Pre-existing Mental Health Conditions Research Articles

Acute Self-Harm Ideation as Presenting Adverse Event Associated with Adalimumab Treatment of Severe Scalp Psoriasis

We present a case of a 34-year-old woman with severe scalp psoriasis who developed acute self-harm ideations and major depressive symptoms shortly after initiating adalimumab treatment. The patient had a history of major depressive disorder, post-traumatic stress disorder, and anxiety, all well-controlled with multiple medications. Following the administration of adalimumab, she experienced intrusive thoughts of self-harm and exacerbation of depressive symptoms, prompting immediate discontinuation of the drug. The patient's symptoms resolved completely three weeks after discontinuation. This case highlights the potential psychiatric risks associated with adalimumab therapy for psoriasis, especially in patients with preexisting mental health conditions. Dermatologists should carefully evaluate patients for psychiatric disorders and suicide risk factors before initiating treatment and be vigilant in monitoring for adverse psychiatric events during therapy. Proper counseling and prompt identification of adverse events are crucial to prevent serious outcomes.

Interventions to reduce loneliness in children and adolescents: A systematic review and meta-analysis

Abstract Despite the growing focus on adolescent loneliness and loneliness interventions, our understanding of successful approaches for tackling loneliness in childhood and adolescence remains limited. While recent reviews have made advances in exploring loneliness interventions for this age group, our understanding of successful approaches remains limited. Key knowledge gaps persist, particularly concerning potential moderators - specifically, the characteristics that may determine the effectiveness of an intervention is sparse, leaving a significant gap in our understanding of which interventions are most effective and for whom. This presentation aims to fill this gap by presenting the findings of a systematic review and meta-analysis on interventions to reduce loneliness in children and adolescents. The presentation will provide a brief overview of the methodology employed and provide insights into the characteristics of the interventions reviewed, including an assessment of their overall effectiveness in alleviating loneliness. The primary focus, however, will be on presenting findings regarding the effectiveness of interventions across different participant groups, including variations based on socio-economic status, age group, pre-existing mental and physical health conditions, as well as baseline levels of loneliness. Additionally, the presentation will explore the impact of different intervention strategies on the effectiveness of loneliness interventions for children and adolescents. Lastly, the presentation will offer reflections on avenues for future research and practice based on the findings.

'I am more stressed if my infection affects others': development of a COVID-19-related stress scale in older people and examination of its validity and associations with mental health risks.

COVID-19 was a collective traumatic event; however, different individuals may have perceived it differently. This study investigated what older people in a collective culture perceived as stressful during COVID-19 and examined how different stressors related to COVID-19 infection and mental health risks. Thirty-six participants from diverse backgrounds engaged in a three-round Delphi study to generate items for a COVID-19-related stress scale for older adults (CSS-OA). Subsequently, 4674 people (aged ≥60 years) participated in a cross-sectional telephone survey; interviewers collected their responses to CSS-OA and information about COVID-19 infection, depressive symptoms, anxiety, loneliness and demographics. Exploratory factor analysis and confirmatory factor analysis were conducted on CSS-OA. A multiple indicator multiple cause (MIMIC) model was used to examine associations between CSS-OA and other measures. The Delphi process generated eight items, all secondary or tertiary stressors related to infection. Exploratory factor analysis revealed a three-factor model, and confirmatory factor analysis confirmed an excellent fit (comparative fit index = 0.99, root mean square error of approximation = 0.06). Pre-existing mental health conditions, having family members/friends infected with COVID-19, loneliness, anxiety and depressive symptoms were associated with higher stress. Conversely, self-infection with COVID-19, older age, being female and living alone were negatively associated with some domains of CSS-OA (all P < 0.05). The Delphi process enhanced our understanding of what older people perceived as stressful, much of which resulted from certain healthcare strategies and reflected cultural influences. These and the MIMIC results highlight the need to balance public health policies with respect to infectious diseases and older people's mental health and quality of life.

