Mental Disorders Research Articles

Improving capacity and flow in a children and young people’s Community Eating Disorder Service (CEDS): how a quality improvement initiative led to a reduction in waiting times in the service

Eating disorders are serious mental health conditions associated with significant morbidity and mortality. High levels of demand on services have led to increases in wait times to access support. Early...

A feasibility study of a preventative, transdiagnostic intervention for mental health problems in adolescence: building resilience through socioemotional training (ReSET)

BackgroundAdolescence is a developmental period during which an estimated 75% of mental health problems emerge (Solmi et al. in Mol Psychiat 27:281–295, 2022). This paper reports a feasibility study of a novel indicated, preventative, transdiagnostic, school-based intervention: Building Resilience Through Socioemotional Training (ReSET). The intervention addresses two domains thought to be causally related to mental health problems during adolescence: social relationships and emotion processing. Social relationships were targeted using principles from interpersonal psychotherapy, while emotion processing was targeted using cognitive-emotional training focused on three areas of emotion processing: Emotion perception, emotion regulation and interoception. The aims of this feasibility study were to (i) assess the acceptability of integrating group-based psychotherapy with individual cognitive-emotional training, (ii) evaluate the feasibility of our recruitment measures, and (iii) assess the feasibility of delivering our research measures.MethodsThe feasibility study involved 41 adolescents, aged 12–14, who were randomly assigned to receive the ReSET intervention or their school’s usual mental health and wellbeing provision.ResultsQualitative data from intervention participants suggested the programme was experienced as a cohesive intervention, with participants able to draw on a combination of skills. Further, the cognitive-training tasks were received positively (with the exception of the interoception training task). The recruitment and research measures were successfully delivered in the school-based setting, with 97.5% retention of participants from baseline to post-intervention assessment. Qualitative data was overwhelmingly positive regarding the benefits to participants who had completed the intervention. Moreover, there was only limited data missingness.ConclusionsWe conclude that a trial of the ReSET intervention in a school setting is feasible. We discuss the implications of the feasibility study with regard to optimising school-based interventions and adaptations made in preparation for a full-scale randomised controlled trial, now underway.

Can housing safeguard the homeless? A longitudinal analysis of violent victimisation, housing, and mental health status of the homeless

ABSTRACT Utilising a routine activity and lifestyle theory framework, this study examines victimisation over time of a localised homeless population with mental health conditions that was part of a 24 month Housing First (HF) At Home-Chez Soi project in the Canadian Prairie City. Negative binomial regression equations to account for severe skews in the victimisation data were estimated at baseline, 12 months and 24 months. In most cases, net of demographic and risky lifestyle controls, at 12 and 24 months from baseline there was an inverse relationship between housing stability and victimisation, and as mental illness became more serious, so did victimisation rates. Serious mental illness was the most consistent and strongest predictor of victimisation, while stable housing effects were weak and sometimes nil. At baseline and 12 months, HF cases showed nil or opposite effects to the Treatment as Usual group, but produced lower victimisation rates at 24 months.

Exploring the attitudes of mental health professionals toward recovery and peer support in Taiwan

BackgroundWhile many Western countries have implemented mental health recovery-oriented and peer support services, they are still in the early stages of development in Taiwan, and the existing literature on professionals’ perspectives regarding recovery-related issues in non-Western contexts remains limited. This study investigates the perspectives of professionals from well-established psychiatric rehabilitation organizations in Taiwan on the concept of recovery and peer support.MethodsData were collected through semi-structured interviews involving 19 professionals from nine organizations, which were then recorded and transcribed verbatim. Subsequently, the data were coded using Atlas.ti 8.0, followed by thematic analysis.ResultsThe analyses identified three main themes. First, attitudes toward recovery encompassed six subthemes: (1) coexisting with illness while finding personal fulfillment, (2) exercising one’s rights and taking personal responsibility, (3) maintaining hope throughout the recovery journey, (4) recognizing the non-linear nature of recovery, (5) acknowledging the individuality of each recovery path, and (6) affirming that recovery is achievable for all. Additionally, four types of peer support were identified: supportive peer, staff assistant, life assistant, and mental health workforce. Furthermore, perspectives on peer support workers included four subthemes: (1) attitudes toward people with mental illness, (2) the need for a robust career support system, (3) organizational and professional support, and (4) self-awareness of people with mental illness.ConclusionsThis study is one of the few that explore the perspectives of professionals on recovery and peer support in non-Western contexts. Professionals from well-established psychiatric rehabilitation organizations in Taiwan embraced most mental health recovery principles, but inconsistencies were found regarding the applicability of recovery to different individuals. Peer support in Taiwan remains largely informal, with concerns primarily focused on environmental factors. However, one personal factor is also critical. People with mental illness in non-Western contexts may require more extensive preparation to serve as peer support workers.

