Past Mental Health Research Articles

Prevalence and predictors of indoor secondhand tobacco smoke exposure among Senegalese household population

ABSTRACT Indoor secondhand tobacco smoke (SHS) exposure imposes substantial health risks among all household members, including children. Earlier studies reported high tobacco use in West African country Senegal. Despite the high health risks, no recent study has presented the situation of indoor SHS exposure in Senegal. Using cross-sectional design, we assessed the prevalence and predictors of indoor SHS exposure in Senegal. We used recent demographic and health survey (DHS) 2023 data of 75,080 household members of all ages. Analyzing these data, the prevalence of indoor SHS was assessed, and binomial logistic regression was used to identify predictors of indoor SHS exposure. The prevalence of indoor SHS exposure in Senegal was 24% (95% CI 23.5–24.2). Females, compared to males, were less likely to get indoor SHS exposure (aOR 0.9; 95% CI 0.8–0.9). Compared to the urban population, rural residents were less likely to get indoor SHS exposure (aOR 0.8; 95% CI 0.7–0.8). Individuals lived in households where members experienced shock events (aOR 1.2; 95% CI 1.1–1.2) and had members with psychological issues (aOR 1.5; 95% CI 1.4–1.6) were more susceptible to indoor SHS exposure. We conclude that indoor SHS exposure is high, particularly among Senegalese males, urban residents, and the poorest wealth quintiles. Additionally, susceptibility to indoor SHS increases with the presence of stressors like past adverse shock events and mental health issues. Both of these stressors encourage indoor smoking and intensify the risk of indoor SHS exposure among all household members. Community-based interventions providing behavior change communication on quitting tobacco and preventing indoor smoking are recommended.

Club Drugs and Psychiatric Outcomes: A Descriptive Case Series from Spain

Background: illegal drugs significantly contribute to global health issues, with health complications often occurring not only in regular users with Substance Use Disorders (SUDs) but also in first-time and occasional users. Methods: this study examines five clinical cases from a public hospital in Ibiza, Spain, where patients presented with acute psychiatric symptoms due to recreational drug use. Results: Contrary to previous studies on SUDs, our patients typically had higher education levels and stable employment. Most of them used multiple substances, with cannabis, cocaine, and alcohol being the most frequently used. There was also a common occurrence of consuming drugs with uncertain contents. Upon admission, typical symptoms included aggression, hallucinations, mood swings, and disorientation in time and space. Conclusions: Our findings underscore the significant mental health risks posed by illicit drugs, even for individuals with no prior psychiatric history. Factors like the drug’s potency, frequency and amount of use, past mental health issues, personality traits, and previous traumatic experiences might influence the onset of these symptoms.

Predicting public mental health needs in a crisis using social media indicators: a Singapore big data study

Mental health issues have increased substantially since the onset of the COVID-19 pandemic. However, health policymakers do not have adequate data and tools to predict mental health demand, especially amid a crisis. Using time-series data collected in Singapore, this study examines if and how algorithmically measured emotion indicators from Twitter posts can help forecast emergency mental health needs. We measured the mental health needs during 549 days from 1 July 2020 to 31 December 2021 using the public’s daily visits to the emergency room of the country’s largest psychiatric hospital and the number of users with “crisis” state assessed through a government-initiated online mental health self-help portal. Pairwise Granger-causality tests covering lag length from 1 day to 5 days indicated that forecast models using Twitter joy, anger and sadness emotions as predictors perform significantly better than baseline models using past mental health needs data alone (e.g., Joy Intensity on IMH Visits, χ2 = 14·9, P < ·001***; Sadness Count on Mindline Crisis, χ2 = 4·6, P = ·031*, with a one-day lag length). The findings highlight the potential of new early indicators for tracking emerging public mental health needs.

