Risk For Mental Health Outcomes Research Articles

Composite healthy lifestyle, socioeconomic deprivation, and mental well-being during the COVID-19 pandemic: a prospective analysis

The adverse psychological and social impacts of COVID-19 pandemic are well characterized, but the role of composite, modifiable lifestyle factors that may interact to mitigate these impacts is not. The effect of socioeconomic deprivation on these lifestyle risks also remains unclear. Based on a nationally representative, longitudinal cohort, we assessed the association between a combination of pre-pandemic lifestyle factors and mental health conditions during pandemic, and the contribution of deprivation to it. Composite lifestyle factors included BMI, smoking status, alcohol consumption, physical activity, sedentary time, sleep duration, and fruit and vegetable intake, with lifestyle scores and lifestyle categories calculated for each participant. Symptoms of depression and anxiety, and personal well-being were assessed by validated scales during the pandemic. Socioeconomic deprivation was characterized by both individual-level (income, wealth, and education) and group-level factors (Index of Multiple Deprivation). Of the 5049 eligible participants (mean [SD] age, 68.1 [10.9] years; 57.2% were female) included in the study, 41.6% followed a favorable lifestyle, 48.9% followed an intermediate lifestyle, and 9.5% followed an unfavorable lifestyle. Compared with favorable lifestyle category, participants in the intermediate and unfavorable lifestyle category were at increased risk of mental health conditions, with the hazard ratio (HR) for trend per increment change towards unfavorable category of 1.17 (95% CI 1.09–1.26) for depression, 1.23 (1.07–1.42) for anxiety, and 1.39 (1.20–1.61) for low well-being. A significant trend of lower risk for mental health conditions with increasing number of healthy lifestyle factors was observed (P < 0.001 for trend). There were no significant interactions between lifestyle factors and socioeconomic deprivation for any of the outcomes, with similar HRs for trend per one increment change in lifestyle category observed in each deprivation group. Compared with those in the least deprived group with favorable lifestyle, participants in the most deprived group adherent to unfavorable lifestyle had the highest risk of mental health outcomes. These results suggest that adherence to a broad combination of healthy lifestyle factors was associated with a significantly reduced risk of mental health conditions during the COVID-19 pandemic. Lifestyle factors, in conjunction with socioeconomic deprivation, independently contribute to the risk of mental health issues. Although further research is needed to assess causality, the current findings support public health strategies and individual-level interventions that provide enhanced support in areas of deprivation and target multiple lifestyle factors to reduce health inequalities and promote mental well-being during the ongoing COVID-19 pandemic.

Psychological Resilience and Adverse Mental Health Issues in the Thai Population during the Coronavirus Disease 2019 Pandemic.

In light of the coronavirus disease 2019 (COVID-19) pandemic and the enormous amount of uncertainty caused by it, mental health issues have become a great concern. Evidence regarding the effects of psychological resilience on the Thai population is scarce. We evaluated psychological resilience during the first wave of the COVID-19 pandemic and its association with the risk of mental health outcomes, such as depression, anxiety, stress, and health-related well-being. This cross-sectional study was a part of the HOME-COVID-19 project, which conducted an online survey of 4004 members of the general population in Thailand using the Brief Resilience Coping Scale. Logistic regression was performed to identify the association between psychological resilience and mental health issues and well-being. Groups with prevalence rates of 43.9%, 39.2%, and 16.9% were classified as low, moderate, and high resilient copers, respectively. Using high resilient copers as a reference group, the low resilient copers had a higher chance of having mental health adversities. The adjusted odds ratio (OR) was 1.89 (95% confidence interval [CI], 1.39–2.56; p < 0.001) for depression, 2.13 (95% CI, 1.45–3.14; p < 0.001) for anxiety, 4.61 (95% CI, 3.30–6.45; p < 0.001) for perceived stress, and 3.18 (95% CI, 2.31–4.38; p < 0.001) for low well-being. For the medium resilient copers, only low well-being was found to be statistically significant (OR, 1.60; 95% CI, 1.16–2.20; p = 0.004). It is important that resilience be considered in the development of strategies for managing the COVID-19 pandemic to prevent or reduce adverse mental health outcomes.

