Mental Disorders Research Articles

The effectiveness of telemedicine applications in mental health services: a meta-analysis study.

This study was conducted to reveal the effectiveness of telemedicine applications in mental health services. For this meta-analysis study, data were obtained by searching PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases for the last 5years in September-December 2023. After the review, 24 studies were included. In this meta-analysis, it was found that telemedicine interventions in mental health services decreased the depression level of individuals (SMD - 0.168, 95% CI - 0.315 to - 0.021; Z = - 2.243; p < .05). In addition, it was determined that the duration of the intervention played a role in the effectiveness of telemedicine interventions applied to individuals. In addition, it was determined that the type of intervention, the country where the research was conducted, and the patient group did not play a role in the effectiveness of telemedicine interventions applied to individuals. Telemedicine applications in mental health services can play an effective role in reducing the burden of chronic mental illness and improving patient outcomes.

Validation and psychometric properties of the bipolar prodrome symptom interview and scale-full prospective Chinese version to assess individuals at risk for bipolar disorder.

Bipolar disorder (BD) is a chronic, severe mental illness with a significant socio-economic burden. The early recognition of BD requires reliable and valid instruments. We evaluated the psychometric attributes of the Bipolar Prodrome Symptom Interview and Scale-Full Prospective (BPSS-FP)-Chinese version. Altogether, 129 participants, aged 16-35 years meeting DSM-5 criteria for major depressive disorder (MDD, n = 27) or BD (n = 76), and 26 healthy controls were recruited. Subjects were evaluated with the BPSS-FP Chinese version, Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), and Cyclothymic-Hypersensitive Temperament questionnaire (CHT). Internal consistency, interrater reliability, criterion validity, and discriminant validity of the BPSS-FP-Chinese version were assessed. Cronbach alpha indices were 0.87, 0.86, and 0.66 for the manic, depressive, and general subscales of BPSS-FP-Chinese version, respectively. Interrater correlation was high, with total agreements of 0.94, 0.95, and 0.94 for the manic, depressive, and general index, respectively. Significant correlations (r ≥ 0.50) were noted between the BPSS-FP manic subscale and both the YMRS and CHT, the depressive subscale and the MADRS, and the general symptom subscale and the CHT. Moderate correlations were detected between the BPSS-FP general symptoms and both the YMRS and CHT (r = 0.40 ~ <0.50). Furthermore, the BPSS-FP mania index demonstrated a moderate correlation with the MADRS, while the depression index had a small correlation with the YMRS (r = 0.10 ~ <0.40). The BPSS-FP-Chinese version has good psychometric properties and can be applied in both clinical and research settings for screening subjects with a risk for BD.

The Association Between Change in Symptom Severity and Personal Recovery in Patients With Severe Mental Illness

Abstract This study examined the relationship between change in symptom severity and personal recovery in patients with severe mental illness (SMI). Forty-nine outpatients at Mentrum/Arkin, Amsterdam, the Netherlands, were assessed at baseline and 3 years later, using the Brief Psychiatric Rating Scale and the Mental Health Recovery Measure. Correlation coefficients and linear regression analyses were used. Further, the impact of severity of symptoms at baseline on change in personal recovery was evaluated. Results show that change in symptom severity explained 31.8% of the variance of change in personal recovery. Change in depression/anxiety explained 27.3% of the variance of change in personal recovery. Higher affective symptom severity at baseline significantly predicted positive change in personal recovery. In conclusion, besides change in symptom severity, other potential determinants of personal recovery should be addressed in treatment of patients with SMI, for example, self-esteem and social functioning. Treatment of depression/anxiety symptoms may increase personal recovery.

Participation in the National Bowel Cancer Screening Program by people with severe mental illness, Australia, 2006-2019: a national data linkage study.

