Regular Mental Health Research Articles

Single-blinded, randomised, parallel-group, controlled trial comparing the efficacy and cost-effectiveness of therapist- and self-guided internet-delivered behavioural activation versus treatment as usual for adolescents with mild to moderate depression: study protocol

IntroductionThe number of adolescents seeking professional help for depression is increasing and, despite advances in treatment, large unmet treatment needs remain. In the current protocol, we describe the design and...

Prevalence of anxio-depressive disorders, insomnia and self-esteem in a Moroccan population addicted to cannabis and/or alcohol: a cross-sectional study

ABSTRACT Background Addiction to cannabis and alcohol is a global public health concern, linked to significant mental health impairments such as anxiety, depression, insomnia, and low self-esteem. This study, conducted in Marrakech’s addiction treatment centers, aims to assess the prevalence of mental health disorders, insomnia, and self-esteem among individuals seeking treatment for alcohol and/or cannabis addiction. Methods This cross-sectional study was conducted from January 1 2023 to January 1 2024. Depression, anxiety, insomnia, and self-esteem were assessed using the HADS, ISI, and Rosenberg scale. Results Anxiety prevalence for cannabis, alcohol, and both substances was 57.9%, 55.2%, and 59.2%, respectively. Depression prevalence was 71.7% (cannabis), 73.1% (alcohol), and 75% (both substances). Sub-clinical insomnia (mild) prevalence for the three groups was 65.4%, 71.6%, and 77.6%. Low self-esteem was observed at 59.1%, 64.2%, and 60.5% for cannabis, alcohol, and both substances, respectively. No significant association has been found between the type of product consumed (cannabis, alcohol, cannabis and alcohol) and anxiety, depression, insomnia and self-esteem. Conclusions These findings highlight prevalent mental health disorders in cannabis and alcohol addiction, underscoring the need for comprehensive, multidisciplinary treatments, including regular mental health screenings, quarterly follow-ups, and family involvement in group therapies at Moroccan addiction centers.

Women's mental health during late pregnancy: A survey conducted in Shandong Province, China.

The study aimed to investigate the general mental health status and its associated factors in women during late pregnancy. The objective was to provide a scientific basis for developing psychological interventions tailored to this specific population. The research was conducted from May 2021 to July 2022, involving the recruitment of 200 women attending maternal and child health clinics for their late-pregnancy checkups. Data collection was carried out using a comprehensive approach, involving several validated tools. The participants completed a general demographic and sociological questionnaire along with four standardized psychological assessment scales: the 12-item General Health Questionnaire (GHQ-12), the Athens Insomnia Scale (AIS-8), the Generalized Anxiety Disorder 7 (GAD-7), and the 9-question Patient Health Questionnaire (PHQ-9). A total of 200 valid questionnaires were collected for analysis. The study revealed that the overall prevalence of positive detection of general mental health problems in women during late pregnancy was 11%. Significant differences were observed in the positive detection rate of general mental health status based on various factors such as the quality of relationships with husbands, pregnancy intentions, insomnia, anxiety, and depression (p<0.01). Furthermore, participants with general mental health problems displayed notably higher scores on the AIS-8, PHQ-9, and GAD-7 scales compared to those without such problems (p<0.01). Regression analysis indicated that pregnancy intention and PHQ-9 scores were influential factors affecting the general mental health of women during late pregnancy (p<0.05). The study highlights high rates of general mental health problems during late pregnancy, with unplanned pregnancy and elevated depression scores as key risk factors. Regular mental health screening and targeted interventions are essential to support women during this critical period and enhance the well-being of both mothers and babies.

