Mental Health Diagnoses Research Articles

Understanding attitudes and beliefs regarding COVID-19 vaccines among transitional-aged youth with mental health concerns: a youth-led qualitative study

BackgroundTransitional-aged youth (16–29 years) with mental health concerns have experienced a disproportionate burden of the COVID-19 pandemic. Vaccination is limited in this population; however, determinants of its vaccine hesitancy are...

Chatbot for mental health diagnosis using data augmentation techniques and deep learning

Chatbot for mental health diagnosis using data augmentation techniques and deep learning

An exploration of anxiety and depressive symptoms among sexual and gender minority young adults visiting a drop-in center for youth experiencing homelessness

BackgroundResearch suggests that marginalized young adults, particularly sexual and gender minorities (SGM), face distinctive healthcare transition challenges. SGM often navigate a complex intersection of identities, experiences, and stressors that can contribute to mental health disparities. However, they often lack access to appropriate support and resources tailored to their needs, which can result in increased psychological distress. Drop-in centers are effective mental health interventions for marginalized communities. Therefore, we conducted a study to explore the healthcare access experiences and mental health outcomes of young adult SGM compared to their non-SGM counterparts. MethodsWe surveyed 151 young adults aged 18–25 who visited two drop-in centers for young adults experiencing homelessness in Houston, Texas, between October and November 2018. Depressive and anxiety symptoms were assessed using Patient Health Questionnaire- 4 (PHQ-4.ther variables included demographics, prior mental health diagnosis, and experiences of homelessness and involvement in justice. ResultsTransgender and gender-diverse individuals had higher proportions of anxiety symptoms than their cisgender counterparts, while gay and lesbian individuals were more likely to experience depressive symptoms. In general, SGM individuals were three times more likely to report a previous anxiety diagnosis and four times more likely to report a previous depression diagnosis than their non-SGM counterparts. However, we did not find a significant association between having anxiety or depressive symptoms with seeking healthcare, experiences of homelessness, and justice involvement. ConclusionThe findings suggest that drop-in centers can provide targeted care for SGM youth with intersecting needs, thus improving their mental health outcomes. Nevertheless, more research is needed to understand further and inform more targeted and effective evidence-based interventions that support SGM young adults across the trajectory of experiences, changing needs, and care coordination over time during this critical and vulnerable transition to adulthood.

Supporting patients with a mental health diagnosis to use online services in primary care. A qualitative interview study

Supporting patients with a mental health diagnosis to use online services in primary care. A qualitative interview study

Young Adults at the National Epicenter of the COVID-19 Outbreak: Understanding the Impact and Future Challenges of Social Distancing on Mental Health Outcomes.

To understand the role and future implications of social distancing on mental health and substance use in young adults between the ages of 18 and 35 living in high-disease-prevalent areas of New York. Participants completed a self-administered online survey through Qualtrics. 43.9% of the sample met criteria for moderate or severe anxiety, and 53.1% of the sample met criteria for moderate to severe depression. 76.1% of the sample experienced both anxiety and depressive symptoms. Despite this, the rates of lifetime mental health diagnoses, treatment, and access to mental health services were low. Rates of depression and anxiety differed across socio-demographic variables (gender, income, sexuality, education, and insurance status). Experiencing severe symptoms of the COVID-19 virus, poor coping skills, loneliness, increased alcohol use, and sleep disturbances were linked to higher rates of depression, anxiety, or both. As the first epicenter of COVID-19 in the United States, New York represents an important location for prevention researchers to learn about how COVID-19 affected a diverse population of young adults. It is essential that researchers and practitioners proactively develop early and appropriate interventions to address the ongoing mental health crisis and also plan for future crises.

The Prevalence of Mood Disorders Among Health and Non-health Undergraduate Students in King Saud University, Riyadh, Saudi Arabia: A Cross-Sectional Study.