To compare rates of participation in the National Bowel Cancer Screening Program (NBCSP) and follow-up for people with severe mental illness with those for people without severe mental illness or not prescribed antidepressants. Retrospective cohort study; analysis of de-identified linked NBCSP, Pharmaceutical Benefits Scheme (PBS), and Medicare Benefits Schedule (MBS) data. Australia, 2006-2019. People aged 50-74 years (NBCSP-eligible) with severe mental illness, defined as those dispensed two or more prescriptions for second generation antipsychotics or for lithium (PBS data), and a random sample of people aged 50-74 years eligible for Medicare-subsidised services but never prescribed psychotropic medications (antipsychotics, lithium, antidepressants). NBCSP participation (returned faecal occult blood test sample), valid test result, positive test result, and follow-up colonoscopy rates. A total of 119 475 people with severe mental illness and 1 090 574 control group people were included in our analyses. The proportion of women was larger in the severe mental illness group (51.3%) than the control group (48.7%), as were the proportions who lived in inner regional areas (23.5% v 19.1%) or in areas in the lowest socio-economic quintile (21.8% v 14.7%). The NBCSP participation rate was lower among people with severe mental illness (adjusted incidence rate ratio [IRR], 0.70; 95% confidence interval [CI], 0.69-0.84). The proportion of valid test results was smaller for people with severe mental illness (95.9% v 98.7%; adjusted IRR, 0.97; 95% CI, 0.96-0.99), and the positive test result proportion larger (12.3% v 6.6%; adjusted IRR, 2.01; 95%CI, 1.94-2.09). The proportion of positive test results followed by colonoscopy was smaller for people with severe mental illness (71.7% v 82.6%; adjusted IRR, 0.88; 95% CI, 0.85-0.92). People with severe mental illness were less likely to participate in the NBCSP or to undergo colonoscopy after a positive test result than other Australians. These differences may contribute to higher colorectal cancer mortality among people with severe mental illness. The contributions of differences in cancer stage at diagnosis and subsequent treatment to higher colorectal cancer mortality require further study.

Clinical patterns of metabolic syndrome in young, clinically stable, olanzapine-exposed patients with schizophrenia.

Schizophrenia (SCZ) is a chronic, disabling mental illness with a high disease burden and is often comorbid with metabolic syndrome (MetS). The aim of this study was to determine the prevalence of MetS in young, clinically stable, olanzapine-exposed patients with SCZ and to explore predictive factors affecting the development and severity of MetS. A total of 274 patients with SCZ who met the inclusion criteria were enrolled in this study, and their demographic data and general clinical information were collected. Concurrently, patients were assessed for psychopathology, illness severity, and antipsychotic drug-related adverse effects. The prevalence of MetS in the target population was 35.77%, and the MetS subtype of abdominal obesity + high triglycerides + low level of high-density lipoprotein cholesterol accounted for the majority of patients in the MetS subgroup. Binary logistic regression showed that body mass index (BMI), uric acid (UA), thyroid-stimulating hormone, and QT-c interval could significantly and positively predict the development of MetS. Multiple linear regression showed that olanzapine concentration, BMI, and UA could significantly and positively predict higher MetS scores. This study reports the clinical patterns of MetS in young, clinically stable, olanzapine-exposed patients with SCZ and identifies the correlations influencing the development and severity of MetS. These findings could potentially be applied toward the prevention of and intervention in MetS.

Barriers and enablers to shared decision-making in assessment and management of risk: A qualitative interview study with people using mental health services

The assessment and management of risk are fundamental to mental health care provision and are considered high-priority tasks by professionals worldwide. Clinical guidance recommends for risk to be identified and managed collaboratively with the individual, but studies indicate that this may not be happening in practice. The aim of this study was to identify the barriers and enablers to collaborative risk assessment and management based on shared decision-making from service users’ perspectives. A qualitative approach using semi‐structured interviews was employed. The Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour, informed data collection and analysis. Thirteen service users living with severe mental illness took part in an interview. The majority of participants reported not having been involved in the identification of their risk and most were unaware of the information included in their risk management plan. Perceived barriers to involvement were power dynamics between professionals and service users, difficulty talking about sensitive risk topics, and the emotional impact of engaging in these discussions. Perceived enabling factors for involvement included the possibility of gaining a better understanding of risk issues, and discussion about risk enhancing the individual’s ability to maintain their own well-being and safety. Most participants expressed a willingness to be involved in shared decision-making and believed that their friends and family would enable them to be involved. The findings of this study offer valuable insights for targeting behaviour change in future intervention design that seeks to increase shared decision-making in risk assessment and management with individuals with severe mental illness.