Post-traumatic, Depression, Anxiety, and Stress Symptoms among Malaysian Firefighters

INTRODUCTION: Emergency responders, including firefighters are frequently exposed to life-threatening situations in their daily lives causing an increased risk for occupational stress, anxiety, depression and post-traumatic stress symptoms (PTSS). Hence, this study aimed to determine the prevalence, and correlation of PTSS with stress, anxiety, and depression among Malaysian firefighters. MATERIALS AND METHODS: A cross-sectional study was conducted among firefighters stationed in 20 fire and rescue stations in Penang, Malaysia using self-administered online survey through a purposive sampling. Information collected were sociodemographic data, measurement of severity of PTSS via Post-Traumatic Checklist-5 (PCL-5), and assessment of depression, anxiety, and stress via Depression, Anxiety, and Stress Scale (DASS-21). A descriptive analysis and Pearson's correlation coefficient analyses were employed in study analysis. RESULTS: Out of 562 firefighters participated in the study, the prevalence of PTSS, stress, anxiety, and depression was 5.0%, 2.1%, 13.0%, and 8.5%, respectively. Among those with PTSS, 28.6%, 78.6%, and 67.9% suffered from stress, anxiety, and depression, respectively. Hence, anxiety was highly coexisted with PTSS. There was significant positive correlation between PTSS score and the score of stress (r=0.656, P&lt; 0.001), anxiety (r=0.699, P&lt; 0.001), and depression (r=0.700, P&lt; 0.001). CONCLUSION: Our study findings suggested that stress, anxiety, and depression can co-occur with PTSS. Hence, firefighters should have regular mental health assessments as the concurrent effect of multiple medical conditions may require comprehensive treatment to address the various aspects of each condition.

Mental health among school children and adolescents in China: A comparison of one-child and multiple-children families from a nationwide survey

The influence of China’s “one-child” policy on the mental health of children and adolescents is still unclear. This study examined the associations between number of children and children’s mental health using data from the national school children and adolescents survey of China. Mental health was measured using the Achenbach’s Child Behavior Checklist (CBCL). Linear regression models were used to explore the relationship between number of children per family and children’s mental health. A total of 64,017 students were enrolled, with 68.60 % from one-child families. Compared with children from one-child families, those from multiple-children families had significantly higher scores on the total CBLC and each of its subscales (all P<0.001). Analyses suggested children from multiple-child families have a higher risk of mental health problems (total problems on the CBCL: adjusted B=2.217, 95 %CI=1.883–2.550, P<0.001). Regular mental health assessments should be implemented and effective interventions should be developed for those in need.

Follow-up of telemedicine mental health interventions amid COVID-19 pandemic

The initiation of the program Mental Health Support Program for Coronavirus Infection addressed the increased demand for mental health services in the province of Salamanca, resulting from the COVID-19 pandemic. The psychiatry service provided care for COVID-19 patients, their families, and healthcare workers who treated them, as these groups were identified as being at risk. This study aims to describe the assistance provided, including personnel and resources utilized, types of interventions carried out, and to assess the demand for mental health care and predominant symptoms and emotions experienced by patients. Billboards and the complex’s intranet publicized the program. Specific clinical approach using telemedicine were provide from March 2020 to December 2021 to COVID-19 patients, their relatives, and healthcare workers. 216 patients were included with a mean age of 53.2 years, with women comprising 77.3% of this group. All the groups received treatment in similar proportions. Over a period of 730 h, a total of 1376 interventions were performed, with an average duration of 31.8 min per intervention. The program could treat 79.6% of these patients without requiring referrals to other services. When the program concluded, only 21 participants (9.7%) were discharged to the local mental health network to continue their mental health treatment. The program effectively reduced the burden on regular mental health services due to its ability to treat most patients without requiring referrals. The program was able to attend to most mental health requests with minimal involvement of the regular mental health service.

Burnout Prevalence and Associated Factors Among Palliative and Hospice Care Professionals During the COVID-19 Endemic: An Exploratory Survey.

Burnout is a significant issue for palliative and hospice professionals, exacerbated by the impact of Coronavirus Disease 2019 (COVID-19) on healthcare professionals. It is crucial to update our understanding of prevalence data, identify associated factors, and evaluate support resources during the COVID-19 pandemic. We aimed to explore the prevalence of burnout among palliative and hospice care workers, 2years into the COVID-19 pandemic by using the Maslach's Burnout Inventory; anxiety, using General Anxiety Disorder-7 (GAD-7), workload, risk perception of COVID-19, confidence in protective measures (personal, workplace, and government), and usage and perceived helpfulness of support resources. Univariate logistic regression analysis was conducted to analyse burnout against these factors. Of the 115 respondents encompassing doctors, nurses and social workers (76.5% female; average age 40.9), 48.7% experienced burnout. Burnout correlated with increased anxiety, higher COVID-19 risk perception, heavier workload, and reduced confidence in protective measures. Peer support, COVID information, and psychological programs were rated as the most effective for coping. The study indicates considerable levels of burnout among palliative and hospice care workers, linked to workload, anxiety, and perceived risk. Traditional mental health interventions had limited efficacy; respondents favoured peer support and organisational changes. The findings stress the need for a holistic approach, including diverse resources, workload management, and regular mental health assessments.