Association of youth climate change worry with present and past mental health symptoms: a longitudinal population-based study

Young people are worried about climate change but the association with current and past mental health symptoms is rarely examined in longitudinal population-based samples. Drawing on a population-based birth cohort from the Canadian province of Quebec (n = 1325), this study used a cross-over design to (1) test the association between climate change worry at age 23-years and concurrent mental health symptoms assessed on standardised instruments, and (2) test the association between adolescent (15 and 17 years) symptoms of anxiety, depression, inattention-hyperactivity, and aggression-opposition and climate worry at age 23-years. Participant sex, cognitive ability, socioeconomic status, and parental mental health were adjusted for. Descriptive statistics showed that most participants were worried about climate change: 190 (14.3%) were extremely worried, 383 (28.9%) were very worried, 553 (41.7%) were somewhat worried, and 199 (15.0%) were not at all worried. In analysis 1, worry about climate change was associated with significantly higher concurrent anxiety, depression, and self-harm symptoms, even after adjustment for adolescent symptoms. In analysis 2, anxious adolescents were significantly more likely to be extremely worried about climate change six years later (RRR = 1.51, 95%CI = 1.10–2.07), while aggressive-oppositional adolescents were significantly less likely to be somewhat worried (RRR = 0.79, 95%CI = 0.63–0.0.99), very worried (RRR = 0.61, 95%CI = 0.48–0.78), or extremely worried (RRR = 0.51, 95%CI = 0.37–0.72). Taken together, participants who were worried about climate change had more concurrent mental health symptoms but were also more likely to have prior symptoms. Adolescents with higher anxiety were more likely to worry about climate change in early adulthood, while those with higher aggression-opposition were less likely to worry. Future studies should track climate worry longitudinally alongside symptoms using prospective follow-up studies.

The Relation of Health Anxiety to Treatment Utilization Among Patients with Substance Use Disorders: The Moderating Role of Racial/Ethnic Background

Background: Although health anxiety is broadly related to the overutilization of healthcare, limited research has examined this relation among individuals with substance use disorders (SUDs), or the extent to which racial/ethnic differences influence this relationship. Objectives: The purpose of the current study is to examine the moderating role of racial/ethnic minoritized background in the relationship between health anxiety and treatment utilization among individuals with SUDs. In the present study, patients with SUDs receiving residential treatment in Mississippi (N=118; 62% racial/ethnic minoritized status, 35.6% White) completed a measure of health anxiety and answered questions about past mental health, physical health, and substance use treatment. Regression models examined whether racial/ethnic minoritized status (White vs. racial/ethnic minoritized status) moderated the relation of health anxiety to treatment utilization among patients with SUDs. Treatment utilization was examined by asking whether participants had seen a doctor or mental health provider, engaged in substance use treatment, or alcohol treatment prior to their current treatment (dichotomous), as well as the number of times they had engaged in each treatment (physical health, mental health, substance use, and alcohol treatment) in the past year (continuous). Results: Results revealed that the facets of health anxiety involving concerns about pain and disease phobia were positively associated with treatment utilization, but only among racial/ethnic minoritized participants, with concerns about pain positively associated with self-reported physical health treatment utilization (OR=0.70, 95% CI=0.50; 0.97) and disease phobia positively associated with past mental health (B = 0.36, p = 0.023) and alcohol use treatment (B=-0.23, p=.009). Conversely, disease phobia was related to less prior alcohol use treatment among White participants (B=-0.23, p=.009). Conclusions: Overall, among patients in residential treatment for SUDs, racial/ethnic minoritized participants with SUDs reported more health anxiety compared to white participants, and certain facets of health anxiety (i.e., concerns about pain and worry about severe illness) were linked to heightened treatment utilization among racial/ethnic minoritized individuals.

Relationships of self-reported opioid and benzodiazepine use with health-related quality of life among adults with spinal cord injury