Functional disability, health care access, and mental health in Ukrainians displaced by the 2022 Russian invasion

Armed conflict has negative mental health impacts on internally displaced people and refugees, however, much less is known of its effects on the mental health of displaced people and refugees with disabilities. We use pan-European data (N = 9,676), collected via an internet health needs survey across April-July 2022, to examine the mental health impacts of the 2022 Russian invasion of Ukraine on the mental health of displaced people with disabilities during the first months of the war. Regression models separately examined associations between functional impairment (vision, walking, existing mental health condition), access to healthcare, welfare payments, and anxiety and sleep quality, controlling for sociodemographic variables. The presence of pre-existing mental health conditions, mobility and vision impairment were each associated with higher levels of anxiety and poorer sleep quality. The ability to access health services and social security payments was also associated with better sleep and lower levels of anxiety. Humanitarian and local authorities must ensure Ukrainian refugees and IDPs are reviewed for their mental health needs, with particular attention to those with known disabilities.

Psychiatric disorders associated with fluoroquinolones: a pharmacovigilance analysis of the FDA adverse event reporting system database.

Fluoroquinolones are broad-spectrum antibiotics with significant antimicrobial activity. Despite their therapeutic benefits, they are associated with a range of adverse drug reactions (ADRs), particularly those affecting the central nervous system (CNS). This study aimed to analyze the psychiatric ADRs linked to fluoroquinolones using data from the FDA Adverse Event Reporting System (FAERS) database. A retrospective pharmacovigilance study was conducted using FAERS data from Q1 2004 to Q4 2023. The data processing phase involved the FDA-recommended deduplication method, and ADRs were classified according to Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analysis was performed using the reporting odds ratio (ROR), and statistical significance was assessed using the Chi-square test or Fisher's exact test. The study identified 84,777 reports associated with fluoroquinolones, with 359,480 Preferred Terms-annotated entries, 27,816 of these reports were psychiatric ADRs. Mood disorders were the most frequently reported, including anxiety, depression, and delirium, with some reports escalating to suicidal ideation and behaviors. The Standardized MedDRA Query classification system was used to categorize these ADRs into Depression, Suicide/self-injury, Psychosis and psychotic disorders, and Non-infectious encephalopathy/delirium. Ciprofloxacin was most frequently linked to depression and suicidal ideation, while moxifloxacin showed a robust correlation with delirium. The risk of psychiatric ADRs varied by age group, with affective disorders more prevalent in adults under 65 and psychosis and delirium in those over 65. Fluoroquinolones are associated with a range of psychiatric ADRs, with notable differences between the drugs in the class. The study highlights the need for caution in prescribing fluoroquinolones, particularly for patients with pre-existing mental health conditions or those in higher risk age groups. The findings also underscore the importance of considering age-specific preventive strategies when administering these antibiotics.

Influence Of Pre-existing Mental Health Conditions And Concussion History On Post-concussion Symptom Severity And Recovery Time In Collegiate Athletes

Influence Of Pre-existing Mental Health Conditions And Concussion History On Post-concussion Symptom Severity And Recovery Time In Collegiate Athletes

Suicide ideation and intentional self-harm as a risk factor for readmission within one year following a trauma alert: A 10 year retrospective analysis

The objective of this analysis is to study physical traumatic injury as a risk factor for suicide ideation and attempts. The analysis is retrospective, focusing on inpatient readmission with suicide ideation or intentional self-harm within one year of hospitalization as a trauma alert (TA). Injured patients were divided into TA and emergencies without activation (EMWA) of trauma services. We estimated the probability of readmission with suicide ideation or intentional self-harm using a logistic regression. Rates of readmission with intentional self-harm and suicide ideation were on average 60 and 45% higher for the TA group (p < 0.01). Over 80% of patients readmitted with intentional self-harm or suicide ideation had a preexisting mental health condition, compared to approximately 45% in the overall sample. Logistic regression results indicate these patients had an odds-ratio of near six, predicting the readmission. When patients with a preexisting mental health condition were excluded from the analysis, TA patients were significantly more likely to experience a readmission with intentional self-harm and suicide ideation. Demographic and socioeconomic characteristics (gender, age, race, insurance status, and median incomes) as well as injury type (traumatic brain injury or TBI) also help predict readmission with suicide ideation and intentional self-harm. The main risk factors for reengagement with self-harm and suicidal ideation/attempt include preexisting mental health conditions, TA status, and socioeconomic status. Targeted, sustained, and prolonged rehabilitation and trauma-informed therapy for this high-risk group of severely injured patients may yield significant health and social benefits.

