Mental Illness In People Research Articles

Ward atmosphere for inpatients with intellectual disability and mental illness: family members’ perceptions and experience

Inpatient admission may be necessary and effective in treatment of mental illness in people with intellectual disabilities. Although risk of mental illness is increased in this population, adaptations of inpatient treatment and ward atmosphere for this population remain sparsely described. For the current qualitative study, family members were interviewed about their experiences of ward atmosphere and mental health nursing in a specialised inpatient ward for adults with intellectual disabilities. Using thematic analysis, four themes were identified. Two concerned participants’ perceptions of the patient’s experience (patients’ therapeutic relationships with staff members, and staff attitudes and specific expertise in working with people with intellectual disabilities), while two concerned the patients’ own experiences (feeling safe and involved, and gaining new knowledge and understanding). These findings indicate that trust in staff is important for family members to feel safe, and that extra effort may be necessary to build such trust among the families of inpatients with intellectual disabilities. Developing good 1:1 therapeutic relationships with the patient, helping the patient feel safe and understood, demonstrating specific experience and skills relating to mental health care for this specific population, family involvement, and understanding inpatient treatment as a collaborative effort, may all contribute to facilitating this trust.

Anxiety and Depression in People with Eczema or Psoriasis: A Comparison of Associations in UK Biobank and Linked Primary Care Data.

Previous research has shown associations between eczema and psoriasis and anxiety and depression. We investigated whether associations are consistent across different settings of ascertainment for depression and anxiety, including interview and survey responses from UK Biobank (a large longitudinal cohort recruiting individuals aged 40-69 years between 2006-2010), and linked primary care data, with the aim of drawing more reliable conclusions through triangulation. In cross-sectional studies, we estimated associations between eczema or psoriasis and anxiety or depression, defining anxiety or depression as 1) self-reported previous diagnosis at UK Biobank recruitment interview; 2) PHQ-9/GAD-7 score indicating depression or anxiety from a UK Biobank mental health follow-up survey in 2016; and 3) diagnosis in linked primary care electronic health record data. We analysed 230,047 people with linked Biobank and primary care data. We found poor agreement between the data sources for eczema, psoriasis, anxiety, and depression. Eg, 9474 had a previous eczema diagnosis in primary care data, 4069 self-reported previous eczema diagnosis at the UK biobank interview, and 1536 had eczema in both data sources (for depression 40,455; 13,320; and 9588 respectively). Having eczema or psoriasis (recorded in primary care or baseline interview) was associated with higher odds of anxiety and depression. Eg, the adjusted odds ratio for depression comparing those with eczema to those without was greater than 1 when defining the outcome from 1) the recruitment interview (1.36, 95% confidence interval 1.27-1.45); 2) the follow-up survey (1.24, 1.09-1.39), and 3) primary care records (1.56, 1.50-1.62). Our findings support increased prevalence of mental illness in people with psoriasis and eczema across multiple data sources, which should be considered in planning of mental health services. However, we found poor agreement in disease ascertainment between settings, with implications for data interpretation in electronic health records.

