Prevalence Of Mental Health Disorders Research Articles

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

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

Empowering Middle-aged Women: Nurturing Mental Health Through Brahma Kumaris Rajyoga

Middle-aged women undergo a critical phase marked by intricate physical, emotional, and social transformations that deeply impact their mental well-being. This period demands a nuanced understanding of mental health concerns and the development of targeted interventions. This review explores the prevalence of mental health disorders among middle-aged women, with a focus on hormonal influences, distinct stressors, and societal dynamics. It delves into the potential effectiveness of Brahmakumaris Rajyoga—a spiritual practice integrating meditation, positive thinking, and self-reflection—as a mental health management strategy. Employing a mixed-methods approach, qualitative interviews and quantitative surveys are conducted to assess the impact of Rajyoga on mental well-being. The review highlights Raj yoga’s potential benefits in stress reduction, anxiety and depression management, self-awareness enhancement, and coping with life transitions. However, further research is needed to establish its efficacy conclusively. The review underscores the importance of a comprehensive strategy encompassing tailored interventions, awareness campaigns, and holistic support networks to address mental health challenges among middle-aged women.

Development and validation of a predictive model for depression risk in the U.S. adult population: Evidence from the 2007–2014 NHANES

BackgroundDepression is a prevalent mental health disorder with a complex etiology and substantial public health implications. Early identification of individuals at risk for depression is crucial for effective intervention and prevention efforts. This study aimed to develop a predictive model for depression by integrating demographic factors (age, race, marital status, income), lifestyle factors (sleep duration, physical activity), and physiological measures (hypertension, blood lead levels). A key objective was to explore the role of physical activity and blood lead levels as predictors of current depression risk.MethodsData were extracted from the 2007–2014 National Health and Nutrition Examination Survey (NHANES). We applied a logistic regression analysis to these data to assess the predictive value of the above eight factors for depression to create the predictive model.ResultsThe predictive model had bootstrap-corrected c-indexes of 0.68 (95% CI, 0.67–0.70) and 0.66 (95% CI, 0.64–0.68) for the training and validation cohorts, respectively, and well-calibrated curves. As the risk of depression increased, the proportion of participants with 1.76 ~ 68.90 µg/L blood lead gradually increased, and the proportion of participants with 0.05 ~ 0.66 µg/L blood lead gradually decreased. In addition, the proportion of sedentary participants increased as the risk of depression increased.ConclusionsThis study developed a depression risk assessment model that incorporates physical activity and blood lead factors. This model is a promising tool for screening, assessing, and treating depression in the general population. However, because the corrected c-indices of the predictive model have not yet reached an acceptable threshold of 0.70, caution should be exercised when drawing conclusions. Further research is required to improve the performance of this model.

Virtual Reality Simulation's Influence on Nursing Students' Anxiety and Communication Skills With Anxious Patients: A Pilot Study

BackgroundAnxiety is the most prevalent mental health disorder in the United States and globally. Nurses do not feel adequately prepared to care for anxious patients, citing a lack of education in effective communication skills. Ineffective communication can negatively influence the therapeutic nurse-patient relationship and patient outcomes. Simulation methods such as high-fidelity simulation and standardized patients have decreased nursing students’ anxiety levels in caring for anxious patients. The use of full immersion virtual reality simulation as an education modality has demonstrated success in nonhealthcare and medical education but is limited in nursing education. SampleThirty-three nursing students from two accredited registered nurse programs. MethodsA quasi-experimental design implementing an anxious patient scenario in full immersion virtual reality simulation was utilized. Spielberger's short-form State Anxiety Inventory assessed students’ anxiety levels, while the simulation's analytics dashboard evaluated their communication skills. ResultsA statistically significant decrease in students’ anxiety levels over time was found. Participants’ communication scores did not demonstrate significance. ConclusionFull immersion VRS demonstrated a decrease in students’ anxiety levels. This study was the first to utilize the simulation's analytics dashboard to evaluate communication skills.

A Comprehensive Analysis of Mental Health Problems in India and the Role of Mental Asylums.

