Psychiatric Screening Research Articles

Artificial intelligence-assisted psychosis risk screening in adolescents: Practices and challenges.

Artificial intelligence-based technologies are gradually being applied to psych-iatric research and practice. This paper reviews the primary literature concerning artificial intelligence-assisted psychosis risk screening in adolescents. In terms of the practice of psychosis risk screening, the application of two artificial intelligence-assisted screening methods, chatbot and large-scale social media data analysis, is summarized in detail. Regarding the challenges of psychiatric risk screening, ethical issues constitute the first challenge of psychiatric risk screening through artificial intelligence, which must comply with the four biomedical ethical principles of respect for autonomy, nonmaleficence, beneficence and impartiality such that the development of artificial intelligence can meet the moral and ethical requirements of human beings. By reviewing the pertinent literature concerning current artificial intelligence-assisted adolescent psychosis risk screens, we propose that assuming they meet ethical requirements, there are three directions worth considering in the future development of artificial intelligence-assisted psychosis risk screening in adolescents as follows: nonperceptual real-time artificial intelligence-assisted screening, further reducing the cost of artificial intelligence-assisted screening, and improving the ease of use of artificial intelligence-assisted screening techniques and tools.

Cognitive and neurobehavioral patterns in a sample of Egyptian patients genetically diagnosed with Duchenne muscular dystrophy

BackgroundChildren with Duchenne muscular dystrophy report a higher rate of cognitive and psychiatric disorders relative to general population. This study will describe and compare the psychiatric and cognitive problems in DMD patients with healthy controls.ResultsA statistically significant difference was found between the case and control groups regarding Total IQ (TIQ) with a mean of (82 ± 16) in cases compared to (94 ± 10) in controls, in which 58% of DMD boys had <90 TIQ and 40% less than 70. We also found that 58% of cases have delayed onset of speech, 38% have attention-deficit/hyperactivity disorder, 6% have autism spectrum disorder, 14% have anxiety disorders, and 22% have major depressive disorder. Ninety-two percent of cases had deletion mutations.ConclusionsAccording to our results, we conclude that boys with DMD had a lower Total IQ and higher rate of psychiatric disorders than the general population. Also, school attendance and speech development are more affected in DMD patients compared to controls, with more speech delay and dropping out of school. So, the authors of this study recommend establishing cognitive and psychiatric screening as a routine in the evaluation and follow-up of DMD children.

A Framework for Automating Psychiatric Distress Screening in Ophthalmology Clinics Using an EHR-Derived AI Algorithm.

PurposeIn patients with ophthalmic disorders, psychosocial risk factors play an important role in morbidity and mortality. Proper and early psychiatric screening can result in prompt intervention and mitigate its impact. Because screening is resource intensive, we developed a framework for automating screening using an electronic health record (EHR)-derived artificial intelligence (AI) algorithm.MethodsSubjects came from the Duke Ophthalmic Registry, a retrospective EHR database for the Duke Eye Center. Inclusion criteria included at least two encounters and a minimum of 1 year of follow-up. Presence of distress was defined at the encounter level using a computable phenotype. Risk factors included available EHR history. At each encounter, risk factors were used to discriminate psychiatric status. Model performance was evaluated using area under the receiver operating characteristic (ROC) curve and area under the precision–recall curve (PR AUC). Variable importance was presented using odds ratios (ORs).ResultsOur cohort included 358,135 encounters from 40,326 patients with an average of nine encounters per patient over 4 years. The ROC and PR AUC were 0.91 and 0.55, respectively. Of the top 25 predictors, the majority were related to existing distress, but some indicated stressful conditions, including chemotherapy (OR = 1.36), esophageal disorders (OR = 1.31), central pain syndrome (OR = 1.25), and headaches (OR = 1.24).ConclusionsPsychiatric distress in ophthalmology patients can be monitored passively using an AI algorithm trained on existing EHR data.Translational RelevanceWhen paired with an effective referral and treatment program, such algorithms may improve health outcomes in ophthalmology.