Mood disorders (MDs) are among the most common of all mental health diagnoses, with increasing prevalence and a devastating impact on individuals, families, and the community. This study aimed to estimate the frequency of MDs among health and non-health profession students. A cross-sectional survey was conducted on 391 students to estimate the self-reported prevalence of different MDs and to screen for bipolar disorder (BD) using the mood disorder questionnaire (MDQ) and for depressive, anxiety, and stress symptoms using the Depression, Anxiety, and Stress Scale - 21 items (DASS-21). MDs were reported by 24.9% (n=50) of health profession students and 22.8% (n=31) of non-health profession students. For BD, it affected 35.3% of students in the health profession and 47.4% (n=46) of students without the health profession, although the difference was not statistically significant. The most reported MDs among health and non-health profession students were major depression (4.9% vs. 4.2%), seasonal affective disorder (SAD) (3.3% vs. 2.1%), dysthymia (2.4% vs. 2.8), and BD (2% vs. 2.8%), respectively. None of the observed differences between the two groups were statistically significant. According to DASS-21 scores for health and non-health profession students, severe depressive and severe anxiety symptoms were more common among non-health students (45.1% and 59.3%, respectively) than among health profession students (41.4% and 51.1%, respectively). However, stress was higher among health-related than non-health-related students (19.4% and 18.1%, respectively). MDs constitute a high burden among university students regardless of their field of study, creating an increased urgency to incorporate ways to promote the mental well-being of students and to manage those with an MD. Further research is needed to identify effective preventive strategies for depression in the future.

Positive and adverse childhood experiences and mental health outcomes of children

ObjectiveResearchers and policymakers have identified adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction as a contributing factor to poor mental health outcomes for children. Positive childhood experiences (PCEs) like open family communication styles, having the ability to live and play in a safe, stable, and protective environment, having constructive opportunities for social engagement, and receiving mentorship from adults have been found to improve the mental health of children. PurposeThis paper explores the role of ACEs and PCEs on the mental health outcomes of children. MethodA sample of 22,628 children ages 6–17 from the National Survey of Children's Health (2017–2020) was used to explore the relationship between PCEs and ACEs and the mental health of children. Logistic regression analysis is used to model the effect of PCEs and ACEs on the odds of child mental health diagnoses. ResultsFindings indicate that with each additional ACE, there was a significant increase in the odds of reporting a MH condition (OR = 1.25, 95 % CI 1.09–1.43). Conversely, with each additional PCE, there is a significant decrease in the odds or reporting a MH condition (OR = 0.76, 95 % CI 0.68–0.84). There was also evidence that PCEs moderate the relationship between ACEs and reports of mental health conditions. When counts of ACEs are low, PCEs provide a protective effect on reports of mental health. But when the count of ACEs are high, children with higher numbers of PCEs have similar reports of mental health conditions. SummaryThis study provides information about the moderating effect of PCEs on the relationship between ACEs and child mental health diagnosis with the goal of informing policies and interventions focused on ameliorating the growing crisis of children's negative mental health and well-being. What is known?Adverse childhood events (ACEs) like abuse, neglect and household dysfunction are known to negatively impact the mental health and well-being of children. Positive childhood experiences (PCEs), on the other hand, can positively influence the mental health and well-being of children. What does this article add?This study examines the association between adverse and positive childhood experiences to understand how they impact the mental health outcomes of children ages 6–17. Findings indicate that when ACEs are lower, the impact of PCEs are positive, but when ACEs are higher, PCEs do not make much difference in reports of mental health problems.

COVID-19 IMPACT ON HEALTH JOURNEYS FOR VETERANS WITH CHRONIC CONDITIONS

Abstract The majority of Veterans receiving care in the Veterans Administration (VA) are over 65 years, and many have multiple chronic conditions and functional limitations. In this mixed methods pilot study, we sought to understand how these Veterans experienced the pandemic and associated VA health system changes across two contrasting (rural/urban) VA New York medical settings. From December 2021-January 2023, we conducted semi-structured interviews including co-created journey maps and extracted participants’ demographic and clinical characteristics and outpatient encounters. Journey maps visualized health and related episodes and associated pain and bright spots calibrated by intensity. 40 Veterans participated. An intense COVID-19 reaction emerged in 25% (10/39) of participant journeys. A majority (80%; 8/10) had a mental health (MH) diagnosis, compared to 55% (21/39) overall. A journey typically began with feeling shocked, afraid, or in extreme distress; subsequently there was divergence with some expressing feeling better and others describing lingering negative effects on daily routines, views of a changed world, and persistent VA service impacts. Some reported new perceptions of vulnerability due to age and decreased well-being. Participants in this group used on average more outpatient care before and during the pandemic than other participants and transitioned to greater consumption of virtual care, reflecting utilization trends across participants with mental health diagnoses. The group had mixed feelings about the benefits of virtual care. Ongoing challenges with COVID-19 may indicate the potential need for additional well-designed supportive services and environments particularly sensitive to the long-term impact of COVID-19.