Impact of Psychological and Social Determinants on Health

The World Health Organization defines the Social Determinants of Health (SDH) as "the conditions under which people are born, grow, work, live, and age, as well as the broader set of forces and systems influencing the conditions of daily life". Psychosocial variables and social determinants both have an important role in determining a person's health and well-being. The psychological, social, and cultural dimensions of these issues can have an impact on a person's behavior and health. Stress, education, poverty, social exclusion, discrimination, and violence are a few examples of these psychosocial determinants. These elements can be protective or, on the other hand, raise the risk of physical and mental illness and lower people's quality of life. Social determinants of health are a combination of social, economic, and physical factors. They play a role in determining the patterns of illness, disease, and health that are observed in a population. They establish the circumstances in which people are conceived, develop, live, work, and age. Health and medical care, economic security, social and communal context, local geography and built environment, and education are all examples of social determinants of health. The connection between individuals and their social and physical environments frequently worsens poor health outcomes. Low socioeconomic position, unemployment, strained family ties, and hazardous neighborhoods have been shown in studies to have a significant negative impact on mental health. Additionally, those who suffer from severe psychological disorders are more probable to experience social segregation, poverty, food insecurity and housing uncertainty all of which can decrease quality of life and hamper rehabilitation. Pakistan experienced the largest gain among the SAARC nations between 2013 and 2018, increasing its happiness score by 26 points, and is expected to rank among the top 20 gainers globally in 2020 [2]. However, it lowers to 4.934from 2018-2020 and is ranked 105 out of 149 happiest countries. There could be a number of causes for this downward tendency. The need of the hour is to pinpoint the causes of Pakistan's declining happiness level. These findings would help policymakers get rid of or manage the factors contributing to people's lower levels of happiness. It is improbable to understate the importance of social and psychological factors in determining health. Healthcare systems and politicians may create initiatives that successfully promote well-being, lessen health inequities, and enhance overall health outcomes by understanding and addressing these variables. A healthier and more equal society must be built via comprehensive strategies that incorporate socioeconomic inequities and mental health care. In order to promote a more inclusive and sustainable society, the international community is making great progress towards reaching many Sustainable Development Goals (SDGs). We are covering several SDGs described by United Nations which include: SDG 1, “No Poverty”; SDG 2, "Zero Hunger"; SDG 3, "Good Health and Well-being"; SDG 4, "Quality Education"; SDG 5, "Gender Equality"; SDG 8, "Decent Work and Economic Growth" and SDG 10, "Reduced Inequalities". The elimination of poverty, hunger, and inequality, as well as the promotion of sustainable economic growth, are the top priorities behind these objectives. By achieving these objectives, we can collectively work towards a more sustainable and equitable future in which no one is left behind.

Self-help Digital Interventions Targeted at Improving Psychological Well-being in Young People With Perceived or Clinically Diagnosed Reduced Well-being: Systematic Review.

BackgroundLevels of well-being are declining, whereas rates of mental health problems remain high in young people. The World Health Organization defines mental health as not merely the absence of mental disorder but also includes social and psychological well-being as integral to positive mental health, highlighting that mental health is applicable to young people with mental health conditions and those without a diagnosis of a mental health condition. Reduced mental well-being have been identified in studies of young people with clinical populations, as well as in populations consisting of nonclinical young people. Self-help digital interventions can be delivered at mass at a low cost and without the need for trained input, thereby facilitating access to support for well-being. Self-help interventions are effective in young people with mental health conditions, but systematic reviews of such studies have been limited to randomized controlled trials, have not included reduced well-being as an inclusion criterion, and do not consider engagement factors such as retention.ObjectiveThe objective of this study was to systematically review all controlled studies of digitally delivered, self-administered interventions for young people aged 9 to 25 years, with perceived or clinically diagnosed reduced psychological well-being. Participant retention and effectiveness of the interventions were also explored.MethodsA systematic search of the PsycInfo, EMBASE, Cochrane, Scopus, and MEDLINE databases from inception to 2021, reference searches of relevant papers, and gray literature was carried out for digitally controlled studies conducted with young people with perceived or clinically diagnosed reduced well-being, aimed at improving psychological well-being. Data were extracted to identify the effectiveness and retention rates of the interventions and the quality of the studies.ResultsOverall, 1.04% (12/1153) of studies met the inclusion criteria: 83% (10/12) of studies were randomized controlled trials and 17% (2/12) were controlled pre-post studies. Most (6/12, 50%) studies aimed to improve symptoms of depression; 3 interventions aimed at both anxiety and depressive symptoms and 2 studies aimed at improving social functioning difficulties. Owing to the high risk of bias across interventions and lack of similar outcome measures, a meta-analysis was not conducted. Retention rates across studies were regarded as good, with moderate to high retention. Overall, the findings indicated that predominantly self-administered self-help interventions improved well-being in the areas targeted by the intervention and identified additional areas of well-being that were positively affected by interventions. Few interventions supported psychological well-being that was different from those used by young people with a clinical diagnosis of mental illness or young people from neurodiverse backgrounds.ConclusionsThe findings, along with the advantages of self-help interventions, highlight the need for upscaling self-help interventions to better support vulnerable populations of young people who experience poor psychological well-being.Trial RegistrationPROSPERO CRD42019129321; https://tinyurl.com/4fb2t4fz