This review article provides a comprehensive overview of the current state of mental health in India, highlighting the challenges faced, the existing initiatives, and the future directions for improving mental healthcare delivery. India is grappling with a high prevalence of mental health disorders, including depression, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders. The burden of mental health issues on individuals, families, and society is immense, leading to reduced quality of life, impaired functioning, and significant economic and social consequences. Various social and cultural factors, such as stigma, discrimination, gender inequalities, poverty, rapid urbanization, and cultural beliefs surrounding mental illness, further exacerbate the challenges of addressing mental health problems. Access to mental healthcare remains a significant concern, with considerable gaps in access to and quality of treatment and limited availability of mental health professionals, especially in rural areas. Inadequate infrastructure, a lack of awareness, and insufficient integration into primary healthcare systems hinder access to appropriate care. The historical development of mental asylums in India is examined, highlighting their establishment, purpose, and evolution over time. Critiques and challenges associated with mental asylums are discussed, including stigmatization, human rights concerns, the absence of human center approaches, quality of care, and the need for alternative approaches to mental healthcare.

Physiotherapy students’ knowledge and attitudes about their role in mental health

Background: As the prevalence of mental health disorders (MHD) increases, physiotherapy students will be increasingly exposed to patients with MHD in their undergraduate studies. International research has shown that students who have mental health included in their curriculum have more knowledge and positive attitudes towards patients with MHD. In South Africa, little is known about physiotherapy students’ attitudes towards and knowledge of mental health.Objectives: To establish the knowledge of and attitudes towards the role of physiotherapy in determining the mental health attitudes.Method: In our cross-sectional, descriptive study, third- and fourth-year physiotherapy students at the University of the Witwatersrand were purposefully sampled. Online questionnaires, based on the Mental Health Knowledge Schedule (MAKS) and Mental Illness Clinicians’ Attitudes (MICA) scales were completed.Results: Thirty-four students participated in our study. Overall, all students indicated a moderate level of knowledge and a positive attitude towards mental health with mean MAKS score: 26.94 (standard deviation [s.d.]: 3.57) and MICA-4 score: 39.12 (s.d.: 16.12). Fourth-year students had more knowledge and a better attitude towards mental health when compared to the third-year students.Conclusion: Third- and fourth-year University of the Witwatersrand physiotherapy students have moderate knowledge and a positive attitude towards the role of physiotherapy in mental health.Clinical implications: The inclusion of mental health in the physiotherapy curriculum may improve students’ knowledge and attitudes towards mental health and prepare them for managing these complex patients in the future.

“My young life, finished already?”: a qualitative study of embedded social stressors and their effects on mental health of low-wage male migrant workers in Singapore

BackgroundIncreasing evidence shows low-wage migrant workers experience a high prevalence of mental health disorders and adverse health outcomes. Significant disparities in health services usage among migrant workers create added vulnerability to health complications. However, much remains unclear about how vulnerabilities are constructed in migrant worker populations. Additionally, no studies in Singapore have attempted to critically examine the degree to which social environment and structures affect the health and wellbeing of migrant workers. Therefore, this study aimed to critically situate the socio-structural factors creating conditions of vulnerability among migrant workers using a social stress perspective.MethodsWe conducted semi-structured individual and group interviews with migrant workers focused on individual life experiences, community experiences (individual and collective social capital), health (mental and physical health concerns) and stress response behaviours. We used a grounded theory approach to identify sources of stress and stress responses and uncover pathways to social vulnerabilities.ResultsFindings from 21 individual and 2 group interviews revealed that migrant workers were embedded in a cycle of chronic stress driven by structural factors that were mutually reinforced by stressors arising from their social environment. Socio-structural stressors enacted as poor living, working and social conditions resulted in their negative quality-of-life appraisal. Stressors arising from being “foreign” resulted in anticipated stigma, concealment, and healthcare avoidance. These factors synergistically created a persistent mental health burden for migrant workers.ConclusionsFindings highlight the need to address the mental health burden placed on migrant workers and create avenues for migrant workers to seek psychosocial support to manage their stressors.