A-46 High School Soccer and Risk for Mental Health Outcomes in Adulthood: A National Longitudinal Study

Abstract Purpose: There is concern that participation in contact sports during youth might confer risk for later in life mental health problems. We examined whether playing high school soccer was associated with higher rates of depression, anxiety, and suicidality in early to middle adulthood. Methods: The National Longitudinal Study of Adolescent to Adult Health (“Add Health”) database was analyzed at Wave I (n = 6503; median age = 15), Wave III (median age = 22), Wave IV (median age = 29), and Wave V (n = 4196; median age = 38). We compared those who played soccer to those who did not play contact sports on mental health outcomes. Results: There were 221 participants who played high school soccer (102 men and 119 women) compared to 2388 who denied participation in contact sports (784 men and 1604 women). During their late 30s, approximately 17.4% of men and 31.0% of women reported a lifetime history of depression, and 15.6% of men and 28.8% of women reported a lifetime history of anxiety. Suicidal ideation, in the past year, was reported by 7.1% of men and 6.8% of women. When comparing those who played soccer to those who did not, there were no statistically significant differences in the proportions who had a lifetime diagnosis of depression or anxiety, or suicidal ideation in the past year, during Waves III, IV, or V of data collection (p-values&amp;gt;0.05). Conclusions: Adults who played high school soccer did not have greater mental health problems at three different time points spanning more than 20 years after high school.

Exploring the Existence of Distinct Subclasses of Intimate Partner Violence Experience and Associations with Mental Health

Intimate Partner Violence (IPV) is a worldwide societal concern. Adversities such as IPV are known to impinge upon mental health and socio-economic development. However, much of the existing literature addresses single or dual constructs of IPV abuse rather than capturing the more common polyvictimisation experience and how they impact on mental health. Using a Northern Irish university student sample (n = 753), latent class analysis was employed to examine distinct patterns of IPV experience stratified by gender (n = 184 males (24.44%); n = 569 females (75.56%)). Regressions were then employed to assess whether there were differential associations between the latent classes of IPV and a range of mental health outcomes. While a greater number of females reported experiencing IPV, patterns of IPV victimisation across gender were found to be similar. Results indicated that three latent classes were optimal across both genders; one characterised by Low or no IPV (males: 48.37%; females: 56.24%), another characterised by predominantly physical and emotional denigration (males: 34.24%; females: 27.42%), and a third characterised by multiple endorsements of different types of IPV (males: 17.39%; females: 16.34%). Differences in mental health outcomes across gender are noted. Classes characterised by multiple forms of abuse report an increased risk of mental health outcomes including posttraumatic stress disorder, anxiety and depression but not alcohol use. The study extends the existing literature which highlights the importance of acknowledging psychological and emotional abuse (PEA) as a significant abuse type in the IPV experience. The study also reaffirms the need for definitional clarity and development of standardised measurement tools of PEA within the research context and beyond.

Dispositional gratitude predicts the development of psychopathology and suicidal behaviors: Results from a 7-year population-based study of U.S. military veterans

BackgroundDispositional gratitude has been implicated as a psychological characteristic that may modulate risk for mental health outcomes. Using a population-based sample of U.S. military veterans, this study evaluated the association between dispositional gratitude and the development of psychopathology and suicidal behaviors over a 7-year period. MethodsA nationally representative sample of U.S. veterans was surveyed at four timepoints across seven years. Analyses were restricted to veterans without incident outcomes at baseline. Multivariable analyses were conducted to examine the relation between baseline levels of dispositional gratitude and risk of developing (a) major depressive disorder (MDD), generalized anxiety disorder (GAD), or posttraumatic stress disorder (PTSD); (b) suicidal ideation; and (c) suicide attempts. ResultsA total 9.6% of veterans developed MDD, GAD, and/or PTSD, 9.5% developed suicidal ideation, and 2.8% reported having attempted suicide over the 7-year follow-up period. Among veterans with high levels of dispositional gratitude, incidence was lower for MDD/GAD/PTSD (8.0%), suicidal ideation (6.8%), and suicide attempts (1.5%). Conversely, veterans with low dispositional gratitude were at substantially higher risk of developing MDD/GAD/PTSD (27.7%), suicidal ideation (33.6%), and suicide attempts (20.3%). ConclusionsHigh dispositional gratitude may help protect against the development of psychopathology and suicidal behaviors in U.S. military veterans, whereas low gratitude may increase risk of developing these outcomes. Collectively, these results support the potential utility of enhancing gratitude as part of primary prevention efforts for veterans, service members, and other populations at heightened risk for adverse mental health outcomes.