CHALLENGES AND CONSIDERATIONS IN RESEARCH WITH OLDER ADULTS EXPERIENCING HOMELESSNESS

Abstract Individuals in their late 50s and 60s constitute the fastest growing cohort of homeless adults; homelessness among the older adult population is expected to triple by 2030 (Culhane et al., 2019). Older adults find themselves homeless due to systemic (e.g., unaffordable housing, structural racism, increasing healthcare costs) and individual factors (e.g., substance misuse, mental health diagnoses). Unhoused older adults have high rates of multiple chronic conditions (Henwood et al., 2018) worsened by unmet healthcare needs (Baggett et al., 2010). Older adults, especially those with serious illness, struggle to find and maintain housing compared to younger adults without illness. Patient and clinician-informed services/programs are needed, but the nature of serious illness and homelessness research comes with unique considerations. Research challenges in this population include inclusive and adequate recruitment, participant screening, and boundary issues (Hanson et al., 2014; Lashley, 2023). We will present lessons learned from completing two successful qualitative studies with unhoused older adults and clinical subject groups. Issues encountered during our research include dealing with recruitment obstacles, evaluating and responding to participants’ cognitive impairment and mental health issues, managing emotional labor experienced by the research team, developing stakeholder relationships, and making decisions about adequate and appropriate study compensation. We describe challenges, opportunities, and suggestions for collecting primary data from unhoused older adults. We encourage gerontological researchers not to avoid this hard-to-reach, high-risk population. The lessons learned in designing and implementing studies tailored to the unique challenges of unhoused older adults can promote inclusion of the perspectives and needs this population.

FACTORS CONTRIBUTING TO GROWING DEPRESSION AMONG ELDERS IN SUB-SAHARAN AFRICA

Abstract While growing research has addressed physical ailments and communicable diseases in the older adult population in Sub-Saharan Africa, little research has investigated mental health conditions such as depression and anxiety among older Africans. In many African nations, mental health diagnoses are not acknowledged let alone well understood by the general public. Little has been documented about the extent of depression among older adults in Sub-Saharan Africa and the factors contributing to depression among older African adults. This study used secondary sources and a synthesis of recent empirical literature to examine and document the extent of depression among older adults in Sub-Saharan Africa and the contributing factors to geriatric depression. Sources indicate that mental health symptoms of Africans are often considered the work of evil spirits or may be overlooked by families. Available studies report rates of geriatric depression ranging from 37.8% in Ghana, 40% in South Africa, 41.2% in Ethiopia, and up to 44% in Tanzania. Older women in Sub-Saharan Africa have higher rates of depression than older men. Contributing factors to depression include lack of formal education, chronic illness, unstable income, and waning social supports. With an estimated 2 out of 5 older adults in Sub-Saharan Africa experiencing depression, interventions are needed to address the factors contributing to depression among older adults as well as culturally relevant interventions to ameliorate current symptoms. Interventions common in Global North nations such as anti-depressant medication or private therapy may not be appropriate for older African adults struggling with depression.

The impact of stress and well-being during the COVID-19 pandemic on mental health in U.S. veterans.

The COVID-19 pandemic disrupted life around the globe and negatively impacted mental health (MH), including among military veterans. Building on previous research with U.S. veterans, the present study examined the association between a broad array of pandemic stressors and well-being on MH outcomes. A total of 372 veterans (51.3% women) from all service eras completed measures of posttraumatic stress disorder and depression during early (timepoint 1 [T1]) and peri-pandemic (timepoint 2 [T2]) periods. Pandemic-related stressors and well-being (satisfaction in life domains) were assessed at the peri-pandemic timepoint (T2). Logistic regression analyses were used to investigate associations between stressors and well-being with the likelihood of a probable MH diagnosis at T2 controlling for T1 MH status. More negative physical and MH impacts of the pandemic in addition to fewer positive consequences and lower satisfaction with paid work, finances, health, romantic relationships, and social life were associated with a higher likelihood of a probable T2 MH diagnosis. COVID infection was associated with lower odds of a probable T2 MH diagnosis. There were significant indirect effects, such that physical and MH impacts of the pandemic were associated with T2 MH via well-being. Overall, these findings highlight the role of stress and well-being on MH during a global pandemic. Interventions to address well-being may be important to address veteran MH during other periods of stress. Future research should examine the generalizability of study findings and further investigate factors that contribute to veterans' MH resilience during stressful life experiences.

