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2.
JAAPA ; 37(5): 1-5, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38662901

RESUMO

ABSTRACT: Work-related injuries can harm mental health and affect other facets of injured workers' lives. Clinicians must be aware of the problem of emotional distress and treat the whole patient after a workplace injury. More education and information are needed for clinicians, employers, and workers' compensation carriers so that injured workers can be properly screened for mental health issues and supported during treatment. Further research is needed to establish a protocol for early intervention to minimize the negative emotional and mental health effects of workplace injuries.


Assuntos
Saúde Mental , Traumatismos Ocupacionais , Indenização aos Trabalhadores , Humanos , Traumatismos Ocupacionais/psicologia , Estresse Psicológico , Local de Trabalho/psicologia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia
3.
Psychother Psychosom Med Psychol ; 74(5): 174-182, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38580309

RESUMO

The mental health of refugees is influenced by a variety of pre-, peri- and postmigratory factors. It remains largely unclear how social determinants influence the utilization of psychiatric-psychotherapeutic treatment. We applied a questionnaire survey to 189 refugees from a clinical sample in a psychiatric hospital and from a control sample, which was not in treatment. The influence of social factors on psychopathology and utilization of care was analyzed by means of a CHAID algorithm. The total sample was highly stressed (54% PTSD and 41.4% depression symptoms). Patients were more severely affected in all psychometric scales as well as in traumatization and they were less able to draw on resources such as a social network or residence permit. The strongest predictor for psychotherapeutic-psychiatric treatment was social isolation in the living environment. For patients, the lack of a work permit was the strongest predictor of depression symptoms. The results point to the importance of postmigratory social determinants for the mental health of refugees. In particular, stable social relationships, together with formal factors such as work permit and residence title, should help to reduce mental distress and the need for psychiatric treatment.


Assuntos
Saúde Mental , Refugiados , Determinantes Sociais da Saúde , Isolamento Social , Humanos , Refugiados/psicologia , Masculino , Feminino , Alemanha , Adulto , Pessoa de Meia-Idade , Isolamento Social/psicologia , Inquéritos e Questionários , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem , Idoso , Depressão/psicologia
4.
Compr Psychiatry ; 132: 152484, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38626596

RESUMO

BACKGROUND: Despite the high prevalence of mental disorders and epilepsy in low- and middle-income countries, nearly 80% of patients are not treated. In Madagascar, initiatives to improve access to epilepsy and mental health care, including public awareness and training of general practitioners (GPs), were carried out between 2013 and 2018. Our study's main objective was to assess the effectiveness of these initiatives, two to five years post-intervention. METHODS: This quasi-experimental study (intervention vs. control areas) included five surveys assessing: general population's Knowledge Attitudes and Practices (KAP), GPs' KAP , number of epilepsy and mental health consultations at different levels of the healthcare system, diagnostic accuracy, and treatments' availability. OUTCOMES: In the general population, KAP scores were higher in intervention areas for epilepsy (11.4/20 vs. 10.3/20; p = 0.003). For mental disorders, regardless of the area, KAP scores were low, especially for schizophrenia (1.1/20 and 0.1/20). Among GPs, KAP scores were higher in intervention areas for schizophrenia (6.0/10 vs. 4.5/10; p = 0.008) and epilepsy (6.9/10 vs. 6.2/10; p = 0.044). Overall, there was a greater proportion of mental health and epilepsy consultations in intervention areas (4.5% vs 2.3%). Although low, concordance between GPs' and psychiatrists' diagnoses was higher in intervention areas. There was a greater variety of anti-epileptic and psychotropic medications available in intervention areas. INTERPRETATION: This research has helped to better understand the effectiveness of initiatives implemented in Madagascar to improve epilepsy and mental health care and to identify barriers which will need to be addressed. FUNDING: Sanofi Global Health, as part of the Fight Against STigma Program.