“It’s a lot of things”: Zimbabwean university students’ perceptions on the causes of suicide ideation and suicidality among youths during the COVID-19 pandemic

ABSTRACT This research studies university undergraduate students’ perceptions of the causes of suicide and suicidality among the youths in Zimbabwe with reference to the case of Midlands State University. The research also examined the contribution of COVID-19 to suicide and suicidality and the role of the family and church in suicide and suicidality causation or prevention. A qualitative methodology was used to collect data through semi-structured interviews, key informant interviews and a focus group discussion using a sample of 31 participants. Thomas Joiner’s Interpersonal theory of suicide is utilised and adapted to explain suicide ideation among Zimbabwean youths. Abusive, fractured family and romantic relationships, economic frustrations, stigmatisation, loneliness, drug abuse and the pressure to conform were some of the causes of suicide ideation. The research recommends increased regular mental health and suicide prevention awareness campaigns to inform the students on the available services. Supportive, stable and positive relationships and interactions within families and churches are necessary to build resilience against suicide ideation and suicidality.

Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

Clinical characteristics and outcomes of children, adolescents and young adults with overweight or obesity and mental health disorders

BackgroundMental disorders are important comorbidities in youth with obesity. Aim was to describe the clinical characteristics and outcome of youth with overweight or obesity having comorbid mental disorders.MethodsData from children, adolescents, and young adults (age 6–30 years) with overweight or obesity and mental disorders (depression, anxiety disorder, eating disorder, attention deficit disorder (ADHD)) from 226 centers in Germany and Austria participating in the Adiposity Patient Registry (APV) were analyzed and compared with those without reported mental disorders using regression modeling.ResultsMental health comorbidity was reported in a total of 3969 out of 114,248 individuals with overweight or obesity: 42.5% had ADHD, 31.3% anxiety disorders, 24.3% depression, and 12.9% eating disorders. Being male (OR 1.39 (95%CI 1.27;1.52)), of older age (1.42 (1.25;1.62)), or with extreme obesity (1.45 (1.30;1.63)) were most strongly associated with mental health comorbidity. Regression analysis showed that mean BMI-SDS was significantly higher in the group of individuals with depression and eating disorders (BMI-SDS 2.13 (lower; upper mean:2.09;2.16) and 2.22 (2.17;2.26)) compared to those without reported mental health comorbidity (BMI-SDS 2.008 (2.005;2.011); p < 0.001). In youth with ADHD, BMI-SDS was lower compared to those without reported mental disorders (BMI-SDS 1.91 (1.89;1.93) vs 2.008 (2.005;2.011); p < 0.001). Proportion of severe obesity was higher in individuals with depression (23.7%), anxiety disorders (17.8%), and eating disorders (33.3%), but lower in ADHD (10.3%), compared to those without reported mental disorders (13.5%, p < 0.002). Proportions of dyslipidaemia and abnormal carbohydrate metabolism were not different in youth with and without reported mental health comorbidity. BMI-SDS change after one year of lifestyle intervention program ranged between −0.22 and −0.16 and was similar in youth without and with different mental disorders.ConclusionHealth care professionals caring for youth with overweight or obesity should be aware of comorbid mental disorders and regular mental health screening should be considered.

