Treatment Of Mental Health Disorders Research Articles

Perspectives, Experiences, and Practices in the Use of Digital Information Technologies in the Management of Depression and Alcohol Use Disorder in Health Care Systems in Colombia.

Digital information technologies are increasingly used in the treatment of mental health disorders. Through this qualitative study, researchers illuminated perspectives, experiences, and practices among diverse stakeholders in the use of digital information technologies in the management of depression and alcohol use disorders in Colombia. In-depth interviews and focus groups were conducted in five primary care institutions across Colombia. Thematic analysis was used to analyze the data. The use of technology in the treatment of mental health disorders can facilitate the evaluation and diagnosis, treatment, and promotion and prevention of mental health disorders, as well as multiple nonmental health applications in the primary care setting. Potential barriers to the use of technology in this setting include challenges of digital literacy, access to technology, confidentiality, and financing. This study can inform the implementation of digital information technologies in the care of depression and problematic alcohol use within health care systems in Colombia.

Culturally Sensitive PTSD Screening in Non-Western Youth: Reflections and Indications for Mental Health Practitioners

Abstract Children around the world are exposed to traumatic events and research confirms that cultural factors play a central role in the psychological experience of trauma and the manifestation of symptoms in trauma and stress-related disorders. The DSM-5 and ICD-11 call on practitioners to consider the role of culture and context in the manifestation, assessment, and treatment of mental health disorders. This article analyzes peer-reviewed literature involving youth and adolescent PTSD screening in non-Western contexts, revealing only few instruments that have undergone validation for cultural contexts outside those for which they were developed. Studies that include cultural validation show marked differences in methodology and conceptual framework for adaptation, translation, and validation, and disagreement on the scale and scope of tools necessary to assess the impact of trauma in non-Western youth. The discussed studies reveal a need to debate a uniform methodology for cultural adaptation and validation of PTSD screening instruments.

Self-perceived competencies in the diagnosis and treatment of mental health disorders among general practitioners in Lima, Peru

AimTo assess the self-perceived competencies in diagnosing and treating patients with mental health disorders, among recently graduated general practitioners (GPs) from Lima, Peru.MethodsA cross-sectional study was performed in April 2017 at a General Practitioner’s meeting held for those who were going to perform the social service, by the Peruvian College of Physicians in Lima. Attendees were invited to answer a questionnaire that evaluated their self-perception of competence in diagnosing and treating four different mental health disorders; major depression, anxiety disorder, alcohol dependence, and schizophrenia.ResultsOut of 434 evaluated GPs, the following percentages were self-perceived as competent in their adequate diagnosis of depression (70.5%), anxiety (73.3%), alcohol dependence (67.6%), and schizophrenia (62.0%). Concerning pharmacological treatment, these percentages were 46.6, 47.5, 39.0 and 37.6%, respectively. Referring to all the studied mental disorders, 41.6% of participants self-perceived competence in providing an adequate diagnosis, 36.1% in providing non-pharmacological treatment, and 20.1% in providing pharmacological treatment.ConclusionThe rate of adequate self-perceived competences was higher for diagnosis than for treatment of patients with mental health disorders. These results highlight the importance of designing and implementing interventions to improve medical education so as to develop the skills necessary to confront mental health disorders.

Help-seeking behaviors among Chinese people with mental disorders: a cross-sectional study

