients with non-communicable diseases (NCDs) like Type 2 Diabetes Mellitus (Type 2 DM), Hypertension (HTN), and Coronary Artery Disease (CAD). This study assessed the burden of anemia in patients with Type 2 DM, HTN, and CAD, and to identify its prevalence, types, and association with these chronic diseases. Methods: A cross-sectional study was carried out, involving 250 patients diagnosed with Type 2 DM, HTN, and CAD. Patients were categorized as anemic based on WHO criteria: males with Hb < 13 gm% and females with Hb < 12 gm%. Data were collected through a structured questionnaire. Laboratory investigations included Hb, serum creatinine, MCV, MCHC, and reticulocyte count. Statistical analysis was accomplished using chi-square tests and logistic regression to examine associations between anemia and NCDs. Results: Anemia was prevalent in 80% of the study population, with normocytic anemia being the most common type (45%). Significant correlations were found between anemia and Type 2 DM (p=0.036), HTN (p=0.032), and CAD (p=0.013). Anemic patients had significantly lower Hb levels and MCHC, and higher serum creatinine and reticulocyte counts compared to non-anemic patients. Conclusion: The study highlights a high prevalence of anemia among patients with NCDs, indicating a critical need for routine screening and integrated management of anemia in this population. Addressing anemia could improve clinical outcomes and enhance the quality of life for individuals with chronic diseases. Recommendations: Healthcare providers should implement regular anemia screening for patients with NCDs and adopt integrated care approaches that address both chronic diseases and anemia. Further research is needed to explore the underlying mechanisms linking anemia and NCDs and to develop targeted interventions. Keywords: Anemia, Non-Communicable Diseases, Type 2 Diabetes Mellitus, Hypertension, Coronary Artery Disease..

Anaemia and Chronic Kidney Disease: A Brief Review on the Direction of Their Relationship

Chronic kidney disease (CKD) is a significant global health concern, affecting approximately 10% of the adult population worldwide. Anaemia is the common complication in CKD, which severely impacts patient quality of life and increases the risk of cardiovascular complications. The primary cause of anaemia in CKD patients is insufficient production of erythropoietin (EPO), a hormone essential for red blood cell production, due to impaired kidney function. Other contributing factors include disruptions in iron metabolism, chronic inflammation, and elevated hepcidin levels, which hinder iron absorption and availability. Anaemia exacerbates symptoms such as fatigue, weakness, and cognitive impairment in CKD patients, significantly diminishing their daily functioning and overall well-being. Effective management of anaemia in CKD patients necessitates a comprehensive approach involving regular monitoring of haemoglobin and iron levels, timely administration of treatments such as EPO and intravenous iron, and addressing underlying causes. This review provides an overall overview of the pathophysiological connections, clinical implications, diagnosis, and management strategies for anaemia in CKD patients, highlighting the need for ongoing research and integrated care approaches.

The BigMove Intervention for People With Physical and Mental Health Conditions: A First Evaluation of Self-Perceived Health, Quality of Life, Coping and Mental and Social Functioning.

The BigMove intervention aims to improve the functioning and quality of life of people with physical and mental health conditions via an integrated care approach. This pilot study evaluates the impact of the intervention on self-perceived health (SPH), quality of life (QoL), active coping behaviour, and mental and social functioning. Data were analysed from N = 457 participants who had been referred to the intervention by their general practitioner (mean age 48.98 years; 76% female). Three patient-reported and one clinician-rated measures were used: SPH, QoL (MANSA), active coping behaviour (UPCC-ACT), mental and social functioning (HoNOS). Pre- and post-intervention measurements (from 2011 to 2018) were compared using paired-samples t-tests. Due to missing data, analyses were conducted with 205-257 participants per completed outcome. Associations with age and sex were assessed using repeated-measures ANOVA. Clinically relevant change was evaluated with the Edwards-Nunnally index and standard error of measurement (SEM) scores. Post-intervention, there were statistically significant improvements for all outcomes (p < 0.0001) with moderate to large effect sizes (d = 0.41 to 1.02). The observed changes in outcomes can be considered as clinically relevant improvements. This pilot study provides preliminary evidence that the intervention has positive effects on SPH, QoL, active coping behaviour, and mental and social functioning.