BackgroundThere is limited understanding of the relationships between prescription opioid and benzodiazepine use and indices of health-related quality of life (HRQOL) among those with spinal cord injuries (SCI). ObjectiveTo identify the relationships between self-reported prescription opioid and benzodiazepine use and two indicators of HRQOL, number of days in poor physical health and poor mental health in the past 30 days among adults with SCI. MethodsA cross-sectional cohort study of 918 adults with chronic (>1 year), traumatic SCI living in the Southeastern United States was conducted. Participants completed a self-report assessment (SRA). ResultsIn the preliminary model, both opioid and benzodiazepine use were associated with a greater number of days in poor physical health and poor mental health in the past month. After controlling for health conditions (pain intensity, spasticity, anxiety and perceived sleep insufficiency), opioid use was associated with 2.04 (CI = 0.69; 3.39) additional poor physical health days in the past 30 days, and benzodiazepine use was associated with 2.18 (CI = 0.70; 3.64) additional days of poor mental health. Age was associated with greater number of poor physical health days and fewer poor mental health days. Lower income was associated with poor mental health days. Most of the health conditions were significantly related to the number of past month poor physical and mental health days. ConclusionsOpioid and benzodiazepine use are associated with poor physical and mental HRQOL, even after controlling for health conditions. Treatment strategies should consider potential unanticipated negative consequences of pharmacological interventions.

Psychological distress during the COVID-19 pandemic normalization phase in China: A multigroup latent profile analysis among healthcare workers and the general population

The COVID-19 pandemic is no longer considered a “global public health emergency”; nonetheless, it has left a long-lasting effect on people's mental health. Existing studies examined the impact of COVID-19 on people's mental health; however, most of these investigations were carried out during the acute phase. This study addresses the gaps in knowledge regarding the psychological distress experienced by healthcare workers and the general population in China during the normalization period, as well as the shared and distinct associated factors. Data were collected in March 2022. Five hundred and three healthcare workers and 307 general individuals participated. Online questionnaires were administered. Collected data for mental health indices included depression, anxiety, insomnia, and resilience. Various statistical analyses were conducted, including independent sample t-tests, chi-square tests, one-way analyses of variance, multigroup latent profile analyses, and multinomial logistic regression analyses. Healthcare workers had lower prevalence rates of depression and anxiety and a higher level of resilience than the general population. Latent profile analyses suggested four profiles based on levels of psychological distress (i.e., low, mild, moderate, and high) derived from four indices (i.e., depression, anxiety, insomnia, and resilience). The person-centered approach revealed that the general population had more individuals in moderate and high distress classes and fewer in the mild distress class. Healthy lifestyles, past mental health issues, and epidemic burnout were common influencing factors for both groups. However, epidemic uncertainty was identified as the distinct contributing factor for the general population. Directions for future research and interventions are discussed.

570 Adult Self-Inflicted Burn Demographics in West Texas

Abstract Introduction Self-inflicted burns (SIB) are a subset of burns defined based on self-injury, sometimes also referred to as self-immolation. The United States generally reports SIB in the context of psychiatric ailment. However, due to the difference in geographic locations, the West Texas burn coverage has never been checked for SIB patients. We hypothesize that patients with SIB have higher rates of psychiatric disorders and are generally older men. Methods We obtained a list of all patients admitted to the burn intensive care unit (BICU) with a Second/Third-degree burn. After, we verified the inclusion of patients meeting the study criteria from July 01, 2011, to July 01, 2021, ages between 18 and 89, and a completed Lund-Browder Chart. Data was collected from a mix of manual chart review from electronic health records and electronic data retrieval. Patients were split into two groups, SIB and non-intentional burns (NIB). Bivariate analysis was conducted using Mann Whitney U test and either Fisher’s exact test or Chi-square test when independent variables were categorical. Results The initial data set (n=2,875) decreased due to missing burn documentation, burn intensive care unit admission, and incomplete records and was split into two groups: SIB (n=49) and NIB (n=1,243). The average age and percentage of male patients compared between NIB and SIB were not significant (p=0.32, p=0.39). However, TBSA, frequency of inhalation injury, burn symmetry, suicidal ideation, history of drug abuse, history of self-harm, history of mental illness, past mental health hospitalization, and mortality were all significantly higher in the SIB group (p&amp;lt; 0.001). There was also a statistically significant higher frequency of psychological disorders in the SIB group for depression, acute schizophrenia, borderline personality disorder, bipolar disorder (p&amp;gt;0.001), anxiety disorders (p=0.02), post-traumatic stress disorder (p=0.006), atypical psychosis, drug-induced psychosis, and delirium (p=0.04). Conclusions The demographics of the West Texas SIB population are comparable to that of the United States, predominantly older male patients. Similarly, many psychiatric disorders occur at a higher frequency in SIB patients than NIB: depression, acute schizophrenia, borderline personality disorder, anxiety disorder, post—traumatic stress disorder, bipolar disorder, atypical psychosis, drug-induced psychosis, and delirium. Applicability of Research to Practice While SIB patients make a small portion of the total burn population, there burns are often associated with worse outcomes – mortality, larger burns, and length of stay. The severity of their injuries begs the need for further analysis and hopefully prevention of SIB. Addressing psychiatric facilities and preventing these incidents from occurring may offer preventative methods.