BackgroundFailure to seek treatment for mental health disorders is a serious public health concern. Unfortunately, there is little insight into help-seeking and its associated factors in China which has undergone rapid economic development in the past 30 years and has an increasing prevalence of mental disorder. Therefore, this study aimed to (1) investigate help-seeking rates in healthcare and non-healthcare settings and (2) investigate the correlates of help-seeking behavior in a large Chinese survey.MethodsData came from the Tianjin Mental Health Survey (TJMHS), a representative sample of adult community residents in the Chinese municipality of Tianjin (n = 11,748). Of these, 1759 individuals had ≥1 axis-I diagnosis according to the Diagnostic and Statistical manual– fourth edition (DSM-IV) and were administered a Help-Seeking Questionnaire.Results15.7% of patients reported that they had ever sought help during their entire lifetime before the interview, with 4.5% seeking help in mental healthcare, 3.2% in other healthcare and 8.1% in non-healthcare settings (e.g., family, friends, and spiritual advisor). Among help-seekers, the first help was mostly sought in non-healthcare settings (58.4%), followed by healthcare (27.5%) and mental healthcare settings (24.5%). Female gender, younger age, having 7–9 years vs 0–6 years of education, a low income, a psychotic disorder and having ≥2 disorders were associated with increased help-seeking. Older age, being married and having a psychotic or organic disorder were associated with increased help-seeking in healthcare vs. non-healthcare settings.ConclusionA small percentage of persons with mental disorders in the Tianjin region seek help and among those who do, variations in the types of help-seeking may be partially explained by demographic and clinical characteristics.

The intersection between the oculomotor and hippocampal memory systems: empirical developments and clinical implications.

Decades of cognitive neuroscience research has shown that where we look is intimately connected to what we remember. In this article, we review findings from human and nonhuman animals, using behavioral, neuropsychological, neuroimaging, and computational modeling methods, to show that the oculomotor and hippocampal memory systems interact in a reciprocal manner, on a moment‐to‐moment basis, mediated by a vast structural and functional network. Visual exploration serves to efficiently gather information from the environment for the purpose of creating new memories, updating existing memories, and reconstructing the rich, vivid details from memory. Conversely, memory increases the efficiency of visual exploration. We call for models of oculomotor control to consider the influence of the hippocampal memory system on the cognitive control of eye movements, and for models of hippocampal and broader medial temporal lobe function to consider the influence of the oculomotor system on the development and expression of memory. We describe eye movement–based applications for the detection of neurodegeneration and delivery of therapeutic interventions for mental health disorders for which the hippocampus is implicated and memory dysfunctions are at the forefront.

3.44 CHARACTERISTICS OF PROVIDERS USING A CHILD PSYCHIATRIC ACCESS PROGRAM IN MARYLAND

Despite a significant increase in outpatient visits for diagnosis and treatment of mental health disorders among youth, there is a growing gap between the need for and availability of pediatric mental health services (MHS). Child Psychiatry Access Programs (CPAPs), similar to the Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP) program, have shown promise in increasing access to MHS. The purpose of this study is to describe the types of primary care clinicians (PCCs) that call BHIPP and to examine patterns of their use of BHIPP services.

23.1 CHANGES IN GENERAL AND SPECIFIC PSYCHOPATHOLOGY FACTORS DURING PSYCHOSOCIAL TREATMENT FOR DEPRESSION IN ADOLESCENTS

Clinical practice often focuses on diagnosis and disorder-specific interventions for mental health disorders, counter to increasing evidence of a general factor, which accounts for shared variance in symptoms across the spectrum of psychopathology. We examined longitudinal trajectories of general and specific factors of psychopathology in depressed adolescents recruited to a clinical trial. The objectives were to determine: 1) changes in general and specific factors during the trial; and 2) whether there were differential treatment effects on symptom trajectories.

5.2 SYSTEMATIC REVIEW OF POLYPHARMACY STUDIES IN CHILD AND ADOLESCENT PSYCHIATRY: THE ASD STUDIES

The objective of the literature review was to identify research supporting the use of 2 or more psychotropic medications in the treatment of mental health disorders in children and adolescents. A subset of the articles (n = 13) focused on adding medications to risperidone in the treatment of ASD in children and adolescents. Previous research has shown that risperidone is well-tolerated and efficacious in treating the behavioral symptoms associated with ASD in children and adolescents, but there is little evidence that it positively affects social/cognitive functioning.

