Mental Health Disorders In Patients Research Articles

Penerapan Metode Forward Chaining Dan Dempster-Shafer Pada Sistem Pakar Deteksi Dini Gangguan Kesehatan Mental

Early detection of mental health disorders is a major challenge in the field of health. The forward chaining method and the Dempster-Shafer theory are two approaches that can be used in the development of expert systems for early detection of mental health disorders. The forward chaining method is used to identify early symptoms that may indicate mental health disturbances, whereas the dampster-sshafer theories are used to manage uncertainty in the conclusion process, while the dampster-shafer theorem is used for managing uncertainties in the diagnosis process. The study combines both approaches in the development of an expert system for the early detection of mental health disorders. Furthermore, Dempster-Shafer's theory is used to combine evidence from various symptoms and take into account the uncertainty in diagnosis. This method is implemented in a computer-based expert system that can assist health professionals in the early detection of mental health disorders in patients. The system tests were conducted using information from a number of patients who had been clinically diagnosed, and the results suggested that this approach could provide accurate results in the early detection of mental health disorders. In conclusion, the combination of the forward chaining method and the Dempster-Shafer theory achieved 100% accuracy of the system with an average density of 73,496%.

The risk factors for mental health disorders in patients with type 2 diabetes: An umbrella review of systematic reviews with and without meta-analysis

BackgroundPatients with type 2 diabetes have a nearly twofold higher rate of diagnosed mental disorders than those without diabetes. The association between type 2 diabetes and mental disorders is well established in the literature and recognized as a bidirectional relationship. This study aims to conduct an umbrella review of risk and protective factors for mental health disorders in patients with type 2 diabetes and assess the credibility of the evidence for the association between each factor and mental health disorders. MethodsA comprehensive search was conducted of Medline via PubMed, Web of Science, EMBASE, CINHAL, and PsycINFO from inception to November 17, 2022, to identify systematic reviews with and without meta-analyses examining associations of factors with mental health disorders in patients with type 2 diabetes. For each association, we recalculated the summary effect size and 95% confidence intervals using random-effects models. We also reported the 95% prediction interval and between-group heterogeneity. ResultsThe study included 11 systematic reviews that met the inclusion criteria, comprising eight meta-analyses and three without meta-analyses. This involved approximately 489,930 participants and encompassed 26 unique factors. Six factors were rated as having suggestive evidence at the Class III level. These factors were obesity (n = 18,456, OR 1.75 [1.2 to 2.59], I2 97.7%), neuropathy (n = 3898, OR 2.01 [1.60 to 2.54], I2 44.5%), diabetes complications (n = 1769, OR 1.90 [1.53 to 2.36], I2 39.3%), peripheral blood concentrations of CRP (n = 1742, SMD 0.31 [0.16 to 0.45], I2 84.1%), female sex (n = 35,162, OR 1.36 [1.19 to 1.54], I2 64.5%), and social support (n = 3151, OR 2.02 [1.51 to 2.70], I2 87.2%). ConclusionsSeveral factors associated with mental health disorders in patients with type 2 diabetes were identified with varying degrees of supporting evidence. Significantly, obesity, neuropathy, complications, peripheral blood CRP concentrations, female sex, and social support emerged with suggestive evidence. An investigation of these factors should be conducted to target interventions accordingly. It may be helpful to prioritize patients who have these risk factors as high-risk groups and to implement plans and policies to enhance support before mental health disorders occur.

Newly Diagnosed Mental Health Disorders in Patients With Breast Cancer Receiving Radiation Therapy

ObjectivesPatients with a mental health disorder (MHD) have higher age-adjusted mortality compared to the general population. Few reports investigate factors contributing to MHD among breast cancer patients receiving radiotherapy. Here, we report the incidence of acquired MHD after the diagnosis of breast cancer and treatment with radiotherapy. MethodsUtilizing a single-institution, prospectively maintained database, we analyzed patients with breast cancer treated with radiotherapy between 2012 and 2017. We cross-referenced these patients with newly acquired ICD-10 MHD codes within 3 years post-breast cancer diagnosis. The study included baseline NCCN distress tool scores and area deprivation index (ADI). Univariate (UVA) and multivariable (MVA) Cox regression analyses were conducted to evaluate factors impacting new MHD onset. ResultsOf the 967 included patients, 318 (33%) developed an MHD after their breast cancer diagnosis, which were predominately anxiety (45.1%) and depression (20.1%) related, with a median (IQR) time to diagnosis of 30 (24–33) months. UVA showed lymph node-positive disease, receipt of chemotherapy, receipt of a mastectomy, high comorbidity index, divorced status, retired status, and fourth-quartile ADI as significant predictors. On MVA, only receipt of chemotherapy (HR=1.70, p=0.014) and divorced status (HR=2.04, p=0.009) remained significant. Fourth-quartile ADI, retired status, and high comorbidity index showed trends towards significance (HR=1.78, p=0.065; HR=1.46, p=0.094; HR=1.41, p=0.059, respectively). On MVA examining the effects of the radiotherapy type on MHD, whole breast with regional nodal irradiation (WBI+RNI) (HR=2.31, p=0.015) and post-mastectomy radiotherapy (PMRT) (HR=1.88, p=0.024) were both strong predictors of MHD development. Additionally, an NCCN distress tool score of >3 was also predictive of MHD onset. ConclusionIn this cohort, one in three patients with localized breast cancer developed a new MHD, predominantly related to anxiety and depression. MHD risk was higher among divorced patients, those receiving chemotherapy, and patients receiving PMRT or WBI+RNI. These findings highlight the importance of future studies and targeted interventions to support this vulnerable population.