3.74 Validation of the Child Behavior Checklist and Achenbach Test Observation Form for Use With american indian Children in the Navajo Nation

There are virtually no psychiatric screening or diagnostic instruments validated for use with American Indian Children in the Navajo Nation, the largest American Indian reservation in the United Sates. In order to begin to remedy this problem, we completed a preliminary study examining the validity and reliability of the Child Behavior Checklist (CBCL) and the Achenbach System of Empirically Based Assessment (ASEBA) Test Observation Form (TOF) for American Indian children in the Navajo Nation. The CBCL is a parent report to screen for developmental psychopathology, whereas the TOF is a companion form, completed by trained assessors, to rate observed behaviors in 2- to 18-year-old children.

Identifying Patients with Epilepsy Having Depression/Anxiety Disorder Using Common Spatial Patterns of Functional EEG Networks

PurposeThe presentation of epilepsy with depression/anxiety disorder (E-AD) is a complex comorbidity, and a systematic psychiatric screen poses a heavy economic burden on the patients. Typically, distinguishing between E-AD patients and epilepsy without depression/anxiety disorder (E-no-AD) needs multiple evaluations, which is incredibly difficult owing to the high costs. Therefore, there is an urgent need for a reliable assessment protocol to preemptively distinguish between the two types of patients.MethodsWe collected the resting-state electroencephalography (EEG) signals from E-AD patients and E-no-AD patients and constructed the functional networks for the two groups of. The connectivity strength and the corresponding network properties of different frequency bands were statistically compared to explore the inherent differences. Based on the differences in functional networks, we evaluated the classification performance using different network features, including the network properties, principal component analysis (PCA) and spatial patterns of networks (SPN).ResultsUsing the support vector machine, the differentiation of the 4416 EEG segments from E-no-AD patients and 6346 EEG segments from E-AD patients was realized using three different network features. The results revealed that the SPN feature of functional network connectivity was remarkably superior to the traditional network feature for distinguishing between the two patient groups, with an appreciable classification accuracy of 89.90% and sensitivity of 87.37% and specificity of 91.67%.ConclusionThese findings demonstrate the superiority of functional SPN features as a reliable way to characterize the differences between E-AD and E-no-AD patients and potentially provide insights regarding the complex mechanisms causing E-AD in patients.

Mental health in pre-COVID-19 and during the COVID-19 pandemic: a comparative study using symptom checklist-90-R.

The aim of this study is to search the psychopathological effects of the Coronavirus disease on the patients with psychiatric symptoms on the COVID-19 pandemic process. The study was designed according to the data obtained from 323 patients (171 women and 152 men) who participated in the study pre-COVID-19 period and 423 patients (205 women and 218 men) who participated in the study during COVID-19 period. All participants underwent the Symptom Checklist-90-Revised (SCL-90-R) examination. The SCL-90-R is a psychiatric screening tool that measures the level of reactions elicited by the compulsion or negative stress of individuals. The SCL-90-R was utilized to define psychiatric symptoms and evaluate psychological problems, statistically compared to patient groups with similar demographic and sociocultural characteristics (education level, marital status). There were no statistically significant differences in participants' characteristics for the mean age distribution, marital status, education level, and smoking habits between the groups of pre-COVID-19 and during COVID-19 period (p>0.05). When comparing the scores of the participants' SCL-90-R Psychological Symptom Screening Scale and its sub-dimensions before and during the COVID-19 period, no statistically significant difference was found between the scores of the participants in both groups (p>0.05). 187 patients (52.97%) had the disease, and 166 patients (47.03%) did not have the disease during COVID-19 period. It was observed that there was statistically significant difference for obsessive-compulsive and depression scores of the SCL-90-R scale between the participants who had or had not COVID-19 (p<0.05). It was higher in the first group. There was a statistically significant difference between the depression, anxiety and phobic anxiety scores of the vaccinated compared to the unvaccinated participants (p<0.05). Psychological symptoms general and subscales during the COVID-19 pandemic were similar to pre-pandemic levels according to the SCL-90-R. This is important for planning mental health provisions and for long-term impact of the COVID-19 pandemic.