Optimizing Orthogeriatric Hip Fracture Care: Why Fracture Type Matters

Hip fractures significantly impact morbidity and mortality among frail older adults, posing ongoing challenges in orthogeriatric care despite significant advancements. Established in the 1960s by Devas and Irvine, this field integrates orthopedics, trauma services, and geriatric medicine to address the complex needs of this population comprehensively. A critical and underexplored aspect is the precise identification and tailored treatment of various fracture types, each linked to unique clinical challenges and outcomes. This special article emphasizes the complex interplay between specific fracture types, their management options, and the roles of comorbidity and polypharmacy, highlighting the essential role of orthogeriatricians. Orthogeriatricians navigate the complexities posed by comorbidities, frailty, and polypharmacy, significantly influencing treatment outcomes. Their roles have expanded to include decision making about both operative and nonoperative strategies, emphasizing patient-centered care and moving beyond simplistic categorizations of “hip fractures.” As future experts on the nuances of fracture types and their broader health implications, orthogeriatricians are also crucial in advancing treatment protocols that address preoperative and postoperative needs. Their comprehensive knowledge ensures effective in-hospital management and postdischarge planning, aligning treatment strategies with the holistic needs of frail older adults. The ongoing evolution of orthogeriatric practices promises to enhance decision-making and patient outcomes through a more informed and integrated care approach.

Periodontitis in Psoriatic Patients: Epidemiological Insights and Putative Etiopathogenic Links.

Psoriasis, a systemic autoimmune disorder primarily affecting the skin, manifests through erythematous plaques and scales, impacting approximately 2-3% of the global population. Chronic periodontitis, a prevalent oral disease characterized by the destruction of tooth-supporting tissues, affects roughly 10-15% of adults worldwide. Emerging evidence suggests a bidirectional relationship between psoriasis and chronic periodontitis, supported by epidemiological studies indicating a higher prevalence of periodontitis among individuals with psoriasis and vice versa. Both conditions are chronic inflammatory diseases marked by dysregulated immune responses and altered cytokine profiles, notably involving proinflammatory cytokines such as TNF-α and IL-17. Clinical studies highlight a reciprocal impact of treating one condition on the other, underscoring the necessity of interdisciplinary collaboration between dermatologists and periodontists in managing patients with both conditions. This narrative review provides a comprehensive overview of the relationship between psoriasis and chronic periodontitis, examining epidemiological associations, shared inflammatory pathways, genetic insights, microbial dysbiosis, environmental factors, and clinical implications. The review emphasizes the importance of integrated care approaches and the potential for targeted therapeutic interventions to improve both psoriatic and periodontal patient outcomes, advocating for further research into the molecular and cellular mechanisms underpinning the comorbidity of these diseases.

The Brain-Heart Axis: An Umbrella Review on Impact of Psychiatric Disease on Incidence, Management, and Outlook of Cardiovascular Disease.

Psychiatric conditions, such as depression, anxiety, bipolar disorder, and schizophrenia, are increasingly recognized as significant risk factors for cardiovascular disease (CVD). This review systematically analyzes evidence from various databases to provide a comprehensive understanding of the impact of psychiatric illnesses on the incidence, management, and prognosis of CVD. Key findings suggest a bidirectional relationship between psychiatric disorders and CVD, indicating that mental health conditions can predispose individuals to CVD, while CVD can exacerbate or trigger psychiatric symptoms. The review explores the underlying mechanisms of these associations, including behavioral factors, stress responses, and medication side effects. It also examines the challenges in managing CVD patients with comorbid psychiatric conditions, emphasizing the importance for integrated care approaches. This review underscores the necessity of considering mental health as an integral component of cardiovascular care and calls for further research to develop tailored management strategies for these complex conditions, ultimately aiming to improve patient outcomes and quality of life. This comprehensive analysis provides valuable insights for future investigations and guides clinicians in optimizing care for patients with both psychiatric and cardiovascular conditions.