Comparing mental health disorders among sex trafficked children and three groups of youth at high-risk for trafficking: A dual retrospective cohort and scoping review

BackgroundIndividuals at high-risk for trafficking are often subject to preexisting complex trauma that only intensifies during the trafficking experience. This greatly increases their risk of mental illness, although the actual prevalence of mental health disorders in children who are sex trafficked remains unclear. ObjectiveTo examine the prevalence of mental health diagnoses among a sample of youth identified as being sex trafficked, and to discuss these rates in relation to other high-risk groups reported in the literature. Participants and setting143 female and male child trafficking victims in Wisconsin. MethodsWe retrospectively reviewed individual medical records, identifying mental health diagnoses and behaviors. The results were compared to summarized prevalence data for mental health disorders in sex trafficked, runaway children, juvenile offenders, and foster care children identified via a scoping review. ResultsWe observed significantly higher rates of ADHD (52.4%, p < 0.0001), bipolar disorder (26.6%, p < 0.0001), and PTSD (19.6%, p < 0.05 to p < 0.0001) in our sample of trafficked youth compared to all high-risk groups, as well as for depression (45.5%), anxiety (19.6%), conduct disorder (19.6%), ODD (25.9%), and psychosis (14.0%) relative to multiple groups individually. ConclusionsThe complex trauma suffered by child survivors of sex trafficking can impart numerous effects with overlapping symptomatology of many mental health disorders. Survivors’ adaptive responses to complex trauma may lead to improper diagnosis and treatment of mental health disorders at the expense of prompt access to trauma-focused therapies. Alternative diagnoses and treatments of this complex dysfunction are discussed.

Cue-Elicited Anxiety and Alcohol Craving as Indicators of the Validity of ALCO-VR Software: A Virtual Reality Study.

Background: This study is part of a larger project aiming to develop a virtual reality (VR) software to be implemented as a clinical tool for patients diagnosed with alcohol use disorder (AUD). The study is based on previous research in which we identified factors that elicit craving for alcohol in a sample of AUD patients, and which led to the development of a virtual reality software to be used in cue exposure treatments of alcohol use disorder (ALCO-VR). The main objective of this study was to test the effectiveness of ALCO-VR to elicit cue-induced craving and anxiety responses among social drinkers (SD) and AUD patients. Our secondary objective was to explore which responses (cue-induced craving or anxiety) can best differentiate between AUD patients and the SD group. Method: Twenty-seven individuals (13 AUD patients and 14 SD) participated in this study after giving written informed consent. Their anxiety and alcohol craving levels were measured by different instruments at different stages of the procedure. The VR equipment consisted of Oculus Rift technology, and the software consisted of the ALCO-VR platform. Results: Our data indicate that the ALCO-VR software can elicit responses of anxiety and alcohol craving, especially in the group of AUD patients. The cue-induced anxiety response differentiated AUD patients and the SD group better than the cue-induced craving response. Conclusions: The general interest in applying new technologies to the assessment and treatment of mental health disorders has led to the development of immersive real-life simulations based on the advantages of VR technology. Our study concluded that the ALCO-VR software can elicit anxiety and craving responses and that cue-induced anxiety responses can distinguish between AUD and SD groups better than cue-induced craving. The data on craving and anxiety were assessed consistently by different instruments. In addition, we consider that ALCO-VR is able to ecologically assess cue-induced anxiety and alcohol craving levels during exposure to VR alcohol-related environments.

General and post-disaster mental health servicing in Vanuatu: A qualitative analysis

BackgroundNatural disasters contribute to the burden of mental illness, increased poverty and environmental degradation in developing Pacific countries. The aim of this study was to review the attitudes and opinions in relation to the delivery of post-disaster and general mental healthcare in Vanuatu. MethodThis qualitative study design applied semi-structured interviews to collect data from key informants. A total of 11 participants were involved in 11 interviews. The sample group consisted of; i) four government health representatives; ii) four non-government participants with knowledge of mental healthcare in Vanuatu; and iii) three community members from the village of Emua, Efate Island. NVivo qualitative data processing software assisted with thematic analysis of the transcribed data. ResultsThe key findings of this study were associated with mental healthcare in Vanuatu and exhibited themes including: i) low levels of mental health literacy; ii) a deficiency of general and post-disaster mental health services; iii) the increased prevalence of mental health disorders following a disaster; and iv) strategies to improve general and post-disaster mental healthcare. ConclusionFindings indicate a range of challenges impeding the provision of mental healthcare in Vanuatu. Future actions should aim to: i) enhance levels of mental health literacy to diminish the stigma associated with mental illness; and ii) facilitate decentralised mental healthcare to enable the development of community based services. Increased levels of mental health literacy and improved access to community services will assist the identification and treatment of mental health disorders in Vanuatu.