Psychiatric morbidity in people with autoimmune arthritides as a model of inflammatory mechanisms in mental disorders

BackgroundRheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions.ObjectiveIn this matched-cohort study, we aimed to investigate whether the associations...

The association between sexual violence and mental disorders among women victim-survivors in sub-Saharan Africa: a systematic review and meta-analysis

BackgroundSexual violence is a serious public health and human rights problem with both short-term and long-term consequences. This review aims to systematically assess the link between sexual violence and poor...

Long-term seizure and psychosocial outcomes of patients with ring chromosome 20 syndrome: A cohort study of 47 cases.

We retrospectively investigated a cohort of patients with ring chromosome 20 syndrome (r20), aiming to provide information on the prognosis of r20 regarding seizures, cognitive function, comorbidities, and social living. Patients diagnosed with r20 in our hospital were identified, and clinical data were extracted from medical records. We used the following seizure outcome classification: favorable seizure outcome, a condition in which seizures do not interfere with daily life, including no seizures, subclinical discharges, sleep seizures or mild focal aware seizures; poor seizure outcome, a condition in which seizures interfere with daily life. Clinical variables were compared between favorable and poor seizure outcome groups. Forty-seven patients (64% female) were studied. Mean age ± standard deviation (SD) at epilepsy onset was 7.5 ± 3.7 (range 1-15) years. Mosaicism rate was 33 ± 24% (range 1%-97%). Fourteen patients (30%) were classified in the favorable seizure outcome group and 33 (70%) in the poor seizure outcome group. Multivariable analysis identified lower mosaicism rate and higher rate of lamotrigine use as independent factors associated with a favorable seizure outcome. The most effective drug was lamotrigine (69%), followed by valproate (43%) and other sodium channel blockers. Intellectual disability was present in 27 patients (57%), autism spectrum disorder in 8 (17%), and psychiatric symptoms in 10 (21%). Of 30 adult patients, 7 (23%) were employed, 5 (17%) were employed previously but unemployed at the last follow-up, 3 (10%) were employed as disabled, 6 (20%) received employment support, 3 (10%) were college students, and 6 (20%) had no employment history. Twenty-five patients (83%) lived with their families. Two patients (7%) were married. In 30% of r20 patients, drug treatment improved seizures to a degree minimally disruptive to daily life. Lamotrigine use was associated with favorable seizure outcome. Social constraints in employment, residence, and marriage were significant, indicating the need for comprehensive epilepsy care.

Type 2 Inflammation and Its Role in Dermatologic Diseases.

Atopic dermatitis, prurigo nodularis, and chronic spontaneous urticaria are immune-mediated, inflammatory skin conditions characterized by intense itch and disease-specific skin lesions. Despite their different clinical presentations, the three diseases are unified by an aberrant type 2 immune response involving type 2 cytokines, immune cells, and sensory nerves that may underlie their shared clinical manifestations of inflammation and pruritus. The chronic nature of these conditions is associated with significant impairment in patients' quality of life and psychological disorders, such as anxiety and depression. This article reviews type 2 inflammation and its role in atopic dermatitis, prurigo nodularis, and chronic spontaneous urticaria, focusing on the pathophysiologic drivers of type 2 inflammation in each dermatologic condition. Understanding the shared immune mechanisms that underlie these seemingly distinct skin diseases and other concomitant inflammatory conditions is critical for applying therapeutic interventions targeting the type 2 immune pathway.

