Suicide Risk Among Adolescents With ADHD: An Overview From the National Inpatient Sample Data Set.

ABSTRACT: Studies have shown an association between attention deficit hyperactivity disorder (ADHD) and suicide; however, it has not been studied from inpatient hospitalization data among adolescents. For this study, data from the National Inpatient Sample data set were used. Based on the diagnosis of ADHD, the patient sample was stratified into two groups. Study group was composed of patients with ADHD, and control group was selected by propensity score matching (1:1), which composed of patients without ADHD. The primary outcome was suicidal ideation/attempt between the groups. Prevalence of SI was 25.1% in patients with ADHD versus 10.3% among patients without ADHD. Prevalence of SA was also very high (8.0% vs 3.9%) among patient with ADHD compared with non-ADHD group. After controlling for covariates, ADHD was a strong predictor of suicidal ideation/attempt with an odds ratio of 2.18. It is important to screen for suicidality in patient with ADHD given the high prevalence of suicidality.

Human Umbilical Cord Blood Infusions in the Management of Autism Spectrum Disorder.

Objective: To provide an overview of the role of umbilical cord blood (UCB) in managing autism spectrum disorder (ASD) symptoms in children aged 4-8 years.Data Sources: A systematic literature search was conducted using the terms (autism OR autism spectrum disorder AND umbilical cord blood infusion UCB OR umbilical cord blood). The review was limited to articles published in the English language from 1945 to September 2020. The database search included PubMed, Scopus, and EMBASE.Study Selection: The initial search revealed 165 hits of potential relevance.Data Extraction: The articles were analyzed to obtain clinical information relevant to meeting the review objectives.Data Synthesis: After title, abstract, and full article review, 3 UCB studies were selected for analysis.Results: The systematic review showed mixed results. In the first study, improvements were seen in the socialization and communication domains and adaptive behavior with UCB infusion. The Pervasive Developmental Disorder Behavior Inventory composite T score and Expressive One-Word Picture Vocabulary Test (EOWPVT) score also improved. Symptomatic improvement was seen in half of the patients. The second study showed no improvement in the EOWPVT, Receptive One-Word Picture Vocabulary Test, Clinical Global Impressions scale, or Vineland Adaptive Behavior Scales (VABS), second edition. The third study showed nonsignificant improvement in the VABS, third edition socialization scale scores; however, major improvement in the communication domain was seen for those with nonverbal IQ ≥ 70. No serious adverse events were reported in any of the studies.Conclusion: Few studies have evaluated the role of UCB infusion in addressing symptoms of ASD. Due to the limited number of studies, more research is warranted.

Risk of Suicide in Patients With Bipolar Disorder Having Comorbid Chronic Pain Disorders: Insights From the Nationwide Inpatient Sample Data From 2016 to 2018.

ABSTRACT: Bipolar disorders (BDs) are associated with significant risk of suicide. BD patients (age ≥18 years) admitted to the hospital were identified from the National Inpatient Sample dataset. Based on the secondary diagnosis of chronic pain disorder (CPD), patients were stratified into two groups (1) BD with CPD (BD + CPD) and (2) BD without CPD (BD - CPD). Groups were matched (1:1) for the type of BD and compared for baseline characteristics and suicidal ideation/attempt (SI/SA). Compared with BD - CPD, most patients in the BD + CPD group were older (mean age, 47.6 vs. 40.4 years), female (58.4% vs. 55.2%), and white (77.2% vs. 66.7%). After adjusting for covariates, compared with the BD - CPD group, the BD + CPD group had 21% more risk of SI/SA (odds ratio, 1.21, p < 0.001). CPD is independently associated with the increased risk of suicide among patients with BD. Thus, comorbid CPD among patients admitted for BD can be an essential risk factor for suicide.

The Association of Psychological Stressors With Cannabis Use During Pregnancy: Findings From the National Survey on Drug Use and Health 2017-2019.

