Risk Of Serious Mental Illness Research Articles

Stress perception following childhood adversity: Unique associations with adversity type and sex.

Childhood adversity is associated with poor mental and physical health outcomes across the life span. Alterations in the hypothalamic-pituitary-adrenal axis are considered a key mechanism underlying these associations, although findings have been mixed. These inconsistencies suggest that other aspects of stress processing may underlie variations in this these associations, and that differences in adversity type, sex, and age may be relevant. The current study investigated the relationship between childhood adversity, stress perception, and morning cortisol, and examined whether differences in adversity type (generalized vs. threat and deprivation), sex, and age had distinct effects on these associations. Salivary cortisol samples, daily hassle stress ratings, and retrospective measures of childhood adversity were collected from a large sample of youth at risk for serious mental illness including psychoses (n = 605, mean age = 19.3). Results indicated that childhood adversity was associated with increased stress perception, which subsequently predicted higher morning cortisol levels; however, these associations were specific to threat exposures in females. These findings highlight the role of stress perception in stress vulnerability following childhood adversity and highlight potential sex differences in the impact of threat exposures.

Clinical staging for youth at-risk for serious mental illness.

The first aim of this project was to identify a sample of youth who met different stages of risk for the development of a serious mental illness (SMI) based on a published clinical staging model. The second aim was to determine whether participants allocated to the different stages were a good fit to the model by comparing these groups on a range of clinical measures. This two-site longitudinal study recruited 243 youth, ages 12 to 25. The sample included (a) 42 healthy controls, (b) 43 non-help seeking individuals with no mental illness but with some risk of SMI, such as having a first-degree relative with a SMI (stage 0), (c) 52 help-seeking youth experiencing distress and possibly mild symptoms of anxiety or depression (stage 1a) and (d) 108 youth with attenuated symptoms of SMI, such as bipolar disorder or psychosis (stage 1b). Participants completed a range of measures assessing depression, anxiety, mania, suicide ideation, attenuated psychotic symptoms, negative symptoms, anhedonia and beliefs about oneself. There were no clinical differences between HCs and participants in stage 0. For most of the clinical measures, participants in stage 1b had more severe ratings than participants in stages 1a and 0 and HCs; those in stage 1a had more severe ratings than HCs and stage 0 participants. These results suggest that the staging process used to allocate participants to various stages is a good fit. That is, the clinical ratings followed an ordering effect consistent with that hypothesized in the staging model.

Physical effort exertion and pain: Links with trait-based risk for psychopathology

People with serious mental illness (SMI) are at an increased risk for physical health complications, such as cardiovascular disease and obesity. Low levels of physical activity is a major contributor to these health complications. One factor associated with limited physical activity in the broader sedentary population is pain. While preliminary findings suggest an association between lack of physical activity and pain in SMI, conclusions are still unclear. Thus, the goal of this correlational study was to examine associations between trait-based risk for psychopathology (hypomanic personality, schizotypy, and anhedonic depression) and the experience of pain following a physical endurance/effort task. Healthy participants (N = 43; 18 females) completed self-report measures of trait-based risk for psychopathology. They also reported on the experience of pain before and after the Time To Exhaustion (TTE) test. Findings revealed that risk for psychosis and anhedonic depression were associated with increases in pain following the TTE test, accounting for other key variables, such as age and self-reported physical exercise. Risk for mania was unrelated to changes in pain. These results suggest that the experience of pain in relation to physical endurance/effort may contribute to diminished physical activity among people at risk for SMI.

Early Intervention in Mental Health for Adolescents and Young Adults: A Systematic Review.

The purpose of this systematic review was to describe the evidence for the effectiveness of early intervention to improve and maintain performance in occupations for youths with or at risk for serious mental illness (SMI). Titles and abstracts of 670 articles were reviewed, 234 were retrieved for full review, and 30 met inclusion criteria. Moderate to strong evidence supports cognitive remediation (CR) and mixed evidence supports cognitive-behavioral therapy (CBT) as an adjunct modality to improve general functioning. Moderate to strong evidence supports use of supported employment and supported education (SE/E) to improve social and occupational outcomes in employment and academics. Strong evidence supports family psychoeducation (FPE) to prevent relapse and rehospitalization and improve problem-solving skills and general functioning. Occupational therapy practitioners should integrate CR, SE/E, and FPE into early intervention with youth with or at risk for SMI. In addition, CBT is an effective modality for use with this population.

Increasing amphetamine use and forensic involvement among clients of three residential Indigenous alcohol and other drug services in Victoria, Australia.