Prevalence and risk factors of anxiety and depression in patients with multi-drug/rifampicin-resistant tuberculosis.

Mental health disorders in patients with multi-drug or rifampicin-resistant tuberculosis (MDR/RR-TB) receive consistent attention. Anxiety and depression can manifest and may impact disease progression in patients with MDR/RR-TB. Given the heightened stressors resulting from the COVID-19 pandemic, this scenario is even more concerning. To evaluate the prevalence of and risk factors associated with anxiety and depression among patients with MDR/RR-TB in southern China. A facility-based cross-sectional study was undertaken at Guangzhou Chest Hospital in southern China, encompassing a cohort of 219 patients undergoing outpatient and inpatient treatment for MDR/RR-TB. Anxiety and depressive symptoms were assessed using the 7-Item Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9). The ramifications of anxiety and depression were examined using univariate and multivariate logistic regression analyses, with odds ratios (ORs) and age- and sex-adjusted ORs (AORs) employed to quantify their influence. All data underwent statistical analysis using SPSS 25.0, with statistical significance established at P < 0.05. Two hundred and nineteen individuals with MDR/RR-TB were included in the study. The prevalence of anxiety and depression was 57.53% (n = 126) and 65.75% (n = 144), respectively, with 33.3% (n = 73) of the participants experiencing both conditions simultaneously. Multivariate logistic regression analysis revealed that an age of 20-40 years [anxiety AOR = 3.021, 95% confidence interval (CI): 1.240-7.360; depression AOR = 3.538, 95% CI: 1.219-10.268], disease stigma (anxiety AOR = 10.613, 95% CI: 2.966-37.975; depression AOR = 4.514, 95% CI: 2.051-10.108) and poor physical health (anxiety AOR = 7.636, 95% CI: 2.938-19.844; depression AOR = 6.190, 95% CI: 2.468-15.529) were significant risk factors for moderate levels of anxiety and depression. We found that individuals with MDR/RR-TB had an elevated risk of anxiety and depression. To decrease the likelihood of unfavorable treatment outcomes, it is imperative to carefully monitor the psychological wellbeing of patients with MDR/RR-TB and promptly address any detrimental psychiatric conditions.

Preoperative diagnosis of mental health disorder and dysphagia following anterior cervical spine surgery.

Mental health disorders (MHDs) have been linked to worse postoperative outcomes after various surgical procedures. Past studies have also demonstrated a higher prevalence of dysphagia in both acute and community mental health settings. Dysphagia is among the most common complications following anterior cervical spine surgery (ACSS); however, current literature describing the association between an established diagnosis of an MHD and the rate of dysphagia after ACSS is sparse. All patients who underwent ACSS between 2014 and 2020 with a minimum of 6 months of follow-up were retrospectively evaluated at a single institution. Patients were divided into cohorts depending on an established diagnosis of an MHD: the first had no established MHD (non-MHD); the second included patients with a diagnosed MHD. Outcomes were measured using pre- and postoperative patient-reported outcome scores, which included the Swallowing Quality of Life survey for dysphagia, as well as physical and mental health questionnaires. Postoperative dysphagia surveys were obtained at final follow-up for both patient cohorts. A total of 68 and 124 patients with and without a diagnosis of a MHD were assessed. The MHD group reported significantly worse baseline Patient-Reported Outcomes Measurement Information System depression scale scores (p < 0.001), 12-Item Short-Form Health Survey (p < 0.001), and Veterans RAND 12-Item Health Survey (p = 0.001) mental health components compared to non-MHD group. This group continued to have worse mental health status in the postoperative period, as reported by Patient-Reported Outcomes Measurement Information System depression scale scores (p = 0.024), 12-Item Short-Form Health Survey (p = 0.019), and Veterans RAND 12-Item Health Survey (p = 0.027). Postoperative assessment of Swallowing Quality of Life scores (expressed as the mean ± SD) also showed worse dysphagia outcomes in the MHD cohort (80.1 ± 12.2) than in the non-MHD cohort (86.0 ± 12.1, p = 0.001). ACSS is associated with significantly higher postoperative dysphagia in patients diagnosed with an MHD when compared to patients without an established mental health diagnosis. Given the high prevalence of MHDs in patients with spinal pathology, it is important for spine surgeons to take note of the increased incidence of dysphagia faced by this patient population.