Goal Setting for Participatory Person-Centered Geriatric Rehabilitation-From Function-Centered Rehabilitation towards Digitally Supported Personalized and Integrated Care for Older People.

As chronic illness is common among older people, self-care practices for older people are needed to control health status, to prevent possible complications and to ensure optimal quality of life. The literature has demonstrated that integrated care approaches are one key success factor for delivering person-centered and sustainable care for older people, with rehabilitation being a cornerstone in tertiary care prevention for older citizens. The current paper addresses the state of the literature for person-centered geriatric rehabilitation (GR) and the importance of personalized and participatory goal setting. In accordance with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), social participation and the related goals are of particular importance for the entire rehabilitation process. The social participation of individuals enrolled into GR is therefore one of the milestones to be achieved during GR. Personalized goal setting during the entire rehabilitation process, Comprehensive Geriatric Assessment (CGA) and shared decision making allow a comprehensive care approach separate from solely function-based rehabilitation. The review also focusses on recent developments in digitalization in healthcare and delivers insights into how healthcare professionals' collaborative practice supports sustainable rehabilitation results in patients of advanced chronological age.

Diabetic retinopathy incidence, predictors and its association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia: joint model.

Diabetes mellitus (DM) is a global public health problem characterized by an elevated blood glucose level. Monitoring blood sugar levels is vital for effective diabetes management and preventing complications. However, the association between longitudinal biomarkers and the incidence of diabetic complications is often overlooked. Therefore, this study aimed to assess the incidence of diabetic retinopathy, predictors, and association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia. A multicenter retrospective follow-up study was carried out in referral hospitals in Amhara region, Ethiopia. A random sample of 462 newly diagnosed DM patients was selected. The proportional hazard assumption was checked for the survival sub-model, and for the longitudinal sub-model, the normality assumption was checked. Then the joint modeling with time-dependent lagged parameterizations was fitted. Model assumptions and comparisons were checked. Finally, the hazard ratio with a 95% confidence interval (CI) with a corresponding P-value<0.05 was used to identify predictors. In this study, Overall, 54 patients developed DR, and the incidence rate was 2.33 per 1000 person-months over the follow-up period, with a 95% CI of [1.78, 3.05]. Rural residence (AHR = 2.21, 95% CI: [1.21, 4.05]), hypertension co-morbidity (AHR = 3.01, 95% CI: [1.85, 6.53]), and longer duration of DM (>5 years) (AHR = 2.28, 95% CI: [1.91, 5.15]) were important predictors for the incidence of DR. In addition, the incidence of DR was substantially correlated with the time-dependent lagged value of FBS change (AHR = 4.20, 95% CI [1.62, 10.85]). In this study, the incidence of diabetic retinopathy was somewhat high when compared to prior similar studies in Ethiopia. A joint model of longitudinal fasting blood sugar level changes was significantly associated with an increased risk of DR. Besides, being rural residence, hypertension co-morbidity, and a longer duration of DM were significant predictors for the incidence of DR. Therefore, public awareness, an integrated care approach, and prioritizing glycemic control are highly recommended.

Implementation of an atrial fibrillation better care (ABC) pathway management strategy: Findings from the Iranian registry of atrial fibrillation