Assuntos
Epilepsia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Madagáscar/epidemiologia , Epilepsia/terapia , Epilepsia/epidemiologia , Epilepsia/psicologia , Epilepsia/diagnóstico , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Clínicos Gerais/estatística & dados numéricos , Transtornos Mentais/terapia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Acessibilidade aos Serviços de Saúde , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/estatística & dados numéricos
5.
BMC Psychiatry ; 24(1): 256, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575916

RESUMO

BACKGROUND: Severe mental illness (SMI) imposes a substantial worldwide burden of disability, highlighting the need for comprehensive and adaptable mental health services. This study aims to assess the efficacy and cost-effectiveness of community-based mental health services (CBMHS) in reducing relapse and rehospitalization rates among individuals with SMI in Iran. METHOD: A systematic review and meta-analysis were conducted. Medline, EMBASE, ISI, SCOPUS, and ProQuest were searched until December 2022. We focused on randomized controlled trials, quasi-experimental studies, or economic studies related to individuals with SMI. Out of 127 articles, 17 were selected for a full-text review. The primary outcomes were the severity of psychopathology, rehospitalization rates, and the mental health of caregivers. We also examined community-based interventions and their impact on various outcomes. Data extraction and risk of bias assessment were performed, and critical appraisal was conducted using JBI checklists. Meta-analysis was carried out using STATA software. (PROSPERO registration. CRD42022332660). RESULT: Rehospitalization rates among patients who received CBMHS were significantly lower, with an odds ratio of 2.14 (95% CI: 1.44 to 3.19), indicating a 2.14 times lower likelihood than those who received treatment as usual. A reduction in psychopathology accompanied this, SMD: -0.31, 95% CI: -0.49 to -0.13, I2 = 40.23%). Moreover, there was a notable improvement in social skills (SMD: -0.7, 95% CI: -0.98 to -0.44, I2 = 0.00%). The burden on caregivers also decreased (SMD: -0.55, 95% CI: -0.99 to -0.1, I2 = 63.2). The Incremental Cost-Effectiveness Ratio (ICER) for QUALY was acceptable, albeit with a wide range of 613 to 8400 Dollars. CONCLUSION: CBMHS has demonstrated effectiveness and efficiency in Iran as a developing country. Additionally, it shows promise in mitigating the shortage of acute psychiatry beds. Using multiple data collection tools poses a limitation regarding data consolidation and conducting a meta-analysis.


Assuntos
Serviços Comunitários de Saúde Mental , Transtornos Mentais , Humanos , Serviços de Saúde Comunitária , Análise Custo-Benefício , Irã (Geográfico) , Transtornos Mentais/terapia , Transtornos Mentais/psicologia
6.
BMC Public Health ; 24(1): 1157, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38658920

RESUMO

BACKGROUND: It is still unknown whether the mechanisms proposed by the Reserve Capacity Model (RCM) explaining socio-economic health and wellbeing inequities in high income countries can be applied to low-income countries. This study investigates whether different reserve capacities (intra-, inter-personal, and tangible) can explain the association between relative socio-economic position (SEP) and wellbeing outcome measures among Ethiopian women working in Foreign Direct Investment (FDI). METHOD: Using a cross-sectional design, we collected quantitative survey data among 2,515 women working in the apparel and floriculture sectors in Ethiopia, measuring GHQ-12 mental health problems, multi-dimensional wellbeing, relative SEP, psychological capital (PsyCap), social support (emotional and financial social support network), and tangible assets (e.g., owning mobile phone, having access to toilet facilities). We used cluster-adjusted structural equation modelling to test whether PsyCap, social support, and/or tangible assets mediate the association between relative SEP (IV) and GHQ-12 mental health problems and multi-dimensional wellbeing (DVs). RESULTS: PsyCap and the size of the financial support network significantly mediate the socio-economic gradient in both wellbeing outcomes. The size of the emotional social support network shows no association with multi-dimensional wellbeing and shows an unexpected negative association with GHQ-12 mental health problems scores, including a significant mediation effect. Tangible assets show no association with the wellbeing outcome measures and do not mediate socio-economic mental health problems and wellbeing inequities. CONCLUSIONS: The RCM can be applied in low-income countries, although in unexpected ways. Similar to findings from high-income countries, PsyCap and size of the financial social support network show significant mediation effects in explaining mental health problems and wellbeing inequities in Ethiopia. These reserves could therefore serve as a buffer for socio-economic inequities in mental health and wellbeing and can therefore assist in decreasing these inequities for women working in FDI sectors in Ethiopia.