Exploring the implementation of the school-based mental health program for adolescents in Indonesia: A mixed-methods study

Background: Mental health issues among adolescents have become a public concern in Indonesia. The Indonesian government introduced the School-Based Mental Health (SBMH) program in 2017 and has implemented it in all public junior high schools in Jakarta. However, there is a relative scarcity of evidence regarding how schools have implemented the SBMH. Objective: This study aimed to explore the SBMH program and its implementation in public junior high schools. Methods: Mixed methods were employed in 12 public junior high schools (6 from East Jakarta and 6 from West Jakarta) using a purposive sampling method from May 6 to August 30, 2021. Descriptive statistics and content analysis were applied to the data analysis. Results: The main inhibiting factor for the implementation of the SBMH program was the school curriculum. Schools that received the Health School Award had more trained teachers to facilitate the SBMH program compared to schools without the award. Consequently, schools with the award successfully implemented regular mental health education in the classroom, screening, and counseling for students with mental health issues more effectively than schools without the award. Conclusion: The government should gradually strengthen resources to facilitate the SBMH program in the long term. In the short and medium term, the government should develop a collaboration network by supporting external mental health providers, professionals, and counselors.

Longitudinal associations of depression and diabetes with Alzheimer’s disease and related dementias risk among American Indian and Alaska Native people

AbstractBackgroundAlzheimer’s disease and related dementias (ADRD) research worldwide indicate that it is more common in indigenous than in non‐indigenous populations. The increased risk for ADRD among indigenous people may be partially due to the population’s high rates of depression and diabetes. Thus, we examined the relationship of depression and diabetes, alone and together, with incident ADRD in a large sample of American Indian and Alaska Native people (AI/ANs).MethodWe used data from the Indian Health Service (IHS) Improving Health Care Delivery Data Project with a sample of 65,801 AI/ANs aged ≥ 45 years. The IHS Data Project includes data for a purposeful sample of AI/ANs who lived in 15 IHS service units, which are IHS geographic classifications located throughout the United States. We used Cox proportional hazard models to estimate associations between ADRD risk and baseline depression and diabetes.ResultWe found that 2.3% of our sample received an ADRD diagnosis during FY2010‐13. Compared to persons with neither depression nor diabetes, unadjusted models indicated that those who had both depression and diabetes had twice the risk of developing ADRD (Hazard Ratio (HR) = 2.02, 95% CI = 1.72‐2.37). The unadjusted risk among those with depression only was 77% higher (HR = 1.77, 95% CI = 1.50‐2.08). Adjusted analyses showed that the HR for those with depression and diabetes was 1.82 (95% CI = 1.53‐2.16) and those with depression only had a hazard ratio of 1.70 (95% CI = 1.44‐2.00) for ADRD. The association between depression and diabetes and depression only with ADRD risk was stronger for persons aged 45 to 64 years compared to persons aged ≥ 65 years. In the adjusted models, we did not find a relationship between only having diabetes and ADRD risk.ConclusionOur findings suggest that depression by itself and depression with diabetes increases the risk of ADRD in AI/ANs aged ≥ 45 years. In the future, ensuring clinical and behavioral services for AI/ANs include regular mental health screening and depression treatment might help decrease ADRD risk. Such efforts may also focus on middle‐aged persons.

7.P. Workshop: Early warning systems for changes in the mental health of populations