IntroductionThe Atrial Fibrillation Better Care (ABC) pathway is such an integrated care approach, recommended in guidelines. The aim of this service evaluation study was to evaluate the impact of implementing the ABC pathway in Iranian population. MethodsIn this prospective longitudinal cohort study, consecutive patients with a diagnosis of AF were initially evaluated. Patients at baseline were evaluated in hence of adherence to ABC pathway strategy. After study enrolment, first and second follow-up service evaluations were conducted at 6 and 12 months, respectively. ResultsThe use of vitamin K antagonists (VKA) decreased from 25.1 % at enrolment to 13.8 % at follow-up; instead, non-VKA oral anticoagulants (NOAC) utilization increased from 40.0 % to 86.1 %, while antiplatelet treatment decreased from 34.9 % to 0 %. Use of antihypertensive drugs, ARBs, diuretics, and statins increased after implementation of the ABC pathway. Implementation of the ABC pathway approach led to a decrease in the occurrence of stroke/TIA (from 6.3 % to 2.2 %, p = 0.002), systemic thromboembolism (from 1.4 % to 0.0 %, p = 0.04), nose bleeds (from 0.8 % to 0.6 %, p = 0.04), skin bruising (from 1.2 % to 0.0 %, p = 0.002), and heart failure (from 7.7 % to 4.7 %, p = 0.04). The proportion of patients in EHRA Class I-II increased from 93.3 % at enrolment to 98.1 % at follow-up. ConclusionIn this first study from a Middle East population, compliance with ABC pathway strategy in the management of AF was associated with optimization of management and general improvements in patient outcomes during follow-up.

STUDY OF THE LONG-TERM EFFECTS OF DIABETES ON THE OVERALL HEALTH AND QUALITY OF LIFE IN THALASSEMIA PATIENTS

Thalassemia is a genetic blood disorder characterized by chronic anemia, requiring regular blood transfusions and chelation therapy. Diabetes mellitus is a common complication in thalassemia patients, primarily due to iron overload affecting the pancreas. This study investigates the long-term effects of diabetes on the overall health and quality of life in thalassemia patients. The research aims to understand how diabetes exacerbates complications associated with thalassemia and to identify strategies for improved management and care. The study includes a cohort of thalassemia patients with diabetes, compared to a control group of thalassemia patients without diabetes. Parameters assessed include glycemic control, incidence of diabetes-related complications, and overall health markers such as liver function, cardiovascular health, and renal function. Quality of life is measured using standardized questionnaires addressing physical, emotional, and social well-being. Preliminary findings indicate that thalassemia patients with diabetes have a significantly higher incidence of comorbid conditions, including cardiovascular disease and renal impairment (De Sanctis et al., 2016). Additionally, the quality of life in these patients is notably lower, with increased reports of fatigue, pain, and psychological distress (Haines et al., 2013). Effective management of diabetes in thalassemia patients, through regular monitoring and tailored treatment plans, is crucial in mitigating these adverse effects and improving patient outcomes (Farmaki et al., 2006). This study underscores the importance of integrated care approaches for thalassemia patients with diabetes, emphasizing the need for multidisciplinary teams to address the complex interplay of these conditions. Further research is needed to develop targeted interventions that can enhance the long-term health and quality of life for this vulnerable patient population. Results: study indicated that plant extracts exhibited higher inhibition than antibiotics. The minimum inhibitory concentration (MIC) while the results of the lowest inhibitory concentration of carvacrol for the bacterial species under study showed that it had an effect at a concentration of 615 µg/ml against Escherichia coli, 307.5 µg/ml for the species Corynebacterium stratium, Morganella morganii and Pseudomonas aeruginosa, and the least effect was 76.875 µg/ml on Staphylococcus aureus, it gave less results than the antibiotic used Carvacrol (Absorbance was measured at Wavelength 600) .

Bidirectional Relationships between Sarcopenia and Pelvic Floor Disorders.

Sarcopenia and pelvic floor disorders (PFDs) are prevalent and often cooccurring conditions in the aging population. However, their bidirectional relationship and underlying mechanisms remain underexplored. This narrative review aims to elucidate this relationship by exploring potential causative interplays, shared pathophysiological mechanisms, and common risk factors. A comprehensive literature search was conducted to identify relevant studies focusing on epidemiological associations, interaction mechanisms, and implications for patient care. While epidemiological studies demonstrate associations between sarcopenia and PFDs, our findings reveal a cyclical relationship where sarcopenia may exacerbate PFDs through mechanisms such as decreased muscle strength and mobility. Conversely, the presence of PFDs often leads to reduced physical activity due to discomfort and mobility issues, which in turn exacerbate the muscle atrophy associated with sarcopenia. Additionally, shared risk factors such as physical inactivity, nutritional deficiencies, metabolic syndrome, and menopausal hormonal changes likely contribute to the onset and progression of both conditions. These interactions underscore the importance of concurrently integrated care approaches that address both conditions. Effective management requires comprehensive screening, the recognition of contributing factors, and tailored exercise regimens supported by a multidisciplinary approach. Future research should focus on longitudinal studies tracking disease progression and evaluating the efficacy of multidisciplinary care models in optimizing patient outcomes.