Antidepressant intervention to possibly delay disease progression and frailty in elderly idiopathic pulmonary fibrosis patients: a clinical trial

BackgroundIdiopathic pulmonary fibrosis (IPF) is more likely to occur in the elderly population, and these patients often become depressed. It has been recognized that psychological disorders are not conducive to the control of many diseases. Thus, this study aims to determine whether alleviating depression can delay the progression of IPF and frailty in elderly patients with IPF.MethodsIPF patients over 60 years old were included in the study. None had a prior history of psychological disorders. All developed depression after being diagnosed with IPF. During the 12-month follow-up, some patients received anti-depression interventions and the rest didn’t. Depression, IPF, frailty and peripheral inflammation at baseline and after follow-up were evaluated by indicators and scales such as BDI-II, FVC %pred, 6MWT, mMRC, CFS, TFI, SGRQ, K-BILD, IL-6, and TNF-α. Multivariate logistic regression was employed for data analysis.ResultsThere were 213 elderly patients with IPF. Among the 89 patients who received anti-depression interventions, the above-mentioned indicators and scales did not deteriorate during the follow-up period (P > 0.05). Among the remaining 124 patients, the FVC %pred, and 6MWT levels decreased, and the mMRC grade, CFS, TFI, SGRQ and K-BILD scores, and peripheral IL-6 and TNF-α levels increased during the follow-up period (P < 0.05).DiscussionCompared with non-intervened IPF patients, those receiving anti-depression interventions seemed to maintain a certain stability in IPF, frailty, and peripheral inflammation over a period.ConclusionImproving depression may help delay the deterioration of patients' IPF and frailty at certain stages.Trial registration: Registration on UMIN-CTR. Registration number: UMIN000057161. Date of registration: February 27th, 2025.

Structural basis for psilocybin biosynthesis

Psilocybin shows significant therapeutic potential for psilocybin-assisted psychotherapy in addressing various psychiatric conditions. The biosynthetic approach promises rapid and efficient production of psilocybin. Understanding the enzymes that contribute to the biosynthesis of psilocybin can enhance its production process. In this study, we elucidate the crystal structures of L-tryptophan-specific decarboxylase PsiD in both its apo and tryptamine-bound states, the 4-hydroxytryptamine kinase PsiK bound to its substrate, and several forms of the methyltransferase PsiM in either apo or substrate-bound forms derived from the psychedelic mushroom. Structure-based evaluations reveal the mechanisms of self-cleavage and self-inhibition in PsiD, along with the sequential catalytic steps from 4-hydroxytryptamine to the final compound, psilocybin. Additionally, we showcase the antidepressant properties of biosynthetic intermediates of psilocybin on female mice experiencing depression-like behaviors induced by sub-chronic variable stress. Our studies establish a structural basis for the future biosynthetic production of psilocybin using these enzymes and emphasize the clinical potential of norbaeocystin.

Film Therapy and Anxiety Disorders, Self-Esteem and Quality of Life. Report From Research.

The article explores the applicability of film therapy in anxiety disorders, focusing on its role in enhancing self-esteem and improving quality-of-life assessments in patients. Anxiety is characterized as a serious clinical issue occurring in the context of numerous mental and emotional disorders. This study aims to analyze the theoretical foundations and research findings regarding film therapy as a psychotherapeutic method, with a particular focus on its impact on anxiety reduction, self-esteem, and quality of life. The study presents key theoretical considerations, tools used, and research methodology. A selection of self-esteem issues and their significance for mental health is examined. The research process includes an evaluation of film therapy's effectiveness through specific assessment tools. The findings indicate that film therapy significantly contributes to reducing anxiety, improving self-esteem, and enhancing quality-of-life measures. The therapeutic process involving film therapy is particularly effective in a long-term perspective. The study highlights the key tenets of film therapy and its integration into psychotherapeutic practice. The interconnections between film therapy and broader psychological and emotional processes are examined. Film therapy is a valuable therapeutic method that plays a crucial role in anxiety management, self-esteem improvement, and quality-of-life enhancement. Future studies should explore its broader applications and long-term benefits.

