Mental Health Problems In People Research Articles

Mobile Phone and Web-based Cognitive Behavior Therapy for Depressive Symptoms and Mental Health Comorbidities in People Living With Diabetes: Results of a Feasibility Study.

BackgroundDepression is often comorbid with diabetes; however, undertreatment of depressive symptoms in people affected is common.ObjectiveWe studied preliminary acceptability and effectiveness of a fully automated, mobile phone, and web-based public health intervention, myCompass, for reducing depressive symptoms and improving mental health comorbidities in people with diabetes.MethodsIn this single-group feasibility study, 89 volunteers with type 1 (n=34) or type 2 (n=55) diabetes and at least mild depressive symptoms used myCompass for 7 weeks. Web-based measures of depressive and anxious symptoms, functional impairment, diabetes-specific variables, and user satisfaction were completed at baseline, postintervention, and 3-month follow-up.ResultsRetention rates were 54% (n=48) at postintervention and 36% (n=32) at follow-up. Depressive symptoms were significantly improved at postintervention (P<.001; within-group effect size d=1.05), with gains persisting at follow-up. Mental health comorbidities, including anxiety (P<.001), functioning (P<.001), and diabetes-specific distress (P<.001), also showed significant and sustained improvement. Satisfaction with myCompass was high, with convenience and ease of program use, and relevance of program content rated positively by participants.ConclusionsThe myCompass program shows promise as an acceptable and effective treatment for depression and comorbid mental health problems in people with diabetes. The program is broadly available, free to use, and may benefit patients with diabetes who do not access services and/or wish to manage their mental health themselves. Replication of these findings in a controlled study is warranted.

Pharmacotherapy for mental health problems in people with intellectual disability.

Psychotropic medications are commonly prescribed to people with intellectual disability. We reviewed current evidence-based pharmacotherapy options and recent updates to guide clinicians in their medication management plans. Antipsychotics, particularly risperidone, appear to be effective in reducing problem behaviors in children with intellectual disability. Evidence in adults is inconclusive. Methylphenidate appears to be effective, and α-agonists appear promising in reducing attention-deficit hyperactivity disorder symptoms. Lithium might be effective in reducing aggression. Evidence is limited to support the use of antiepileptic drugs, anxiolytics, and naltrexone for management of problem behaviors. Antidepressants may be poorly tolerated and might not be effective in reducing repetitive/stereotypic behaviors.In recent trials, glutamatergic and GABAergic agents for fragile X syndrome, and acetylcholinesterase inhibitors for Down's syndrome, failed to show efficacy. Growth hormone treatment might improve cognition and behavior in Prader-Willi syndrome population. Results from oxytocin trials on social behaviors are inconclusive albeit promising. Melatonin appears to improve sleep. Most trials of dietary supplements did not show benefits. Evidence-based pharmacotherapy options in people with intellectual disability are limited, and many agents can cause substantial adverse events. For this reason, clinicians should consider pharmacotherapy as only a part of comprehensive treatment, and regularly assess drug effects, adverse events, and the feasibility of decreasing dose or withdrawing medications.

Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990–2014

ABSTRACTMental health problems continue to be a significant comorbidity for people with HIV infection, even in the era of effective antiretroviral therapy. Here, we report on the changes in the mental health diagnoses based on clinical case reports amongst people with HIV referred to a specialist psychological medicine department over a 24-year period, which include the relative increase in depressive and anxiety disorders, often of a chronic nature, together with a decline in acute mental health syndromes, mania, and organic brain disorders. In addition, new challenges, like the presence of HIV and Hepatitis C co-infection, and the new problems created by recreational drugs, confirm the need for mental health services to be closely involved with the general medical services. A substantial proportion of people with HIV referred to specialist services suffer complex difficulties, which often require the collaboration of both psychiatrists and psychologists to deal effectively with their difficulties.