Adverse events associated with oseltamivir and baloxavir marboxil in against influenza virus therapy: A pharmacovigilance study using the FAERS database.

Influenza virus is a widespread pathogen that poses significant health risks to humans. Oseltamivir and Baloxavir Marboxil are commonly utilized medications for both treating and preventing influenza infections. Despite their widespread use, there remains a need to thoroughly investigate their safety profiles and potential adverse reactions. This study aims to comprehensively analyze the adverse events associated with oseltamivir and baloxavir marboxil in real-world clinical settings, with the goal of assessing their safety and potential risks in the management of influenza virus infections. We conducted a retrospective analysis utilizing data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database, spanning from the first quarter of 2004 to the third quarter of 2023. The analysis encompassed examination of drug utilization patterns, types of adverse events reported, patient demographics, and other pertinent factors. From the first quarter of 2004 to the third quarter of 2023, FAERS collected over 17,035,521 adverse event reports (AE reports). Among these reports, there were 38,384 reports associated with oseltamivir, and 3,364 reports associated with baloxavir marboxil. Oseltamivir and Baloxavir Marboxil were primarily used for the treatment of influenza virus infections, accounting for 62.43% and 67.49% of their total usage, respectively. The main adverse reactions reported for oseltamivir were vomiting (case reports = 1402) followed by confusional state (case reports = 353), while for baloxavir marboxil, adverse reactions mainly centered around off-label use (case reports = 378) and intentional product use issues (case reports = 278). In terms of systemic adverse reactions, oseltamivir primarily affected psychiatric disorders (n = 45), whereas baloxavir marboxil mainly impacted the gastrointestinal system (n = 7). Additionally, regarding adverse reactions in pregnant women, the occurrence of normal newborns was a significant signal for oseltamivir, suggesting a certain level of safety during maternal use. Conversely, reports of adverse reactions such as respiratory arrest were documented for baloxavir marboxil, while no such reports were associated with oseltamivir. This study provides a comprehensive analysis of the adverse reactions observed with the clinical use of oseltamivir and baloxavir marboxil, revealing the safety and risks associated with these two drugs in the treatment and prevention of influenza virus infections. Firstly, although both drugs are used for influenza treatment, they exhibit different types of adverse reactions. Oseltamivir predominantly affects the psychiatric system, while baloxavir marboxil primarily impacts the gastrointestinal system. Additionally, oseltamivir demonstrates a certain level of safety for use in pregnant women, while reports of adverse reactions such as respiratory arrest are associated with baloxavir marboxil. Despite the clinical significance of this study, limitations exist due to the voluntary nature of data reporting, which may lead to reporting biases and incomplete information. Future research could employ more rigorous prospective study designs, integrating clinical trials and epidemiological studies, to more accurately assess the safety risks of oseltamivir and baloxavir marboxil.

Comprehensive Symptom Prediction in Inpatients With Acute Psychiatric Disorders Using Wearable-Based Deep Learning Models: Development and Validation Study.