Applications of the Camera Aura Detection Diagnostic Tool for Psychologist in Handling Cases of Mental Health Disorder Due to Domestic Violence in Surabaya City Area

ABSTRACT The Community Service Program is implemented in the form of synergistic collaboration between the Surabaya Ministry of Health Polytechnic and the Surabaya City Health Service and the Kenjeran Community Health Center as partners that are oriented towards community independence, especially the psychologist community in the implementation of the use of the GDV Camera Aura Detection Tool for Psychologists in Treatment. Cases of Mental/Psychological Health Disorders Due to Domestic Violence in the Surabaya City Area. In connection with the increasing number of cases of mental/psychological disorders due to domestic violence in the Surabaya City area, the limited number of personnel and diagnostic tools has resulted in a lack of treatment for these patients, which has an impact on disrupting the health service system for patients. Mental health, which is a mental or psychological disorder, is still a concern for the Indonesian government at this time. In 2018, as many as 282,654 household members or 0.67 percent of the population in Indonesia experienced mental disorders. Meanwhile, mental disorders due to domestic violence in the city of Surabaya in 2015 amounted to 46.42%, in 2016 the percentage was 46.15%, and in 2017 the percentage was 50%. During the Covid 19 pandemic (2020-2021), 355 women experienced psychological violence. This Community Service activity is an application of several studies in accordance with the road map research that has been carried out by the team leader, including regarding analysis of aura detection with an EEG tool in 2016 which proves that the recorded results of the aura detection tool with EEG results in 2 conditions Psychologically there are differences. On Indonesian Journal of Electrical Engineering and Computer Science Vol. 31, No. 1, July 2023, pp. 553~561 ISSN: 2502-4752 (Scopus Q3) by title ”Aura Detection Using Thermal Camera with Convolutional Neural Network Method for Mental Health Diagnosis” The results obtained from this community service activity were the implementation of socialization and assistance regarding psychological condition examinations using aura detection technology for doctors, psychologists and nurses at partner health centers; Psychological conditions were identified in 6 patients, namely 2 were domestic violence cases and 4 were members of the general public.

Applications of the Camera Aura Detection Diagnostic Tool for Psychologist in Handling Cases of Mental Health Disorder Due to Domestic Violence in Surabaya City Area

ABSTRACT The Community Service Program is implemented in the form of synergistic collaboration between the Surabaya Ministry of Health Polytechnic and the Surabaya City Health Service and the Kenjeran Community Health Center as partners that are oriented towards community independence, especially the psychologist community in the implementation of the use of the GDV Camera Aura Detection Tool for Psychologists in Treatment. Cases of Mental/Psychological Health Disorders Due to Domestic Violence in the Surabaya City Area. In connection with the increasing number of cases of mental/psychological disorders due to domestic violence in the Surabaya City area, the limited number of personnel and diagnostic tools has resulted in a lack of treatment for these patients, which has an impact on disrupting the health service system for patients. Mental health, which is a mental or psychological disorder, is still a concern for the Indonesian government at this time. In 2018, as many as 282,654 household members or 0.67 percent of the population in Indonesia experienced mental disorders. Meanwhile, mental disorders due to domestic violence in the city of Surabaya in 2015 amounted to 46.42%, in 2016 the percentage was 46.15%, and in 2017 the percentage was 50%. During the Covid 19 pandemic (2020-2021), 355 women experienced psychological violence. This Community Service activity is an application of several studies in accordance with the road map research that has been carried out by the team leader, including regarding analysis of aura detection with an EEG tool in 2016 which proves that the recorded results of the aura detection tool with EEG results in 2 conditions Psychologically there are differences. On Indonesian Journal of Electrical Engineering and Computer Science Vol. 31, No. 1, July 2023, pp. 553~561 ISSN: 2502-4752 (Scopus Q3) by title ”Aura Detection Using Thermal Camera with Convolutional Neural Network Method for Mental Health Diagnosis” The results obtained from this community service activity were the implementation of socialization and assistance regarding psychological condition examinations using aura detection technology for doctors, psychologists and nurses at partner health centers; Psychological conditions were identified in 6 patients, namely 2 were domestic violence cases and 4 were members of the general public.