ABSTRACT: Even though marijuana is illegal on the federal level, it is one of the most used drugs in the United States during pregnancy. Our study investigates the relationship between numerous socioeconomic, demographic, and mental health risk variables and substance use during pregnancy. We examined data from the National Survey on Drug Use and Health from 2017 to 2019. Compared with the no serious psychological distress (SPD) group, the odds of using cannabis were higher in pregnant women with past-month SPD. In this study, in comparison with unmarried pregnant women, married pregnant women had a 67% lower chance of currently using cannabis. Racially, Hispanic pregnant women had 3 to 4 times higher odds for current use of cannabis as compared with the other races. Preventing cannabis use and its adverse effects by screening pregnant women could be part of the current strategy for reducing cannabis use.

School-Based Approaches to Prevent Depression in Adolescents.

Depression is one of the highest prevalent mental illnesses and is one of the common illnesses that can have its onset during childhood or adolescence. It is estimated that up to 20% of children experience mental illness worldwide. Preventing the onset of depression in children and adolescents should be a vital public health goal that will improve public health and decrease health care costs. We reviewed literature that described school-based interventions to prevent the onset of depression, reduce the severity of depressive symptoms, and enhance global functioning in adolescents. Our research also provides strategies for school-based intervention programs that are mainly categorized into three main subtypes. We also discussed each subtype and its advantages and limitations. The goal is to bring the readers an understanding of the importance of preventing depression on a community level, beginning at schools.

The Role of Psychological First Aid to Support Public Mental Health in the COVID-19 Pandemic.

Psychological first aid (PFA) is one of the vital tools in delivering psychological interventions to those who have undergone or experienced traumatic events. Traumatic experiences during calamities, outbreaks of infections, and war can induce a significant amount of stress in the absence of early and effective intervention provided by trained caregivers. The coronavirus pandemic has caused significant levels of fear as governments impose quarantine and lockdown to contain the infection. Countries around the globe have halted several social and economic operations to curb the spread of coronavirus disease-19 (COVID-19). However, panic, helplessness, and horror aided by the infection due to the lack of a definitive cure has exposed the population to significant mental distress, thus warranting psychological intervention.

How Essential Is to Focus on Physician's Health and Burnout in Coronavirus (COVID-19) Pandemic?

An infection of novel coronavirus (COVID-19) that originated from Wuhan city of China in December 2019 converted rapidly into pandemic by March 11, 2020. To date, the number of confirmed cases and deaths has risen exponentially in more than 200 countries, with an estimated crude mortality ratio of at least over 2%. The unpreparedness to tackle the unprecedented situation of coronavirus has contributed to the rising number of cases, which has generated an immense sense of fear and anxiety amongst the public. It has further resulted in the inadequacy and unavailability of essential medical supplies, physicians, and healthcare workers (HCW). Although the chief focus is on minimizing transmission through prevention, combating infection, and saving lives by ramping up the development of treatment and vaccines, very little attention is on the critical issue of physician burnout, resident burnout, and the psychological well-being of HCW. Until now, no significant steps have been taken by the authorities to minimize the COVID-19 specific contributing factors for burnout. The COVID-19 has posed strain on the entire healthcare system already, and it is vital to remediate the issue of physician and resident burnout urgently with concrete actions to avoid subsequent potential short-term and long-term adverse implications.

Scaling the great wall: The impact of communication barriers on quality of psychiatric care in Chinese patients.

BACKGROUND: Racial and ethnic minorities (such as Chinese-speaking (CS)) are known to have less equitable access to mental health services than Caucasians. These disparities have a powerful influence on minority groups that already endure a greater burden from mental health needs. AIM: The aim was to identify perceived provider barriers to care for CS patients. METHODS: The study involved an 11-item web-based survey to multidisciplinary health professionals in the department of psychiatry at a 75-bed teaching community mental health center. RESULTS: More than half the respondents agreed that there are disparities in the management of CS versus non-CS patients primarily due to the language barrier (46%). However, older participants and participants who worked fewer hours per week in patient care were less likely to agree (rho = -.27, p = .05 and rho = .33, p = .015, respectively) that these perceived difficulties prevented them from caring for these patients. CONCLUSION: The study revealed that certain modifiable factors like the limited availability of interpreters and culturally appropriate services, rendering psychoeducation and forming therapeutic alliances with CS patients, posed the greatest challenges on inpatient units. In light of these findings, we aim to make recommendations to remediate concerns of limited provider availability by proposing ways to efficiently utilize current resources and advocate for better staffing to improve the overall well-being of this challenging patient subset.