Diagnosis of mental illness does not affect postoperative outcomes in patients undergoing endovascular aortic aneurysm repair in the VA healthcare system

ObjectiveMental illness can be a debilitating chronic disease associated with a higher likelihood of preexisting medical comorbidities and postoperative morbidity and mortality. Given the relative prevalence of mental health disorders among the veteran population, we sought to examine postoperative outcomes in patients undergoing endovascular aortic aneurysm repair (EVAR). MethodsRetrospective review of a single institution Veterans Administration Hospital operative database was used to identify patients who underwent EVAR from January 2010 to December 2021. Patients’ demographics, comorbidities, medications, and intraoperative variables were collected. In addition, mental illness status was evaluated to stratify patients based on preexisting anxiety, depression, posttraumatic stress disorder, substance abuse disorder, or major psychiatric illness. The study’s primary outcomes were postoperative complications, mortality, and follow-up rates. Secondary outcomes included hospital length of stay, readmission rates, and intervention rates. ResultsA total of 241 patients underwent infrarenal EVARs at our institution. One hundred forty patients (58.1%) were diagnosed with mental illness, whereas 101 (41.9%) had no prior diagnosis of mental illness. Of the 241 patients, 65.7% had a history of substance abuse disorder, 38.6% depression, 29.3% post-traumatic stress disorder, 19.3% anxiety, and 3.6% major psychiatric illness. There was no statistical difference in the number of medical comorbidities, race, smoking status, or medications compared with patients without mental illness. We found no statistical difference in access type, wound infection rates, hypogastric coiling, estimated blood loss, and operating time. χ2 analysis demonstrated a statistically significant lower overall postoperative complication rate (28.6% vs 32.7%; P = .05) and decreased loss to follow-up (8.6% vs 15.8%; P = .05) among patients with a preexisting mental illness diagnosis. There were no statistically significant differences in readmission rate, length of stay, or 30-day mortality. When stratified by type of mental illness, binary logistic regression demonstrated no statistically significant differences in primary outcomes of postoperative complications, readmission rates, loss to follow-up, and 1-year mortality. Cox proportional hazards modeling demonstrated no significant difference in cumulative survival in patients diagnosed with a mental illness (0.56; 95% confidence interval, 0.29-0.107; P = .08). ConclusionsThere was no association between the presence of a prior mental health diagnosis and adverse outcomes following EVAR. Preceding mental illness did not correlate with an increased rate of complications, readmission, length of stay, or 30-day mortality in a veteran population. Lower loss to follow-up rates in patients with mental illness may reflect overall Veterans Health Administration expansion in resources and surveillance of these at-risk individuals. Further research is needed to assess the association between postoperative outcomes and mental illness.

Recognizing the psychological impact of a glioma diagnosis on mental and behavioral health: a systematic review of what neurosurgeons need to know.

A cancer diagnosis is life altering and frequently associated with both acute and long-lasting psychosocial and behavioral distress for patients. The impact of a diffuse glioma diagnosis on mental health is an important aspect of the patient experience with their disease. This needs to be understood by neurosurgeons so these concerns can be appropriately addressed in a timely fashion and integrated into the multidisciplinary care of neuro-oncology patients. The relatively grave prognosis associated with diffuse gliomas, the morbidity associated with treatment, and the constant threat of developing a new neurological deficit all can negatively affect a patient's mental ability to cope and ultimately manifest in mental health disorders such as anxiety and depression. The objective of this systematic review was to describe the variety of behavioral health disorders patients may experience following a glioma diagnosis and discuss possible treatment options. The PubMed, Web of Science, Embase, and PsycINFO databases were searched through July 1, 2022, using broad search terms, which resulted in 5028 studies that were uploaded to Covidence systematic review software. Duplicates, non-English-language studies, and studies with irrelevant outcomes or incorrect design were removed (n = 3167). A total of 92 articles reporting behavioral health outcomes in brain tumor patients were categorized and extracted for associations with overall mental health, anxiety, depression, distress, stress, pharmacology, interventions, and mental health in caregivers. The authors identified numerous studies reporting the prevalence of mental health disorders and their negative influence in this population. However, there is a paucity of literature on therapeutic options for patients. Given the strong correlation between patient quality of life and mental well-being, there is a considerable need for early recognition and treatment of these behavioral health disorders to optimize everyday functioning for patients.