Health literacy and its determinants among school-going children: a school-based cross-sectional study in Nepal.

Limited health literacy is linked to unhealthy behaviors, adverse health outcomes, poor quality of life and financial burdens on society. However, little is known about the level of health literacy, especially among school-going children. This cross-sectional study assesses health literacy levels and their determinants in 354 school children from Kathmandu Metropolitan City, utilizing a multi-stage cluster sampling method. The 10-item Health Literacy for School-Aged Children was used to measure the student's literacy levels. Bivariate analysis and multivariable logistic regression at the significance level of 0.05 were performed to determine factors associated with limited health literacy. The majority of participants (76.6%) had moderate health literacy, while 13.8% had a high level and 9.6% had a low level of health literacy. Students from nuclear families had lower odds [adjusted odds ratio (aOR): 0.4; 95% CI: 0.2-0.8] of having limited health literacy. Students whose mother education was up to secondary school (aOR: 10.1; 95% CI: 1.3-78.9), students with pre-existing mental health conditions (aOR: 3.7; 95% CI: 1.4-9.6) and students with unsatisfactory health status (aOR: 3.9; 95% CI: 1.5-10.5) had higher odds to have limited health literacy. These results suggest the importance of prioritizing school health promotion and education activities for students with pre-existing mental health conditions and mothers with low educational attainment. Implementing peer support group programs for children with mental illnesses, mobilizing school health professionals and introducing interventions such as vocational training of mothers can collectively improve health literacy among school-going children.

Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study

BackgroundData on the predictors of nonmedical problems (NMP) in older adults attending the emergency department (ED) for low acuity conditions is lacking and could help rapid identification of patients with NMP and integration of these needs into care planning. ObjectivesTo determine the prevalence and predictors of NMP among older adults attending EDs for low acuity conditions. MethodsProspective cohort study in eight EDs (May–August 2021). We included cognitively intact ≥65 years old adults assigned a low triage acuity (3–5) using the CTAS. A questionnaire focusing on 11 NMP was administered. We used multiple logistic regression to identify predictors of NMP. ResultsAmong the 1,061 participants included, the mean age was 77.1 ± 7.6, majority were female, and 41.6 % lived alone. At least one NMP was reported by 704 persons. Prevalence of each NMP: outdoor (41.1 %) and indoor (30.2 %) mobility issues, difficult access to dental care (35.1 %), transportation (4.1 %) and medication (5.4 %), loneliness (29.5 %), food insecurity (10.3 %), financial difficulties (9.5 %), unsafe living situation (4.1 %), physical/psychological violence (3.4 %), and abuse/neglect (3.3 %). Predictors of NMP were: age (OR 1.04 for each additional year), living alone (OR 2.20), pre-existing mental health conditions (OR 3.12), heart failure (OR 1.42), recent surgery/admission (OR 1.75), memory decline (OR 2.76), no family physician (OR 1.74) and consulting for a fall/functional decline (OR 2.48). ConclusionsNonmedical problems are frequent among older adults. We need to implement holistic ED processes that integrate these problems into care planning.

The influence of prior COVID-19 diagnosis on concussion recovery outcomes.