Assessing the complex and multifaceted symptoms of patients with acute psychiatric disorders proves to be significantly challenging for clinicians. Moreover, the staff in acute psychiatric wards face high work intensity and risk of burnout, yet research on the introduction of digital technologies in this field remains limited. The combination of continuous and objective wearable sensor data acquired from patients with deep learning techniques holds the potential to overcome the limitations of traditional psychiatric assessments and support clinical decision-making. This study aimed to develop and validate wearable-based deep learning models to comprehensively predict patient symptoms across various acute psychiatric wards in South Korea. Participants diagnosed with schizophrenia and mood disorders were recruited from 4 wards across 3 hospitals and prospectively observed using wrist-worn wearable devices during their admission period. Trained raters conducted periodic clinical assessments using the Brief Psychiatric Rating Scale, Hamilton Anxiety Rating Scale, Montgomery-Asberg Depression Rating Scale, and Young Mania Rating Scale. Wearable devices collected patients' heart rate, accelerometer, and location data. Deep learning models were developed to predict psychiatric symptoms using 2 distinct approaches: single symptoms individually (Single) and multiple symptoms simultaneously via multitask learning (Multi). These models further addressed 2 problems: within-subject relative changes (Deterioration) and between-subject absolute severity (Score). Four configurations were consequently developed for each scale: Single-Deterioration, Single-Score, Multi-Deterioration, and Multi-Score. Data of participants recruited before May 1, 2024, underwent cross-validation, and the resulting fine-tuned models were then externally validated using data from the remaining participants. Of the 244 enrolled participants, 191 (78.3%; 3954 person-days) were included in the final analysis after applying the exclusion criteria. The demographic and clinical characteristics of participants, as well as the distribution of sensor data, showed considerable variations across wards and hospitals. Data of 139 participants were used for cross-validation, while data of 52 participants were used for external validation. The Single-Deterioration and Multi-Deterioration models achieved similar overall accuracy values of 0.75 in cross-validation and 0.73 in external validation. The Single-Score and Multi-Score models attained overall R² values of 0.78 and 0.83 in cross-validation and 0.66 and 0.74 in external validation, respectively, with the Multi-Score model demonstrating superior performance. Deep learning models based on wearable sensor data effectively classified symptom deterioration and predicted symptom severity in participants in acute psychiatric wards. Despite lower computational costs, Multi models demonstrated equivalent or superior performance than Single models, suggesting that multitask learning is a promising approach for comprehensive symptom prediction. However, significant variations were observed across wards, which presents a key challenge for developing clinical decision support systems in acute psychiatric wards. Future studies may benefit from recurring local validation or federated learning to address generalizability issues.

Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship.

Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are prevalent psychiatric conditions, each affecting a substantial portion of the global population. When these conditions coexist with a Substance Use Disorder (SUD), the complexity of the clinical presentation is heightened. Herein, we describe two cases of individuals who have comorbid OCD and/or MDD and substance use disorder that highlight the importance of addressing the coexisting psychiatric illness when treating the SUD. These cases highlight the importance of tailored, multidisciplinary care, offering a potential therapeutic strategy based on medications for comprehensive recovery in individuals facing complex comorbid disorders. An integrated treatment approach, encompassing both psychiatric and substance treatment perspectives, is imperative.

Adverse childhood experiences, subsequent negative life events, and their impact on health in occupational rehabilitation patients: a mixed-methods study

IntroductionAdverse childhood experiences (ACEs) are prevalent globally and can negatively impact an individual's lifespan by not only increasing the likelihood of encountering other negative life events (NLEs), but also escalating the risk of illness, absenteeism due to sickness, unemployment, and reliance on disability benefits in adulthood. Therefore, the objective of this study was to explore the prevalence of ACEs and NLEs, as well as their health impacts among patients undergoing occupational rehabilitation.Materials and methodsA total of 80 participants diagnosed with musculoskeletal disorders and/or common mental disorders who participated in two occupational rehabilitation programs in Norway were included. Data were collected by questionnaire and in-depth interviews (39 participants) at the start of the intervention. Comparative quantitative and qualitative analysis was conducted between individuals with a history of ACEs and those without these experiences. Thematic analysis was used to identify the impact of ACEs and NLEs on the health of the informants.ResultsHalf of the participants reported ACEs. Of these, 18% reported one ACE, 22% reported 2–3 ACEs and 9% reported 4 or more ACEs. Also, 25% were categorized as revictimized. The two groups with ACEs had more NLEs in adulthood compared to those without ACEs (p &amp;lt; 0.001), revictimized the most (mean numbers between groups 3.1, 4.5 and 5.9). Furthermore, a history of ACEs was associated with a higher number of reported mental health issues compared to those who had not experienced ACEs (p &amp;lt; 0.01). However, there were no significant differences between the two ACE groups. NLEs had a substantial impact on the participants’ current health status, whether they occurred in childhood or adulthood. In adult life, a high workload (psychologically or physically), interpersonal challenges, and financial struggles had an especially negative impact. Additionally, accidents and complications related to surgeries were also significant NLEs causing health problems. For most, there were complex interactions between NLEs and health.ConclusionsThe prevalence of ACEs and NLEs is high among occupational rehabilitation patients. ACEs are associated with subsequent victimization, interpersonal challenges, financial struggles, and increased mental health issues in adulthood. These findings highlight the need for systematic screening and a holistic, individualized approach in occupational rehabilitation programs to potentially mitigate the adverse effects of NLEs on health and work participation.