P441. Working Memory Impairment is Associated With Altered Brain Morphometry and Structural Connectivity in Children and Adolescents With Chromosome 22q11.2 Deletion Syndrome

Working memory (WM) impairment contributes to learning difficulties and may be a risk indicator for later mental illness in people with neurodevelopmental disorders like chromosome 22q11.2 deletion syndrome (22q11.2DS). Neural activation associated with WM processing shifts from parietal to frontal regions throughout age in the neurotypically developing brain. In children with 22q11.2DS, however, activation is restricted to the frontal cortex, and parietal development is atypical. The aim was to determine neurocorrelates of WM in children with 22q11.2DS.

The risk of mental illness in people living with HIV in the UK: a propensity score-matched cohort study.

Prevalence of mental illness is higher in people living with HIV than in the general population, but the incidence of composite mental illness and its components is unclear. We aimed to identify the risk of incident mental illness along with individual conditions of depression, anxiety, and severe mental illness in people living with HIV in the UK. Data for this population-based cohort were extracted from the IQVIA Medical Research Database, a nationally representative UK-based database of primary care electronic health records. We included adults (aged ≥18 years) living with HIV, matched with adults without HIV using propensity score matching (1:1 ratio). The primary outcome was composite mental illness comprising a diagnosis of depression, anxiety, or severe mental illness. Secondary outcomes were individual mental health conditions. Cox proportional hazard regression models were used to compare the risk of each outcome between people with and without HIV. Each model excluded those with the outcome at baseline. Individuals were followed up prospectively. The study period was from Jan 1, 2000, to Jan 1, 2020. Of 7167 people living with HIV without mental illness at baseline, 586 developed a mental illness (incidence rate 19·6 per 1000 person-years) compared with 418 of 7167 people without HIV (incidence rate 12·1 per 1000 person-years), resulting in an adjusted hazard ratio (HR) of 1·63 (95% CI 1·44-1·85). People living with HIV had higher incidence rates for depression (15·4 per 1000 person-years), anxiety (7·2 per 1000 person-years), and severe mental illness (1·6 per 1000 person-years) compared with people without HIV (7·9, 5·0, and 0·6 per 1000 person-years, respectively), with adjusted HRs of 1·94 (95% CI 1·68-2·24) for depression, 1·38 (1·15-1·66) for anxiety, and 2·18 (1·41-3·39) for severe mental illness. People living with HIV have an increased risk for developing composite mental illness, depression, anxiety, and severe mental illness compared with people without HIV. People living with HIV should be regularly screened for mental illness; however, there is a strong need to improve prevention of mental illness in people living with HIV and for more outreach programmes to ensure that no groups of people living with HIV are being underdiagnosed. None.

Increased risk of mental illness in people with HIV.

People with HIV who are diagnosed promptly and treated can now anticipate a life expectancy similar to that of people without HIV.1 However, despite this remarkable narrowing of the gap in mortality risk, a stark disparity in mental health, evident in the early days of the epidemic,2 appears to persist. Studies across a range of countries and settings, using various measurement tools, have consistently found a high burden of depressive symptoms among people with HIV,3 with some reporting a two times higher prevalence compared with the general population or HIV-negative control groups.

Impact of parasitic infection on mental health and illness in humans in Africa: a systematic review.

A growing body of research implicates inflammation as a potential pathway in the aetiology and pathophysiology of some mental illnesses. A systematic review was conducted to determine the association between parasitic infection and mental illnesses in humans in Africa and reviewed the state of the evidence available. The search focused on publications from Africa documenting the relationship between parasites from two parasite groups, helminths and protozoans, and four classifications of mental illness: mood affective disorders, neurotic and stress-related disorders, schizotypal disorders and unspecified mental illnesses. In the 26 reviewed papers, the prevalence of mental illness was significantly higher in people with parasitic infection compared to those without infection, i.e., 58.2% vs 41.8% (P < 0.001). An overall odds ratio found that the association of having a mental illness when testing positive for a parasitic infection was four times that of people without infection. Whilst the study showed significant associations between parasite infection and mental illness, it also highlights gaps in the present literature on the pathophysiology of mental illness in people exposed to parasite infection. This study highlighted the importance of an integrated intervention for parasitic infection and mental illness.