Abstract To meet the information needs arising from the COVID-19 pandemic, public health institutes and agencies in several countries began to monitor the mental health of populations at a higher frequency. Quarterly, monthly, weekly, or even daily data on key indicators are being used to inform governments, practitioners, and members of the public of mental health developments taking place in the context of multiple dynamic and ongoing crises. High-frequency surveillance represents a novel approach in public mental health, with more traditional monitoring centering around annual or more sporadic estimates. While these “early warning systems” are of particular importance in times of crisis, continuous observation may be key to crisis preparedness and holds potential as part of regular mental health surveillance. It can provide an evidentiary basis to enable swift action for mental health promotion and prevention. What we have learned about this new surveillance strategy after the first few years of application warrants discussion. This workshop therefore seeks to address the following questions: 1. How has this approach been implemented and what have been central findings and experiences? 2. What are unresolved challenges and future directions in addressing them? 3. What are (untapped) potentials of high-frequency surveillance within public mental health, also beyond the pandemic? In this workshop, teams from three European national public health institutes who have implemented a high-frequency surveillance approach to mental health will present their strategy, results, and experiences in order to discuss potentials, challenges, and questions of utility to policymakers and practitioners with the audience. A speaker from the Robert Koch Institute in Germany will present on the ongoing surveillance of several indicators based on over three years of monthly cross-sectional survey data, highlighting emerging questions around the identification of meaningful change and effective communication with policymakers. A speaker from Sciensano, the Belgian Institute of Health, will show results from quarterly surveillance based on survey data that are reported on a dedicated dashboard, focusing on the post-pandemic use of longitudinal data and its particular advantages in mental health monitoring. As a third perspective, a presentation from Santé publique France will provide insights into a twofold surveillance approach based on weekly and then monthly cross-sectional survey data as well as daily routine data from emergency department visits. All three surveillance systems observed dynamic and worrying developments in pandemic times and beyond. A brief introduction on early warning systems for changes in population mental health will precede the three presentations, which will serve as the foundation for a moderated discussion including the audience. Key messages • High-frequency surveillance for the early detection of changes in population mental health can enable swift action for mental health promotion and prevention in times of crisis and beyond. • Three public health institutes present their experiences with the application of this new surveillance approach, aiming to contribute to its further development through discussion and exchange.

Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets.

Royal Canadian Mounted Police (RCMP) officers self-report high levels of mental health disorder symptoms, such as alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Participation in regular mental health monitoring has been associated with improved mental health disorder symptom reporting and may provide an accessible tool to support RCMP mental health. The current study assessed relationships between self-reported mental health disorder symptoms and the completion of daily surveys (i.e., daily mental health disorder symptom monitoring) by RCMP cadets during the Cadet Training Program (CTP). Participants were RCMP cadets (n = 394; 76.1% men) in the Standard Training Program who completed the 26-week CTP and daily self-monitoring surveys, as well as full mental health assessments at pre-training (i.e., starting the CTP) and pre-deployment (i.e., ~2 weeks prior to deployment to the field). Symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder were assessed. Changes in mental health disorder symptom reporting from pre-training to pre-deployment were calculated. Spearman's rank correlations were estimated for number of daily surveys completed and change in mental health disorder symptom scores between pre-training and pre-deployment. There were statistically significant inverse relationships between number of daily surveys completed and number of mental health disorder symptoms reported; specifically, cadets who completed more daily surveys during CTP reported fewer symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. An inverse correlation between number of daily surveys completed and mental health disorder symptom scores indicated that participation in daily mental health monitoring was associated with improvements in self-reported mental health disorder symptoms between pre-training and pre-deployment. Regular self-monitoring of mental health disorder symptoms may help to mitigate mental health challenges among RCMP cadets and officers.

Suicidal ideation, attempts and its determinants among young adults in Meghalaya: a cross sectional study.

Suicide is a major health issue in India. Withthe advent of the COVID-19 pandemic, people have experienced loss on a tremendous scale. The impact of these losses on the youth will be massive leading to a rise in depression cases, suicidal ideation and ultimately suicidal attempts. Hence there is a need to determine the prevalence of suicidal ideation, suicide attempts and the predictors forboth suicidal ideation and attempts among the young adults in Meghalaya. This cross-sectional study was conducted among the students aged 18-25 years in NEIGRIHMS and Synod College in Shillong between March to April 2022. Data was collected by using questionnaire method. The prevalence of suicidal ideation and suicidal attempts was found to be 15.9 % (12.3-20.3) and 5.8 % (3.7-8.9) respectively. There was a strong relationship for suicidal ideation with urban students, with less family members, those who had unhealthy relationship with their parents, stress, complicated relationship/loss of loved ones and also those with experience of violence/abuse and behavioural problems. However, the attempts were found tobe associated only with the loss of the loved ones. The prevalence, though smaller is a serious concern considering the fact that the burden of suicides is on a rise and hence regular mental health counselling along with the management of the stress is needed at the educational institutional level which could prove to be beneficial to the students.