Meta-Analysis of the Efficacy of Rapid Rehabilitation Surgical Nursing in Lumbar Disc Herniation

Background: Lumbar disc herniation (LDH) is a common cause of lower back pain and radiculopathy. In recent years, the enhanced recovery after surgery (ERAS) concept has been increasingly applied in orthopedics and gastrointestinal surgery. Purpose: To investigate the effect of using rapid rehabilitation surgical care for lumbar disc herniation by meta-analysis. Data source: Google Scholar, PubMed Medical, Cochrane and Embase databases were used for the analysis. Research selection: An initial search yielded a total of 322 relevant articles. Duplicate pieces of literature were screened using Endnote. In addition, non-randomized controlled trials and studies with a sample size of less than 30 were excluded. A total of seven papers were included in this study. Main outcomes: The Rapid Rehabilitation Surgical Nursing (RRSN) group showed significantly higher patient satisfaction (RR = 1.24; 95% CI: 1.06, 1.26; p &lt; 0.01) and self-assessed health (Total MD = 5.67; 95% CI: 4.27, 7.06; p &lt; 0.01) compared to the Normal Nursing (NN) group. Pain levels (MD = −0.66; 95% CI: −0.97, −0.36; p &lt; 0.01), disability levels (MD = −18.64; 95% CI: −32.53, −4.76; p &lt; 0.01), anxiety risk (SAS-MD = −4.33; 95% CI: −6.23, −2.44; p &lt; 0.01), and depression risk (SDS-MD = −4.29; 95% CI: −7.50, −1.07; p &lt; 0.01) were significantly lower in the RRSN group compared to the NN group. According to the GRADE classification, the certainty for patient satisfaction is high, while the certainty for post-care pain, functional capacity, risk of psychological disorders, and self-assessed health status is moderate. Conclusions: Rapid recovery surgical nursing can significantly improve postoperative recovery of lumbar disc herniation, increase patient satisfaction, reduce the risk of psychological disorders, improve lumbar function, and alleviate patient pain.

Microglia Sing the Prelude of Neuroinflammation-Associated Depression.

Major depressive disorder (MDD) is a psychiatric condition characterized by sadness and anhedonia and is closely linked to chronic low-grade neuroinflammation, which is primarily induced by microglia. Nonetheless, the mechanisms by which microglia elicit depressive symptoms remain uncertain. This review focuses on the mechanism linking microglia and depression encompassing the breakdown of the blood-brain barrier, the hypothalamic-pituitary-adrenal axis, the gut-brain axis, the vagus and sympathetic nervous systems, and the susceptibility influenced by epigenetic modifications on microglia. These pathways may lead to the alterations of microglia in cytokine levels, as well as increased oxidative stress. Simultaneously, many antidepressant treatments can alter the immune phenotype of microglia, while anti-inflammatory treatments can also have antidepressant effects. This framework linking microglia, neuroinflammation, and depression could serve as a reference for targeting microglia to treat depression.

Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin-differences study.

Adverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding. We used the twin-difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a UK population-representative birth cohort of 2,232 same-sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18. Among children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin-difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co-twins, concordant for ACE exposure. The apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.