The Function of a Crisis Intervention and Outreach (MHIST) Team Within an Intellectual Disability Service

Introduction The incidence of mental health problems in people with intellectual disability (ID) varies but is higher than the general population. Often individuals with ID and comorbid mental health issues are admitted to General Adult Psychiatric beds highlighting difficulties with communication, the deficit in skills and lack of confidence of mainstream staff. This lead to the development of the Mental Health Outreach Service in 2008 as a pilot to address the needs of the increasing number of adults with intellectual disability and mental health problems being admitted to mainstream psychiatric wards within Lothian. Objectives Present evidence of an Outreach Service for individuals with ID and mental health issues, the functioning of the team and the impact on preventing admissions. Aim To describe the functioning of the MHIST Team and present the demographic profile of the clients on the caseload. Method Data was reviewed from the referral and discharge information for the MHIST Team over the period of 2011-2013. Results During the review period the MHIST Team had an average caseload of 51 patients per year, mixed between community and hospital. The length of involvement ranged from 3 days to 1379 days depending on the reason for referral, diagnosis and time for transfer to specialist ID bed. Conclusion It is beneficial to have a dedicated Outreach Team within an ID Service to reduce or prevent admissions through intensive support and in certain cases support hospital admissions into General Psychiatry by aiding communication, skills and education and support of the mainstream nurses.

Modifying Cognitive-Behavioral Therapy for a Depressed Older Adult With Partial Sight: A Case Report.

Depression is a common mental health problem in older adults, especially among those suffering from visual impairment. A clinical case of an Indonesian older adult with retinal detachment (75% blindness) suffering from Major Depressive Disorder, based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria, was reported. Her principal motivation to seek help was her depressive symptoms, as well as her husband’s discomfort with her change. A modified standardized cognitive-behavioral therapy was delivered in eight sessions, and a clinically significant reduction of depressive symptoms was observed at the middle of the treatment (Session 5); symptoms were further reduced at follow-up. This case report showed that conventional evidence-based psychological treatment can be modified to handle mental health problems in people with visual impairments.

Intellectual disability and mental health: is psychology prepared?

Purpose – The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach – The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings – The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications – This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value – This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning.

Service Use for Mental Health Problems in People with Delusional-Like Experiences: A Nationwide Population Based Survey

ObjectivePrevious population-based studies have found that delusional-like experiences (DLEs) are prevalent in the community, and are associated with a wide range of mental health disorders. The aim of the study was to investigate mental health service use by people with DLEs.MethodsSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007 of 8 841community residents aged between 16 and 85 years. The Composite International Diagnostic Interview (CIDI) was used to identify DLEs. Service utilization was assessed using a module that elicited information about hospital admissions, consultations with various health professionals, and prescription medication use. This study focussed on service use for mental health problems. We used logistic regression to examine the association, adjusting for potential confounding factors.ResultsOf 8 773 included participants, 8.4% (n = 776) positively endorsed one or more DLEs. With respect to consultations for mental health needs, individuals who endorsed DLEs were more likely to consult health professionals compared with those who did not endorse DLEs. Individuals with DLEs were also more likely to use prescription medicine. When we repeated the main analysis in a subgroup excluding any CIDI diagnosis of mental health disorders the results remained largely unchanged.ConclusionsDLEs are common in the general population, and individuals with DLEs have an increased rate of accessing services for their mental health needs. Individuals endorsing both DLEs and increased help-seeking may identify a group of vulnerable people who have increased risk of developing psychotic illnesses later in life. This needs closer scrutiny in longitudinal prospective studies.

Intellectual Disabilities and Mental Health: United States–Based Research

In the United States, research directed specifically at improving our understanding of the psychiatric assessment and treatment of individuals with intellectual disabilities (ID) has grown, yet lags far behind efforts for typically developing children and adults. In the United States, a lack of a national approach to the mental health problems of people with ID has likely contributed to a lack of a clear and cohesive national research agenda for “dual diagnosis” of intellectual disabilities and mental health disorders. Despite these concerns, much has been learned and important progress has been made. This article provides an overview of the latest developments in research and social policy on behalf of persons with ID and mental health needs in the United States.