Exploring the Comorbidity, Pathophysiology, and Integrated Treatment Strategies of Hypertension and Depression

Hypertension and depression are widely prevalent conditions with substantial comorbidity. Hypertension, characterized by persistently elevated arterial pressure, is associated with significant cardiovascular morbidity and mortality. Depression, a multifactorial mood disorder, adversely affects mental and physical health through mechanisms involving neuroinflammation, neurotransmitter imbalances, and hormonal dysregulation. The association between these disorders has been recognized since the mid-20th century.Historical medical literature from ancient Chinese and Indian systems identified symptoms indicative of hypertension, later classified as a distinct disease entity by Fredrick Akbar Mahomed in the 19th century. Notable epidemiological studies have elucidated the significant relationship between hypertension and depression, particularly among medical students and other high-risk populations.Research indicates that common pathophysiological mechanisms, including sympathetic nervous system overactivity, chronic inflammation, and endothelial dysfunction, underlie the comorbidity of hypertension and depression. Elevated levels of norepinephrine, proinflammatory cytokines, and oxidative stress contribute to the expression or worsening of both conditions. Shared genetic and environmental factors further compound this relationship, highlighting the need for integrated treatment strategies.Pharmacological interventions, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have shown potential to improve mental health outcomes in patients with comorbid hypertension and depression. However, inconsistent findings regarding the impact of antihypertensive medications on depression necessitate further investigation. The comorbidity of these conditions complicates treatment adherence, leading to poorer health outcomes and increased healthcare costs.The clinical implications of this unidirectional or bidirectional comorbidity are considerable, affecting quality of life, treatment adherence, and overall health outcomes. Integrated care approaches, incorporating lifestyle modifications and combined pharmacological treatments, have shown promise in improving compliance and outcomes.Despite extensive research, limitations persist, including difficulties in establishing causality, inconsistent diagnostic criteria, and the influence of confounding variables. Future research should focus on clarifying the bidirectional relationship between these conditions, the impact of social determinants, and the efficacy of various treatment modalities. Identifying high-risk populations and refining intervention strategies are crucial for improving clinical outcomes in patients with comorbid hypertension and depression.This paper aims to review the current literature regarding the association and comorbidity of hypertension and depression.Abbreviations: ACE: Angiotensin-Converting Enzyme; ARBs: Angiotensin Receptor Blockers; DBP: Diastolic Blood Pressure; mm Hg: Millimeters of Mercury; QoL: Quality of Life; SBP: Systolic Blood Pressure

Cataract Surgery and Mental Health: A Comprehensive Review on Outcomes in the Elderly.

Cataract surgery is a widely performed and highly effective procedure that significantly improves vision in elderly patients. This narrative review examines the impact of cataract surgery on mental health outcomes in the elderly, focusing on conditions such as depression, anxiety, and cognitive decline. The review highlights the prevalence of cataracts in older adults and the importance of mental health in this demographic, emphasizing the interconnectedness of visual and mental health. Improved vision following cataract surgery has been associated with enhanced quality of life, increased independence, and better psychological well-being. Mechanisms linking visual improvement to mental health benefits include biological pathways, psychosocial factors, and overall health improvements. However, socioeconomic factors, access to healthcare, and patient education play crucial roles in achieving positive outcomes. This review also compares cataract surgery with other interventions, providing a cost-benefit analysis and discussing the long-term sustainability of mental health benefits. Practice recommendations include pre-surgical mental health screening, integrative care approaches, and guidelines for postoperative care focusing on mental health. The review concludes with suggestions for future research to further explore the relationship between cataract surgery and mental health in the elderly, aiming to enhance clinical practice and public health strategies.