Exploring the Rationale for the Use of the Ketogenic Diet in the Treatment of Mental Health Disorders

(1) Background: The ketogenic diet (KD) was developed in the 1920s as a treatment for pediatric epilepsy and is emerging as a possible treatment option for certain mental health disorders. There is a link between certain mental health disorders and epilepsy, suggesting some commonality among underlying mechanisms. (2) Methods: The literature relating to mental disorders and the KD is sparse. The authors attempt to a narrative review of the existing literature to show that there may be validity to studying the KD as a treatment for certain mental health disorders. (3) Results: Various types of mitochondrial dysfunction and impaired oxidative metabolism have been identified in many mental health disorders (bipolar disorder, major depressive disorder, autism, schizophrenia, and others). Mitochondrial deficits may affect neuroplasticity and cause synaptic dysfunction, which could change brain structure and function in a way that might affect behavior. The KD has been associated with epigenetic changes in the genes associated with mitochondrial function. Chronic oxidative stress and inflammation have also been implicated in mental health disorders and may be reduced by the KD. The KD regulates glutamatergic transmission and may initiate extracellular changes as well, in a manner similar to pharmacological agents used to stabilize moods. The KD may be difficult for patient adherence and has been associated with many and potentially severe adverse effects. The role of the KD in addressing treatment-resistant pediatric epilepsy is established and epilepsy is comorbid with a number of mental health conditions. (4) Conclusions: There is a paucity of literature on this subject and there is no robust clinical evidence in support of the use of the KD for treating mental disorders but there are indications that the KD can reduce systemic inflammation, improve cerebral mitochondrial metabolism, and enhance endogenous antioxidation, all of which may be helpful in treating certain mental health conditions. The KD is also associated with serious health risks and clinicians must weigh risks versus benefits.

The physics of brain network structure, function and control

The brain is a complex organ characterized by heterogeneous patterns of structural connections supporting unparalleled feats of cognition and a wide range of behaviors. New noninvasive imaging techniques now allow these patterns to be carefully and comprehensively mapped in individual humans and animals. Yet, it remains a fundamental challenge to understand how the brain's structural wiring supports cognitive processes, with major implications for the personalized treatment of mental health disorders. Here, we review recent efforts to meet this challenge that draw on intuitions, models, and theories from physics, spanning the domains of statistical mechanics, information theory, and dynamical systems and control. We begin by considering the organizing principles of brain network architecture instantiated in structural wiring under constraints of symmetry, spatial embedding, and energy minimization. We next consider models of brain network function that stipulate how neural activity propagates along these structural connections, producing the long-range interactions and collective dynamics that support a rich repertoire of system functions. Finally, we consider perturbative experiments and models for brain network control, which leverage the physics of signal transmission along structural wires to infer intrinsic control processes that support goal-directed behavior and to inform stimulation-based therapies for neurological disease and psychiatric disorders. Throughout, we highlight several open questions in the physics of brain network structure, function, and control that will require creative efforts from physicists willing to brave the complexities of living matter.