Reviewing Research of Mental Health Problems for People With Intellectual Disabilities

Reviewing Research of Mental Health Problems for People With Intellectual Disabilities

Cognitive coping and goal adjustment are associated with symptoms of depression and anxiety in people with acquired hearing loss

Objective: The present study examined the joint influence of cognitive coping strategies and goal adjustment on symptoms of depression and anxiety in people with acquired hearing loss (AHL). Design: The study had a cross-sectional design in which participants were asked to fill in written questionnaires. Study sample: The sample consisted of 119 individuals with moderate to profound AHL, acquired in adulthood. Symptoms of depression and anxiety, cognitive coping strategies, and goal-related coping processes were assessed. Results: Relationships between these variables were statistically tested by Pearson correlations and multiple regression analyses. The results showed that ruminative and catastrophizing ways of coping were related to the reporting of more symptoms of depression and/or anxiety. In contrast, refocusing attention to more pleasant issues, disengaging from unattainable goals, and re-engaging in alternative, meaningful goals were related to the reporting of less symptomatology. Conclusions: These results provide us with important targets for prevention and intervention of mental health problems in people with AHL.

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. A Dutch version of the Mini PAS-ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large-scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. The Dutch version of the Mini PAS-ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion-validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. The present research reconfirmed the use of the Mini PAS-ADD as a primary screening device for the identification of mental health problems among people with ID.

Mental health care for Canadians with developmental disabilities.

Abstract My research focuses on the promotion of mental health and the treatment of mental health problems in people with developmental disabilities. People with developmental disabilities are at high risk for developing mental health problems or serious challenging behaviours at some point in their lives. Research is needed to address these mental health concerns by studying programs that can promote mental health in people with developmental disabilities, die experiences of parents of people with developmental disabilities, and the training needs of graduate students in psychology to provide mental health care to clients with developmental disabilities. More generally, Canadian psychology has an important role to play in mental health promotion for individuals with developmental disabilities. Keywords: developmental disability, intellectual disability, autism spectrum disorders, mental health Approximately 1-3% of the population has a developmental disability (DD), which includes individuals with intellectual disabilities and/or autism spectrum disorders (American Psychiatric Association, 2000; Ouellette-Kuntz & Paquette, 2001). Individuals with DD are at high risk for developing mental healdi problems and have poorer prognosis dian typically developing individuals. In Great Britain for instance, 36% of children with DD also meet criteria for a co-occurring mental healtii problem, a prevalence rate five times greater than in peers without DD (Emerson & Hatton, 2007), and similar rates are found in adults with DD (Cooper, Smiley, Morrison, Williamson, & Allan, 2007). Mental healdi disorders are important predictors of poor overall health in individuals with DD (Linehan, Noonan Walsh, van Schrojenstein Lantman-de VaIk, & Kerr, 2004). As a result of the sizable population base and level of need, it is important to conduct research that investigates protective factors that bolster mental health, and there is a need for new and more effective treatment options mat rectify problems when they arise. My program of research comprises three streams that study: (a) interventions that can improve mental health in people with DD, (b) families who care for people with DD, and (c) mental health services and training that can increase access to mental health care for people with DD. Research on Interventions One efficient way of targeting mental healdi risk is to identify programs that serve a protective role by promoting mental health before problems arise. More specifically, I have been involved in studying Special Olympics, a sport organisation for children and adults with DD, which has long been noted by parents and professionals as a program that can enhance the self-esteem, confidence, independence, and socialization of participants (Klein, Gilman, & Zigler, 1993). My research was among the first in Canada to quantitatively examine psychological benefits of involvement, studying athlete participation in Special Olympics over a 3-year period, and finding positive changes in athletes' self-concept, and adaptive and maladaptive behaviours (Weiss & Bebko, 2009). This research identified specific program characteristics (e.g., the number of competitions and years in the program) that related to addete psychological well-being (Weiss, Diamond, Demark, & Lovald, 2003). Empirically identifying variables of import has led to a renewed focus on ensuring that sport programming results in positive psychological benefits for athletes with DD, and has informed program developers about the aspects of the program that should be emphasised (e.g., focusing on creating more opportunities for local level competitions). Research on Families If we are interested in prevention and intervention for people with DD, it is integral that research be directed toward understanding and supporting parents, who are significant agents in maintaining the mental health of their children across the life span. …