While the clinical presentations of COVID-19 and concussion are not identical, there is a significant overlap in symptomology (e.g., fatigue, headache) and neurological deficits (e.g., cognitive, vestibular). However, limited research has examined the effect of prior COVID-19 diagnosis on concussion outcomes. Therefore, the purpose of this study was to determine if prior diagnosis of COVID-19 influences concussion outcomes, including concussion assessment scores and recovery time, in college-aged individuals. A prospective study of college-aged individuals (COVID-19: n = 43, mean age 21.3 [SD 2.5] years; no COVID-19: n = 51, mean age 21.0 [SD 2.5] years) diagnosed with concussion was conducted. Demographics, injury details, the Sport Concussion Assessment Tool 5th Edition (SCAT5), and the Vestibular/Ocular Motor Screening (VOMS) were completed at the acute (within 5 days after concussion) and full medical clearance (FMC) (within 3 days after FMC) visits. Mann-Whitney U-tests determined differences in concussion outcomes between groups. Cox proportional hazards regression models were fitted to assess the relationship between factors associated with concussion symptom resolution and days to FMC, and covariates were selected based on previous literature indicating potential confounds (e.g., female sex, acute symptom severity, preexisting mental health conditions). Hazard ratios with 95% confidence intervals were reported for each predictor variable. No significant differences were found between groups for SCAT5 and VOMS composite and total scores. Significant differences were found between COVID-19 and no-COVID-19 groups in days to symptom resolution (11.5 days vs 8 days, p = 0.021), but not in days to FMC (14 days vs 12 days, p = 0.099). The association between COVID-19 groups and days to clearance was not significant when adjusting for sex, race, history of depression/anxiety, and total number of concussion symptoms at the acute visit [χ2(5) = 8.349, p = 0.138]. However, male sex (HR 2.036, 95% CI 1.033-4.014; p = 0.040) was associated with a quicker time to FMC. Prior COVID-19 diagnosis did not influence cognitive abilities and vestibular/ocular functioning as measured by the SCAT5 and VOMS postconcussion. While prior COVID-19 diagnosis did result in a significantly longer duration to symptom resolution when compared with individuals who did not have a prior COVID-19 diagnosis, prior COVID-19 did not significantly influence time to FMC by a healthcare provider. Clinicians should consider that individuals with a prior diagnosis of COVID-19 might experience prolonged symptoms postconcussion.

CO205 Impact of GLP-1A Treatment on Eating Disorder Incidence: A Comparative, Real World Data Study in Patients With and Without Pre-Existing Mental Health Conditions

CO205 Impact of GLP-1A Treatment on Eating Disorder Incidence: A Comparative, Real World Data Study in Patients With and Without Pre-Existing Mental Health Conditions

The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia

BackgroundThe COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events. MethodsWe used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status. ResultsWe found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress. ImplicationsOur findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.

Identification of individual-level clinical factors associated with increased risk of death during heatwaves: a time-stratified case-crossover study using national primary care records in England

BackgroundDespite an increase in heat-related deaths occurring in England in recent years, one of the key recommended actions of identifying individuals at risk and deploying targeted interventions is not routinely...

Effects of blast exposure on anxiety and symptoms of post-traumatic stress disorder (PTSD) among displaced Ukrainian populations.

Generalized anxiety and symptoms of post-traumatic stress disorder (PTSD) are common among individuals forcibly displaced during war and conflict. Blast exposure may be one important contributor of such symptoms. The aims of this study were to provide data on blast-related experiences of internally displaced persons (IDPs) and refugees following Russia's invasion of Ukraine, and to assess the influence of blast exposure on generalized anxiety, and PTSD flashbacks and nightmares. An online health needs survey was distributed to Ukrainian IDPs and refugees between April and July 2022 using Facebook Ads Manager. Participants reported whether they experienced blast exposure since the beginning of the invasion, and whether they took medication for a mental health condition before the war started. Finally, they completed measures of generalized anxiety (GAD-2), and PTSD flashbacks and nightmares. Analyses included 3253 IDPs and 5073 refugees (N = 8326). Results revealed that 67.6% of total participants- 79.9% of IDPs and 61.7% of refugees-reported blast exposure since Russia's invasion. Further, 69.1% (95% CI: 68.05, 70.15) of total participants met the cut-off for generalized anxiety in which further diagnostic evaluation was warranted. Compared to refugees, IDPs reported higher generalized anxiety and greater frequency of PTSD symptoms, specifically flashbacks and nightmares. Further analyses revealed that the impact of blast exposure on flashback frequency was stronger among IDPs compared to refugees (β = 0.51; t(8322) = 11.88, p < .0001, 95% CI: 0.43, 0.60) and among participants with pre-existing mental health conditions compared to those without (β = 0.18; t(8157) = 2.50, p = .013, 95% CI: 0.04, 0.33). Mental health and psychosocial support must be prioritised within humanitarian relief for both IDPs and refugees and especially among people with underlying mental health conditions.