Identification of group differences in predictive anticipatory biasing of pain during uncertainty: preparing for the worst but hoping for the best.

Pain anticipation during conditions of uncertainty can unveil intrinsic biases, and understanding these biases can guide pain treatment interventions. This study used machine learning and functional magnetic resonance imaging to predict anticipatory responses in a pain anticipation experiment. One hundred forty-seven participants that included healthy controls (n = 57) and individuals with current and/or past mental health diagnosis (n = 90) received cues indicating upcoming pain stimuli: 2 cues predicted high and low temperatures, while a third cue introduced uncertainty. Accurate differentiation of neural patterns associated with specific anticipatory conditions was observed, involving activation in the anterior short gyrus of the insula and the nucleus accumbens. Three distinct response profiles emerged: subjects with a negative bias towards high pain anticipation, those with a positive bias towards low pain anticipation, and individuals whose predictions during uncertainty were unbiased. These profiles remained stable over one year, were consistent across diagnosed psychopathologies, and correlated with cognitive coping styles and underlying insula anatomy. The findings suggest that individualized and stable pain anticipation occurs in uncertain conditions.

Impact of a private sector residential early parenting program on clinically significant postnatal depressive symptoms experienced by women: Audit of routinely collected data.

Early parenting services in Australia offer brief structured residential programs to address moderate to severe non-psychotic mental health problems among women and unsettled infant/toddler behaviours. The aims were to (1) estimate the immediate and medium-term impact of a five-night psychoeducational residential early parenting program on postpartum depressive symptoms and (2) identify the factors associated with improvement or worsening of postpartum depressive symptoms after completing the program and six weeks post-discharge. Audit of routinely collected medical record data from pre-admission, pre-discharge and post-discharge assessments of a consecutive cohort of women admitted, with their infants/toddlers in a 15-month period to Masada Private Hospital Early Parenting Centre. Data included structured questions assessing: demographic characteristics, access to family and social support, past and current mental health problems, reproductive and obstetric health, chronic health conditions, breastfeeding problems, coincidental major life events, health risk behaviours and infant/toddler feeding, sleeping and crying behaviours. Standardised instruments included the Partner Interaction after Birth Scale (PIBS), the MacLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Modified Fatigue Assessment Scale (FAS) and selected items from the Karitane Parenting Confidence Scale. The primary outcomes were Edinburgh Postnatal Depression Scale scores at pre-discharge and follow up assessments. Data were analysed using multinomial logistic regression models in which individual and psychosocial characteristics at pre-admission were included as predictors of the likelihood of the changes of the outcomes from pre-admission to pre-discharge and follow up. Complete data from 1220 of 1290 (95%) eligible women were available to assess pre-admission to pre-discharge and from 559 (45.8%) to assess pre-discharge to six-week follow-up changes. The mean pre-admission EPDS score was 11.7 (95% CI: 11.5; 12.0), pre-discharge it was 7.1 (95% CI: 6.9; 7.4) and at six-week follow up it was 5.7 (95% CI: 5.3; 6.1). We found that almost all women experienced a clinically meaningful and rapid improvement in depressive symptoms of at least this magnitude (reduction in mean EPDS scores of 4.6 points from pre-admission to pre-discharge (five nights) and a further reduction of 1.2 points pre-discharge to follow up) (six weeks) and we identified an interpretable set of risk factors for symptoms that did not improve or worsened. The adverse outcomes were associated with having symptoms of borderline personality disorder, a partner experienced as lacking kindness and care, coincidental adverse events and having a child younger than six months. Residential early parenting programs, which take a psycho-educational approach to strengthening caregiving skills, maximising agency, and reducing helplessness, have a rapid beneficial effect on women's postpartum depressive symptoms. These programs provide a valuable and effective component of comprehensive mental health services. Long-term dialectical behaviour therapy is indicated for women with borderline personality disorder traits for whom early parenting programs alone are insufficient to improve depressive symptoms.