Design and development of a mobile mental health application for individuals with depression and anxiety: design science research methods

ABSTRACT Mobile applications for depression and anxiety are valuable in low-resource settings with limited mental health services. Engaging users and key stakeholders in application design and development ensure patients’ needs are met, particularly in developing countries. Currently, no mental health applications are tailored to the Ethiopian context. The Design Science Research Method was applied to present the requirements of mental health professionals and usability tests. The results of the study informed essential features such as information on depression, anxiety, and psychological distress; self-care strategies; self-assessment tools; and reminders for medication and appointments. The Cognitive Walkthrough (CW) results showed that study participants liked and agreed with most of the app interface design. Furthermore, closed testing results showed high user satisfaction, highlighting its potential to be widely adopted for other types of mental health conditions in Ethiopia. Overall, this paper provides a comprehensive and methodologically rigorous approach to developing a mobile mental health app tailored to the needs of low-resource settings, with a specific focus on Ethiopia. The research contributions lie in identifying key stakeholder requirements, involving mental health professionals in the design process, utilizing iterative feedback from experts, and preparing the app for real-world testing.

The burden and determinants of mental health disorders in Abu Dhabi, United Arab Emirates: a retrospective cohort

BackgroundAssessing the burden of mental health disorders is critical for planning the best healthcare services and responding to community needs. This study aimed to assess the mental health burden in Abu Dhabi, United Arab Emirates and its important determinants.MethodologyThis retrospective cohort study included participants from a national cardiovascular screening program (Weqaya) in Abu Dhabi, United Arab Emirates, from 2010 to 2013. The data were collected through electronic medical records (EMRs). A total of 8699 subjects were included, with an average follow-up period of 9.2 years. Participants’ EMRs were reviewed in 2023 by physicians and nurses through electronic medical records for a diagnosis of mental health disorders or any psychiatric medication prescribed.ResultsThe prevalence of mental health disorders among this cohort was 3.8%. Compared with males, females had a greater prevalence of mental illnesses. The highest prevalence of mental health disorders was among younger age groups (< 30 years old). Mood disorders had the highest prevalence. A history of psychiatric illnesses was significantly associated with the following baseline characteristics at screening: prediabetes mellitus status, smoking status, coronary heart disease status, dyslipidemia at screening, high-density lipoprotein (HDL) level and female sex. With regard to associated outcomes during the follow-up years, psychiatric illness was significantly associated with smoking at any time, chronic kidney disease, metabolic dysfunction-associated fatty liver disease (MUFLD), and diabetes mellitus. Moreover, logistic regression revealed that death, as a dependent variable, was associated with an increased risk of mortality. Such an increase in mortality compared with that in the general population was not found among patients with psychiatric illnesses who were using statins.ConclusionThe prevalence of diagnosed and treated mental health disorders was not as high as that in other regions of the world, but when adjusted for age, it was close to the average worldwide prevalence. The discrepancy between questionnaire-based prevalence and our prevalence highlights the mental health burden that necessitates further studies. Furthermore, more studies are needed to estimate the prevalence in the total population of the UAE. The higher risk of mortality found in this study indicates that mental illness is either a risk factor for death or an outcome of higher-risk patients, which also needs to be confirmed by future studies.

The budget impact analysis of nicotine replacement therapy among patients who smoke tobacco and have mental illness in South Africa and the implications

BackgroundTobacco use is the world's leading preventable cause of death, with the highest burden in low and middle-income countries (LMICs). Those who have mental illness are particularly vulnerable, with a smoking rate two to five times higher than that of the general population. Quitting smoking has demonstrated benefits for mental health, including reducing stress and improving the quality of life. However, the economic feasibility of introducing Nicotine Replacement Therapy (NRT) in the psychiatric medical environment in South Africa has not yet been explored. This study aims to address this gap by assessing the impact on the budget of implementing an NRT-based smoking cessation program in a psychiatric hospital.MethodsThis retrospective and cross-sectional study followed a budget impact analysis framework. Data were retrieved between May 19 and Aug 18, 2023, from 214 patients' medical records. Using primary and secondary data, an ingredients costing approach was used to estimate direct treatment costs of NRT smoking cessation. All costs were expressed in ZAR (South African currency). The economic evaluation was conducted from the payer's perspective, and the results were reported at a 5% discount rate. A two-way 10% sensitivity analysis was conducted.ResultsThe study showed that study participants were primarily black, male, unemployed, diagnosed with schizophrenia and smoked lightly (69.16% ±3.46). Implementing the 3-month treatment period of NRT smoking cessation program would result in an expenditure of R1 478 915.42 for 214 patients. The hospital will require an additional 0.15% (±0.0095) of the total hospital budget and 6.09% (±0.31) of the hospital pharmacy budget.ConclusionOur findings indicate that while implementing a NRT is crucial for improving the overall health outcomes among patients with mental illnesses, substantial investment would be required. The budgetary allocation for NRT smoking cessation interventions would vary by treatment settings and program duration. Consequently, careful consideration of budget allocation and resource distribution is necessary to ensure the program's sustainability within the broader healthcare framework in South Africa.