Stress, Burnout and Coping Strategies among Frontline Health Workers during Covid-19 Pandemic: Review

The doctors, Nurses and other health care providers are at frontline in this covid-19 pandemic, are exposed to tremendous occupational stressors that render them liable for occupational burnout due to workload, Lack of medical professionals and infrastructure. The COVID-19 pandemic had a massive impact on healthcare systems and health care workers across the globe leading to increasing the risks of psychological distress in health care professionals. Several occupational risk factors are challenging to healthcare workers who are at high risk of mental health outcomes, including Burnout Syndrome. Several studies are conducted to detect level of stress, fear, burnout experiencing by frontline health workers which shows the frontline health workers are under stress, fear. This article reviews the possible causes for burnout and strategies to cope up during covid-19 pandemic among frontline health workers.

Protective and resilience factors to promote mental health among Indigenous youth in Canada: a scoping review protocol

IntroductionMany mental health concerns emerge in adolescence and young adulthood, making this a critical period to initiate early interventions for mental health promotion and illness prevention. Although Indigenous young people...

Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes

BackgroundExtensive research demonstrates that Adverse Childhood Experiences (ACEs) are highly interconnected and have numerous health consequences well into adulthood. Yet, there is a dearth of focused research that examines ACEs and health inequities for American Indians (AIs). ObjectiveTo assesses the prevalence of ten types of childhood adversities, explore constellations of exposures, and examine whether there are differential risks of mental health outcomes according to sub-group classification. Participants and settingAdult AIs with type 2 diabetes from five reservation-based tribal communities in the Great Lakes region of the U.S. MethodsPrevalence was estimated using a modified version of the World Health Organization's ACE-International Questionnaire. To examine heterogeneity in ACEs exposures, latent class analysis was used. Risk of mental health outcomes was calculated by class. ResultsThe four most common ACEs reported were residing with someone who abused substances, witnessing household violence, incarceration of a household member, and sexual abuse. Three latent classes were identified: low risk (56.7%), family maladjustment with high probabilities of household violence, incarceration, and substance abuse (27.1%), and complex trauma (16.3%) with moderate to high probabilities of exposure to all ACEs. The most consistent differences in mental health outcomes were between the low risk and complex trauma classes. ConclusionsIdentification of a high number of participants in the low-risk class helps structure a more wholistic image of AI families, as negative stereotypes of AIs are abundant. For the minority of individuals in the complex trauma class, risk for chronic mental health challenges and co-morbidities appears to be high.

Minorities within Minorities: Mental Health Outcomes within Sexual Minority Youth

ABSTRACT The mental health disparities for lesbian, gay, bisexual, and queer (LGBQ) compared to heterosexual youth are well established. However, evidence indicates there may be diversity in risk for mental health outcomes within sexual minority youth. This study examined mental health outcomes in 1,933 young people (aged 16 − 25 years) who used the online mental health platform ReachOut. We explored mental health outcomes (mental health service use and hospitalization, depression, anxiety, and stress), and risk for suicide among heterosexual, gay/lesbian, bisexual, queer+, and questioning young people. Compared to their heterosexual peers, bisexual, queer+, and questioning young people had significantly higher levels of depression, anxiety, and risk for suicide. Bisexual and queer+ young people also had significantly higher levels of stress compared to heterosexual youth. Bisexual and young people questioning their sexuality were significantly more likely to have a previous mental health hospitalization. Gay/lesbian youth did not significantly differ from heterosexuals on depression, anxiety, stress, or previous hospitalization, but did for risk of suicide. These findings underscore the importance of measuring, reporting, and addressing the distinct mental health experiences of sexual minority youth.

SARS/MERS/SARS-CoV-2 Outbreaks and Burnout Syndrome among Healthcare Workers. An Umbrella Systematic Review.