Mental healthcare access among resettled Syrian refugees in Leipzig, Germany.

Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8). Descriptive, regression and effect modification analyses assessed associations between selected predictor variables and mental health service access. The sampling strategy means findings are applicable only to Syrian refugees in Leipzig. Of the 513 respondents, 18.3% had moderate/severe anxiety symptoms, 28.7% had moderate/severe depression symptoms, and 25.3% had PTSD symptoms. A total of 52.8% reported past year mental health problems, and 48.9% of those participants sought care for these problems. The most common reasons for not accessing mental healthcare services were wanting to handle the problem themselves and uncertainty about where to access services. Adjusted Poisson regression models (n=259) found significant associations between current mental health symptoms and mental healthcare service access (RR: 1.47, 95% CI: 1.02-2.15, p=0.041) but significance levels were not reached between somatization and trust in physicians with mental healthcare service access. Syrian refugees in Leipzig likely experience high unmet mental health needs. Community-based interventions for refugee mental health and de-stigmatization activities are needed to address these unmet needs in Leipzig.

E-cigarettes in college: Associations between mental health and e-cigarette use with other substances.

College students are a priority population for substance use prevention, and other studies have reported associations between mental health and e-cigarette use. This study described the association of mental health to e-cigarette and other substance use (ECIG+ use) among US college students. We used Fall 2018 and Spring 2019 National College Health Assessment data among undergraduate students aged 18-24 years (n=55654) at 138 institutions. We characterized substance use patterns and used multinomial regression to model adjusted odds of past 30-day ECIG use type [no substance use (reference); sole e-cigarette use; e-cigarette use and other substance use (ECIG+ use); no e-cigarette use but other substance use] by mental health characteristics, past 12-month diagnosis/treatment and psychological distress, individual characteristics, and college characteristics. Alcohol was the most prevalent substance (58%) used, followed by cannabis (23%) and e-cigarettes (15%). Nearly all (95%) students who used e-cigarettes reported using another substance. Adjusted odds of ECIG+ use (vs no substance use) were higher among students with past 12-month mental health diagnosis/treatment (AOR=1.5; 95% CI: 1.4-1.6) and higher psychological distress (AOR=1.1; 95% CI: 1.1-1.2). Other characteristics significantly associated with ECIG+ use included gender identity, sexual orientation, race and ethnicity, self-rated health, year in school, cumulative grade average, fraternity/sorority membership, and current residence. Most students who used e-cigarettes also reported other substance use, and this pattern of use was associated with poorer mental health outcomes than no substance use. Clarifying the relationship between mental health and ECIG+ use may enhance health interventions for college students.

Delivery of bright light therapy within the Veterans Health Administration

BackgroundBright light therapy (BLT) is efficacious for seasonal and non-seasonal depression. However, the current state of BLT use in practice is unknown, impeding efforts to identify and address utilization gaps. This study's objective was to investigate BLT delivery in a nationwide U.S. healthcare system. MethodsThis was a retrospective observational study of electronic medical records from all veterans who received outpatient mood disorder-related care in the Veterans Health Administration (VHA) from October 2008 through September 2020. BLT delivery was measured through the placement of light box consults. ResultsOf the 3,442,826 veterans who received outpatient mood disorder care, only 57,908 (1.68 %) received a light box consult. Consults increased by 548.44 % (99.9 % credible interval: 467.36 %, 638.74 %) over the timeframe and displayed a robust yearly cycle that peaked on either December 21st or December 22nd. Past mental health treatment for a mood disorder was associated with a higher probability of a consult (relative risk = 4.79, 99.9 % CI: 4.21, 5.60). There was low representation related to veteran age, gender, race, and ethnicity. LimitationsNo information on patients who declined light boxes or actual light box use following consult placement. ConclusionsOutpatient BLT delivery for mood disorders in the VHA remains low, despite significant growth over the past decade. It also displays a strong seasonal rhythm that peaks on the winter solstice, suggesting a limited focus on seasonal depression and a suboptimal reactive approach to changing sunlight. Overall, there exists ample opportunity for novel implementation efforts aimed at increasing utilization of BLT.