Addressing mental health problems in Australians with cerebral palsy: a need for specialist mental health services

ABSTRACT Background: The prevalence of mental illness in people with cerebral palsy is higher than that of the general population. In Australia there are few mental health services that are adequately prepared to address the unique mental health concerns of people with cerebral palsy. Aim: Our aim is to raise awareness that specialist mental health services are lacking in Australia, and to urge healthcare workers to address this. Method: A brief perspective piece describing the current lack of specialist mental health services available in Australia for people with cerebral palsy. Conclusion: Our commentary emphasises the importance of addressing mental health problems in Australians with cerebral palsy. It provides actions that need to be implemented to improve the recognition and treatment of mental illness in people with cerebral palsy.

Attitudes of primary care physicians toward patients with mental illness in Medina, Saudi Arabia

Background: Personal attitudes and beliefs toward mental illness set the stage for how they interact with mental illness people, provide opportunities, and support a person with mental illness. Attitudes and beliefs about mental illness are shaped by personal knowledge about mental illness, interacting or knowing someone with mental illness, and cultural pattern about mental illness. The general population tends to choose primary care physicians as their entry point to mental care. The present study was aimed at assessing the attitudes of primary care physicians towards patients with mental illness in Medina, Saudi Arabia. Methodology: A cross-sectional study was carried out. The study population included all primary health care center (PHC) consultants, specialists, and family medicine residents in Madinah, Saudi Arabia. A total of 41 PHC practice sites were involved. The study tool comprised of three main sections using the Social Distance Scale and Dangerousness Scale. Result: The number of individuals who cooperated with the study and responded to the research application were 134 doctors. Majority of them (51.5%) were males, the study show there were no significant differences of the attitudes among the primary care physicians based on gender, country of origin, medical degree, years of experience, and no significant differences were observed in the dangerousness scale by age group but show substantial differences in the Social Distance Scale by age group. Conclusions: In conclusion, the attitudinal level of primary care physicians toward patients with mental illness in Saudi Arabia was acceptable, and authors strongly recommend the need of future educational involvement and interventions.

From population to neuron: exploring common mediators for metabolic problems and mental illnesses.

Major mental illnesses such as schizophrenia (SZ) and bipolar disorder (BP) frequently accompany metabolic conditions, but their relationship is still unclear, in particular at the mechanistic level. We implemented an approach of “from population to neuron”, combining population-based epidemiological analysis with neurobiological experiments using cell and animal models based on a hypothesis built from the epidemiological study. We characterized high-quality population data, olfactory neuronal cells biopsied from patients with SZ or BP, and healthy subjects, as well as mice genetically modified for insulin signaling. We accessed the Danish Registry and observed (1) a higher incidence of diabetes in people with SZ or BP and (2) higher incidence of major mental illnesses in people with diabetes in the same large cohort. These epidemiological data suggest the existence of common pathophysiological mediators in both diabetes and major mental illnesses. We hypothesized that molecules associated with insulin resistance might be such common mediators, and then validated the hypothesis by using two independent sets of olfactory neuronal cells biopsied from patients and healthy controls. In the first set, we confirmed an enrichment of insulin signaling-associated molecules among the genes that were significantly different between SZ patients and controls in unbiased expression profiling data. In the second set, olfactory neuronal cells from SZ and BP patients who were not pre-diabetic or diabetic showed reduced IRS2 tyrosine phosphorylation upon insulin stimulation, indicative of insulin resistance. These cells also displayed an upregulation of IRS1 protein phosphorylation at serine-312 at baseline (without insulin stimulation), further supporting the concept of insulin resistance in olfactory neuronal cells from SZ patients. Finally, Irs2 knockout mice showed an aberrant response to amphetamine, which is also observed in some patients with major mental illnesses. The bi-directional relationships between major mental illnesses and diabetes suggest that there may be common pathophysiological mediators associated with insulin resistance underlying these mental and physical conditions.