DIAGNOSIS AND TREATMENT OF DEPRESSION IN PERSONS WITH INTELLECTUAL DISABILITY

This paper considers, from the theoretical point of view, the problem of diagnosing and treatment of depressive disorders in people with intellectual disability (ID), relying primarily on the results of previous researches, which stress the etiological, symptomatic, diagnostic and therapeutic specifics when it comes to depression and its correlates in this population. The interest in mental health and psychopathology of people with ID intensified during the seventh decade of the previous century, when it became clear that some cognitive and behavioral symptoms are not, as hitherto thought, only a part or a consequence of the syndrome of intellectual disability, but a sign of ongoing mental disorder. So, the idea of ''dual diagnosis'' was born, and now it provides guidelines for the growing number of studies which theoretically and empirically review different issues of mental health problems in people with ID. Likewise, the observation of syndrome groups of genetic disorders resulting in intellectual disability has led to the narrowing of the circle of genetic syndromes that carry increased risk for the onset of depression and its correlates, such as: Down syndrome, Fragile X syndrome and Prader-Willi syndrome. Potential diagnostic problem in people with ID, when it comes to depression, may arise from ''diagnostic overshadowing’’ of depression symptoms, which often remain hidden under abnormal behavior and adjustment disorders, especially in patients with severe forms of ID. As a possible way to overcome these problems some authors have proposed the concept of ''behavioral equivalents of depression'' or behavioral disorders that evidently can be associated with depression, such as social withdrawal, aggression, hostility, irritability, psychomotor agitation or retardation. Intensification of these forms of behavior may be a sign of developing depression, and in that sense, this view represents a useful starting point. When it comes to therapeutic approaches, there is a general tendency in favour of psycho pharmacotherapy in the treatment of depression, although there is a growing number of researches that prove the favourable effects of cognitivebehavioral and psychoanalytic psychotherapy. Acta Medica Medianae 2011;50(3):81-89.

The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: Findings from an Australian national survey of youth

Young people are an important source of first aid for mental health problems in people they are close to, but their first aid skills remain inadequate. Research into the factors that influence mental health first aid skills are required to reveal targets for improving these skills. This study examined the influence of stigma on first aid actions taken by young people to help someone close to them with a mental health problem. Participants in a national telephone survey of Australian youth (aged 12-25 years) reported on their stigmatising attitudes based on one of three disorders in vignettes: depression, depression with alcohol misuse, and social phobia. At a two-year follow-up interview, they were asked if they knew a family member or close friend with a problem similar to the vignette character since the initial interview, and those who did reported on the actions taken to help the person. Of the 1520 participants interviewed at follow up, 507 reported knowing someone with a similar problem. Young people's stigmatising attitudes (weak-not-sick, social distance and dangerousness/unpredictability) influenced their first aid actions. Social desirability could have affected the assessment of stigma, we could not assess the severity of the first aid recipient's problem or the benefit derived from the first aid provided, and the proportion of variance explained was modest. Reducing stigma may help to improve the first aid that people with mental health problems can receive from young people who are close to them.

Assessment of mental health problems in people with Down syndrome: key considerations

Accessible summary People with Down syndrome can have problems with the way they think, feel, and act. Those who help people understand these difficulties need to have information about the factors that can contribute to such problems. This knowledge is important so difficulties can be found early, and help given. SummaryThe dual disability literature is marked by a lack of reviews with respect to assessment of specific aetiological groups. The current review summarises the wide body of literature relevant to the assessment of psychiatric and behavioural problems in people with Down syndrome. Adequate assessment within this population requires knowledge, not only of epidemiological findings with respect to psychiatric and behavioural problems, but also an understanding of other important areas including psychometrics, neurocognitive functioning, dementia and other medical issues. These areas are reviewed, and directions for future research are proposed.

Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study

BackgroundPeople who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed.MethodsGuidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds.ResultsThere were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper.ConclusionsThere are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic events, but the degree to which it helps has not yet been adequately demonstrated. An evaluation of the effectiveness of these guidelines would be useful in determining their value. These guidelines may be useful to organisations who wish to develop or revise curricula of mental health first aid and trauma intervention training programs and policies. They may also be useful for members of the public who want immediate information about how to assist someone who has experienced a potentially traumatic event.