Telemedicine-delivered treatment interventions for substance use disorders: A systematic review

With increased negative impacts from opioid and other substance use disorders in the US, it is important for treatments to not only be effective, but also accessible to patients. Treatment delivery via telemedicine, specifically, the use of videoconferencing, which allows real time communication between a patient and a clinician at a distant site, has been shown to be an effective approach for increasing reach and access to treatments for mental health disorders and other chronic illnesses. This systematic review identified and summarized studies examining the effectiveness of telemedicine interventions to deliver treatment for patients with substance use disorders. Out of 841 manuscripts that met our search criteria, 13 studies met the inclusion criteria. Studies covered interventions for nicotine, alcohol and opioid use disorders. They varied widely in size, quality, and in the comparison groups examined. Studies examined both delivery of psychotherapy and medication treatments. Most studies suggested telemedicine interventions were associated with high patient satisfaction and are an effective alternative, especially when access to treatment is otherwise limited. However, there were substantial methodological limitations to the research conducted to date. Further studies are needed, including larger scale randomized studies that examine different models of telemedicine that can be integrated into existing healthcare delivery settings, to increase the use of effective treatments for patients with substance use disorders.

Biofield Energy Treatment: Physicochemical and Thermal Characterization of L-Tryptophan

L-tryptophan is an essential amino acid that needs to be supplemented through protein-rich diet and it helps in growth and nitrogen balance in the humans.The aim of this studyis to evaluate the effect of the Trivedi Effect®-Consciousness Energy Healing Treatment on the L-tryptophan in terms of its physicochemical and thermal properties by usingmodern analytical techniques. The method involved dividing the testsample into two parts and providing the Consciousness Energy Healing Treatmentto one part (named as Biofield Energy Treated sample), remotely by a renowned Biofield Energy Healer, Dahryn Trivedi; while the other part didn’t receive any treatment called a control sample. The particle size values of the treated sample was increased by 4.77% (d10), 6.37% (d50), 6.72% (d90), and 6.49% {D(4,3)}; thus, the specific surface area was increased by 4.35% comparedto the control sample. The PXRD peak intensitiesand crystallite sizes of the treated sample were significantly altered ranging from -82.69% to 30.54% and -17.15% to 179.73%, respectively, in comparison to the control sample. The total weight loss of the treated sample was significantly reduced by 11.60% during the heating process that resulted in a significant increase in the residual amount of the sample by 1093.33% as compared to the control sample. The melting temperature and the latent heat of fusion of the treated sample was significantly increased by 1.12% and 6.79%, respectively, compared to the untreated sample. Hence, the L-tryptophan might forma new polymorph after the Trivedi Effect®-Consciousness Energy Healing Treatment that may possess better solubility and bioavailability profile along with improved thermal stability compared with the untreated sample. Thus, the Trivedi Effect®-Consciousness Energy Healing Treatment could be considered as a novel approach for designing the formulations with improved drug profile and efficacy. The treated L-tryptophan would be more useful for the treatment of mental health disorders, premenstrual dysphoric disorder (PMDD), attention deficit-hyperactivity disorder (ADHD), obsessive-compulsive disorder, depression, and bipolar disorder, etc.

Prevalence of mental health conditions and pain in adults with skeletal dysplasia.

We sought to examine the prevalence of depression and anxiety in adults with skeletal dysplasias, and to assess any correlations with pain. Participation was via an anonymous REDCap survey, which consisted of sociodemographic questions followed by the brief pain inventory-short form (BPI-SF), patient health questionnaire-8 (PHQ-8), and generalized anxiety disorder-7 (GAD-7) questionnaires. These assessed pain, depression, and anxiety respectively. Of the 336 usable responses, 16.1% scored 10 or greater on the PHQ-8 consistent with current depression while 17.3% scored 10 or greater on the GAD-7 consistent with current anxiety. The majority of participants (76.2%) experienced pain, which was significantly associated with prior mental health diagnoses (p < 0.05). A total of 34% reported either a prior diagnosis of depression or scored 10 or greater on the PHQ-8, and 31% reported either a prior diagnosis of anxiety or scored 10 or greater on the GAD-7. This study identified a substantial percentage of individuals with mental health concerns as well as pain in the adult skeletal dysplasia population. Further research is warranted to investigate barriers to service or treatment of mental health disorders as well as pain management.