Excess mortality associated with mental illness in people living with HIV in Cape Town, South Africa: a cohort study using linked electronic health records

SummaryBackgroundMental disorders can adversely affect HIV treatment outcomes and survival. Data are scarce on premature deaths in people with mental disorders in HIV-positive populations, particularly in low-income and middle-income countries. In this study, we quantified excess mortality associated with mental disorders in HIV-positive people in South Africa, adjusting for HIV treatment outcomes.MethodsFor this cohort study, we analysed routinely collected data on HIV-positive adults receiving antiretroviral therapy (ART) in Cape Town, South Africa between Jan 1, 2004, to Dec 31, 2017. Data from three ART programmes were linked with routine medical records on mental health treatment from Jan 1, 2010, to Dec 31, 2017, and mortality surveillance data from the South African National Population Register up to Dec 31, 2017. People living with HIV aged 15 years or older who initiated ART at a programme site were eligible for analysis. We followed up patients from ART initiation or Jan 1, 2010, whichever occurred later, to transfer, death, or Dec 31, 2017. Patients were considered as having a history of mental illness if they had ever received psychiatric medication or been hospitalised for a mental disorder. We calculated adjusted hazard ratios (aHRs) with 95% CIs for associations between history of mental illness, mortality, and HIV treatment outcomes (retention in care with viral load suppression [VLS; viral load <1000 copies per mL], retention in care with non-suppressed viral load [NVL; viral load ≥1000 copies per mL], and loss to follow-up [LTFU; >180 days late for a clinic visit at closure of the database]) using Cox proportional hazard regression and multistate models.Results58 664 patients were followed up for a median of 4·3 years (IQR 2·1–6·4), 2927 (5·0%) of whom had a history of mental illness. After adjustment for age, sex, treatment programme, and year of ART initiation, history of mental illness was associated with increased risk of mortality from all causes (aHR 2·98 [95% CI 2·69–3·30]), natural causes (3·00 [2·69–3·36]), and unnatural causes (2·10 [1·27–3·49]), compared with no history of mental illness. Risk of all-cause mortality in people with a history of mental illness remained increased in multivariable analysis adjusted for age, sex, treatment programme, year of ART initiation, CD4 count and WHO clinical stage at ART initiation, retention in HIV care with or without VLS, and LTFU (2·73 [2·46–3·02]). In our multistate model, adjusted for age, sex, year of ART initiation, cumulative time with NVL, and WHO clinical stage and CD4 cell count at ART initiation, rates of excess all-cause mortality in people with history of mental illness were greatest in patients retained in care with VLS (aHR 3·43 [95% CI 2·83–4·15]), followed by patients retained in care with NVL (2·74 [2·32–3·24]), and smallest in those LTFU (2·12 [1·78–2·53]). History of mental illness was also associated with increased risk of HIV viral rebound (transitioning from VLS to NVL; 1·50 [1·32–1·69]) and LTFU in people with VLS (1·19 [1·06–1·34]).InterpretationMental illness was associated with substantial excess mortality in HIV-positive adults in Cape Town. Excess mortality among people with a history of mental illness occurred independently of HIV treatment success. Interventions to reduce excess mortality should address the complex physical and mental health-care needs of people living with HIV and mental illness.FundingNational Institutes of Health, Swiss National Science Foundation, South African Medical Research Council.

Impactos no comportamento e na saúde mental de grupos vulneráveis em época de enfrentamento da infecção COVID-19: revisão narrativa

Objetivo: Realizar uma revisão narrativa das repercussões no comportamento e na saúde mental da população vulnerável e de medidas adotadas, no enfrentamento da pandemia do COVID-19. Revisão bibliográfica: Devido imprevisibilidade da pandemia do COVID-19, consequências mentais, são cada vez mais relatadas. Suspeitos, infectados, profissionais de serviços essenciais, os que vivem sozinhos, instituições como casas de repouso, prisões, centros de detenção de imigrantes, idosos, portadores de doença mental, imunodeprimidos e sem-teto, estão mais propícios aos danos de saúde física e mental. A intensificação de sentimentos como medo, raiva, estresse, insegurança e frustração estão associados a um maior risco de desenvolvimento para transtornos psiquiátricos. Para minimizar esses sentimentos, é relevante que meios de comunicação emitam notícias verdadeiras sobre o enfrentamento da pandemia e programas de lazer e cultos religiosos online sejam identificados, por ressaltarem emoções positivas. Considerações finais: As repercussões da pandemia do COVID-19 são comparadas a desastres naturais e guerras, pelo receio em adoecer, ficar desempregado, desamparado, ser estigmatizado caso venha a se infectar e, o medo de morrer. A sensação de incerteza quanto ao futuro econômico e educacional traz também implicações na saúde mental. Estratégias sociais, educacionais, econômicas devem ser implantadas para minimizar os danos causados pela COVID-19.