Evaluation of routine health monitoring for metabolic disorders in patients with serious mental illness on psychotropic medications: a study from Ethiopia.

Compared to the overall population, patients with mental health problems are more likely to experience concurrent physical illnesses, poorer health outcomes, and mortality. Psychotropic medications, which are the pillars in the management of mental health conditions, are associated with adverse effects such as weight gain, an increased level of glucose, and elevated circulating lipid levels, all of which contribute to metabolic disorders. Inadequate health monitoring may led to suboptimal interventions and worsening of these conditions. However, there is a lack of studies assessing routine health monitoring practices for metabolic disorders and their determinants among patients with serious mental illnesses taking psychotropic medications in Ethiopia. This study aimed to evaluate routine health monitoring for metabolic disorders and its determinants in patients with serious mental illnesses on psychotropic medications in Ethiopia. A hospital based prospective follow-up study was conducted among patients with serious mental illness taking psychotropic medications who attended the outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Eligible participants were selected using a simple random sampling technique. Routine health monitoring was evaluated using guidelines and previous literature. Binary logistic regression was employed to identify the determinants of routine health monitoring, with statistical significance determined by a p-value of less than 0.05 and a 95% confidence interval (CI). The overall routine health monitoring practice for metabolic disorders was found to be sub-optimal. Vital signs were the most commonly assessed parameters. Key determinants of routine health monitoring included participants aged 45 and above (AOR (95% CI): 2.82 (1.34-5.92), having social insurance (AOR (95% CI): 2.94 (1.86-4.64), availability of laboratory tests at the hospital (AOR (95% CI): 3.46 (2.16-5.55), and reporting of medication-related side effects (AOR (95% CI): 1.96 (1.21-3.17)). Routine health monitoring for metabolic disorders in patients with serious mental illnesses attending the outpatient psychiatry department was inadequate. Health care providers should give more attention to younger patients, those without health insurance, and who are not reported side effects. These findings provide crucial insights for improving routine health monitoring and promoting better health outcomes.

Driving a motor vehicle and living with a mental health condition: The personal and professional experiences of consumer lived experience staff.

Driving a motor vehicle is an important activity for people living with a mental health condition, as it can support engagement in the community as part of recovery. There is little research exploring mental health consumers' experiences with driving and no found research on the role of mental health lived experience staff in assisting consumers with safe driving. It is essential to learn about consumers' experiences of driving to know the supports they find useful in understanding their driver responsibilities and self-regulating their driving through periods of changing health and wellness. This study explored the personal and professional experiences of lived experience consumer staff related to driving a motor vehicle while also living with a mental health condition. The research was guided by the interpretive paradigm and codesign principles. Qualitative data were derived from semi-structured interviews with (n= 9) lived experience consumers working in a public mental health service. Data were thematically analysed. Our research team involved consumer and occupational therapy coresearchers. Five main themes were identified: (1) Driving means freedom and independence, (2) A nuanced understanding about the impact of mental health on driving, (3) I/we can manage: A range of strategies, (4) Driving is not something mental health staff tend to discuss, and (5) Do not beat around the bush, just talk about it. Consumers want support and direct conversations about driving and their mental health, medication side effects, and strategies to gain their licence, maintain, or return to driving. Alongside mental health clinicians, consumer lived experience staff could play a vital role in supporting safe driving.