Age-gender differences in the relationships between physical and mental health

Previous studies have identified that smoking, exercise and breadth of social interaction mediate the strong associations between physical and mental health. However, these studies have been restricted to older populations, have not explored differences by gender, and have not considered online social interaction. We explore how the effects of four mediators (exercise, smoking, in-person and online social interaction) of the two-way relationships between past and future physical and mental health vary across eight age and gender groups. We use data from a representative sample of the UK population consisting of 175,779 observations on 41,995 adults from Understanding Society (UKHLS) between 2009 and 2019. Within a mediation framework, we estimate the percentage of the total effects that can be explained by the proposed mediating factors. We show that exercise, smoking, in-person and online social interaction are significant mediators of the effect of mental health on future physical health. In-person social interaction is the largest of these, accounting for 2.3% of the total effect. Smoking, in-person and online interaction are significant mediators of the effect of physical health on future mental health. Again, in-person interaction is the largest of these, accounting for 3.0% of the total effect. The percentages of the total effects mediated by each factor differ substantially by age and gender. Seeking to avoid the harmful effects of poor physical health on future mental health should focus on increasing physical activity in older men, and on increasing in-person social interaction in both men and women. Seeking to avoid the harmful effects of poor mental health on future physical health should focus on increasing physical activity and in-person social interaction in older men and women, and on reducing smoking in younger men and women.

Assessing Attendance Frequency and Duration at a Drop-In Animal Visitation Program Among First-Semester University Students Separated From Their Pets

ABSTRACT Anxiety and stress among incoming university students are associated with higher rates of mental health disorders and decreased academic success. One approach universities employ to prevent these problems is the implementation of Animal Visitation Programs (AVPs). While efficacy trials suggest positive effects, little is known about students’ program uptake (e.g., attendance frequency and duration) or students’ characteristics (e.g., current mood and past mental health, pet ownership, and pet separation anxiety) that shape program uptake. This study identified student characteristics that predicted AVP uptake in a subsample (n = 209) of randomly selected first-year university students (n = 2,000) who were screened for pet ownership and randomly assigned to attend a semester-long drop-in AVP program (i.e., seven 2-hour sessions) (n = 105) with registered therapy dogs or a waitlist control group (n = 104). Using logistic and multiple regression modeling, participants’ mental health history, current mood, and relationship with their childhood pet were modeled on students’ attendance frequency and duration. Students’ early session uptake was negatively associated with mental health history (B frequency = –0.876, p = 0.03, OR = 0.417) and perceived stress (B frequency = –0.177, p = 0.04, OR = 0.838; β duration = –0.433, p = 0.02, d = 0.61) and positively associated with current anxiety (B frequency = 0.179, p = 0.01, OR = 1.196; β duration = 0.513, p = 0.01, d = 0.66). Overall attendance was negatively associated with levels of pet separation anxiety (β frequency = –0.342, p = 0.004, d = 0.70; β duration = –0.286, p = 0.03, d = 0.53) and identifying as male (β frequency = –0.308, p = 0.003, d = 0.72; β duration = –0.321, p = 0.004, d = 0.68) and was positively associated with early uptake (β frequency = 0.627, p < 0.001, d = 1.40; β duration = 0.532, p < 0.001, d = 1.08). Findings suggest that program attendance may be enhanced by prioritizing access to students experiencing anxiety upon arrival to campus, rather than students experiencing stress, pet separation anxiety, or those reporting a history of mental health problems. Administrators should strongly promote attendance to the first session as this is significantly associated with greater program uptake.