Impact on the use and cost of other services following intervention by an inpatient pathway homelessness team in an acute mental health hospital

Background Mental illness in people experiencing homelessness is common and a key reason for attendance at emergency departments and admission to hospital. Aims This paper describes how the KHP Pathway homeless team impacted use and cost of health and wider services. The Pathway model had never been adopted by a mental health hospital, and there had never been an economic analysis to evaluate service use before and after intervention. Method Service use was measured using an adapted version of the Client Service Receipt Inventory (CSRI) with a simple before and after design at admission, 3 months and 6 months after discharge from hospital. Results During the first 3-month follow-up, over half the participants saw a GP, with an increase in the proportion seeing a psychiatrist, social worker and a mental health nurse. Attendance at emergency departments was substantially lower than at baseline. The mean total service cost was £818 at base line and £414 at 3 months. Conclusions The adapted version of the CSRI demonstrates that patients seen by the Pathway Homelessness Team were supported to use community and scheduled health and care services. The service overcomes barriers, frequently experienced by people experiencing homelessness, in accessing support and community healthcare in the UK.

Cat-dependent diseases cost Australia AU$6 billion per year through impacts on human health and livestock production

Abstract ContextCats are the definitive or primary host for pathogens that cause diseases in people and livestock. These cat-dependent diseases would not occur in Australia if cats had not been introduced, and their ongoing persistence depends on contacts with cats. Toxoplasma gondii is a protozoan parasite that cycles between cats and any other warm-blooded animals. People infected by T. gondii may appear asymptomatic, or have a mild illness, or experience severe, potentially lethal symptoms; the parasite may also affect behaviour and mental health. T. gondii is also a major contributor to spontaneous abortion in sheep and goats. Two species of Sarcocystis, another genus of protozoan parasite, cycle through cats and sheep, causing macroscopic cysts to form in sheep tissues that reduce meat saleability. Toxocara cati, the cat roundworm, causes minor illnesses in humans and livestock, and the bacterium Bartonella henselae causes cat scratch disease, an infection that can be contracted by people when scratched or bitten by cats carrying the pathogen. AimsWe estimated the economic costs of cat-dependent pathogens in Australia. MethodsWe collated national and global data on infection rates, health and production consequences. Key resultsWe estimated the costs of two cat-dependent diseases (toxoplasmosis, cat scratch disease) in people at AU$6.06 billion (plausible range AU$2.11–10.7 billion) annually, and the costs to livestock production from toxoplasmosis and sarcocystosis at AU$11.7 million (plausible range AU$7.67–18.3 million). Most of the human health costs are due to the associations between T. gondii and higher rates of traffic accidents and mental illness in people. The causality behind these associations remains uncertain, so those costs may be overestimated. Conversely, our estimates are incomplete, infections and illness are under-reported or misdiagnosed, and our understanding of disease outcomes is still imperfect, all of which make our costs underestimated. ConclusionsOur analysis suggests that substantial benefits to public health and livestock production could be realised by reducing exposure to cats and breaking parasite transmission cycles. ImplicationsReducing feral cat populations in farming and urban areas, reducing the pet cat population and increasing rates of pet cat containment could help reduce the burden of cat-dependent diseases to people and livestock.

Common mental illness in people with sensory impairment: results from the 2014 adult psychiatric morbidity survey.