Screening for mental health problems in childhood cancer survivorship: a systematic review

Abstract Many survivors of childhood cancer suffer from psychological late effects. Therefore, regular psychological screening is strongly advised. Experts recommend screening for mental disorders and symptoms for all survivors at every follow-up visit, regardless of age. However, there is little practical guidance on screening for mental health problems in childhood cancer survivorship care. The aims of this systematic review were to (a) collect comprehensive information on available screening tools, (b) determine which health care professionals performed the screening, and (c) identify practical considerations regarding the timing of screening. The databases PubMed, PsycINFO, and CINAHL were systematically searched for peer-reviewed publications concerning childhood cancer, mental health problems, survivorship, and screening published between January 1990 and January 2023. The search yielded 2268 potentially relevant articles, of which 32 were included in the narrative synthesis. We found that (a) many suitable screening tools are available for the target population, of which the Distress Thermometer, Brief Symptom Inventory-18, Symptom Checklist-90, and Pediatric Quality of Life Inventory were the most commonly used in all studies; (b) professionals of different disciplines were involved in screening, and examples include clinical nurse specialists and psychologists; and (c) early onset, regular, and long-term screening are recommended if resources are available. In conclusion, selecting a screening tool in a clinical setting depends on various factors such as time and cost. However, many brief screening tools can be easily implemented without a large investment of resources. Furthermore, professionals from various disciplines can perform the screening. If they have no background in psychology, training is recommended to give them confidence in dealing with mental health issues. In conclusion, consistent and regular mental health screening is crucial for childhood cancer survivors, and we believe that the benefits outweigh the costs.

Association between Grit and depressive symptoms at the timing of job start among medical residents during the COVID-19 pandemic in Japan: a cross-sectional study

ABSTRACT Introduction The COVID-19 pandemic had an additional negative impact on the mental health of healthcare workers, including residents. Previous studies revealed that grit, which is an individual trait to achieve long-term goals unrelated to intelligence quotient, is not only positively associated with academic achievement and career success but also negatively correlated with depression. This study aimed to examine the association between grit and depressive symptoms among residents at the time of job start during the coronavirus disease 2019 (COVID-19) pandemic in Japan. Materials and methods This cross-sectional study used data from all post-graduate year 1 residents from March 2020 to April 2022 at Tokyo Medical and Dental University, Tokyo, Japan. Grit was measured by the Japanese version of Grit-S. The resident’s depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. The association of interest was examined using logistic regression analysis. Results Among 221 residents, 28 (12.7%) have depressive symptoms. One unit increase in Grit-S score after adjusting for age, sex, graduated university, and sleeping hours was associated with lower odds of having depressive symptoms by 63% (odds ratio [OR]: 0.37; 95% confidence interval [CI]: 0.19–0.74). Further, the perseverance of effort subscale score was associated with lower odds of having depressive symptoms after covariate adjustment (OR: 0.43; 95% CI: 0.22–0.84). Conclusions Higher grit scores were associated with lower odds of having depressive symptoms among residents at the timing of job start during the COVID-19 pandemic. Regular mental health assessment is particularly important for residents with low grit scores at entry.

Parental Preferences for Mental Health Screening of Youths From a Multinational Survey

Screening youths for mental disorders may assist in prevention, promote early identification, and be associated with reduced related lifetime impairment and distress. To assess parents' and caregivers' comfort with and preferences for pediatric mental health screening and factors associated with these preferences. This survey study used an online survey available from July 11 to 14, 2021, through Prolific Academic. Analyses were conducted from November 2021 to November 2022. The survey was administered to English-speaking parents and caregivers in the US, UK, Canada, and 16 other countries who were aged 21 years or older and had at least 1 child aged 5 to 21 years living at home. The main outcomes were parental preferences regarding content, implementation, and review of the findings of pediatric mental health screening. Parental comfort with screening topics was reported on a 6-point Likert scale with 6 indicating highest comfort. Mixed-effects logistic regression models were used to evaluate factors associated with parental comfort levels. Of 1200 survey responses requested, data were collected from 1136 participants (94.7%). The final sample meeting the inclusion criteria comprised 972 parents and caregivers aged 21 to 65 years (mean [SD] age, 39.4 [6.9] years; 606 [62.3%] female). A total of 631 participants (64.9%) supported annual mental health screening for their child, and 872 (89.7%) preferred reviewing the screening results with professional staff (eg, physicians). Participants reported significantly decreased comfort with child self-report compared with parent-report screening assessments (b = -0.278; SE = 0.009; P < .001), although they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child's age, participants were generally comfortable discussing all 21 screening topics on the survey. The greatest comfort was with sleep problems (mean [SE] score, 5.30 [0.03]); the least comfort was with firearms (mean [SE] score, 4.71 [0.05]), gender identity (mean [SE] score, 4.68 [0.05]), suicidality (mean [SE] score, 4.62 [0.05]), and substance use or abuse (mean [SE] score, 4.78 [0.05]). In this survey study of parents and caregivers, parent-reported and child self-reported mental health screening in primary care settings was supported by the majority of the sample, although comfort levels differed according to various factors (eg, screening topic). Participants preferred to discuss screening results with professional health care staff. In addition to parental need for expert guidance, the study findings highlight the growing awareness of child mental health needs and the importance of addressing mental health concerns early via regular mental health screenings.