Understanding the relationship between time spent outdoors, mental well-being and health-related behaviours in a Spanish sample: A real time smartphone-based study

IntroductionCOVID-19 pandemic has affected our lifestyle and physical and mental well-being. We aimed to study the effect of being outdoors and mental well-being after the COVID-19 pandemic. Material and methodsWe used smartphone based ecological momentary assessments (EMA) (Urban Mind app) to study the mental well-being of the Spanish general population. We collected socio-demographic data, past and current physical and mental health, and social and physical environment. Participants were recruited during 5 months (February to June 2021). Longitudinal associations between EMA and anxiety, depression, loneliness, tiredness, and happiness during the assessments were investigated using random intercept ordinal logistic regression models. Results274 subjects downloaded the app and completed the baseline assessment. 66 participants completed at least 50 % of the assessments. Being outdoors was related to a lower likelihood of anxiety (OR: 0.48, 95 %CI 0.34–0.66), depression (OR: 0.40, 95 %CI 0.28–0.56), tiredness (OR: 0.47, 95 %CI 0.35–0.63), and loneliness (OR: 0.59, 95 %CI 0.42–0.84), and a higher likelihood of happiness (OR: 2.14, 95 %CI 1.57–2.93). ConclusionsBeing outdoors is related to better mental health in the general population independently of other factors (baseline mental well-being or socio-demographic characteristics). Public policies should include measurements to promote outdoor spaces in urban settings.

Increasing prevalence of mental disorders in smokers seeking treatment of tobacco dependence: a retrospective observational study

BackgroundThere has been a noticeable relative increase in psychiatric comorbidities among smokers as opposed to the general population. This is likely due to comparatively slower decrease in smoking prevalence among individuals with mental health conditions. This study aims to assess the prevalence trend of past or current mental health disorders in individuals seeking specialized smoking cessation assistance.MethodsWe conducted a retrospective single-centre observational study to assess the presence of mental disorders such as anxiety, depression, bipolar affective disorder, or schizophrenia in personal history of 6,546 smokers who sought treatment at the Centre for Treatment of Tobacco Dependence in Prague, Czech Republic between 2006 and 2019. The study examined the impact of gender, age, and the effect of successive years on the prevalence of the mental disorders using Poisson distribution regression.ResultsIn the studied cohort, 1,743 patients (26.6%) reported having one or more mental disorders. Compared to patients without a psychiatric disorder, they exhibited similar levels of carbon monoxide in expired air (mean 17 ppm, SD 11 ppm) and scored one point higher on the Fagerström Test of Cigarette Dependence. Among smokers with a mental disorder, women were more prevalent (62%) than men (38%). The prevalence of mental disorders increased on average by 4% every year, rising from 23% in 2006 to 35% in 2019.ConclusionsConsistent with the observation that the prevalence of smoking among people with any mental disorder is higher and declining at a slower rate than in the general population, there is a steadily increasing percentage of these patients seeking specialized treatment over time. Professionals who offer tobacco dependence treatment should be aware of the upward trend in psychiatric disorders among smokers, as more intensive treatment may be needed. Similarly, psychiatric care should pay attention to smoking of their patients.

Dimensional structure of one-year post-COVID-19 neuropsychiatric and somatic sequelae and association with role impairment

This study examined the latent structure of the broad range of complex neuropsychiatric morbidities occurring 1 year after COVID-19 infection. As part of the CU-COVID19 study, 248 (response rate=39.3%) of 631 adults hospitalized for COVID-19 infection in Hong Kong completed an online survey between March-2021 and January-2022. Disorder prevalence was compared against a random non-infected household sample (n=1834). 248 surveys were received on average 321 days post-infection (Mean age: 48.9, 54% female, moderate/severe/critical infection: 58.2%). 32.4% were screened to have at least one mental disorder, 78.7% of whom had concurrent fatigue/subjective cognitive impairment (SCI). Only PTSD (19.1%) was significantly more common than control (14%, p=0.047). Latent profile analysis classified individuals into P1 (12·4%)-no current neuropsychiatric morbidities, P2 (23.1%)-SCI/fatigue, P3 (45.2%)-anxiety/PTSD, P4 (19.3%)-depression. SCI and fatigue pervaded in all profiles (P2-4) with neuropsychiatric morbidities one-year post-infection. PTSD, anxiety and depressive symptoms were most important in differentiating P2-4. Past mental health and P4 independently predicted functional impairment. Neuropsychiatric morbidity was associated with past mental health, reduced resilience, financial problems, but not COVID-19 severity. Their confluence with depressive and anxiety symptoms predicted impairment and are associated with psychological and environmental factors.