424. High Prevalence of Neuropsychiatric Symptoms and Pre-COVID-19 Mental Health Disorders in Patients with Post-Acute COVID

Abstract Background Individuals with post-acute COVID syndrome (PAC), also known as long-COVID, have new or continuing symptoms lasting more than 1 month from COVID-19 infection. Patients may present with neuropsychiatric (NP) and non-NP symptoms. Whether prior mental health disorders correlate with NP symptoms is unknown. The study aims were to describe the demographics, clinical factors, comorbid conditions, and presenting symptoms of PAC. Methods We included patients evaluated at Baystate Health PAC clinic from January 2021-April 2022, with prior COVID-19 infection and new or persistent symptoms of at least 6 weeks. We defined the primary presenting symptoms as NP (cognitive dysfunction (brain fog), anxiety, or depression) or non-NP (dyspnea, fatigue, dizziness, palpitations). The clinician’s diagnostic impression was recorded and characterized as NP or non-NP. Demographics Results We randomly selected 150 of 250 clinic patients for chart review. Most were women, 117 (78%); mean age was 52. Most 106 (71%) had mild acute COVID illness; 36 (24%) were hospitalized. 49% (n=73) had a pre-existing mental health disorder: mood disorder (depression/bipolar) 26 (17%), anxiety 18 (12%), both anxiety and mood disorder 27 (18%). The most common presenting symptoms in order of frequency were fatigue, dyspnea, brain fog, anxiety, depression, and palpitations. 106 (71%) had at least 1 NP presenting symptom or combination of NP symptoms; cognitive dysfunction with anxiety in 23 (15%), and cognitive dysfunction with anxiety and mood disorder in 13 (9%). The clinician's final diagnostic impression was fatigue (47%), cognitive dysfunction (36%), anxiety (29%) depression (33%) and PTSD (3%). A NP diagnosis was made in 81 (54%). Primary Symptoms Primary Diagnosis Conclusion The majority of PAC clinic patients were female and had mild COVID illness. We noted a high prevalence of pre-existing mental health disorders. More than two-thirds presented with one or more NP symptom. Further studies should explore the association of pre-COVID mental health disorders with PAC. Disclosures All Authors: No reported disclosures

Newly Diagnosed Mental Health Disorders in Patients with Breast Cancer Receiving Radiation Therapy

Patients with a mental health disorder (MHD) have higher age-adjusted mortality compared to the general population. There are few reports investigating the factors that contribute to newly diagnosed MHD following the diagnosis and treatment of breast cancer. Here, we report the incidence of acquired MHD after the diagnosis and treatment of breast cancer in patients who received radiation therapy. A database query of a single institution, prospectively maintained database identified patients diagnosed with breast cancer who received whole or partial breast irradiation (WB/PBI) or post-mastectomy radiotherapy (PMRT). A second query of the patients' electronic medical record cross-referenced those patients with ICD-10 mental health diagnosis codes (F1-F99) that were newly acquired following the diagnosis of breast cancer. Univariable and multivariable analyses were performed, analyzing the effect of multiple factors on new mental health diagnoses. Odds ratios (OR) were calculated with a linear regression model, examining demographic characteristics, cancer stage, surgery type, receipt of chemotherapy or hormone therapy, insurance type, and substance use. We identified 1129 patients, aged 26 - 92 years at the time of breast cancer diagnosis, who were treated at our institution between 2012 and 2017. 136 patients had a pre-existing MHD and were excluded from the analysis. 714 (74%) received WB/PBI, and 254 (26%) received PMRT with a median follow up of 63 months. 318 patients (33%) were diagnosed with MHD following breast cancer diagnosis. Median time to diagnosis of MHD was 30 months following the initial breast biopsy. On univariable (UVA) and multivariable analysis (MVA), N+ disease (UVA OR = 1.70, p<0.001), mastectomy (UVA OR = 1.55, p<0.01), receipt of chemotherapy (MVA OR = 1.77, p<0.0001), divorced relationship status (MVA OR = 2.38, p = 0.007), and retired employment status (MVA OR = 1.93, p<0.0001) conferred an increased risk of developing MHD. The primary new MHD identified following completion of radiation therapy included anxiety related disorders (44.4%), depression related disorders (19.4%), tobacco use disorder (12.9%), and dementia related disorders (6.2%). One in three patients treated with radiation therapy developed a new MHD following the diagnosis of breast cancer in this cohort. The majority of acquired MHD in this study were depression and anxiety related disorders. Patients who received chemotherapy, were divorced, or were retired were at a higher risk of developing MHD following breast cancer diagnosis. Further prospective studies are needed to identify potential interventions that would benefit this at-risk population.