Impact of the Covid pandemic on the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions: a systematic review and meta-analysis

IntroductionExisting systematic reviews have suggested mixed effects of the Covid pandemic on the mental health of children and young people. Those with pre-existing mental health and neurodevelopmental conditions have been suggested to be disproportionately affected, but this has not been meta-analysed. Most reviews of studies in clinical populations to date only include cross-sectional studies during the first lockdown or longitudinal cohorts up to early 2021, which limits our understanding of causality and long-term effects. To our knowledge, this is the first systematic review and meta-analysis to examine the longitudinal impact of the pandemic on the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions.ObjectivesTo compare 1) mental health pre versus during Covid, and 2) mental health during Covid.MethodsMedline, Embase, APA PsycInfo, and Global Health databases were searched up to August 2023. Longitudinal studies reporting mental health outcomes in children and young people (≤18 years old) with pre-Covid mental health and/or neurodevelopmental conditions were included. Cohorts were deemed eligible if children and young people were diagnosed using a diagnostic assessment, scored above clinical threshold on validated measures, or attended mental health services pre-Covid. Outcomes included internalising, externalising, and other symptoms. Studies were narratively synthesised by symptom category and meta-analyses performed where number of studies reporting the same outcomes were sufficient (≥5).Results6,083 records were identified and 21 studies (N=2,617) were included. These widely differed in country, setting, diagnosis, outcome, and timepoints under study. The narrative synthesis highlighted mixed findings in mental health changes during the pandemic for all three symptom categories showing increases, reductions, and no changes. Only studies reporting changes in internalising symptoms pre- versus during the pandemic were in sufficient number to be amenable to meta-analysis.ConclusionsOur findings suggest the pandemic’s impact on the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions were complex and varied. We highlight an urgent need for longitudinal Covid research on long-term mental health outcomes in this vulnerable group. Understanding risk factors and longitudinal trajectories is warranted to guide clinical practice and policy.Disclosure of InterestNone Declared

The influence of preinjury mental health problems on post-concussion outcome: A meta-analysis

It is difficult to anticipate may suffer long-term health issues as a result of a Postconcussion (PC) sustained while participating in sports. This research analyzes the relationship between Pre-Injury Mental Health (PMH) issues and the clinical result of a sports-related PC. The following databases were the basis for the research: SPORT Discus, Web of Science, EMBASE, MEDLINE, CINAHL, PubMed, Scopus, Cochrane Library, and PsycINFO. Studies distributed before February 2019 that looked at MHP as a possible signal of a worse Clinical Outcome (CO) or a slower clinical improvement from a PC was considered. In the end, 12 types of research with subjects were considered after 355 entire texts of the 4046 publications that were reviewed were examined. In 9 out of 12 studies, individuals who have experienced prior to the Studies varied greatly in their approaches, and most did not emphasize MH as a primary predictor or prognostic factor. For the inst ad, it is better to utilize it as a secondary or even a third predictor. Most studies were small or small sample sizes for those exhibiting PMH concerns. There was no information given on the beginning age, kind, course, severity, or duration of MH issues. While doing baseline tests before the season, it was not specified to what extent MH problems were visible. The co of a sport-related pc may be worse for athletes with preexisting Mental Health Conditions (MHC). Research is needed to understand the mechanisms at play here better, to more accurately measure the risk for each MHC, to build superior, advanced treatment and recuperation strategies regarding these students-athletes by comprehending the procedures that underlie the higher risk.

Prevalence and Correlates of Complicated Grief in Military Primary Care: Implications for Healthcare Providers.

Grief is a universal experience, but for approximately 1 in 10 individuals, grief can become impairing. Despite servicemembers' frequent exposure to death, research on grief in the military remains limited. The purpose of the study was to explore the prevalence and correlates of complicated grief (CG) in military primary care. A quantitative survey was conducted with 161 non-treatment-seeking service members, veterans, and their dependents, of whom 138 reported a significant loss. Results revealed that 35% of the respondents who were bereaved met the cut-off score of 25 on the Inventory of Complicated Grief (ICG). Furthermore, 10% met the cut-off score of 30 on the Prolonged Grief Disorder-13-Revised Scale (PG-13-R). Importantly, death by suicide and pre-existing mental health conditions were associated with greater symptom severity. These findings have important implications for primary care providers and other clinicians working with military populations.