Somatic and psychiatric symptoms of brain tumors - a review of the literature

Introduction and Purpose Brain tumors cause a variety of somatic and psychiatric symptoms, which vary depending on the age of the patient and the location and type of tumor. Symptomatology includes both physical symptoms, such as headache, nausea, seizures and weakness, and psychiatric symptoms, including mood, personality and cognitive dysfunction. In children, the clinical picture is more complex and includes specific developmental difficulties. The purpose of this paper is to analyze the various symptoms accompanying brain tumors in order to detect them early and enable faster diagnosis. Material and Methods A comprehensive literature review was conducted using the PubMed database, focusing on articles published until the end of 2023.The search included the keywords: "brain tumors" "symptoms" "headache" and "psychiatric" in various combinations. Relevant studies were selected based on criteria such as somatic and psychiatric symptoms and early diagnosis of brain tumors. Results Accumulating data show the diversity of symptoms associated with brain tumors. Somatic symptoms such as headache, optic disc swelling, nausea, and seizures depend on intracranial pressure and tumor location. Psychiatric symptoms, including personality changes, mood disorders, and cognitive impairment, pose a significant diagnostic challenge in adult patients. In children, brain tumors can cause developmental delay and atypical neurological symptoms. Conclusions The symptoms of brain tumors are highly variable and difficult to diagnose, which significantly delays proper diagnosis of the disease. Its early detection is crucial as it improves the prognosis of patients, significantly improves their quality of life, and allows for the introduction of effective therapeutic interventions.

Indicators of mental adaptation disorders in combatants of the special military operation

Relevance. Participants of armed conflicts are exposed to extreme stress amid life-threatening situations, which can lead to mental adaptation disorders exacerbated by combat stress disorders. Combatants facing these conditions require psychological correction and psychotherapy.The objective is to assess the risk of mental adaptation disorders in combatants using traditional diagnostics and fasts screening methods.Methods. A cohort of 163 combatants who participated in the special military operation underwent clinical and psychological examination. The average age of subjects was 34.3 years, and the average time of service in the special military operation was 8.2 months. The combatants’ psychological status was evaluated using the Mississippi Scale (military version), the Beck Depression Inventory, and the Beck Anxiety Inventory. In addition, a set of screening methods, like PC-PTSD-5, PHQ9, and GAD-7, were used to evaluate the risk of mental maladaptation, depressive symptoms, and anxiety. In the course of examination, the reliability of responses was assessed using 10 adapted questions for sincerity evaluation obtained from a standardized personality assessment method. The present study shows the median value, as well as the upper and lower quartiles (Me [Q1; Q3]). The consistency of the studied indicators was evaluated using Spearman’s rank correlation coefficient.Results and analysis. The average sincerity score was 7 [6; 8] points, showing sufficient reliability of the examination results. The psychological test results re concordant with the overall transformation pattern in the functional and mental profile of stress exposed combatants, depending on the duration of exposure to combat conditions. The average Mississippi Scale scores were 71 [63; 84] points, and 2 [1; 3] points on the PC-PTSD-5, associated with absence of mental adaptation disorders and a low probability of PTSD, respectively. PTSD clinical symptoms were identified in 3.7% of the examined combatants (compared to 14.3% in foreign publications), and mental adaptation disorders were observed in 8.6%. All these methods showed moderate, positive, and statistically significant (r = 0.627; p &lt; 0.001) consistency of obtained indicators. The average Beck Depression Inventory score was 7 [3; 12] points, and the PHQ-9 score was 5 [3; 8] points, suggesting absence or mild depression, respectively. The methods demonstrated strong, positive, and statistically significant (r = 0.799; p &lt; 0.001) consistency among the indicators. The average Beck Anxiety Inventory score was 10 [4; 18] points, and the GAD-7 screening method score was 5 [2; 6] points, corresponding to low or moderate anxiety. For both methods, the consistency among indicators was moderate, positive, and statistically significant (r = 0.567; p &lt; 0.001).Conclusion. The study justified the reliability of results obtained by traditional tests and screening methods, showing trustworthy indications for psychological correction (psychotherapy) in the examined combatants.