THE EFFECT OF MENTAL HEALTH ON DETROIT RESIDENCE IN OLDER ADULTS DURING THE COVID-19 PANDEMIC

Abstract The COVID-19 pandemic had a tremendous impact on global experience of anxiety and depression. Due to social isolation and quarantine, older adults faced unique challenges that disproportionately increase their risk for health outcomes. The purpose of this retrospective study was to examine the relationship between Detroit versus non-Detroit residence and incident mental health disorders. The patient population included older adults (age 65 and older) from a large metropolitan urban health system with patient encounters between December 2018 - June 2021. The primary predictor, Detroit metropolitan status, was based on zip code. Outcome variables, incident depression, anxiety, and composite mental health disorders, were based on screening measures (PHQ-2, PHQ-9 and GAD-7 scores), ICD diagnosis, medical prescriptions, and behavioral health referrals. Fully adjusted logistic regression analysis derived odds ratios of incident outcomes in Detroit versus non-Detroit patients. A total of 5,300 older adult patients were included in this study. Older adults residing in Detroit had significantly reduced odds of incident anxiety compared to non-Detroit residents (OR:0.45; 95%CI:0.26,0.75, p=0.003). Incident depression and composite mental health outcomes also showed protective effects in Detroit patients; however, these outcomes were not statistically significant. Overall, patients residing in Detroit had 55% decreased odds of developing anxiety during the pandemic. Additional research should explore facilitators and barriers to mental health diagnoses during the COVID-19 pandemic for older adults in an urban setting.

Latent class analysis of emergency department patients engaged in telehealth peer recovery support services and associations of identified classes with post-discharge outcomes

BackgroundPeople with substance use disorders (SUDs) frequently use emergency department (ED) services. Despite evidence demonstrating that post-discharge SUD treatment linkage effectively reduces the number of ED re-presentations, relatively few hospitals have implemented interventions to identify and connect patients with SUDs to appropriate care. ED-based peer recovery support specialist (PRSS) interventions have emerged as a promising approach for hospitals, but more research is needed to understand the extent to which these interventions meet the needs of patients who present to the ED for different reasons and with various underlying concerns. MethodA retrospective cohort analysis used data from a telehealth PRSS program in 15 EDs within one Indiana hospital system. The study included 2950 ED patients who engaged with telehealth PRSS services between September 2018 and September 2021. Latent class analysis identified patterns of patient characteristics associated with post-discharge PRSS engagement and ED re-presentations. Covariate predictors and distal outcomes were assessed to examine the associations between class membership, demographic factors, and patient outcomes. ResultsThe study team selected a six-class model as the best fit for the data. Class 1, representing patients with opioid use disorder and mental health diagnoses who presented to the ED for an opioid overdose, was used as the reference class for all other statistical tests. Multinomial logistic regression analysis demonstrated significant associations between covariate predictors, outcomes, and class membership. Regression results also demonstrate PRSSs had greater success contacting patients with prior year ED use and patients with a successful post-discharge PRSS contact were less likely to re-present to the ED. ConclusionResults highlight the heterogeneity of patients with SUDs and emphasize the need for tailored interventions to address patient-specific needs more effectively. They also provide support for the perceived utility of PRSS engagement for ED patients.

Clinically Recognized Depression and Mental Health Treatment in a Single Center Cohort of Patients with Systemic Sclerosis.

In this study, we investigated the prevalence of depression, depression treatment, and symptom burden in patients with systemic sclerosis (SSc) and examined their associations with the center for epidemiologic studies depression scale revised (CESD-R) scores. The Prospective Registry in Scleroderma at Massachusetts General Hospital (PRISM) is a longitudinal registry of patients with SSc. Among participants with CESD-R score ≥ 16, indicating possible depression, a chart review was performed for mental health diagnoses and treatments. We examined the relation of demographic and clinical factors to the presence of mental health diagnoses or treatment using logistic regression. We evaluated the association of SSc symptoms and the COVID-19 pandemic with a CESD-R score using quantile regression. Of 214 patients enrolled in PRISM, 129 participants (38% diffuse and 59% limited) completed at least one CESD-R questionnaire. In the first survey, 29% had possible depression (CESD - R ≥ 16) and 16% had probable depression (CESD - R ≥ 23). Of 20 participants with probable depression, 90% received treatment for a mood disorder. In a multivariable logistic regression model among participants with CESD - R ≥ 16, none of the evaluated variables (CESD-R score, age, gender, employment status, race, and ethnicity) was associated with mental health diagnosis or treatment. Higher baseline dyspnea index, modified Rodnan skin score, and the University of California Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal total score and subscores were associated with higher CESD-R score. In this single-center cross-sectional study, 16% of participants had significant depressive symptoms. Dyspnea, extent of skin involvement, and gastrointestinal symptoms were associated with depression symptoms.

Predicting risk of suicidal behavior from insurance claims data vs. linked data from insurance claims and electronic health records.