Profile of Adult Users Seeking Mental Health Apps for the Relief of Anxiety

Anxiety disorders are among the most prevalent mental health disorders. In various settings, patients are using apps for the relief of their symptoms. Digital applications are recommended by international guidelines, but most apps available are not scientifically validated. Little is known about the profile of adult users searching for mental health apps, in the general population. In this study, we propose to identify the user profile of real-world users searching for mental health apps to reduce anxiety. We used the app TUYB Ansiedade® for this study and divided the users in three groups: health professional referral, social network and search engine. We got 453 completed first assessments, indicating that the users that found the app through Social Networks have higher values of anxiety, depression and lower perceived quality of life and resilience. Our results support the conclusion that users searching and engaging with apps in social networks have a lower mental well-being profile and this should inform app developers, guidelines on app use for mental health and policy makers. The policies regarding Social Networks and app developers should be improved to account for the mental health of their users.

Facilitators and barriers for implementation of community-based mental health interventions in Western and Eastern Europe - a systematic literature review

ABSTRACT With a high prevalence of mental health disorders in Europe and the increasing call for human-rights approaches in their treatment, the number of community-based mental health (CBMH) interventions is growing within the region. However, the implementation of these CMBH interventions differs between countries and regions, especially between Western and Eastern European countries. The reasons for these differences are based on societal and health systems, but also the design and implementation of the intervention. This systematic literature review examined the existing literature on CMBH interventions in Europe, to identify facilitators and barriers in the implementation process. Emerging themes that were found are the importance of collaboration, the availability of adequate resources, and the consideration of the community perspective in the process. The differences between Western and Eastern Europe which were discovered were mostly caused by a lack of financial and human resources and a higher existing stigma around mental health disorders in communities.

The prevalence of self-harm and mental disorders among individuals with intellectual disabilities

Objective Mental health disorders are prevalent among individuals with intellectual disabilities (ID). However, there is a lack of research on the impact of concomitant autism spectrum disorders (ASD) or attention deficit hyperactivity disorder (ADHD) on the mental health within this population. We aimed to investigate the prevalence of mental health disorders and registered healthcare visits due to self-harm among individuals with ID. Method We used administrative data for all healthcare with at least one recorded diagnosis of mental health disorder or self-harm during 2007–2017 among people with a diagnosis of Down syndrome (DS; n = 1298) and with ID without DS (IDnonDS; n = 10,671) using the rest of the population in Stockholm Region (n = 2,048,488) for comparison. Results The highest odds ratios for a mental health disorder were present in females with IDnonDS (9.01) followed by males with IDnonDS (8.50), compared to the general population. The ORs for self-harm among individuals with IDnonDS were high (8.00 for females and 6.60 for males). There were no registered cases of self-harm among individuals with DS. The prevalence of an anxiety or affective disorder was higher among individuals with ID including DS with concomitant ASD or ADHD. Neighbourhood socio-economic status was associated with a lower occurrence of mental health disorders and self-harm in wealthier areas for all outcomes and for all groups. Conclusions Self-harm and psychiatric comorbidities were common among individuals with ID without DS with an attenuated difference among those with concomitant ASD or ADHD, which calls for attention.