Psychosis in acute methamphetamine intoxication is usually self-limiting and can be managed in the emergency department: A retrospective series.

There is little recent published data characterising acute psychosis associated with methamphetamine intoxication. We aim to describe the clinical features of psychosis, management of acute behavioural disturbance and disposition of patients with psychosis associated with acute methamphetamine intoxication. This is a retrospective review of patients presenting with acute (use within 24 h) methamphetamine intoxication, with features of psychosis (presence of delusions, hallucinations or formal thought disorder), to an ED over 4 months in 2020. All presentations were extracted from a toxicology unit database and each medical record reviewed. Demographics, past mental health diagnoses, clinical features and disposition were extracted. There were 287 presentations of methamphetamine intoxication over the period. Of these 287 presentations, 205 (71%) had features of acute psychosis, occurring in 171 patients (111 males [65%], median age 36, range 16-57 years). Paranoid delusion occurred in 134 of 205 (65%) presentations and was the most common feature of psychosis. Chemical sedation was given to 194 (95%), with 143 (70%) receiving parenteral sedation to manage acute behavioural disturbance. Complete resolution of psychotic symptoms occurred in 170 of 205 (83%) of exposures. There were 9 of 205 (4%) presentations that resulted in a mental health admission. Most presentations - 200 of 205 (98%) - were managed within the ED, primarily the short-stay unit. The median length of stay was 15 h (interquartile range 11-20 h). In this series of patients presenting to ED with acute methamphetamine intoxication, psychosis appeared to occur commonly and was mostly short-lived, resolving within 24 h in the majority of patients.

Reducing sickness absence and stigma due to mental health difficulties: a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail)

BackgroundCommon mental disorders are the leading cause of workplace absences. The Prevail intervention programme aims to reduce stigma and to educate staff and managers about evidence-based low intensity psychological interventions for common mental disorders (depression, anxiety, stress, and distress). Prevail is innovative in taking a public health approach. It is designed to be given to all employees irrespective of their past or current mental health. Prevail was evaluated in three studies examining: (1) the acceptability of the intervention and perceived usefulness; (2) whether the intervention altered stigmatic attitudes and motivation to seek help; and (3) whether the intervention reduced sickness absence, both overall and due to mental health problems.MethodsA two-armed cluster randomised control trial (RCT) evaluated the effectiveness of Prevail. Employees (N = 1051) at a large UK government institution were randomised to an active intervention or control arm in teams identified by their managers (n = 67). Employees in the active arm received the Prevail Staff Intervention. The managers in the active arm also received the Prevail Managers Intervention. Participants’ satisfaction and analysis of the Prevail Intervention were gathered by a bespoke questionnaire. Questionnaire measures of attitudes to mental health and mental health stigma were taken 1–2 weeks prior to the intervention and approximately 4 weeks post-intervention. Data relating to sickness absence were gathered via the official records in the time period 3-month post-intervention and for the same period 12 months earlier.ResultsPrevail was evaluated highly favourably by both the staff and their managers. Prevail produced significant reductions in self-stigma and anticipated stigma due to mental health difficulties. Crucially, sickness absence was significantly reduced by the Prevail Intervention.DiscussionPrevail achieved its goals of producing a palatable and engaging intervention that altered staff’s attitudes and stigmatic beliefs related to mental health and, crucially, produced a strong reduction in work-pace absenteeism. As the Prevail programme is aimed at common mental health problems and was not specialised to this particular workforce, the study provides the evidence-base for a mental health intervention programme that could be used by many organisations across the world.Trial RegistrationISRCTN12040087. Registered 04/05/2020. https://doi.org/10.1186/ISRCTN12040087. A full protocol for the randomised control trial was published: Gray NS, Davies H, Snowden RJ: Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health 2020, 20(1):1–9.