Observational studies assessing effects of medical products on suicidal behavior often rely on health record data to account for pre-existing risk. We assess whether high-dimensional models predicting suicide risk using data derived from insurance claims and electronic health records (EHRs) are superior to models using data from insurance claims alone. Data were from seven large health systems identified outpatient mental health visits by patients aged 11 or older between 1/1/2009 and 9/30/2017. Data for the 5 years prior to each visit identified potential predictors of suicidal behavior typically available from insurance claims (e.g., mental health diagnoses, procedure codes, medication dispensings) and additional potential predictors available from EHRs (self-reported race and ethnicity, responses to Patient Health Questionnaire or PHQ-9 depression questionnaires). Nonfatal self-harm events following each visit were identified from insurance claims data and fatal self-harm events were identified by linkage to state mortality records. Random forest models predicting nonfatal or fatal self-harm over 90 days following each visit were developed in a 70% random sample of visits and validated in a held-out sample of 30%. Performance of models using linked claims and EHR data was compared to models using claims data only. Among 15 845 047 encounters by 1 574 612 patients, 99 098 (0.6%) were followed by a self-harm event within 90 days. Overall classification performance did not differ between the best-fitting model using all data (area under the receiver operating curve or AUC = 0.846, 95% CI 0.839-0.854) and the best-fitting model limited to data available from insurance claims (AUC = 0.846, 95% CI 0.838-0.853). Competing models showed similar classification performance across a range of cut-points and similar calibration performance across a range of risk strata. Results were similar when the sample was limited to health systems and time periods where PHQ-9 depression questionnaires were recorded more frequently. Investigators using health record data to account for pre-existing risk in observational studies of suicidal behavior need not limit that research to databases including linked EHR data.

Which veterans with PTSD are most likely to report being told of their diagnosis?

Veterans who do not know about their posttraumatic stress disorder (PTSD) diagnosis experience a fundamental barrier to accessing effective treatment. Little is known about the characteristics that influence veterans’ PTSD diagnosis knowledge (i.e., report of being told they have a PTSD diagnosis by a healthcare provider). Veterans who met probable and provisional criteria for PTSD on the self-report PTSD checklist for DSM-5 were identified from the Comparative Health Assessment Interview Research Study (n = 2335). Weighted logistic regression was performed to identify demographic variables, clinical characteristics, and social determinants of health (e.g., economic instability, homelessness, healthcare coverage) associated with PTSD diagnosis knowledge among post-9/11 veterans. Approximately 62% of veterans with probable and provisional PTSD had PTSD diagnosis knowledge. Predictors with the strongest associations included another mental health diagnosis (OR = 6.10, CI95:4.58,8.12) and having Veterans Affairs (VA) healthcare coverage (OR = 2.63, CI95:1.97,3.51). Veterans with combat or sexual trauma were more likely to have PTSD diagnosis knowledge than those with different trauma types. Results suggest veterans with VA healthcare coverage and military-related trauma are more likely to be informed by a healthcare professional about a PTSD diagnosis. Further research is needed to improve PTSD diagnosis knowledge for those with non-military-related trauma and those without VA healthcare coverage.

Anxiety trajectories from pregnancy to one-year postpartum and their contributors during the COVID-19 pandemic

ABSTRACT Background Anxiety in the peripartum period (pregnancy through one-year postpartum) has negative impacts on mothers and infants. During the COVID-19 pandemic, high rates of anxiety were reported worldwide, but trajectories for how these symptoms change longitudinally in the peripartum period remain unknown. Methods A total of 1,411 women who were pregnant during the second U.S. COVID-19 surge completed four study questionnaires between December 2020 and March 2022, including assessments of anxiety symptoms (GAD-7) and individual and community-level contributors. Latent Class Growth Mixture Models (LCGMM) were used to identify anxiety trajectories, and multinomial logistic regression was used to identify contributors to class membership. Results Three classes of anxiety symptom trajectories were identified. Class 1 (n = 956, 67.8%) experienced minimal/mild anxiety throughout the peripartum period. Class 2 (n = 362, 25.7%) experienced initial moderate anxiety that remained stable. Class 3 (n = 93, 6.6%) experienced initial moderate anxiety that increased to severe in the postpartum period. Stress and history of mental health diagnosis contributed to higher initial levels of anxiety and ongoing social support contributed to lower levels of anxiety. In addition, financial insecurity increased the risk of belonging to Class 3. Conclusions Screening for anxiety symptoms and psychosocial vulnerabilities in the peripartum period is vital, as is early intervention. This is especially the case among women with limited financial and social resources who may experience chronic or worsening anxiety as they transition to parenthood.

Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid.

Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in childrenand youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0-21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care.