Rural homelessness: its effect on healthcare access, healthcare outcomes, mobility, and perspectives of novel technologies

ABSTRACTRural homelessness is an undeniable public health issue that is understudied in the research literature. The purpose of this study was to determine the sociodemographics, physical and mental health status, barriers to access to care, and perspectives on potential technological advances of homeless individuals. A structured 45–90 min interview was utilized to gather demographic, physical health, mental health, mobility, and technology use data from a sample of 75 homeless individuals within three shelters in three micropolitan Nebraska cities. Individuals in this region were more likely to be white, unmarried, and mobile who have various physical and mental health disorders. Adherence to treatment of mental health disorders ranged from 43–60 percent. This population had increased employment, access to healthcare services, and use of technology than predicted. Leaders from all over the country can use these data to help improve state and local efforts to better cater to this vulnerable population's needs.

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine.

Is virtual reality (VR) already a reality in behavioral health? To answer this question, a meta-review was conducted to assess the meta-analyses and systematic and narrative reviews published in this field in the last twenty-two months. Twenty-five different articles demonstrated the clinical potential of this technology in both the diagnosis and the treatment of mental health disorders: VR compares favorably to existing treatments in anxiety disorders, eating and weight disorders, and pain management, with long-term effects that generalize to the real world. But why is VR so effective? Here, the following answer is suggested: VR shares with the brain the same basic mechanism: embodied simulations. According to neuroscience, to regulate and control the body in the world effectively, the brain creates an embodied simulation of the body in the world used to represent and predict actions, concepts, and emotions. VR works in a similar way: the VR experience tries to predict the sensory consequences of an individual's movements, providing to him/her the same scene he/she will see in the real world. To achieve this, the VR system, like the brain, maintains a model (simulation) of the body and the space around it. If the presence in the body is the outcome of different embodied simulations, concepts are embodied simulations, and VR is an embodied technology, this suggests a new clinical approach discussed in this article: the possibility of altering the experience of the body and facilitating cognitive modeling/change by designing targeted virtual environments able to simulate both the external and the internal world/body.

Virtual Reality Therapy: Emerging Topics and Future Challenges.

Virtual reality (VR) is no longer a fantasy or a novelty to be used for pure entertainment. It is a technology that has, over the past three decades, taken hold and enriched multiple areas of science, most notably healthcare. Starting from these premises, this special issue will specifically investigate how VR and other important advanced technologies are being adopted and adapted for use in the healthcare field, with a specific focus toward the diagnosis and treatment of mental health disorders.

Digital Interventions for Mental Disorders: Key Features, Efficacy, and Potential for Artificial Intelligence Applications.

Mental disorders are highly prevalent and often remain untreated. Many limitations of conventional face-to-face psychological interventions could potentially be overcome through Internet-based and mobile-based interventions (IMIs). This chapter introduces core features of IMIs, describes areas of application, presents evidence on the efficacy of IMIs as well as potential effect mechanisms, and delineates how Artificial Intelligence combined with IMIs may improve current practices in the prevention and treatment of mental disorders in adults. Meta-analyses of randomized controlled trials clearly show that therapist-guided IMIs can be highly effective for a broad range of mental health problems. Whether the effects of unguided IMIs are also clinically relevant, particularly under routine care conditions, is less clear. First studies on IMIs for the prevention of mental disorders have shown promising results. Despite limitations and challenges, IMIs are increasingly implemented into routine care worldwide. IMIs are also well suited for applications of Artificial Intelligence and Machine Learning, which provides ample opportunities to improve the identification and treatment of mental disorders. Together with methodological innovations, these approaches may also deepen our understanding of how psychological interventions work, and why. Ethical and professional restraints as well as potential contraindications of IMIs, however, should also be considered. In sum, IMIs have a high potential for improving the prevention and treatment of mental health disorders across various indications, settings, and populations. Therefore, implementing IMIs into routine care as both adjunct and alternative to face-to-face treatment is highly desirable. Technological advancements may further enhance the variability and flexibility of IMIs, and thus even further increase their impact in people's lives in the future.