A-186 Injury Mechanism, Premorbid Intelligence, and Psychological Outcomes Post Mild Traumatic Brain Injury

Abstract Objective: This study aimed to explore psychological outcomes of individuals who sustained a mild traumatic brain injury (mTBI) as impacted by injury mechanism and premorbid intelligence. Cognitive outcomes post mTBI are well-researched, and the impact of premorbid intelligence has routinely been shown in the literature to impact cognitive outcomes, but type of injury and psychiatric outcomes have received much less attention. Method: All 108 participants were referred for outpatient neuropsychological evaluation following presentation to the emergency room with head injury. A multivariate analysis of covariance (MANCOVA) was used to explore the relationship of injury mechanism (motor vehicle accident (MVA) or fall) to psychological outcomes as measured by the major depressive disorder, generalized anxiety disorder, alcohol abuse/dependence, drug abuse/dependence, and posttraumatic stress disorder (PTSD) scales on the Psychiatric Diagnostic Screening Questionnaire (PDSQ). Premorbid intelligence as assessed using WRAT—4 Reading was the covariate. A binary logistic regression was also used to determine which PDSQ scales were predictors of injury mechanism. Results: In the MANCOVA analysis, alcohol abuse/dependence was the sole variable approaching significance (p = .068). The logical regression equation model accurately classified 98.9% of MVA cases, wherein alcohol abuse/dependence emerged as the lone significant predictor (p = .028). Conclusions: Contrary to literature on cognitive outcomes, premorbid intelligence was not associated with psychological outcomes post mTBI. Independent of injury mechanism, no significant differences among PDSQ outcome scales were discovered. Finally, those with mTBI due to MVA had a higher probability of alcohol abuse/dependence compared to those with those suffering a mTBI from a fall.

Decreased self-reported receiving of social touch and social support predict loneliness in healthy adults

Loneliness has emerged as a public health concern. Previous research has reported its deleterious effects on physical and mental health; however, some specific psychophysiological mechanisms in healthy adults remain to be elucidated. The aim of the current study is to investigate whether self-reported social support and social touch (giving and receiving social touch), as well as resting heart rate variability (HRV), are significant negative predictors of loneliness in healthy adults. The study sample consists of 120 healthy students (50% female) with a mean age of 21.85 years old (DP= 2.21). The students were asked to complete a psychiatric screening questionnaire utilizing loneliness, social support, and social touch scales. HRV was derived from an electrocardiographic signal recorded for 15 min, with the participant relaxed in a supine position. Linear regression analyses were conducted to evaluate loneliness as a function of social support, social touch (giving or receiving touch), and resting HRV. The results show that social support (p< 0.001) and social touch, specifically receiving touch (p< 0.002), accounted for a significant proportion of the variance in loneliness. However, neither giving touch nor resting HRV was a significant predictor of loneliness. The current study highlights specific psychosocial factors in healthy adults that should be considered as promising pathways in order to reduce or work toward preventing loneliness, thus promoting better health and well-being.

Universal Suicide Screening Is Feasible and Necessary to Reduce Suicide.

Back to table of contents Previous article Next article Controversies in Psychiatric ServicesNo AccessUniversal Suicide Screening Is Feasible and Necessary to Reduce SuicideJulie Goldstein Grumet, Ph.D., Edwin D. Boudreaux, Ph.D.Julie Goldstein GrumetSearch for more papers by this author, Ph.D., Edwin D. BoudreauxSearch for more papers by this author, Ph.D.Published Online:11 Jul 2022https://doi.org/10.1176/appi.ps.202100625AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Psychiatric Services $35.00 Add to cart PPV Articles - Psychiatric Services Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 74Issue 1 January 01, 2023Pages 81-83 Metrics KeywordsSuicideSelf-destructive behaviorEmergency psychiatryGeneral hospital psychiatryPractice guidelinesAdolescentsPDF download History Published online 11 July 2022 Published in print 1 January 2023

Validity and Reliability of the Iranian Rapid Assessment for Psychiatric Illness Screening Instrument (IRA-PISI) in Primary Health Care