Assuntos
Transtornos Mentais , Apoio Social , Humanos , Feminino , Adulto , Estudos Transversais , Etiópia , Transtornos Mentais/psicologia , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem , Disparidades nos Níveis de Saúde , Saúde Mental/estatística & dados numéricos , Inquéritos e Questionários
7.
Nurse Educ Today ; 138: 106190, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38583345

RESUMO

BACKGROUND: The Strengths Model, a framework grounded in the belief that everyone has an inherent capability to cope with challenges, is designed to support the hopes and aspirations of people with psychiatric disabilities, guiding them toward their desired self-image. The model originally gained attention in the field of social welfare and has since become popular in the field of community mental health. There is an increasing demand for nurses to understand and implement this model in the support they provide. OBJECTIVES: To clarify how implementation of the Strengths Model in nurse education impacts students' perceptions of their clients with psychiatric disabilities. DESIGN: Qualitative descriptive study informed by Grounded Theory. SETTING: Public university nursing practicum. PARTICIPANTS: Sixteen fourth-year students undertaking a practicum using the Strengths Model. METHODS: Semi-structured interviews. RESULTS: The core concept identified was that people with psychiatric disabilities uncover their own inherent strengths. Students began their engagement by listening to clients' dreams and goals. Then, three processes were identified that led to the outcome of students seeing clients in terms of their limitations, while one process was identified that led to the alternate desirable outcome of students developing a sense of respect for clients. CONCLUSIONS: These findings indicate that the process leading to students developing a sense of respect for clients with psychiatric disabilities involved three interrelated factors: students listening to clients' dreams and goals, both parties working together to discover the clients' dreams, and clients uncovering their own inherent strengths and then leveraging them. Incorporating the Strengths Model, which takes a person-centric approach to support the agency of people with psychiatric disabilities, into nurse education has the potential to foster healthcare professionals who respect people with psychiatric disabilities, see them on an equal footing, and consider themselves partners in facilitating the recovery journey.


Assuntos
Bacharelado em Enfermagem , Pesquisa Qualitativa , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Feminino , Bacharelado em Enfermagem/métodos , Masculino , Adulto , Transtornos Mentais/psicologia , Teoria Fundamentada , Percepção , Entrevistas como Assunto , Atitude do Pessoal de Saúde
8.
Am J Mens Health ; 18(2): 15579883241249103, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38686846

RESUMO

Mental illness is difficult to discuss among men due to notions of remaining tough, being a man, and societal expectations. In rural communities this is particularly evident which is further exacerbated by poor health care access. The aim of this study is to understand the lived experiences of men and their significant others when seeking mental health support in rural areas. A qualitative study was conducted using purposeful sampling. Data were collected using semi-structured interviews in rural or regional areas of Australia. Open-ended questions were asked but more questions were developed from the responses given. Data analysis was conducted using thematic analysis. Four key themes emerged. These encompassed triggers and help-seeking caused by stressors such as work, family, and poor physical health, with support seeking from professional or informal supports. The second theme included challenges securing professional support appointments, while the third was centered on access to medication and travel time. Finally, the final theme encompassed relationships being impacted by poor mental health or created insights into the need to seek help. The experiences explored throughout this study highlight that as men are impacted, so too are married or romantic partners and children; however, they are the catalyst for help-seeking. The study further highlights even when men are psychologically prepared to seek help, it may be difficult to do so. Improving access goes beyond mere medical professionals in rural areas and must focus on supporting families and loved ones to support men.


Assuntos
Serviços de Saúde Mental , Pesquisa Qualitativa , População Rural , Humanos , Masculino , Austrália , Adulto , Pessoa de Meia-Idade , Serviços de Saúde Mental/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Entrevistas como Assunto , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Acessibilidade aos Serviços de Saúde , Idoso , Saúde Mental
9.
Front Public Health ; 12: 1342361, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38660361