43165 Prevalence of mental health disorders in patients with metastatic melanoma treated with Ipilimumab: a multi-site analysis

43165 Prevalence of mental health disorders in patients with metastatic melanoma treated with Ipilimumab: a multi-site analysis

Incidence and Factors Associated With Mental Health Disorders in Patients With Rectal Cancer Post-Restorative Proctectomy.

Most patients with rectal cancer experience bowel symptoms post-restorative proctectomy. The incidence of mental health disorders post-restorative proctectomy and its association with bowel symptoms are unknown. This study aimed 1) to describe the incidence of mental health disorders in patients who underwent restorative proctectomy for rectal cancer and 2) to study the association between incident mental health disorders and bowel dysfunction after surgery. This retrospective cohort study used the Clinical Practice Research Datalink and Hospital Episode Statistics databases. The databases were based in the United Kingdom. All adult patients who underwent restorative proctectomy for a rectal neoplasm between 1998 and 2018 were included. The primary outcome was an incident mental health disorder. The associations between bowel, sexual, and urinary dysfunctions and incident mental health disorders were studied using Cox proportional hazard regression models. In total, 2197 patients who underwent restorative proctectomy were identified. Of 1858 patients without preoperative bowel, sexual, or urinary dysfunction, 1455 had no preoperative mental health disorders. In this cohort, 466 patients (32.0%) developed incident mental health disorders following restorative proctectomy during 6333 person-years of follow-up. On multivariate Cox regression, female sex (adjusted HR 1.30; 95% CI, 1.06-1.56), metastatic disease (adjusted HR 1.57; 95% CI, 1.14-2.15), incident bowel dysfunction (adjusted HR 1.41, 95% CI, 1.13-1.77), and urinary dysfunction (adjusted HR 1.57; 95% CI, 1.16-2.14) were found to be associated with developing incident mental health disorders post-restorative proctectomy. This study was limited by its observational study design and residual confounding. Incident mental health disorders after restorative proctectomy for rectal cancer are common. The presence of bowel and urinary functional impairment significantly increases the risk of poor psychological outcomes among rectal cancer survivors. ANTECEDENTES: La mayoría de los pacientes con cáncer de recto experimentan síntomas intestinales después de la proctectomía restauradora. Se desconoce la incidencia de trastornos de salud mental posteriores a la proctectomía restauradora y su asociación con síntomas intestinales.OBJETIVOS: Los objetivos de nuestro estudio son: a) describir la incidencia de trastornos de salud mental en pacientes sometidos a proctectomía restauradora por cáncer de recto; b) estudiar la asociación entre los trastornos de salud mental incidentes y la disfunción intestinal después de la cirugía.DISEÑO: Este fue un estudio de cohorte retrospectivo que utilizó las bases de datos Clinical Practice Research Datalink y Hospital Episode Statistics.ENTORNO CLÍNICO: Las bases de datos se basaron en el Reino Unido.PACIENTES: Se incluyeron todos los pacientes adultos que se sometieron a una proctectomía restauradora por una neoplasia rectal entre 1998 y 2018.PRINCIPALES MEDIDAS DE VALORACIÓN: El resultado primario fue un trastorno de salud mental incidente. Las asociaciones entre la disfunción intestinal, sexual y urinaria y los trastornos de salud mental incidentes se estudiaron utilizando modelos de regresión de riesgos proporcionales de Cox.RESULTADOS: En total, se identificaron 2.197 pacientes que se sometieron a proctectomía restauradora. De 1.858 pacientes sin disfunción intestinal, sexual o urinaria preoperatoria, 1.455 personas tampoco tenían trastornos de salud mental preoperatorios. En esta cohorte, 466 (32,0 %) pacientes desarrollaron trastornos de salud mental incidentes después de la PR durante 6333 años-persona de seguimiento. En la regresión multivariada de Cox, sexo femenino (HRa 1,30, IC 95% 1,06-1,56), enfermedad metastásica (HRa 1,57, IC 95% 1,14-2,15) e incidencia intestinal (HRa 1,41, IC del 95 %: 1,13 a 1,77) y la disfunción urinaria (aHR 1,57, IC del 95 %: 1,16 a 2,14) se asociaron con el desarrollo de trastornos de salud mental incidentes después de la proctectomía restauradora.LIMITACIONES: Este estudio estuvo limitado por el diseño del estudio observacional y la confusión residual.CONCLUSIÓN: Los trastornos de salud mental incidentes después de la proctectomía restauradora para el cáncer de recto son comunes. La presencia de deterioro funcional intestinal y urinario aumenta significativamente el riesgo de malos resultados psicológicos entre los sobrevivientes de cáncer de recto. (Traducción- Dr. Ingrid Melo ).

Natural language processing identification of documented mental health symptoms associated with risk of mental health disorders in patients with cancer.