Early Changes in Nutritional Status of Elderly Patients with Lung Cancer Undergoing Chemotherapy Are Positively Related with Symptoms of Depression: A Prospective Follow-Up Study

This study aims to assess early effects of chemotherapy on symptom alleviation, nutritional status, and mental health in elderly patients with advanced non-small-cell lung cancer (NSCLC). This prospective study included 45 NSCLC patients (32 males, 13 females) aged 65–82 years (mean age 70.0 ± 4.5 years) with good performance status. Assessments were conducted immediately after diagnosis and after two chemotherapy cycles, focusing on nutritional status (assessed with MNA questionnaire), quality of life (QoL, based on FACT-L and FACT-TOI questionnaires), lung cancer-related symptoms (based on LCSS), and mental health (based on PHQ-9 questionnaire). Despite significant alleviation of symptoms like cough, dyspnea, and body weight loss, there was no significant correlation between changes in symptoms burden and changes in nutritional status (r 2 = 0.122, P = 0.427), and change of patients’ mental condition (r 2 = –0.141, P = 0.255). No significant QoL changes were noted, but a decrease in severe depression frequency was observed. The improvement of patients’ mental condition was related strictly to the improvement of nutritional status (r 2 = -0.589, P < 0.001). The study highlights the vital link between nutritional status and mental health in elderly NSCLC patients, emphasizing the need for integrated care approaches that address both aspects to enhance treatment effectiveness and patient well-being.

INTEGRATING YOGA INTO MENTAL HEALTH CARE: ENHANCING HOLISTIC WELL-BEING

Yoga is a holistic practice that originated in ancient India and has evolved over thousands of years. It encompasses physical postures (asanas), breathing exercises (pranayama), meditation, and ethical principles aimed at achieving harmony between the mind, body, and spirit. Yoga offers numerous benefits, including improved flexibility, strength, balance, stress reduction, relaxation, and mental clarity. It is practiced by people of all ages and backgrounds worldwide, with various styles and approaches catering to different needs and preferences. Beyond its physical aspects, yoga is often embraced as a lifestyle that promotes overall well-being and inner peace. Yoga in mental health care refers to the integration of yoga practices, such as physical postures (asanas), breathing techniques (pranayama), meditation, and mindfulness, into therapeutic interventions for individuals dealing with mental health challenges. It aims to promote emotional regulation, stress reduction, improved self-awareness, and overall well-being as adjunctive or complementary treatments alongside traditional mental health interventions. Yoga in integrative medicine refers to the incorporation of yoga practices into a holistic approach to healthcare that combines conventional medical treatments with complementary and alternative therapies. Integrative medicine emphasizes treating the whole person—mind, body, and spirit—to promote overall health and wellness. Yoga, with its focus on physical postures, breathing techniques, meditation, and mindfulness, can play a significant role in managing various health conditions and enhancing overall well-being when integrated into an integrative medicine approach. Yoga in integrative mental health care involves the incorporation of yoga practices, such as physical postures, breathing exercises, meditation, and mindfulness, into a comprehensive approach to mental health treatment. Integrative mental health care emphasizes treating the whole person and considers various factors contributing to mental well-being, including biological, psychological, social, and spiritual aspects. Yoga can be used as an adjunctive or complementary therapy alongside conventional mental health treatments like psychotherapy and medication. It offers a range of benefits for mental health, including stress reduction, anxiety and depression management, improved mood regulation, increased self-awareness, and enhanced emotional resilience. In integrative mental health care settings, yoga practices are often tailored to meet the specific needs and preferences of individuals with mental health concerns. Yoga sessions may be conducted in group settings or one-on-one sessions with trained instructors who can adapt the practice to accommodate different levels of ability and comfort. Research has shown promising results regarding the effectiveness of yoga in improving various mental health outcomes, making it a valuable component of integrative mental health care approaches aimed at promoting holistic well-being.