Effects of Youth Flexible Assertive Community Treatment: outcomes of an 18-month observational study

PurposeThis Multicenter Youth Flexible ACT Study examined the effect of Youth Flexible Assertive Community Treatment on symptomatic, social, and personal recovery outcomes of adolescents dealing with multifaceted psychiatric and social care needs who do not readily engage in regular office-based mental health services.MethodsNewly admitted clients (n = 199) aged 12–24 years from 16 Youth Flexible ACT teams participated in this observational prospective cohort study. Client and practitioner questionnaires were administered every 6 months, up to 18 months. Latent growth curve analyses were conducted to examine changes in symptomatic, social, and personal recovery outcomes throughout Flexible ACT.ResultsOur analyses of client-reported outcomes showed a decrease in overall psychosocial difficulties, depressive symptoms, and subclinical psychosis symptoms. Moreover, outcomes showed improved social interaction with peers, quality of life, and feelings of empowerment and fewer contacts with the police/legal system. In addition, analyses of clinician-reported outcomes showed a decrease in problems related to family life, peer relationships, school/work attendance, emotional symptoms, and attentional problems. Problems related to personal finance, school and work status, substance misuse, disruptive and aggressive behavior, self-injury, and self-care and independence remained unchanged.ConclusionOur results showed that clients participating in Youth Flexible ACT improved in symptomatic, social, and personal recovery outcomes over 18 months. With its integrated approach and personalized care, this service delivery model is promising for adolescents unable to engage successfully in regular (office based) mental health support services.

Frequency of Depression in Migraine Patients: A Multicentre Cross-Sectional Study from Pakistan

Background: Migraine is a debilitating neurological disorder often accompanied by comorbid psychiatric conditions, including depression. However, the prevalence and correlates of depression among migraine patients in Pakistan are under-investigated. Study Objective: This study aimed to estimate the frequency of depression among migraine patients and assess its association with the severity and impact of migraine on daily and professional life. Material and methods: This Cross-sectional study was conducted at the Punjab Institute of Neurosciences (PINS/LGH) in Lahore over a period of 12 months from January to December 2022. A total of 1250 adults aged 18-75 years, diagnosed with migraines based on the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria, were enrolled. Depression was evaluated using the Urdu version of the Beck Depression Inventory-II (BDI-II). Demographic and clinical data were collected and analyzed. Results: The study reported a significant prevalence of depression among migraine patients, with an observed gender disparity favoring females. Notably, a higher duration and severity of migraines, a greater number of attacks per month, and a profound impact on professional and social life were positively correlated with depression. Practical Implication: significant prevalence of comorbid depression in this particular population, it is imperative to incorporate routine mental health screening as an integral component of standard care protocols. This approach may potentially facilitate early detection and intervention, thereby potentially enhancing overall patient outcomes and quality of life. Conclusion: The high prevalence of depression among migraine patients underscores the need for integrated mental health services within the migraine care paradigm in Pakistan. Regular mental health screening can aid in early detection, facilitating comprehensive management and potentially improving patient outcomes. Keywords: Migraine, Depression, Prevalence, Comorbidity, Mental Health Screening, Pakistan.