Indigenous people seeking residential alcohol and other drug (AOD) rehabilitation in Victoria are most frequently referred to the Ngwala Willumbong Co-operative (Ngwala). This study aimed to describe socio-demographic changes in clients of Ngwala's residential rehabilitation services between 2015 and 2016. Self-assessment surveys completed upon screening for rehabilitation between May 2015 and November 2016 (n = 117) were analysed for socio-demographic data, AOD use and mental health status. Ngwala's monthly summary reports from January 2015 to December 2016 were analysed to compare primary drugs of concern, proportion of forensic clients assessed and admitted across 2015-2016. Independent t-tests and tests of two proportions were used to compare variables between years, with differences considered significant when P < 0.05. Clients were predominantly Indigenous (n = 100, 91%), male (n = 92, 71%) and unemployed (n = 106, 93%). Most clients (n = 92, 88%) were at high risk of serious mental illness (by Kessler Psychological Distress Scale). A significantly higher proportion of forensic clients were admitted in 2016 (n = 221, 60%) compared to 2015 (n = 158, 43%; P < 0.001; 95% confidence interval -0.24, -0.10). The mean monthly number of clients listing amphetamines as their primary drug of concern upon assessment was greater in 2016 (21 ± 7.19 people) compared to 2015 (12 ± 2.78 people; P = 0.01; 95% confidence interval 3.13, 15.37). These findings suggest the proportion of Indigenous people in AOD treatment with amphetamine use problems or forensic involvement is increasing. These trends should be considered in service design and funding decisions.

(201) - Risk for serious mental illness, chronic pain, and pain in response to a physical effort task

(201) - Risk for serious mental illness, chronic pain, and pain in response to a physical effort task

Cities and Mental Health.

More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities. This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers. Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborhood contribute to the mental health burden while little is known about specific interactions between such factors and the built environment. Further insights on the interaction between spatial heterogeneity of neighborhood resources and socio-ecological factors is warranted and requires interdisciplinary research.

Drinking Behavior and Mental Illness Among Evacuees in Fukushima Following the Great East Japan Earthquake: The Fukushima Health Management Survey.

BackgroundRecent evidence from alcohol and trauma studies suggests that disasters are associated with increases in the consumption of alcohol. The Great East Japan Earthquake and the associated nuclear disaster have continued to affect the mental health of evacuees from Fukushima. This study aimed to extend these findings by examining the relationship between drinking behaviors and the risk of mental illness after the compound disaster.MethodsWe conducted the Mental Health and Lifestyle Survey with 56,543 evacuees. Kessler's K6 was used to assess the risk of mental illness, and logistic regression models were applied to analyze how drinking behavior patterns influence the risk of serious mental illness after adjustment for confounding variables.ResultsLogistic regression analysis evidenced that beginning heavy and light drinkers had the highest and a higher risk of serious mental illness, respectively. Individuals who were nondrinkers pre‐ and postdisaster had the lowest proportional risk of mental illness. Abstainers also had some risk to their mental health after the compound disaster.ConclusionsThe results of this study highlight that beginning drinkers have a high risk of serious mental illness. Thus, mental health professionals should pay attention to the drinking behaviors of evacuees, which might predict increased risk of serious mental illness and consequently indicate a need for psychological intervention.

Work Content and Serious Mental Illness among Middle-Aged Men: Results from a 6-Year Longitudinal Study in Japan.

ObjectiveThe present study aimed to determine prospective associations between work content after a working life of more than 20 years and serious mental illness among Japanese men aged 50 to 59 years, using a nationwide population-based survey.MethodsData were extracted from a national longitudinal survey of middle-aged and elderly persons previously conducted by the Ministry of Health, Labour and Welfare in Japan. We analyzed data across 10 work content categories for Japanese men who had been working in the same job type or industry for over 20 years. As part pf the survey, participants completed the Kessler (K)6 scale each year to determine their level of psychological distress (with scores ≥13 indicating serious mental illness). Cox discrete time proposal hazard regression analysis was used to examine potential associations between work content and serious mental illness from 2005 to 2010. Further adjustments were made for other sociodemographic characteristics and lifestyle factors.ResultsThe current study involved a total of 11,942 participants with a mean (± standard deviation [SD]) of follow-up was 3.4 (± 2.0) years, during which time 892 participants (7.5%) had been classified as having a new-onset serious mental illness. Men who had worked in service jobs and in manufacturing jobs at baseline were more likely to develop serious mental illness than those in managerial jobs (hazard ratio 1.37, 1.30, 95% confidence intervals 1.04–1.80, 1.02–1.65) after adjustment for confounding variables.ConclusionThese findings suggest that Japanese men aged 50 to 59 years who have worked in service and manufacturing jobs after a working life of over 20 years have an increased risk of serious mental illness during follow-up. Identifying the most at-risk work content category after a working life of over 20 years would be an essential part of providing more effective interventions for psychological distress among Japanese men in this age group.

Modeling the geographic distribution of serious mental illness in New Zealand

This study aims to estimate, apply, and validate a model of the risk of serious mental illness (SMI) in local service areas throughout New Zealand. The study employs a secondary analysis of data from the Te Rau Hinengaro Mental Health Survey of 12,992 adults aged 16 years and over from the household population. It uses small area estimation (SAE) methods involving: (1) estimation of a logistic model of risk of SMI; (2) use of the foregoing model for computing estimates, using census data, for District Board areas; (3) validation of estimates against an alternative indicator of SMI prevalence. The model uses age, ethnicity, marital status, employment, and income to predict 92.2 % of respondents' SMI statuses, with a specificity of 95.9 %, sensitivity of 16.9 %, and an AUC of 0.73. The resulting estimates for the District Board areas ranged between 4.1 and 5.7 %, with confidence intervals from ±0.3 to ±1.1 %. The estimates demonstrated a correlation of 0.51 (p = 0.028) with rates of psychiatric hospitalization. The use of SAE methods demonstrated the capacity for deriving local prevalence rates of SMI, which can be validated against an available indicator.