1561 Background: Delayed diagnosis and care of mental health disorders (MHD) is a significant challenge in the care for patients with cancer. The objective of this study was to use natural language processing (NLP) to identify words related to mental health documented in clinical notes surrounding the time of cancer diagnosis and assess their predictive ability of future, new MHD. Methods: This single institution cohort study consisted of patients diagnosed with cancer between January 2012 and November 2022. Cancer and MHD were identified based on ICD-10 codes obtained from deidentified electronic health record data. MHD included psychotic disorders (F20-29), mood disorders (F30-39), and anxiety disorders (F40-48). The clinical Text Analysis Knowledge Extraction System was applied to deidentified clinical notes, and symptoms mapped to SNOMED concepts relevant to mental health were identified. These mental health symptoms were aggregated in the 15 days preceding and 15 days following a first cancer diagnosis and analyzed across MHD status. Patient characteristics including sex, age, race, cancer, and insurance were also analyzed. Results: This cohort consisted of 64,010 patients with cancer who had no documented MHD prior to cancer diagnosis, with a majority being 40-64 years old (45.8%) or 65+ (43.7%) and identifying as male (53.0%) or white (60.2%). Most patients had prostate (12.5%), hematologic (10.8%), or breast (10.3%) cancer and private insurance (46.2%). 9,825 (15.3%) patients developed a newly documented MHD, with a median time of 139 days (IQR: 40-466) from cancer diagnosis. The top five most common mental health documented symptoms for all patients were normal mood (23.3%), mental state finding (17.9%), worried (10.2%), feeling content (9.9%), and cognitive function finding (6.6%). Those who had a future MHD had higher documented rates across all mental health symptoms. Multivariate cox proportional hazards model identified 18-39 years old, female, white, and Medicaid or Medicare insurance as independent factors associated with an increased risk of a future, new MHD. Prostate cancer was associated with lower risk of a future MHD. Panic (OR 2.1 [95% CI 1.8-2.4]), feeling nervous (1.9 [1.5-2.4]), feeling guilt (1.9 [1.4-2.5]), mild anxiety (1.8 [1.4-2.4]), and feeling frustrated (1.4 [1.2-1.6]) were identified as the symptoms most strongly associated with an increased risk of a future MHD. Conclusions: NLP extracted mental health symptoms documented in clinical notes correlated with an increased risk of documented MHD. Computational approaches may be tools for improving the timely diagnosis of MHD and referral to specialty services. Further work is needed to investigate potential disparities in documentation and management of care for patients with cancer who develop MHD, including delays between documentation and eventual diagnosis.

Mental health disorders and survival among older patients with diffuse large B-cell lymphoma in the USA: a population-based study

Mental health disorders can potentially decrease quality of life and survival in patients with cancer. Little is known about the survival implications of mental health disorders in patients with diffuse large B-cell lymphoma (DLBCL). We aimed to evaluate the effect of pre-existing depression, anxiety, or both on survival in a US cohort of older patients with DLBCL. Using the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) database, we identified patients aged 67 years or older, diagnosed with DLBCL in the USA between Jan 1, 2001, and Dec 31, 2013. We used billing claims to identify patients with pre-existing depression, anxiety, or both before their DLBCL diagnosis. We compared 5-year overall survival and lymphoma-specific survival between these patients and those without pre-existing depression, anxiety, or both using Cox proportional analyses, adjusting for sociodemographic and clinical characteristics, including DLBCL stage, extranodal disease, and B symptoms. Among 13 244 patients with DLBCL, 2094 (15·8%) had depression, anxiety, or both disorders; 6988 (52·8%) were female, and 12 468 (94·1%) were White. The median follow-up for the cohort was 2·0 years (IQR 0·4-6·9 years). 5-year overall survival was 27·0% (95% CI 25·1-28·9) for patients with these mental health disorders versus 37·4% (36·5-38·3) for those with no mental health disorder (hazard ratio [HR] 1·37, 95% CI 1·29-1·44). Although survival differences between mental health disorders were modest, those with depression alone had the worst survival compared with no mental health disorder (HR 1·37, 95% CI 1·28-1·47), followed by those with depression and anxiety (1·23, 1·08-1·41), and then anxiety alone (1·17, 1·06-1·29). Individuals with these pre-existing mental health disorders also had lower 5-year lymphoma-specific survival, with depression conferring the greatest effect (1·37, 1·26-1·49) followed by those with depression and anxiety (1·25, 1·07-1·47) and then anxiety alone (1·16, 1·03-1·31). Pre-existing depression, anxiety, or both disorders present within 24 months before DLBCL diagnosis, worsens prognosis for patients with DLBCL. Our data underscore the need for universal and systematic mental health screening for this population, as mental health disorders are manageable, and improvements in this prevalent comorbidity might affect lymphoma-specific survival and overall survival. American Society of Hematology, National Cancer Institute, Alan J Hirschfield Award.