Background: An estimated 25% to 30% of patients presenting to family physicians have psychiatric disorders (PDs). Accurate diagnosis of various PDs requires valid and well-designed screening tools and psychiatric interviews. There is no rapid and low-cost tool for PD screening in primary health care (PHC). Objectives: To determine the validity and psychometric properties of the Iranian Rapid Assessment for Psychiatric Illness Screening Instrument (IRA-PISI) in PHC. Methods: This psychometric study was performed among a convenience sample of 257 outpatients presenting to the first-line health services in Tabriz. Psychiatric interviews via DSM-5 were used as the gold standard. The validation process included the face validity (literature review and expert comments), content validity, estimating the best cutoff point, and measuring the sensitivity and specificity of the questionnaire compared to the psychiatric interview. Temporal and internal reliabilities were measured by test-retest and Cronbach's alpha coefficient, respectively. Results: The final questionnaire consisted of 14 items (with a score range of 14 to 70) after removing seven questions from the initial questionnaire (21 items) during the validation process. The sensitivity and specificity of the questionnaire compared to psychiatric interviews were 83.62% and 75.17%, respectively. The overall relevance and the best cutoff point (score) were 0.91% and 28, respectively. Interclass correlation coefficient (ICC) and Cronbach's alpha coefficient were 96% and 83%, respectively. The ICC of items/questions ranged from 89.3 to 100. Conclusions: The IRA-PISI has appropriate validity and reliability for screening common PDs among outpatients presenting to first-line healthcare providers.

Gender differences among persons entering medication treatment for opioid use disorder in the community.

We evaluated gender differences among persons initiating medications for opioid use disorder (MOUD). Analyses of baseline assessments for a study evaluating the impact of MOUD on outcomes included: demographics, DSM-5 diagnoses, depression severity, quality of life (QoL), and medication history (N = 125). When compared to men, women had a greater prevalence of generalized anxiety and posttraumatic stress disorders; and worse psychological QoL. Women were less likely to be prescribed psychiatric medications. Women may benefit from tailored multidisciplinary programs with MOUD. This study identified that women with OUD seeking MOUD in the community had greater sedative hypnotic nonprescribed medication use and psychiatric comorbidity than men, all of which can contribute to poorer retention on MOUD and higher risk of morbidity and mortality. Thus, concurrent psychiatric disorder screening and treatment integrated with MOUD may improve retention on MOUD, opioid relapse and overdose for women.

Increasing Levels of Evidence in Rhinoplasty: Stepping Up Our Role as Leaders in the Specialty.

Increasing Levels of Evidence in Rhinoplasty: Stepping Up Our Role as Leaders in the Specialty.

Migration, Schizophrenia, and Crime: A Study From a Forensic Psychiatric Sample.

BackgroundThe association between mental health problems and crime in immigrants has attracted recent academic interest, with results suggesting that there were possible interactions between immigration, schizophrenia, and criminal behavior. However, very few studies have examined these interactions, especially in developing countries that have mass internal immigration. Therefore, this study sought to identify the associations between the sociodemographic, clinical, and criminal factors in migrants and non-migrants with schizophrenia who had been involved in criminal activities in China.MethodsForensic archives of suspects who had been referred for criminal responsibility assessments in the Sichuan West China Forensic Center from January 2015 to December 2019 were reviewed. The sociodemographic, and criminal activity information of the suspects were extracted, while the clinical and social function were measured by the Brief Psychiatric Rating Scale (BPRS) and Social Disability Screening Schedule (SDSS) based on the archives. A Chi-squared test, a T-test, a Mann-Whitney U test, and Multinomial logistic regression were employed for the statistical analysis.ResultsA total of 552 patients were reviewed and evaluated, 17.2% (n = 95) of which were migrants. The migrant patient group was younger than the non-migrant patient group. The BPRS and SDSS scores for the migrant patient group were lower than for the non-migrant patient group. The migrant patient group had more work experience and more had been employed at the time of the crime than the non-migrant patient group. The unemployed migrant patients were more likely to commit a property-related crime.ConclusionsCompared to the non-migrant schizophrenia patient group, the migrant patient group had less severe psychiatric symptoms and less social function impairments. Employment was an important factor in preventing criminality in patients with schizophrenia, especially for migrant patients. Vocational rehabilitation focuses on developing appropriate employment that can significantly assist in schizophrenia patient recovery, which in turn could reduce their chances of committing crime. Besides, reducing other obstacles to stigma, housing and health insurance would also be beneficial to crime reduction.