RESUMO

Background and objective: Adolescents from Latin America and the Caribbean grow up in a context of social inequality, which diminishes their well-being and leads to impaired emotional-cognitive development. To understand the problem, it is important to synthesize the available research about it. This study aims to explore the knowledge about adolescents' mental health in Latin America and the Caribbean exposed to social inequality. Methods: A systematic scoping review was conducted encompassing a search in five databases (Medline, CINAHL, PsycINFO, Scopus, and LILACS) in June 2022. Articles of various typologies were included without time limit. After two rounds of screening, relevant data were manually extracted and synthesized into self-constructed themes using thematic analysis. Results: Out of 8,825 retrieved records, 42 papers were included in the final review, with a predominance of quantitative approaches. The synthesis revealed two main analytical themes: (a) defining social inequality, wherein intersecting inequalities produce discrimination and determine conditions for social vulnerability; (b) social inequality and mental health, which highlights the association between socio-structural difficulties and emotional problems, amplifying vulnerability to mental ill health and poor mental health care. Conclusion: The scientific evidence reveals that social inequality is related to impaired well-being and mental ill health on the one hand and a lack of access to mental health care on the other hand.


Assuntos
Saúde Mental , Fatores Socioeconômicos , Adolescente , Feminino , Humanos , Masculino , Região do Caribe , América Latina , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Saúde Mental/estatística & dados numéricos
10.
J Forensic Leg Med ; 103: 102661, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38461694

RESUMO

As Forensic Psychology continues to expand as an independent field, professionals regularly resort to psychological assessment tools to assess people involved within the justice system. The Personality Assessment Inventory (PAI) is a 344-item, self-report inventory that aims to provide meaningful information for diagnosis and clinical decision-making, specifically relating to psychopathology, personality, and psychosocial environment. Its applicability in forensic settings has been increasingly recognized on account of its benefits in comparison to other self-report inventories (e.g., MMPI-2, MCMI-III), since it includes scales that are relevant to forensic settings (e.g., violence risk levels, psychopathy, substance abuse), and the existence of profile distortion indicators is useful when dealing with highly defensive and/or malingering populations. The goal of this paper is to conduct a thorough review of the PAI's utility in forensic settings, by focusing on the relevant forensic constructs assessed by the PAI (e.g., personality disorders, psychosis, substance abuse, aggression, recidivism risk, and response distortion), as well as its application to offender and inmate populations, intimate partner violence contexts, family law cases, and forensic professionals. Overall, the PAI continues to gather international recognition and its relevance and usefulness in forensic settings is generally accepted and acknowledged.


Assuntos
Determinação da Personalidade , Humanos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Reincidência , Psicologia Forense , Estabelecimentos Correcionais , Prisioneiros/psicologia , Psiquiatria Legal , Inventário de Personalidade , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Agressão , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
11.
Transl Psychiatry ; 14(1): 171, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38555309

RESUMO

There is widespread overlap across major psychiatric disorders, and this is the case at different levels of observations, from genetic variants to brain structures and function and to symptoms. However, it remains unknown to what extent these commonalities at different levels of observation map onto each other. Here, we systematically review and compare the degree of similarity between psychiatric disorders at all available levels of observation. We searched PubMed and EMBASE between January 1, 2009 and September 8, 2022. We included original studies comparing at least four of the following five diagnostic groups: Schizophrenia, Bipolar Disorder, Major Depressive Disorder, Autism Spectrum Disorder, and Attention Deficit Hyperactivity Disorder, with measures of similarities between all disorder pairs. Data extraction and synthesis were performed by two independent researchers, following the PRISMA guidelines. As main outcome measure, we assessed the Pearson correlation measuring the degree of similarity across disorders pairs between studies and biological levels of observation. We identified 2975 studies, of which 28 were eligible for analysis, featuring similarity measures based on single-nucleotide polymorphisms, gene-based analyses, gene expression, structural and functional connectivity neuroimaging measures. The majority of correlations (88.6%) across disorders between studies, within and between levels of observation, were positive. To identify a consensus ranking of similarities between disorders, we performed a principal component analysis. Its first dimension explained 51.4% (95% CI: 43.2, 65.4) of the variance in disorder similarities across studies and levels of observation. Based on levels of genetic correlation, we estimated the probability of another psychiatric diagnosis in first-degree relatives and showed that they were systematically lower than those observed in population studies. Our findings highlight that genetic and brain factors may underlie a large proportion, but not all of the diagnostic overlaps observed in the clinic.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno Bipolar , Transtorno Depressivo Maior , Transtornos Mentais , Esquizofrenia , Humanos , Transtorno Depressivo Maior/genética , Transtorno do Espectro Autista/genética , Transtornos Mentais/genética , Transtornos Mentais/psicologia , Transtorno Bipolar/genética , Transtorno Bipolar/epidemiologia , Esquizofrenia/genética , Esquizofrenia/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
12.
J Psychiatr Res ; 173: 58-63, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38489871