Suicide-related stigma and its relationship with help-seeking, mental health, suicidality and grief: scoping review.

Suicide-related stigma (i.e. negative attitudes towards people with suicidal thoughts and/or behaviours as well as those bereaved by suicide) is a potential risk factor for suicide and mental health problems. To date, there has been no scoping review investigating the association between suicide-related stigma and mental health, help-seeking, suicide and grief across several groups affected by suicide. To determine the nature of the relationship between suicide-related stigma and mental health, help-seeking, grief (as a result of suicide bereavement) and suicide risk. This review was registered with PROSPERO (CRD42022327093). Five databases (Web of Science, APA PsycInfo, Embase, ASSIA and PubMed) were searched, with the final update in May 2024. Studies were included if they were published in English between 2000 and 2024 and assessed both suicide-related stigma AND one of the following: suicide, suicidal thoughts or suicidal behaviours, help-seeking, grief or other mental health variables. Following screening of 14 994 studies, 100 eligible studies were identified. Following data charting, cross-checking was conducted to ensure no relevant findings were missed. Findings across the studies were mixed. However, most commonly, suicide-related stigma was associated with higher levels of suicide risk, poor mental health, lowered help-seeking and grief-related difficulties. A model of suicide-related stigma has been developed to display the directionality of these associations. This review emphasises the importance of reducing the stigma associated with suicide and suicidal behaviour to improve outcomes for individuals affected by suicide. It also identifies gaps in our knowledge as well as providing suggestions for future research.

The importance of the cumulation of risk factors for antepartum depression

ABSTRACT Objectives Pregnancy is a period of heightened vulnerability to mental health problems. This pilot study aims to investigate the association between psychosocial and obstetric risk factors and the onset of depressive and anxious symptoms during pregnancy, with a focus on cumulative risks. Method Conducted at Ghent University Hospital in Belgium, this prospective observational study involved 378 pregnant women. Participants received a semi-standardized psychosocial assessment at 16 weeks to evaluate potential risk factors, followed by stepped screening protocol for depressive and anxious symptoms at 20 weeks. Due to significant overlap, the analysis focused solely on depressive symptoms. Results Depressive symptoms were identified in 5.5% of participants with a score ≥ 13 on the Edinburgh Depression Scale. Key psychosocial risk factors that increase the risk of antepartum depression include a history of mental health issues, especially depression (Fisher’s exact test (FET), p = .018), experiences of physical (FET, p = .007) or emotional (FET, p = .008) violence, lack of social support (FET, p = .014), and unplanned pregnancy (FET, p = .008). No significant association was found between obstetric factors and depressive symptoms. The study highlights that the accumulation of psychosocial risk factors significantly elevates the risk of depression (Kendall’s τ = 0.22, p < .001). Conclusion These findings underscore the necessity of comprehensive psychosocial assessments in pregnant women, offering deeper insights than mere screenings for depression and anxiety. Recognizing and quantifying these risk factors facilitates targeted interventions. Employing a cumulative risk index effectively identifies women at heightened risk of mental health problems.