Emotional and Behavioural Problems among Preschool Children in Northeast Peninsular Malaysia: Parent Report Version

The rising prevalence of mental health disorders among children is a serious concern. Young children who exhibit early warning signs of mental health issues are more likely to develop symptoms in the same or overlapping regions years later. The research aimed to identify emotional and behavioural problems and associated factors in Malaysian preschools. A sample of young children aged 4–6 years from public and private preschools was chosen using a multistage random sampling method. Data were collected from 18 preschools via a parent survey using the Strengths and Difficulties Questionnaire (SDQ). The sample involved 557 children in the SDQ assessment (92%). The overall estimated prevalence of emotional and behavioural problems was 8.4%. Peer problems were the most prevalent attribute, with a percentage of 19.7%. Conduct problems were found in 5.2%, hyperactivity problems in 5.6%, prosocial behaviours in 13.5%, and emotional problems in 6.8%. Girls showed a significant increase in behavioural and emotional problems compared to boys. Having one parent working, having more than two siblings, and having a single-parent family were associated with emotional and behavioural problems. The prevalence of emotional and behavioural problems in Malaysian children was relatively low compared to data from previous studies and other Asian countries but consistent with European studies. Measuring mental health disparities in young children helps stakeholders launch local early intervention programmes.

Overcommitment at work and mental health: the mediation role of Allostatic load

Despite decades of efforts to test interventions to manage stress at work, the prevalence of mental health disorders has increased significantly among workers. The allostatic load (AL) model offers a potential mechanism through which work-related stress impacts workers' mental health. However, the relationship between stress, AL, and mental health disorders does not disentangle critical components that drive stress at work. This study examined the mediation effect of AL in the relationship between work-related stress and mental health among workers. Two hundred two nursing workers (n = 222; 90.1% female, mean age: 39.5 ±9.6) were randomly recruited from a University Hospital in Sao Paulo(Brazil), and applied the Effort-Reward Imbalance scale (ERI) that assesses work effort, reward, and overcommitment. Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) were the mental health indicators. Ten neuroendocrine, metabolic, immunologic, and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. ERI scores were not associated with either the scores on mental health indicators or the AL index (p>0.1). However, overcommitment were associated with higher SRQ-20 scores (r=-.417, p<0.001) and that relationship was mediated by higher AL index (total effect:B=-.482, 95% CI [-0.7195,-0.2463]; p=0.0001). Overcommitment at work, but not effort-reward imbalance, was associated with psychiatric symptoms, and high AL mediates that relationship. Those findings highlight the need to include personal characteristics assessment when designing tailored interventions to manage stress at work.

Amygdala Response to Fear in Boys With Conduct Problems Following Parent Training: Considering Heterogeneity

Conduct problems (CPs) in childhood, such as conduct disorder and oppositional defiant disorder, are among the most prevalent mental health disorders in childhood and a leading cause for referral to child and adolescent mental health services ( 1 Fairchild G. Hawes D.J. Frick P.J. Copeland W.E. Odgers C.L. Franke B. et al. Conduct disorder. Nat Rev Dis Primers. 2019; 5: 43 Crossref PubMed Scopus (152) Google Scholar ). The 2019 Global Burden of Disease Study found that for the 0- to 14-year-old age category, CPs have now become the leading cause of burden among mental disorders, in terms of both disability-adjusted life years and years lived with disability ( 2 GBD 2019 Mental Disorders CollaboratorsGlobal, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022; 9: 137-150 Abstract Full Text Full Text PDF PubMed Scopus (502) Google Scholar ). Crucially, various prospective longitudinal studies have shown that the negative outcomes observed in youth persist into adulthood and cover a similar range of domains. Importantly, the worst outcomes in adulthood are experienced by those whose CP symptoms persist ( 1 Fairchild G. Hawes D.J. Frick P.J. Copeland W.E. Odgers C.L. Franke B. et al. Conduct disorder. Nat Rev Dis Primers. 2019; 5: 43 Crossref PubMed Scopus (152) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 50 SEE CORRESPONDING ARTICLE ON PAGE 50 Selective Amygdala Hypoactivity to Fear in Boys With Persistent Conduct Problems After Parent TrainingBiological PsychiatryVol. 94Issue 1PreviewParenting interventions reduce antisocial behavior (ASB) in some children with conduct problems (CPs), but not others. Understanding the neural basis for this disparity is important because persistent ASB is associated with lifelong morbidity and places a huge burden on our health and criminal justice systems. One of the most highly replicated neural correlates of ASB is amygdala hypoactivity to another person’s fear. We aimed to assess whether amygdala hypoactivity to fear in children with CPs is remediated following reduction in ASB after successful treatment and/or if it is a marker for persistent ASB. Full-Text PDF Open Access