The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. An umbrella review of systematic reviews and meta-analyses concerning BOS and coronavirus (SARS/MERS/SARS-CoV-2) outbreaks was carried out on PubMed Central/Medline, Cochrane Library, PROSPERO, and Epistemonikos databases. Data relating to COVID-19 is insufficient, but in previous SARS and MERS outbreaks about one-third of HCWs manifested BOS. This prevalence rate is similar to the figure recorded in some categories of HCWs exposed to chronic occupational stress and poor work organization during non-epidemic periods. Inadequate organization and worsening working conditions during an epidemic appear to be the most likely causes of BOS. Preventive care and workplace health promotion programs could be useful for protecting healthcare workers during pandemics, as well as during regular health activities.

Prioritizing Happiness has Important Implications for Mental Health, but Perhaps Only if you Already are Happy

Happiness is frequently posited as an important outcome of quality of life and characteristic of well-adjusted and functioning individuals. Happy individuals are less likely to report adverse mental health. Understanding the importance that individuals place on happiness is less clearly articulated and inconsistent. Valuing or placing higher importance of happiness appear to confer both benefits and risk for mental health outcomes. The primary aim of this study was to examine the relationship between the importance of happiness and mental health outcomes and whether the relationship between happiness and mental health is moderated by the importance individuals place on happiness. We utilised data from two studies, a university student sample (n = 413) and a community sample (n = 248) to examine the study aims. Mental health was operationalised in terms of psychological distress and symptoms of depression and anxiety. Happiness and the level of importance individuals ascribed to happiness were associated with adverse mental health outcomes. In multi-variate analyses, level of happiness was more strongly related to mental health. Interactions between happiness and the importance of happiness revealed that the effect of happiness was moderated by the importance that individuals placed on happiness. Overall happiness and to a lesser extent, the importance of happiness, are significantly associated with mental health outcomes. Happiness was most strongly related to mental health amongst those who rated the importance of happiness more highly.

Baseline income, follow-up income, income mobility and their roles in mental disorders: a longitudinal intra-generational community-based study

BackgroundAlthough a number of studies have found that income mobility associated with an elevated risk of mental disorders, existing research does not provide sufficient evidence of how exactly individuals’ experience of income mobility per se affects their risk of mental health outcomes. This present study aimed to explore roles of baseline income, follow-up income, and income mobility in the development of mental disorders using an intra-generational, longitudinal follow-up study.MethodsWe used data from the Montreal South-West Longitudinal Catchment Area Study. A total of 1117 participants with complete information both on income and past 12-month diagnoses of mental disorders were selected for this study. Diagonal Reference Models were used to simultaneously examine roles of income at baseline, income at follow-up, and income mobility in mental disorders during a 4-year follow-up.ResultsBoth baseline and follow-up income were important predictors for any mental disorder and major depression among males and females. Those with low income had a higher risk of any mental disorders and major depression. No evidence was found to support an association between income mobility (neither downwards nor upwards) and mental disorders. Marital status was uniquely associated with any mental disorder among males. Having a pre-existing diagnosis of any mental disorder at origin was associated with any mental disorder and major depression at the end of the 4-year follow-up.ConclusionsThis study first simultaneously examined roles of income at baseline, at follow-up, and mobility in mental disorders among a large-scale intra-generational community-based study. This present study provides additional evidence on how income is associated with an individuals’ likelihood of mental disorders.

Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI

Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11-1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78-3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42-1.63). Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.

Combined effects of disease management and food insecurity on physical and mental health in Korean adults.

The present study aimed to examine the combined effects of disease management and food insecurity on physical and mental health in a representative Korean population. A cross-sectional study. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012-2015. Adults aged ≥30 years (n 17 934) who participated in the KNHANES. Among health-care factors, unmet health-care needs and mental health counselling were different by food insecurity status, with a higher prevalence in adults with food insecurity. The prevalence of underweight was higher in men with food insecurity (5·9 %), whereas the prevalence of obesity was higher in women with food insecurity (37·4 %), than that in men and women with food security. Food insecurity was associated with a high risk of all mental health outcomes. For the combined effects of disease management and food insecurity, unmet health-care needs was related to increased risk of obesity for food-insecure men (Pinteraction = 0·029) and lack of participation in nutrition education or counselling was related to increased risk of obesity for food-insecure women (Pinteraction = 0·010). In addition, higher unmet health-care needs in adults with food insecurity was related to higher risk of mental health outcomes. Unmet health-care needs may exacerbate obesity for food-insecure men and mental health problems for both food-insecure men and women. In addition, lack of participation in nutrition education or counselling may exacerbate the obesity for food-insecure women.