Attitudes of Australian patients receiving inpatient mental health care towards deprescribing: a cross-sectional survey

BackgroundPsychotropic polypharmacy is common, increasing, and associated with higher risks of adverse effects, hospitalisations and mortality. This study aimed to explore the attitudes and beliefs of people receiving inpatient mental health care toward deprescribing (discontinuing a medication when the current or potential risk outweighs the current or potential benefit) and determine any patient characteristics associated with these attitudes and beliefs.MethodsA cross-sectional survey of patients admitted to two open acute psychiatric inpatient units was conducted over a 6-month period in the Australian metropolitan city of Adelaide. Individuals were eligible to participate regardless of their reason for admission, if they were at least 18 years old and able to converse, read and write in English, and provide informed consent. Participant characteristics and responses to the validated revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire were collected. The rPATD includes questions grouped into four factors: (i) perceived burden of medications, (ii) involvement in medication management, (iii) belief in appropriateness of medications, and (iv) concerns about stopping, plus two global questions. Participants were encouraged to think about medications that they use for their mental health conditions when completing the questionnaire.ResultsOne hundred participants were recruited, with a mean age of 41.6 (SD = 13.7). 65% of participants agreed that they would be willing to stop one or more of their psychotropic medications if their doctor said it was possible. In a binary logistic regression model, willingness to have a medication deprescribed was mostly strongly predicted by Involvement factor score (odds ratio [OR] = 5.92, 95% confidence interval [CI] = 2.10-15-16.70, p < 0.001).ConclusionsA majority of participants were open to having one or more medication deprescribed. When medically justified, mental health professionals should feel comfortable initiating conversations about deprescribing to understand patient attitudes and preferences, fostering shared decision-making for psychotropic medication management.Clinical trial numberNot applicable.

Steeping in how "shut up and color" mindset manifests: Semantic analysis of open-ended responses for barriers to support seeking among veterans.

Despite the long use of surveys in veterans' needs assessments, a disconnect persists between the veterans' needs and the available services. This study employs a hermeneutical framework to semantically analyze open-ended responses and investigate how veterans' perceptions of service barriers are formed. We analyzed 3,325 open-ended responses specifying their perceived barriers in Texas Veterans Needs Survey data from 2023 (n = 16,733). Our analysis revealed that the hurdles stem from the combination of (1) obedience to authority, (2) covert mental health challenges, (3) hopelessness, and (4) self-defeating prophecy created by complex systems and lack of trust. For instance, many reported being told they were not eligible for services or only hinted at their psychological struggles as a hurdle rather than explicitly citing a history of denial or mental health conditions. Fear of unwanted consequences, procrastination due to the self-sufficient mindset, and comparisons to other veterans were observed in relation to the "military mind-set." Minorities and those who withheld their demographic information were more presented in the analytical sample than in the overall survey. Contextualization of qualitative data revealed how the military mindset is intertwined with the veterans' service-seeking behavior. The findings may improve the interpretability and validity of future veteran needs assessments.

Unveiling the role of Na⁺/K⁺-ATPase pump: neurodegenerative mechanisms and therapeutic horizons.

Unveiling the role of Na⁺/K⁺-ATPase pump: neurodegenerative mechanisms and therapeutic horizons.

Multi-omics insight into the molecular networks of mental disorder related genetic pathways in the pathogenesis of inflammatory bowel disease

Mental disorders are associated with inflammatory bowel disease (IBD), but the genetic pathophysiology is not fully understood. We obtained data on mental disorder-related gene methylation, expression, protein levels, and summary statistics of IBD, and performed Summary data-based Mendelian randomization and colocalization analyses to explore the causal associations and shared causal genetic variants between multiple molecular traits and IBD. Integrating multi-omics data, we found QDPR, DBI and MAX are associated with ulcerative colitis (UC) risk, while HP is linked to IBD risk. Inverse associations between gene methylation (cg0880851 and cg26689483) and expression are observed in QDPR, consistent with their detrimental role in UC. Methylation of DBI (cg11066750) protects against UC by enhancing expression. Higher levels of DBI (OR = 0.79, 95%CI = 0.69–0.90) and MAX (OR = 0.74, 95%CI = 0.62–0.90) encoded proteins are inversely associated with UC risk, while higher QDPR (OR = 1.17, 95%CI = 1.07–1.28) and HP (OR = 1.09, 95%CI = 1.04–1.14) levels increase UC and IBD risk. Our findings advance the understanding of IBD’s pathogenic mechanisms and gut-brain interaction.