The Interplay Between Expected Psychological Responses to Exercise and Physical Activity in Analogue Generalized Anxiety Disorder: a Cross-sectional Study.

Expectations for psychological responses to exercise are not well characterized, particularly in people at risk for anxiety-related illnesses. Given the substantial evidence for salutary effects of exercise on anxiety symptoms and emerging recognition for expectations as a critical mechanism of placebo/nocebo effects, this study explored the interplay between expectations and physical activity in young adults with and without analogue generalized anxiety disorder. Participants (N=470, 23.2±4.8 years, 63% female) completed a physical activity and mood survey, including a 7-day physical activity recall questionnaire, and a 20-item questionnaire designed to measure positive and negative expectations for psychological and perceptual responses to exercise, particularly expectations for symptoms in the generalized anxiety disorder symptom profile. Analogue generalized anxiety disorder status was determined using the Generalized Anxiety Disorder subscale of the Psychiatric Diagnostic Screening Questionnaire. For select outcomes, expected exercise-induced changes significantly differed according to analogue generalized anxiety disorder (whole-body pain, sleep quality, psychological well-being, stress, relaxation) and active versus inactive (anxious mood, depressed mood, concentration, physical function, psychological well-being, relaxation) status. However, these findings did not survive corrections for multiple comparisons and the magnitude of these differences was small, approximating 0.25 standard deviations. Expectations for anxious (Spearman's ρ=-0.14, p≤0.002) and depressed mood (ρ=-0.15, p≤0.002), and psychological well-being (ρ=0.15, p≤0.001) were significantly associated with higher physical activity levels. Exercise expectations for anxious mood explained a significant, but small (+1.5%, p≤0.03), amount of variance in physical activity. Expectations for exercise-induced improvements did not significantly differ between young adults based on analogue generalized anxiety disorder or physical activity status.

Associations among Caesarean Section Birth, Post-Traumatic Stress, and Postpartum Depression Symptoms.

Caesarean section (C-section) deliveries account for nearly 30% of births annually with emergency C-sections accounting for 7–9% of all births. Studies have linked C-sections to postpartum depression (PPD). PPD is linked to reduced quality of parent-child interaction, and adverse effects on maternal and child health. New mothers’ perceptions of more negative childbirth experiences, such as unplanned/emergency C-sections, are linked to post-traumatic stress disorder (PTSD), which in turn is related to PPD. Our objectives were to determine: (1) the association between C-section type (unplanned/emergency vs. planned) and PPD symptoms, and (2) if postnatal PTSD symptoms mediate this association. Employing secondary analysis of prospectively collected data from 354 mother-child dyads between 2009 and 2013 from the Alberta Pregnancy Outcomes and Nutrition (APrON) study, conditional process modeling was employed. The Edinburgh Postnatal Depression Scale (EPDS) and the Psychiatric Diagnostic Screening Questionnaire (PDSQ) were administered at three months postpartum, to assess for postpartum depressive and post-traumatic stress symptoms. The direct effect of emergency C-section on PPD symptoms was non-significant in adjusted and non-adjusted models; however, the indirect effect of emergency C-section on PPD symptoms with PTSD symptoms as a mediator was significant after controlling for prenatal depression symptoms, social support, and SES (β = 0.17 (SE = 0.11), 95% CI [0.03, 0.42]). This suggests that mothers who experienced an emergency or unplanned C-section had increased PTSD scores of nearly half a point (0.47) compared to mothers who underwent a planned C-section, even after adjustment. Overall, emergency C-section was indirectly associated with PPD symptoms, through PTSD symptoms. Findings suggest that PTSD symptoms may be a mechanism through which emergency C-sections are associated with the development of PPD symptoms.