Men after the sexual assault: The journey from medical service to court

BackgroundThere may be significant physical and psychological consequences and impacts for males who experience sexual assault as adults, however, published literature in this context is sparse, specifically for the investigative outcomes in the criminal legal process. MethodThis clinical audit tracked 138 adult males who presented for forensic and medical sexual assault care from initial presentation to ACT Police investigation and court outcome from 2004 to 2022. ResultsThere were 103/138 (74.6%) males who attended for medical and forensic care within 72 h of the reported assault. Pre-existing mental health conditions were self-reported in 59/138 (42.7%) males.Nearly half of males 67/138 (48.5%) had a medical evidence kit collected. Males presenting for medical care 44/138 (31.2%) went on to report to ACT Policing, 36/44 (81.2%) of cases did not proceed to court. The most common clearance type was inadequate evidence to proceed (17/44, 38.6%).In 8/44 (18.2%) of adult male cases who subsequently reported to ACT Police, the investigation resulted in entry to the judicial process with a suspect charged with a sexual offence. Five of those cases resulting in a conviction. ConclusionsMany adult male patients presented within timeframes that enabled the provision of time critical medical care and provided an opportunity for forensic medical evidence collection. Many adult males 59 (42.7%) self-reported pre-existing mental health conditions upon initial presentation.Attrition occurred throughout the patient journey with many males not reporting to police and thus not presenting in the legal process. This further emphasises the need for independent sexual violence patient advisors to support adult male victims through the medical and criminal justice process.

Outcomes of critically ill children with pre-existing mental health conditions.

Critically ill children with pre-existing mental health conditions may have an increased risk of poor health outcomes. We aimed to evaluate if pre-existing mental health conditions in critically ill pediatric patients would be associated with worse clinical outcomes, compared to children with no documented mental health conditions. This retrospective observational cohort study utilized the TriNetX electronic health record database of critically ill subjects aged 12-18 years. Data were analyzed for demographics, pre-existing conditions, diagnostic, medication, procedural codes, and mortality. From a dataset of 102 027 critically ill children, we analyzed 1999 subjects (284 [14.2%] with a pre-existing mental health condition and 1715 [85.8%] with no pre-existing mental health condition). Multivariable analysis demonstrated that death within one year was associated with the presence of pre-existing mental health conditions (odds ratio 8.97 [3.48-23.15], P < 0.001), even after controlling for the presence of a complex chronic condition. The present study demonstrates that the presence of pre-existing mental health conditions was associated with higher odds of death within 1 year after receiving critical care. However, the confidence interval was wide and hence, the findings are inconclusive. Future studies with a larger sample size may be necessary to evaluate the true long-term impact of children with pre-existing mental health conditions who require critical care services.

Pre-existing depression, anxiety and trauma as risk factors for the development of post-traumatic stress disorder symptoms following wildfires

The trauma of wildfires leads to one of the most challenging and treatment resistant mental health conditions-namely-post-traumatic stress disorder (PTSD). Research addressing the contribution of pre-existing mental health conditions to the development of PTSD symptoms following traumatization by wildfires is limited. This study examined whether people with pre-existing diagnoses of anxiety, depression, PTSD, insomnia and nightmares, by a mental health professional, are more likely to develop symptoms of PTSD than those with no previous diagnosis following the trauma of wildfires. A total of 126 wildfire survivors from Australia, Canada and the United States of America completed an online survey. An independent sample t-tests revealed that pre-existing diagnosed conditions of depression, an anxiety disorder and PTSD significantly increased the likelihood of developing PTSD symptoms following traumatization by wildfires (t = −2.51, p = 0.014, 95% CI [-18.91 to −2.20], t = −2.61, p = 0.01, 95% CI [-18.91 to −2.57], t = −2.57, p = 0.012, 95% CI [-22.36 to −2.87] respectively). Practitioners working in communities subjected to wildfires need to run a thorough screening of their patients’ pre-existing mental health conditions to provide the right treatment and referral pathways to those affected by the trauma of wildfires.