Epidemiological Analysis of Mental Health Disorders in Patients at Psychiatric Hospitals in the Special Region of Yogyakarta, Indonesia

Background:  Mental disorder is a condition of decreasing all psychiatric conditions that result in deviant behavior. WHO estimates that one in eight people in the world lives with a mental disorder in the world. The COVID-19 pandemic that has occurred since 2019 has had an impact and has had a major impact on the mental health of people in the world and in Indonesia. The Special Region of Yogyakarta is the province with the highest cases of mental disorders in Indonesia based on the results of the 2013 and 2018 Basic Health Research (Riskesdas) surveys. The purpose of this study was to determine the epidemiological description of mental disorders per classification in inpatients at Mental Hospitals in the Special Region of Yogyakarta in 2019-2021.Subjects and Method:  This study used a quantitative descriptive method, sourced from secondary data from Mental Hospitals in the Special Region of Yogyakarta for the period 2019 - 2021. The population in this study was 4,413, with a total sample of 3,919. The inclusion criteria are data of inpatients with mental disorders recorded in the recapitulation of medical records of inpatients at the Mental Hospital for the period 2019 to 2021. Exclusion criteria are incomplete data. The sampling technique used is total sampling. The person variable consists of a classification of mental disorders, age, gender, education level, occupation, marital status, health insurance, and end of care. The instrument used in this research is a dummy table. Data from this study were analyzed descriptively by looking at the frequency and proportion of each variable studied.Results:  The results showed that the highest disease classification was F20-F29 (schizophrenia, schizotypal disorder, and delusional disorder) 76.72%. Most of them were aged 25-44 years (55.60%), male (61.55%), graduated from high school or equivalent (46.54%), did not work (66.90%), and were not married (57.29%). Most of them use national health insurance (62.95%), end of treatment with doctor's approval (97.86%), and length of stay ≤ 42 days (95.1%). Most of the patients came from Sleman Regency (37.25%) and from urban areas (71.37%).Conclusion:  Most patients with mental disorders are in productive age. People with mental disorders are an economic burden that must be borne by their families and the government. So there is a need for comprehensive prevention efforts to reduce the incidence of mental disorders in the community.Keywords:  mental disorders, epidemiological studies, schizophreniaCorrespondence: Siti Kurnia Widi Hastuti, Faculty of Public Health Universitas Ahmad Dahlan. Jl Prof Dr Soepomo Warungboto Umbulharjo, Special Region of Yogyakarta, Indonesia. Email: kurnia.widihastuti@ikm.uad.ac.id. Mobile: +62813-2843-3256.Indonesian Journal of Medicine (2023), 08(02): 204-218https://doi.org/10.26911/theijmed.2023.08.02.10

The impact of intestinal atresia on educational and mental health outcomes in school-aged children: A case–control cohort study

To assess real-world educational outcomes, neurodevelopmental disorders and mental health disorders in patients with intestinal atresia (IA) and compare these to outcomes to age-matched controls. We performed a retrospective case-control study of children with IA born between 1991 and 2017. We evaluated educational outcomes using an Early Developmental Instrument, Grades 3, 7 and 8 assessments, Grade 9 completion and performance, high school graduation, and neurodevelopmental and mental health disorders using International Classification of Diseases codes available from a population-based dataset. We identified a total of 94 IA cases and 940 date-of-birth-matched controls. Cases with chromosomal anomalies were more likely to fail the Early Developmental Instrument (OR = 2.88, p = 0.037), Grade 8 reading (OR = 2.94, p = 0.043) and Grade 12 (OR = 3.25, p = 0.036); cases without chromosomal anomalies were at no greater risk than their peers of failing to meet expectations and did not have an increased risk of anxiety (OR = 0.48, p = 0.12), depression (OR = 0.74, p = 0.6) or hyperactivity disorder (OR = 1.92, p = 0.087). Our study demonstrated that IA patients without chromosomal anomalies are not at higher risk of neurodevelopmental and mental health disorders than controls. These results will offer more accurate outcome predictions for parents of children with IA.

Mental health disorders in patients with end-stage renal failure

Renal failure is commonly accompanied by psychological distress compounding to mental health conditions such as anxiety and depression. Common risk factors towards the development of mental health disorders in people with renal failure include the need to attend regular hemodialysis session and the burden of related complications. A growing body of evidence has elucidated the biochemical and immunological underpinnings of mental health disorders in the context of renal failure. This knowledge calls for strengthening the existing mental health support frameworks and conducting research with the reported molecular pathways as potential therapeutic targets

Association of Low-Grade Glioma Diagnosis and Management Approach with Mental Health Disorders: A MarketScan Analysis 2005-2014.