A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?

Related to a broader context of historical oppression, Indigenous peoples of the USA are overburdened with the mental health challenges that social workers tend to treat, including post-traumatic stress disorder (PTSD), depression, suicide and substance use disorders (SUD). The purpose of this systematic review is to use the Framework of Historical Oppression, Resilience and Transcendence (FHORT) to identify empirical research on risk and protective factors related to mental health and SUD amongst these populations. This systematic review includes peer-reviewed quantitative and qualitative research articles from 1980 to 2017 focusing on the mental health of US Indigenous adults. A total of thirty-eight peer-reviewed empirical articles met inclusion criteria. Results reveal adults within Indigenous populations are at a high risk for mental health outcomes, including PTSD, depression, suicide, SUD and comorbidity across these outcomes. Underlying risk factors across outcomes included historical oppression and loss, family problems and SUD. Protective factors tended to include family and social support and engagement with tribal cultural activities. Significant variability was identified based on gender and geographic regions. Given that protective factors tended to include cultural, familial and community tenets, holistic approaches are the most promising programmes for social workers to work towards.

Mental health outcomes of burn: A longitudinal population-based study of adults hospitalized for burns

PurposeThis study investigates the increased risk of mental health outcomes and health care utilization associated with burn with two year of follow-up using a longitudinal population-based matched cohort design. MethodsAdult burn survivors (n=157) were identified from a provincial burn registry and matched 1:5 with non-burn control subjects from the general population (matching variables age and gender). The prevalence of mental health outcomes and the rates of health care utilization between the groups were compared for the 2years pre and post index date using anonymously linked population-based administrative health care data. Rates were adjusted for age, gender and sociodemographic characteristics. ResultsWhile the burn cohort had an increased prevalence of mental health problems after burn compared to the control cohort, the burn group also had an increased prevalence of pre-burn depression (16.6% vs 7.8%; p=0.0005) and substance use disorders (8.9% vs 3.2%; p=0.001) when compared to controls. Once the pre-existing prevalence of mental illness was taken into account there was no significant change in the prevalence of mental health problems when comparing the burn group to controls over time. ConclusionsAlthough burns may not increase rates of mental health issues and health care utilization, burn survivors are a vulnerable group who already demonstrate increased rates of psychopathology and need for care. The present study highlights the importance of assessment and treatment of mental health outcomes in this population.

Mental health implications for older adults after natural disasters--a systematic review and meta-analysis.

Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.

Gene-environment interaction in major depression: focus on experience-dependent biological systems.

Major depressive disorder (MDD) is a multifactorial and polygenic disorder, where multiple and partially overlapping sets of susceptibility genes interact each other and with the environment, predisposing individuals to the development of the illness. Thus, MDD results from a complex interplay of vulnerability genes and environmental factors that act cumulatively throughout individual’s lifetime. Among these environmental factors, stressful life experiences, especially those occurring early in life, have been suggested to exert a crucial impact on brain development, leading to permanent functional changes that may contribute to lifelong risk for mental health outcomes. In this review, we will discuss how genetic variants (polymorphisms, SNPs) within genes operating in neurobiological systems that mediate stress response and synaptic plasticity, can impact, by themselves, the vulnerability risk for MDD; we will also consider how this MDD risk can be further modulated when gene × environment interaction is taken into account. Finally, we will discuss the role of epigenetic mechanisms, and in particular of DNA methylation and miRNAs expression changes, in mediating the effect of the stress on the vulnerability risk to develop MDD. Taken together, we aim to underlie the role of genetic and epigenetic processes involved in stress- and neuroplasticity-related biological systems on the development of MDD after exposure to early life stress, thereby building the basis for future research and clinical interventions.