Psychiatric Symptoms in Oncological Patients at Nuclear Medicine Department

Objective: In the process of PET/CT scanning, patients go through a general evaluation while their medical history is being taken, but it is often overlooked that these patients should be evaluated not only biologically but also bio psychosocially. Psychiatric symptom profiles and help-seeking behaviours of cancer patients were examined in this study.&#x0D; Methods: Cancer patients presented to nuclear medicine clinic filled out sociodemographic data form, psychiatric admission evaluation form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Symptom Checklist-90 (SCL-90) form for psychiatric symptom screening.&#x0D; Results: In this study 27.8% of the patients had a Beck Depression score ≥18 and were in the risk group for depression, 31.7% of the patients experienced moderate or severe anxiety symptoms. Beck Depression Total and Beck Anxiety Total values were found significantly higher in women than in men. Only 10,2% of the cancer patients reported that they sought psychiatric help in the last 6 months. Among the patients who were risky for depression according to BDI only 25% had been receiving psychiatric help and in among the patients who were risky for anxiety according to BAI only %26.9 had been receiving psychiatric help&#x0D; Conclusion: Nuclear Medicine physicians' interest in psychiatric symptoms and help-seeking behaviors of cancer patients referred to Nuclear Medicine Clinics is very important in terms of psycho-oncology.

Psychiatric Outcomes after Mild Traumatic Brain Injury in Adults

<h3>Research Objectives</h3> To enhance the knowledge regarding psychiatric outcomes after mild traumatic brain injury (mTBI) in adults, specifically considering premorbid psychiatric history. <h3>Design</h3> A retrospective observational study using a clinical dataset from the initial evaluation in clinic. Self-reported premorbid psychiatric history was determined by clinician interviews. <h3>Setting</h3> An ambulatory mTBI clinic. <h3>Participants</h3> Participants were 85 adults with mTBI confirmed by clinicians. Participants were 14 to 365 days post injury with valid psychiatric history and outcomes data. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was part of the clinical assessment process. The PDSQ is a brief screening measure for common psychiatric diagnoses based upon the diagnostic and statistical manual of mental disorders, 4th edition. Major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) scales represented psychiatric outcomes. Raw scores were used as well as binary categories with scores above and below cut-off scores indicating caseness. <h3>Results</h3> There were no significant differences (p > .05) in demographic and injury characteristics (age, gender, race, loss of consciousness, and days since injury) by psychiatric history status (yes/no) with exception of year of education (p= .025). On average, participants were 36.6 years old with 13.8 years of education. Men (47.6%) and women (52.4%) were fairly even in representation. Most participants were Caucasian (89.4%). Individuals with premorbid psychiatric histories had greater symptoms of GAD (F(1, 76)= 11.90, p=.001, partial eta squared=0.14), MDD (F(1, 76)= 4.62, p=.035, partial eta squared=0.06), and PTSD (F(1, 76)= 6.54, p=.013, partial eta squared=0.08). When considering scores above respective cut-offs for each outcome, similar findings were revealed. Of note, the Odds Ratio for positive screens on depression was 7.08 (p < .001), and it was 5.45 (p= .002) for anxiety, among those with a premorbid psychiatric history. There was no association with PTSD screening and premorbid psychiatric history (p= .083). <h3>Conclusions</h3> Premorbid psychiatric history is demonstrably associated with worse psychiatric outcomes after mTBI in adults, particularly for anxiety and depression outcomes. <h3>Author(s) Disclosures</h3> None.

Feasibility of Assessing Adolescent and Young Adult Heart Transplant Recipient Mental Health and Resilience Using Patient-Reported Outcome Measures.