The relationship between chronic disease variety and quantity and suicidal ideation: A cross-sectional study of NHANES

BackgroundThis cross-sectional study examines the link between chronic diseases and suicidal thoughts in U.S. adults using 2013–2018 National Health and Nutrition Examination Survey (NHANES) data, aiming to identify potential risk factors for suicidal ideation. MethodsUsing NHANES data, we analyzed the association between various chronic conditions (hypertension, diabetes, asthma, etc.) and suicidal thoughts, employing logistic regression models adjusted for demographics and lifestyle factors. ResultsThe analysis of 8891 participants revealed a significant association between suicidal thoughts and chronic diseases such as liver disease, diabetes, and asthma. The risk of suicidal ideation is higher with the number of chronic conditions. ConclusionOur findings suggest a strong link between the presence and number of chronic diseases and the risk of suicidal thoughts, emphasizing the importance of integrated care approaches that address both physical and mental health needs.

Mutual effects of gestational diabetes and schizophrenia: how can one promote the other?: A review.

Although the physical complications of gestational diabetes mellitus (GDM) are well known, emerging evidence suggests a significant link with psychiatric conditions such as schizophrenia (SCZ). This review aimed to explore the extent, nature, and implications of the association between GDM and SCZ, exploring how the 2 conditions may reciprocally influence each other. We conducted a comprehensive literature review and, analyzed clinical and mechanistic evidence supporting the mutual effects of GDM and SCZ. This review examined factors such as neurodevelopment and the impact of antipsychotics. The study found that Maternal GDM increases the risk of SCZ in offspring. Conversely, women with SCZ were more prone to hyperglycemic pregnancies. The research highlights significant regional variations in GDM prevalence, with the highest rate in the Middle East, North Africa, and South-East Asia regions. These regional variations may have an impact on the epidemiology of SCZ. Furthermore, this review identifies the potential biological and environmental mechanisms underlying these associations. There is a bidirectional relationship between GDM and SCZ, with each disorder potentially exacerbating the others. This relationship has significant implications for maternal and offspring health, particularly in regions with high GDM prevalence. These findings underline the need for integrated care approaches for women with SCZ during pregnancy and the importance of monitoring and managing GDM to mitigate the risk of SCZ in the offspring. Notably, this study recognizes the need for further research to fully understand these complex interactions and their implications for healthcare.

Mapping the evidence on integrated service delivery for non-communicable and infectious disease comorbidity in sub-Saharan Africa: protocol for a scoping review

IntroductionThe concurrent occurrence of infectious diseases (IDs) and non-communicable diseases (NCDs) presents complex healthcare challenges in sub-Saharan Africa (SSA), where healthcare systems often grapple with limited resources. While an integrated...

Fear of cancer progression and the quality of sexual life of female cancer patients in Romania.

As cancer survival rates increase, it has become crucial to pay attention to the long-term quality of life of survivors, including sexual functioning. The quality of sexual life and fear of cancer progression are often unmet needs, significantly impacting cancer patients' overall quality of life. In this study, we investigate these factors in Romanian female cancer patients and highlight their relationship with mental health and demographic variables. This study included 242 Romanian female cancer patients who completed questionnaires assessing sexual functioning (EORTC QLQ-SHQ22), fear of cancer progression (FoP-Q), depression (PHQ-9), and anxiety (GAD-7). We examined these relationships using descriptive, exploratory, and regression analyses. Around 50% of patients reported impairments in sexual satisfaction and pain during sex. Lower sexual satisfaction increased sexual dysfunction, and heightened fear of cancer progression (FCP) were associated with depression, anxiety, younger age, lower education, rural residence, and unmarried status. This study reveals a complex interplay between sexual health, fear of cancer progression, and psychological well-being among female cancer survivors in Romania. Addressing sexual concerns, providing psychoeducation, promoting coping with the fear of progression, and utilizing interdisciplinary interventions are essential to improving these patients' overall quality of life. These findings underscore the need for integrated care approaches that consider both physical and psychological dimensions of cancer survivorship.