Abstract 4140185: The Burden Of Substance Abuse And Mental Health Disorders In Patients Admitted With Stress Cardiomyopathy

Introduction: Several studies have linked mental health disorders and substance abuse as risk factors for stress cardiomyopathy (SC). However, the true burden of these disorders amongst patients with stress cardiomyopathy remains unknown. Methods: We used the 2016-2020 National Inpatient Sample database to identify hospitalizations for SC who underwent diagnostic catheterization. We assessed the proportion of patients diagnosed with a substance abuse or mental health disorder. Subsequently, the association of these disorders in SC compared to patients admitted for myocardial infarction (MI) was assessed using the chi-square test. Results: From 2016 to 2020, there were 33,075 hospitalizations for stress cardiomyopathy who were diagnosed by cardiac catheterization. Of these patients, 5,920 (17.9 %) had depression, 8,500 (25.7 %) had anxiety, 1058 (3.2 %) had severe stress reactions, and 16,372 (49.5 %) were diagnosed with a mental health disorder. 9,955 (30.1 %) were smokers, 5,358 (16.2%) abused hallucinogens, 5,457 (16.5 %) abused cocaine, 5,457 (16.5%) abused sedatives, 6,019 (18.2 %) abused cannabis, 5,920 (17.9%) abused opioids, 6,416 (19.4 %) abused alcohol. Subsequently, the association of stress cardiomyopathy with mental and substance abuse disorder was compared with patients admitted with myocardial infarction See Table 1. Conclusion: Mental health and substance abuse disorders are common in patients diagnosed with SC. These disorders are more commonly present in SC compared to MI. Further research is needed to assess the significance of these findings.

Perancangan Motion Graphic Edukasi Kami Juga Manusia, Anxiety Disorder

Mental health, is a health issue that is no less important than physical health, but unfortunately public awareness of mental health issues is still very lacking. The lack of public awareness of mental health disorders is influenced by several factors, where one of the most influential factors is the low level of public knowledge about mental health, so that there is an error in the public's perspective on the survivors of mental health disorders themselves. This of course can lead to mistreatment of survivors of mental health disorders, potentially stigmatizing treatments. Based on these data, this study aims to use the right learning media to change the public's perspective on mental health disorders in order to reduce the existing stigmatization. The method used is the design thinking method which is a method of developing a product that begins with efforts to answer problems that exist in society. The results of this study a learning media in the form of video motion graphics with cartoon visual style and a way of delivering information with an emotional and rational approach has its own charm for the audience.

Abstract 4138516: Effects of Serious Mental Illness on Transcatheter Aortic Valve Replacement (TAVR) Outcomes and Access

Introduction: Serious mental illness (SMI) is associated with higher risk of immediate procedural complications after transcatheter aortic valve replacement (TAVR), including myocardial infarction, major bleeding, and acute renal failure. There is limited data on the impact of SMI on in-hospital mortality and 30-day readmissions. We aimed to evaluate access to and outcomes after TAVR for patients with SMI compared to those without SMI. Methods: We performed a retrospective cohort study of adults aged ≥18 years who received TAVR with a primary diagnosis of aortic stenosis using the Healthcare Cost and Utilization Project State Inpatient Database and State Ambulatory Surgery and Services Database in FL, MD, VT, UT, and WI (2016-2019). SMI was defined using ICD-10 codes for schizophrenia spectrum, mood, or anxiety disorders. Primary outcomes include in-hospital mortality, 30-day readmission, length of stay, and routine discharge. The secondary outcome was access type (elective vs. urgent/emergent). Multivariable logistic and negative binomial regression models with adjustment for patient demographics, co-morbidities, and hospital characteristics were used to examine outcomes. Results: Of 21,905 patients who underwent TAVR for aortic stenosis, 2,954 (13.5%) patients had SMI. Overall, 16,762 (76.5%) of patients had elective procedures. Patients with SMI were more likely to be female (59% vs. 41%, p&lt;0.001) and have 3+ co-morbidities (91% vs. 77%, p&lt;0.001) but had similar income quartile distribution (p=0.18), home-to-hospital distance (p=0.09), and clinically similar hospital TAVR volume over the study period (435 vs. 430, p=0.01). After adjustment for potential confounders, access to and outcomes of TAVR differed significantly by SMI status (See Table). Conclusions: SMI patients had increased odds of emergent access to TAVR. After TAVR, SMI patients had longer length of stay and were less likely to be discharged to home. These findings suggest increased discharge planning may be required for patients with SMI after TAVR and highlight the need for additional investigation into barriers to elective TAVR in this vulnerable population.