Undergraduate Student’s Stress, Anxiety, Depression and their Coping styles during Covid-19

Introduction: COVID-19 was responsible for widespread disturbance throughout the educational system and was harmful in a variety of ways. In particular with regard to the state of a student’s psychological health. Purpose: This study examines the relationship between psychological distress (depression, anxiety, and stress) and coping strategies among the students of a private university in Bangladesh during the COVID-19 pandemic. Methodology: A cross-sectional web-based survey was conducted from September 2020 to December 2021 on 951 respondents using the DASS-21 and Brief-COPE questionnaires. Results: The majority of students were experiencing mild to extremely severe depression (75.8%), anxiety (88.5%), and stress (79.1%). The level of stress (p&lt;.001), anxiety (p&lt;.001), and depression (p=.23) was significantly higher among the female students compared with male students. This study also highlights the coping strategies of students. However, sex differences were not profound in adopting coping strategies. The results also showed significant correlation between some Brief-COPE measures, such as acceptance and self-blame (r=.708, p&lt;.001); use of informational support and emotional support (r=.599, p&lt;.001). Conclusion: As the prevalence of mental health disorders was found to be higher among private university students, university authorities should seek necessary assistance from mental health professionals to support their students in overcoming psychological distress not only related to the pandemic but also related to their day-to-day life activities.

Prevalence and associated factors of mental health disorders among Brazilian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study.

The COVID-19 pandemic in Brazil affected mental health among healthcare workers. To objective of this study was to evaluate the mental health of healthcare workers in in the central-west region of the Brazil, estimating the prevalence of mental health disorders, and investigating associated factors, perceptions of safety, and self-perceptions about mental health in times of the COVID-19 pandemic. The questionnaire was divided into two parts that included general information and perceptions about the work process and identified symptoms using the Depression Anxiety Stress Scale-21 (DASS-21), and multiple linear regression analysis was conducted. A total of 1,522 healthcare workers participated in the survey. Overall prevalence of symptoms was calculated for depression (58.7%), anxiety (59.7%), and stress (61.7%). Physicians had 3.75 times greater risk of depression (1.59-8.85, 95% CI). Independent variables associated with depression symptoms were not feeling safe with the way services were organized (1.12:1.03-1.21, 95% CI) and self-perception of poor mental health (8.06: 4.03-16.10% CI). Working in management was protective, and married professionals had 12% lower risk of exhibiting symptoms of depression (0.79-0.99, 95% CI). Participants with self-perception of poor mental health had 4.63 greater risk for symptoms of anxiety (2.58-8.31, 95% CI). Protective factors were not having sought support for mental health (0.90: 0.82-0.99, 95% CI), having a graduate degree (0.71: 0.54-0.94, 95% CI), and not having been diagnosed with COVID-19 (0.90: 0.83-0.98, 95% CI). Perception of poor mental health was associated with 6.95-fold greater chance of developing stress symptoms. Protective factors from stress were having a degree in dentistry (0.81: 0.68-0.97, 95% CI), residing in Mato Grosso do Sul (0.91: 0.85-0.98, 95% CI), and not having sought mental health support services (0.88: 0.82-0.95, 95% CI). The prevalence of mental health disorders is high among healthcare workers, and is associated with professional category, organization of services provided, and self-perception of poor mental health, reinforcing the need for preventative measures.

Irritable bowel syndrome and mental health comorbidity - approach to multidisciplinary management.

Irritable bowel syndrome (IBS) affects 5-10% of the global population. Up to one-third of people with IBS also experience anxiety or depression. Gastrointestinal and psychological symptoms both drive health-care use in people with IBS, but psychological comorbidity seems to be more important for long-term quality of life. An integrated care approach that addresses gastrointestinal symptoms with nutrition and brain-gut behaviour therapies is considered the gold standard. However, best practice for the treatment of individuals with IBS who have a comorbid psychological condition is unclear. Given the rising prevalence of mental health disorders, discussion of the challenges of implementing therapy for people with IBS and anxiety and depression is critical. In this Review, we draw upon our expertise in gastroenterology, nutrition science and psychology to highlight common challenges that arise when managing patients with IBS and co-occurring anxiety and depression, and provide recommendations for tailoring clinical assessment and treatment. We provide best practice recommendations, including dietary and behavioural interventions that could be applied by non-specialists andclinicians working outside an integrated care model.