Although adolescents and young adults may be particularly prone to mental health symptoms after heart transplant, screening practices are variable. To assess the feasibility of using patient-reported outcome (PRO) measures to assess mental health, functional status, and resiliency in posttransplant adolescents and young adult patients. Patients transplanted between ages 15 and 25 years at 3 centers completed 6 PRO instruments via web-based platforms: PROMIS instruments for anxiety, depression, satisfaction with social roles, and physical functioning; the Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5; and the Connor-Davidson Resilience Scale-10. Feasibility (completion, time to completion, and measure missingness) and PRO results were described and compared between patients with congenital heart disease and cardiomyopathy. Nineteen patients (median age at transplant 17.7 y [interquartile range 16.3, 19.2 y], 84% male) were enrolled at an average of 3±1.8 years after transplant. Enrollment was 90% among eligible patients. Measure missingness was zero. The average completion time was 12±15 minutes for all instruments. Timely PRO completion was facilitated by in-clinic application. The PRO results indicated that 9 patients (47%) had at least mild posttraumatic stress disorder symptoms (≥11 points on Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5). Among them, 4 patients had scores >28 suggestive of probable posttraumatic stress disorder. Two (11%) and 6 (32%) patients had anxious and depressive symptoms, respectively. The cardiomyopathy cohort had a higher median Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5 score than that of the congenital heart disease subgroup (11.0 vs 6.0; P=0.015). Twelve (63%) had resiliency scores that were lower than the population average. No significant differences were found in PRO results between patients with cardiomyopathy and congenital heart disease apart from the posttraumatic stress disorder assessment. This novel PRO-based approach to psychiatric screening of adolescents and young adult patients after transplant appears feasible for assessing mental health, functional status, and resiliency, with excellent enrollment and completion rates. These instruments characterized the burden of mental health symptoms within this adolescents and young adult heart transplant cohort, with a high prevalence of posttraumatic stress disorder symptoms. Resiliency scores were lower than in a comparison population. Electronically-administered PRO administration could facilitate more consistent mental health screening in this at-risk group.

Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus

BackgroundAbout a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth. MethodsWe studied a total of 9742 high school, college and university students using following self-administered instruments: - a researcher design socio-demographic questionnaire, Psychiatric Diagnostic Screening Questionnaire (PDSQ) to document psychiatric disorders and various types of suicidal ideas in previous two weeks, Washington Early Recognition Center Affectivity and Psychosis tool to assess stress, affectivity and psychosis, Wealth index questionnaire to document economic indicators based on household items for the families of the students. We used descriptive statistics, univariate analysis, bivariate logistic regression analysis and variables with a p-value of less than <.05 were entered into generalized linear models using logit links to identify independent predictors. ResultsThe overall prevalence of different types of suicidal ideation was (22.6%), major depression was found in 20.0%, affectivity, psychosis and stress was found in 10.4%, 8.7% and 26.0% respectively. Female gender, major depression, stress, affectivity and psychosis and being in high school were significant (p < 0.05) predictors of suicidal ideation. LimitationsThis was a cross sectional study that focused only on suicidal ideas and associated economic factors and mental health disorders. It did not study suicidal behavior. ConclusionFuture studies are needed to study the progression from suicidal ideas to suicidal attempts and the factors associated with that progression.

National Implementation of Emergency Department-Based Follow-up Program for Suicidal Attempts.

BackgroundDeath by suicide is a major public health problem. To provide multidisciplinary support to patients who attempted suicide, emergency department (ED)-based psychiatric screening and intervention programs were offered. We traced the long-term survival outcome of patients visiting the ED after suicide attempts using the national death certificate registration database.MethodsA retrospective observational study was conducted using a database of patients from “Psychiatric Crisis Response Centers” (PCRC) of 27 EDs between January 2013 and August 2015. Patients who visited the ED after attempting suicide were screened and interviewed by social workers from the PCRC. The database was merged with the national death certificate database to trace the death and cause of death of the patients until December 2018. The characteristics and outcomes were compared based on the patient’s compliance with the follow-up case management program.ResultsOf the 12,544 interviewed patients, the data of 9,587 patients were successfully matched with data from the death certificate database. Death by suicide was higher in the noncompliance group (4.5% vs. 12.4%, P < 0.001); however, death caused by factors other than suicide did not differ between groups (4.8% vs. 4.9%, P = 0.906).ConclusionSuicide resulted in a lower long-term mortality rate among patients who complied with the follow-up case management session in the ED-based brief psychiatric intervention and follow-up program.