Simple SummaryLow-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been improving, it is important to consider the effects of diagnosis and treatment on mental health. The aims of this retrospective cohort study were to determine the incidence, prevalence, and risk factors of mental health disorders (MHD) in LGG patients. In our analysis including 20,432 LGG patients, we identified an MHD prevalence of 60.9%. Of those with no history of prior MHD, 16.9% of LGG patients developed a new onset of MHD within 12 months of LGG diagnosis. Risk factors included female gender, ages 35–54, presence of seizures, and first-line surgical treatment. Therefore, proactive surveillance and counseling surrounding MHDs are recommended among LGG patients. Impact of surgery on brain networks affecting mood should also be considered.Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been gradually improving, it is essential that the effects of diagnosis and disease progression on mental health be considered. This retrospective cohort study queried the IBM Watson Health MarketScan® Database to describe the incidence and prevalence of mental health disorders (MHDs) among LGG patients and identify associated risk factors. Among the 20,432 LGG patients identified, 12,436 (60.9%) had at least one MHD. Of those who never had a prior MHD, as documented in the claims record, 1915 (16.7%) had their first, newly diagnosed MHD within 12 months after LGG diagnosis. Patients who were female (odds ratio (OR), 1.14, 95% confidence intervals (CI), 1.03–1.26), aged 35–44 (OR, 1.20, 95% CI, 1.03–1.39), and experienced glioma-related seizures (OR, 2.19, 95% CI, 1.95–2.47) were significantly associated with MHD incidence. Patients who underwent resection (OR, 2.58, 95% CI, 2.19–3.04) or biopsy (OR, 2.17, 95% CI, 1.68–2.79) were also more likely to develop a MHD compared to patients who did not undergo a first-line surgical treatment. These data support the need for active surveillance, proactive counseling, and management of MHDs in patients with LGG. Impact of surgery on brain networks affecting mood should also be considered.

Management of Mental Health Disorders in Patients With Human Immunodeficiency Virus

Compared with the general population, people living with human immunodeficiency virus are at a higher risk of developing mental health conditions such as depression, substance use disorders, posttraumatic stress disorder, suicidality, psychosis, and generalized anxiety disorder. These conditions can negatively impact the patient’s treatment options, adherence to treatment, and eventual health outcome. Unfortunately, these conditions often go undetected and the correlation with the disease unrecognized. Primary care providers for people living with human immunodeficiency virus need to screen and manage these mental health disorders for improved prognosis.

The role of an educational vignette to teach dental students on issues of substance use and mental health disorders in patients at the University of British Columbia: an exploratory qualitative study

BackgroundInverted classroom approaches and the use of vignettes have been suggested in health care education. The objective of this study was to use an educational vignette to discuss issues of stigma around substance use and mental disorders within undergraduate Doctor of Medicine in Dentistry (DMD) and Bachelor of Dental Science in Dental Hygiene (BDSc-DH) students at the University of British Columbia, Canada. Our research question was “how can an educational vignette, depicting a fictitious patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?”MethodsAn educational vignette was developed based on individuals’ lived-experiences with a variety of substance use and/or mental health disorders. This vignette was used to generate in-class discussion involving all the DMD and BDSc-DH undergraduate students enrolled between 2015/16 and 2018/19 who attended a mandatory 2.5 h didactic session using an inverted classroom approach. Students were also encouraged to provide a post-class voluntary written reflection, between 200 and 300 words, around stigma. The authors took written field notes on students’ response to the vignette and used excerpts from students’ de-identified reflections to illustrate the impact of such an educational tool.ResultsA total of 323 DMD and BDSc-DH students attended the didactic sessions between 2015/16 and 2018/19, and 148 reflections were submitted over the same time period. The inverted classroom approached showed to be engaging and collaborative. The vignette promoted open dialogue and was determined to be a conducive tool to generate in-class discussion and reflection. Major themes from the textual data included ‘exploring power relations’ and ‘patient-centered care approach to counteract stigma’. The vignette also enabled the discussion of positive experiences characterized by empathy, reassurance and communication, although it might not have prompted all students to participate in class or in writing the reflections.ConclusionThe inverted classroom approach and the vignette seemed to be an effective way to facilitate dialogue and reflection for most students. This study highlighted the need to explore innovative ways in which to continuously prepare current and future oral health care providers to professionally address the needs of patients with a history of substance use and/or mental health disorders.

Comparative study of prevalence and costs of depression and anxiety among elderly cancer patients.