RESUMO

Medical comorbidity, particularly cardiovascular diseases, contributes to high rates of hospital admission and early mortality in people with schizophrenia. The 30 days following hospital discharge represents a critical period for mitigating adverse outcomes. This study examined the odds of successful community discharge among Veterans with schizophrenia compared to those with major affective disorders and those without serious mental illness (SMI) after a heart failure hospital admission. Data for Veterans hospitalized for heart failure were obtained from the Veterans Health Administration (VHA) and Centers for Medicare & Medicaid Services between 2011 and 2019. Psychiatric diagnoses and medical comorbidities were assessed in the year prior to hospitalization. Successful community discharge was defined as remaining in the community without hospital readmission, death, or hospice for 30 days after hospital discharge. Logistic regression analyses adjusting for relevant factors were used to examine whether individuals with a schizophrenia diagnosis showed lower odds of successful community discharge versus both comparison groups. Out of 309,750 total Veterans in the sample, 7377 (2.4%) had schizophrenia or schizoaffective disorder and 32,472 (10.5%) had major affective disorders (bipolar disorder or recurrent major depressive disorder). Results from adjusted logistic regression analyses demonstrated significantly lower odds of successful community discharge for Veterans with schizophrenia compared to the non-SMI (Odds Ratio [OR]: 0.63; 95% Confidence Interval [CI]: 0.60, 0.66) and major affective disorders (OR: 0.65, 95%; CI: 0.62, 0.69) groups. Intervention efforts should target the transition from hospital to home in the subgroup of Veterans with schizophrenia.


Assuntos
Transtorno Depressivo Maior , Insuficiência Cardíaca , Transtornos Mentais , Esquizofrenia , Veteranos , Idoso , Humanos , Estados Unidos/epidemiologia , Esquizofrenia/epidemiologia , Esquizofrenia/terapia , Alta do Paciente , Veteranos/psicologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Estudos Retrospectivos , Medicare , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Hospitalização
13.
BMJ Open ; 14(2): e078091, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38413156

RESUMO

BACKGROUND: The burden of common mental disorders in low and middle-income countries (LMICs) is growing with little known about how to allocate limited resources to reach the greatest number of people undergoing instances of significant psychological distress. We present a study protocol for a multicentre, parallel-group, superiority, randomised controlled trial. METHODS AND ANALYSIS: Adults with significant psychological distress (K10 score ≥20) will be randomised to receive a stepped care programme involving a self-guided course (Doing What Matters) followed by a more intensive group programme (Problem Management Plus) or the self-guided course alone, both of which will take place in addition to enhanced treatment as usual comprising of a follow-up referral session to available services within the community. We will include 800 participants. An intent-to-treat and completer analysis will explore the impact of the stepped model of care on anxiety and depression symptoms (as measured by the Hopkins Symptom Checklist; HSCL-25) at 24 weeks from baseline. Secondary outcomes include positive psychological well-being, agency, changes in patient-identified problems, quality of life and cost-effectiveness. Linear mixed models will be used to assess the differential impact of the conditions over time. Analyses will focus on the primary outcome (HSCL-25) and secondary outcomes (agency subscale, WHO Well-Being Index, WHO Disability Assessment Schedule V.2.0, EQ-5D, Psychological Outcomes Profiles Scale) for both conditions, with the main outcome time point being the 3-month follow-up, relative to baseline. ETHICS AND DISSEMINATION: This will be the first randomised controlled trial to assess the benefits of a stepped model of care to addressing psychological distress in a LMIC setting. Results will provide important insights for managing limited resources to mental healthcare in these settings and will be accordingly disseminated to service providers and organisations via professional training and meetings, and via publication in relevant journals and conference presentations. We will also present these findings to the Jordanian Ministry of Health, where this institute will guide us on the most appropriate format for communication of findings, including written reports, verbal presentations and/or brochures. Ethical approval was obtained from the University of Jordan School of Nursing Research Ethics Committee (number: PF.22.10). TRIAL REGISTRATION NUMBER: ACTRN12621000189820p; Australian New Zealand Clinical Trials Registry.