People with sensory impairments may be at increased risk of depression and anxiety but experience barriers to accessing treatment. To investigate whether people with sensory impairment have more depressive and anxiety symptoms than people without, whether this is mediated by social functioning and whether they report greater non-treatment. We analysed data from the English 2014 Adult Psychiatric Morbidity Survey using regression models, with the Clinical Interview Schedule-Revised (CIS-R) score as the primary outcome and self-reported hearing and vision impairment as exposures. A secondary outcome was self-reported receipt of mental health diagnosis and treatment. We used structural equation modelling to assess for mediation by social functioning. A total of 19.0% of people with hearing impairment, and 30.9% and 24.5% with distance and near visual impairments, respectively, had clinically significant psychological morbidity. Adjusted mean CIS-R score was 1.86 points higher in people with hearing impairment compared with those without (95% CI 1.30-2.42, P<0.001). People with distance and near vision impairment had mean CIS-R scores 3.61 (95% CI 2.58-4.63, P<0.001) and 2.74 (95% CI 2.12-3.37, P<0.001) points higher, respectively, than those without. Social functioning accounted for approximately 50% of these relationships between sensory impairment and psychological morbidity. We found no evidence of an increased treatment gap for people with sensory impairment. Social functioning, a potentially modifiable target, may mediate an association between sensory impairment and depressive and anxiety symptoms.

El infradiagnóstico del trastorno mental en la población con discapacidad intelectual: estudio de prevalencia en población con diferentes grados de discapacidad intelectual

There are a few studies in the literature analyzing the prevalence of mental illness in people with intellectual disabilities (ID). This study explores the prevalence of mental disorders in adults without previous mental disorder and different degrees of ID. We assessed 142 individuals with varying degrees of ID and with unknown previous psychiatric disorder. We applied the diagnostic battery PAS-ADD based on criteria ICD-10 and DSM-IV TR to analyzed the prevalence of mental disorders in people with mild / moderate ID. We applied the Spanish version of the scale DASH-II to analyze the prevalence of mental disorders in people with severe and profound ID. We found a psychiatric disorder previously undiagnosed in 29.57% of our sample. In people with mild/ moderate ID the most common psychiatric disorder was depressive disorder (33.3%), but in people with severe and profound ID was the anxiety disorder. The most prevalent medical comorbidity was epilepsy (22.5% of the total sample and 39.2% in the population with severe / profound intellectual disabilities). Psychiatric disorders seem to be more common in the population with ID than in the general population, increasing their prevalence and medical comorbidity in severe and profound ID.

Insanity, belonging and citizenship: mentally ill people who went to and/or returned from Europe in the Late Ottoman Era.

The Ottoman Empire, which encompassed a vast territory, had several facilities for the protection and treatment of the mentally ill. By the late nineteenth century, some wealthy families had begun to send their patients to mental hospitals in Europe for better treatment. During the same period, the process of repatriation of mental patients who were Ottoman subjects also began. These processes, which resulted in complex bureaucratic measures, later found a place in regulations and laws. The Ottoman Empire had an additional incentive to protect mentally-ill patients during the Second Constitutional Era, when discussions about 'citizenship' reappeared. This article examines the practices of sending mentally-ill people to Europe and the repatriation of mentally-ill Ottoman subjects from European countries.

Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study

Objectives To describe the incidence of recorded mental illness and challenging behaviour in people with intellectual disability in UK primary care and to explore the prescription of psychotropic drugs in...

Psychotropic Medication Adherence among Community-Based Individuals with Developmental Disabilities and Mental Illness

Psychotropic medications are a common treatment for mental illness in people with developmental disabilities. Medication adherence is a critical determinant of the effectiveness of psychotropic drugs, but psychotropic medication adherence research specific to this population remains limited. This retrospective study analyzed Marketscan® Multi-State Medicaid Database 2003–2007 data. A total of 3,905 eligible community-based Medicaid enrollees aged 18–64 with dual diagnosis of developmental disability and mental illness were included and followed over an average of 510 days. Medication adherence was measured by Proportion of Days Covered (PDC), and logistic regression was used to assess factors associated with adherence. The mean PDC was 0.86, and the non-adherence rate was 25.7%. Factors associated with poor psychotropic medication adherence included minority race/ethnicity, female gender, enrollment in a Medicaid capitated plan, and having gastroesophageal reflux disease (GERD). Better psychotropic medication adherence was related to reductions in emergency room visits, suggesting better utilization outcomes.