Disparities in the geography of serious mental illness in Israel

ObjectiveThe aim of this research is to test and apply a model of the disparities and variations in serious mental illness (SMI) to estimating prevalence in local areas throughout Israel. MethodsThis study employs a secondary analysis of data from the 2003/2004 Israel National Health Survey of 4859 adults aged 21 and over from the household population of legal residents and citizens. It uses small area estimation methods (SAE), specifically to: (i) estimate and test a multivariate logistic model of disparities in the risk of serious mental illness; (ii) use the foregoing model for computing estimates, using census data, for local areas; (iii) validate these estimates against the rate of psychiatric hospitalizations. ResultsThe model uses standard demographic and socioeconomic variables to successfully predict 92.5% of respondents’ statuses as SMI, with a sensitivity of 26.9%, specificity of 95.9%, and an AUC index of .797. The resulting estimates of the percentage of adults with an SMI in the 16 subdistricts ranged between 3.7% and 7.7%, with a national mean of 5.0%. The estimates have a partial correlation of .63 with rates of psychiatric hospitalization in Jewish localities, but elevated rates have not been validated in Arab localities. ConclusionThe use of small area estimation methods demonstrated the capacity for deriving local prevalence rates of serious mental illness, ones that can be validated against psychiatric hospitalization for the majority population group in Israel.

Calcyon upregulation in adolescence impairs response inhibition and working memory in adulthood

Calcyon regulates activity-dependent internalization of α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) glutamate receptors and long-term depression of excitatory synapses. Elevated levels of calcyon are consistently observed in brains from schizophrenic patients, and the calcyon gene is associated with attention-deficit hyperactivity disorder. Executive function deficits are common to both disorders, and at least for schizophrenia, the etiology appears to involve both heritable and neurodevelopmental factors. Here, we show with calcyon-overexpressing Cal(OE) transgenic mice that lifelong calcyon upregulation impairs executive functions including response inhibition and working memory, without producing learning and memory deficits in general. As response inhibition and working memory, as well as the underlying neural circuitry, continue to mature into early adulthood, we functionally silenced the transgene during postnatal days 28-49, a period corresponding to adolescence. Remarkably, the response inhibition and working memory deficits including perseverative behavior were absent in adult Cal(OE) mice with the transgene silenced in adolescence. Suppressing the calcyon transgene in adulthood only partially rescued the deficits, suggesting calcyon upregulation in adolescence irreversibly alters development of neural circuits supporting mature response inhibition and working memory. Brain regional immunoblots revealed a prominent downregulation of AMPA GluR1 subunits in hippocampus and GluR2/3 subunits in hippocampus and prefrontal cortex of the Cal(OE) mice. Silencing the transgene in adolescence prevented the decrease in hippocampal GluR1, further implicating altered fronto-hippocampal connectivity in the executive function deficits observed in the Cal(OE) mice. Treatments that mitigate the effects of high levels of calcyon during adolescence could preempt adult deficits in executive functions in individuals at risk for serious mental illness.

Postnatal affective disorders. Part 1: an introduction

Emotional and behavioural changes affect 50–80% of new mothers between days 3 and 5 of the postnatal period. Ten percent of all recently‐delivered women develop a depressive illness. The incidence of puerperal psychosis is 2 per 1000 births. Women with puerperal psychosis face a 50% risk of serious mental illness at other times in their lives. Learning objectives: To learn about the emotional changes following childbirth. To be aware of the risk factors, clinical features and prognosis of postnatal affective disorders. To be able to prescribe the appropriate care for women with puerperal psychosis and postnatal depression. Ethical issues: Should all women be screened for postnatal mood disorders? Please cite this article as: Oates M. Postnatal affective disorders. Part 1: an introduction. The Obstetrician &amp; Gynaecologist 2008;10:145–150.

Brain Data Reveal Why Psychotherapy Works

Brain Data Reveal Why Psychotherapy Works

Mania precipitated by meditation: a case report and literature review

Meditation is a popular method of relaxation and dealing with everyday stress. Meditative techniques have been used in the management of a number of psychiatric and physical illnesses. The risk of serious mental illness being precipitated by meditation is less well recognized however. This paper reports a case in which two separate manic episodes arose after meditation using techniques from two different traditions (yoga and zen). Other cases of psychotic illness precipitated by meditation and mystical speculation reported in the literature are discussed.

Mania precipitated by meditation: a case report and literature review

Meditation is a popular method of relaxation and dealing with everyday stress. Meditative techniques have been used in the management of a number of psychiatric and physical illnesses. The risk of serious mental illness being precipitated by meditation is less well recognized however. This paper reports a case in which two separate manic episodes arose after meditation using techniques from two different traditions (yoga and zen). Other cases of psychotic illness precipitated by meditation and mystical speculation reported in the literature are discussed.