Real-world treatment modalities, health care resource utilization, and costs among commercially insured patients with newly diagnosed major depressive disorder in the United States.

BACKGROUND: In the United States, major depressive disorder (MDD) is one of the most prevalent mental health disorders. Treatment guidelines for MDD recommend pharmacologic and nonpharmacologic therapies tailored to the patient's disease severity, level of function, and comorbid health conditions. While previous studies examined real-world pharmacologic treatment patterns and costs among patients with MDD, few have examined the use of nonpharmacologic treatments and their association with health care resource utilization (HCRU) and cost. OBJECTIVE: To describe prevalence and associations between patient/provider characteristics and treatment modality and characterize HCRU and cost by treatment modality for patients with newly diagnosed MDD. METHODS: Commercially insured US patients, aged 18-62 years with newly diagnosed MDD between January 1, 2017, and September 30, 2019, were retrospectively identified from the Healthcare Integrated Research Database. Eligible patients were continuously enrolled in the health plan for 1 year before and 2 years after the first MDD diagnosis (index date). Those with co-occurring schizophrenia, bipolar disorder, postpartum depression, substance use disorder, and any prior MDD treatments were excluded. Treatment modalities assessed in the 2-year post-index period included antidepressant only (Rx-only), nonpharmacologic only (non-Rx-only), both antidepressant and nonpharmacologic (combination), and no treatment. HCRU and costs were assessed in the 2-year post-index period by treatment modality. Regression models identified associations between patient/provider characteristics and treatment modality, and the relationship between treatment modality and MDD severity changes. RESULTS: In total, 12,657 patients were included (mean age: 36 years; 60% female). During follow-up, 34% of patients received Rx-only, 25% received non-Rx-only, 28% received combination, and 13% received no treatment. MDD severity at diagnosis (26% mild, 54% moderate, 20% severe) was available for 51% of patients. Post-index inpatient hospitalizations were 11% for those with Rx-only, 10% for non-Rx-only, 16% for combination, and 29% for no treatment, whereas all-cause mean monthly total costs were $792, $633, $786, and $1,292, respectively. In multinomial logistic regression, age, sex, geographic region and urbanicity of patient residence, socioeconomic status, diagnosing provider specialty, and initial diagnosis location were significantly associated (P < 0.05) with treatment modality. In multivariable logistic regression, recipients of Rx-only (odds ratio = 2.03, P < 0.01) or combination (odds ratio = 3.26, P < 0.01) had higher odds of improving MDD severity than patients who received no treatment. CONCLUSIONS: In this real-world sample of commercially insured patients, we observed variations in outcomes by treatment modality and an association between treatment modality and disease severity. Further research is needed to explore the underlying causal relationships between treatment modality and patient outcomes. Study Registration: https://doi.org/10.17605/OSF.IO/YQ6B3 DISCLOSURES: Dr Grabner is an employee of Carelon Research, which received funding from the Innovation and Value Initiative for the conduct of the study on which this manuscript is based. Ms Pizzicato and Mr Yang were employees of Carelon Research at the time the study was conducted. Dr Grabner is a shareholder of Elevance Health. Drs Xie and Chapman are employees of the Innovation and Value Initiative.

EPH70 Trends in Hospitalizations Related to Anxiety, Depression, and/or Substance Use Among Adult Inpatients from 2016-2020 in the United States

Recent research suggests mental health disorder prevalence is increasing in the United States (US). Trends of anxiety, depression, and substance use (ADSU)-related inpatient hospitalizations from 2016-2020 were analyzed to better understand the impact of this increase on healthcare resource utilization.