Stigma and mental health in the Royal Navy: A mixed methods paper

Background: US research suggests that military personnel suffering from mental health problems are reluctant to seek help because of stigma.Aims: First, to identify the prevalence of mental health stigma beliefs in a UK military sample. Second, to investigate whether distressed personnel report more stigma than those who are not distressed.Method: A survey of 1599 naval personnel was undertaken as part of a larger trial prior to examining the effectiveness of a novel trauma support program.Results: The presence of internal stigma was substantial and significantly higher for distressed personnel. The prevalence of stigma about other people's mental health problems was low. Junior personnel reported being more uncomfortable in discussing emotional issues with their peer group than senior staff.Conclusions: Internal stigma remains a significant barrier to help seeking within the Royal Navy, especially for distressed personnel. This may be especially problematic for junior personnel who are known to be particularly vulnerable to developing mental health problems.

Prevention of mental health problems in people with intellectual disability

Purpose of review Little information is available on healthcare provision related to the prevention of mental health diseases in people with intellectual disabilities. This review summarizes recent literature reports concerning mental health problems, services and prevention in people with intellectual disability. Method Electronic searches of Medline, PubMed and PsychInfo literature mainly using the key terms of prevention, health policy, mental health, mental disorder, intellectual disability, learning disability and mental retardation were carried out. Recent findings Most experts agree on the need for prevention or early recognition of mental health problems through better screening and appropriate treatment of people with intellectual disability. Recent studies have attempted to provide treatment-oriented solutions, specific mental health units and integrative treatment or person-centered planning for this service user group, although inequalities in both access to and the efficacy of services still exist in practice. There is also a continuing lack of sound evidence to support preventive policy-making related to the diagnosis and treatment of mental health problems in people with intellectual disability. Such evidence to support the implementation of proposed guidelines, protocols and programs related to preventive mental health policies has been poor and needs development. Summary To minimize the impact of mental health problems in people with intellectual disability, an evidence-based preventive policy is urgently needed for this group of people. In addition, there is an urgent need to establish an appropriate screening and monitoring system to track their mental health status and understand the treatment and side-effect profiles of psychiatric medication used to combat these disorders.

Psychosis and autism: magnetic resonance imaging study of brain anatomy

Autism-spectrum disorder is increasingly recognised, with recent studies estimating that 1% of children in South London are affected. However, the biology of comorbid mental health problems in people with autism-spectrum disorder is poorly understood. To investigate the brain anatomy of people with autism-spectrum disorder with and without psychosis. We used in vivo magnetic resonance imaging and compared 30 adults with autism-spectrum disorder (14 with a history psychosis) and 16 healthy controls. Compared with controls both autism-spectrum disorder groups had significantly less grey matter bilaterally in the temporal lobes and the cerebellum. In contrast, they had increased grey matter in striatal regions. However, those with psychosis also had a significant reduction in grey matter content of frontal and occipital regions. Contrary to our expectation, within autism-spectrum disorder, comparisons revealed that psychosis was associated with a reduction in grey matter of the right insular cortex and bilaterally in the cerebellum extending into the fusiform gyrus and the lingual gyrus. The presence of neurodevelopmental abnormalities normally associated with autism-spectrum disorder might represent an alternative 'entry-point' into a final common pathway of psychosis.

Factor structure of the PAS-ADD Checklist with adults with intellectual disabilities

Background The PAS-ADD Checklist is designed to screen for likely mental health problems in people with intellectual disabilities (ID). The specificity of recommended subscales derived from diagnostic criteria is unclear. This paper therefore investigates the factor structure of the PAS-ADD Checklist to determine the adequacy of empirically derived subscales.Method A total of 1,115 informants who had known service users for a median of 24 months completed the PAS-ADD Checklist on 1,155 adults with ID living either in the community, in residential care, or in hospital settings in a county in North-East England.Results The sample was randomly divided into two, with all item scores dichotomised. An exploratory principal components factor analysis with varimax rotation was conducted on Subsample A, producing an optimal 7-factor solution. However, a confirmatory factor analysis using this factor structure for Subsample B revealed a mediocre to poor fit. Further exploratory and confirmatory factor analyses also indicated that empirically derived PAS-ADD Checklist subscales were inconsistent.Conclusion Given the inconsistency of empirically derived subscales, we do not recommend using the PAS-ADD Checklist to identify specific types of psychopathology. The Checklist may have more utility as a screening tool for general psychopathology and subsequent referral for more detailed assessment.