6595 Background: Depression and anxiety are common among cancer patients and can worsen outcomes. We studied the occurrence of depression and anxiety in three common cancers to investigate whether healthcare costs were greater for cancer patients with two mental health disorders (MHD), depression and anxiety, compared to patients without MHD. Methods: This retrospective analysis used deidentified medical and pharmacy claims from a large national U.S. health insurer. Patients were Medicare Advantage enrollees ≥65 years diagnosed with breast, colorectal, or prostate cancer and continuously enrolled from 1/2018–12/2019. We determined statistically whether the annual prevalence of the two MHDs varied by cancer types. Total costs and costs exclusive of MHD-related expenses in five sub-categories were compared: inpatient, emergency room, non-inpatient medical, professional, and pharmacy. Costs from 2019 claims were presented as per-patient per-month (PPPM). Direct depression- and anxiety-related costs were from claims with depression/anxiety diagnoses or drugs. The impact of MHDs on 2019 healthcare spending was examined using multiple linear regression, controlling for demographic and clinical characteristics. LASSO was used for variable selection. Mann-Whitney U tests compared differences in costs by service types between patients with and without MHDs. Results: Of 19,304 study patients, 8,916 (46%) had coexisting depression or anxiety: (i) 4% depression only; (ii) 27% anxiety only; (iii) 7% depression and anxiety; and (iv) 8% were on antidepressant without MHDs diagnoses. There were significant differences in the rates of MHDs between the three cancer groups, with the highest frequency in breast cancer ( breast vs colorectal. 56% vs 49%, p &lt; 0.0005 ; breast vs prostate. 56% vs 38%, p &lt; 0.0005; colorectal vs prostate. 49% vs 38%, p &lt; 0.0005). After excluding the MHDs-related costs (PPPM mean = $44), the monthly spending was 54% higher for patients with MHDs ($2,184 MHDs vs. $1,406 non-MHDs). After adjusting for covariates, the PPPM costs were 23%–58% higher for the MHD-cohort vs. the non-MHD cohort for each cancer type ( non-MHD vs. with depression only, CI 13%–34%, p &lt; 0.0001; non-MHD vs. with anxiety only, CI 40%-52%, p &lt; 0.0001; non-MHD vs. with depression and anxiety, CI 48%-70%, p &lt; 0.0001; non-MHD vs. with antidepressant only, CI 28%-45%, p &lt; 0.0001). Higher costs in MHD-cohort were observed in all cost categories (p &lt; 0.0001). Conclusions: We found high prevalence of MHDs in patients diagnosed with cancer. Analyses showed that total spending was significantly higher in individuals with cancer and MHD for all cost categories. Explanations for higher costs are unclear, as costs remain high even after adjusting for MHD-related care costs. Research on specific healthcare services driving higher costs and the risk factors for depression and anxiety is needed to address broader MHDs to improve cancer care.

Predictors of mental health disorders in women with breast and gynecological cancer after radical surgery: A cross-sectional study

IntroductionIn lower-middle-income countries, significant progress has been made in the therapeutic management of cancers. However, mental health disorders related to these diseases are usually underestimated by the health system. The aim of this study is to investigate the predictive factors for mental health disorders in Moroccan women with breast or gynecological cancer treated by radical surgery. Material and methodsA cross-sectional study was carried out on Moroccan women treated by radical surgery for breast or gynecological cancer (N = 200). For each cancer type, patients were divided into two groups following age criteria. Hospital Anxiety and Depression Scale and Body image scale were used. ResultsAge had a significant effect on mental health disorders but not the type of cancer. Younger women showed significantly greater mental health disorders than older women (p ≤ 0.001). The predictive model for high anxiety and depression included the effect of the following variables: Being younger, having lower income, and advanced tumor stage. For higher body image dissatisfaction, the variables are as follows: being younger, having fewer children, lower-income, and advanced tumor stage. ConclusionThe association of mental health disorders in patients with breast or gynecological cancer increases their distress. The establishment of management protocols for these disorders is strongly recommended in oncology departments.

Increased risk of mental health disorders in patients with RA during the COVID-19 pandemic: a possible surge and solutions.

Depression is a common co-morbidity among rheumatoid arthritis (RA) patients, which may translate into difficulty performing activities of daily living. COVID-19 is an unprecedented disaster that has disrupted lives worldwide and led to a rise in the incidence of mental health disorders. Given the widespread economic devastation due to COVID-19, many RA patients, already susceptible to mental illness, maybe at an increased risk of inaccessibility to medical care, accentuated stress, and consequent worsening of existent mental health disorders, or the onset of new mental health disorders such as anxiety, post-traumatic stress disorder, or depression. The objective of this review is to assess if there is an increased risk of mental health disorders in patients with RA during the COVID-19 pandemic. Telemedicine has bridged the transition to remote chronic care in the pandemic period, though certain accessibility and technological challenges are to be addressed. Decreased access to care amid lockdowns and a proposed triggering of disease activity in patients with autoimmune disorders may potentially herald a massive spike in incidence or flares of patients diagnosed with RA in the coming months. Such a deluge of cases may be potentially devastating to an overburdened healthcare system. Rheumatologists may need to prepare for this eventuality and explore techniques to provide adequate care during these challenging times. The authors found that there is a significant association between the adverse impact on the mental health of RA patients and the COVID-19 pandemic. However, more research is needed to highlight individual risk factors.