Assuntos
Transtornos Mentais , Qualidade de Vida , Adulto , Humanos , Análise Custo-Benefício , Aconselhamento , Jordânia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Psychiatr Prax ; 51(4): 209-215, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38359870

RESUMO

OBJECTIVE: To investigate variations in intended utilization in cases of an acute psychotic episode, an alcohol related or depressive disorder depending on different case characteristics. METHODS: A telephone survey with case vignettes was conducted (N=1,200). Vignettes varied in terms of urgency of symptoms, daytime, sex of the afflicted person and age/mental disorder. The respondents were asked to indicate whom they would contact first in the described case. RESULTS: Outpatient physicians were named most frequently as the first point of contact (61.1%) while only 6.5% of the respondents named emergency medicine including the medical on call service (8.1% in high urgency cases, i. e. emergencies that did not tolerate any delay). Intended utilization varied by urgency and age/mental illness. CONCLUSION: More Information about the need to seek medical help immediately in cases of mental illnesses with high urgency should be provided.


Assuntos
Transtorno Depressivo , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Alemanha , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/diagnóstico , Transtornos Psicóticos/terapia , Transtornos Psicóticos/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Alcoolismo/terapia , Revisão da Utilização de Recursos de Saúde/estatística & dados numéricos , Idoso , Adulto Jovem , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Adolescente , Programas Nacionais de Saúde/estatística & dados numéricos , Serviços de Emergência Psiquiátrica/estatística & dados numéricos
15.
Kurume Med J ; 69(3.4): 159-165, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38233184

RESUMO

BACKGROUND: Although the therapeutic relationship (or 'alliance') is well known to be a key component of psychiatric treatment, there has been no simple way to objectively measure the patient-therapist relationship. Here, we measured the psychological distance between patients and their therapists by using the Pictorial Representation of Illness and Self Measure (PRISM). PATIENTS AND METHODS: We analyzed the patient-therapist relationship of 112 patients from two hospitals in Japan (54 males, 57 females, 1 unknown; age 46.20 ± 15.03 years [mean ± SD]) who completed the PRISM and self report questionnaires (LSNS-6, K6, and BASIS-32) about their social network, psychological distress, and outcomes of mental health treatment. RESULTS: PRISM measurements were available for all patients who consented to participate. In the comparison by disease category, schizophrenia recorded the closest distance to the psychiatrist in charge, followed by bipolar disorder, depression, and neurotic disorder. Regarding the distance to the psychiatrist in charge, PRISM showed a weak negative correlation (r = -0.23, p < 0.05) with age, indicating that with increasing age, the therapeutic rela tionship was more important to the patients. CONCLUSION: Our findings indicate the possibility of implementing PRISM to assess the impact of the therapeutic relationship in patients with a wide range of psychiatric disorders, and they suggest that PRISM holds great potential for clinical application.


Assuntos
Transtornos Mentais , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Projetos Piloto , Adulto , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Transtornos Mentais/diagnóstico , Japão , Inquéritos e Questionários , Idoso , Relações Profissional-Paciente , Autorrelato
18.
Assessment ; 31(2): 502-517, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37042304

RESUMO

Data aggregation in mental health is complicated by using different questionnaires, and little is known about the impact of item harmonization strategies on measurement precision. Therefore, we aimed to assess the impact of various item harmonization strategies for a target and proxy questionnaire using correlated and bifactor models. Data were obtained from the Brazilian High-Risk Study for Mental Conditions (BHRCS) and the Healthy Brain Network (HBN; N = 6,140, ages 5-22 years, 39.6% females). We tested six item-wise harmonization strategies and compared them based on several indices. The one-by-one (1:1) expert-based semantic item harmonization presented the best strategy as it was the only that resulted in scalar-invariant models for both samples and factor models. The between-questionnaires factor correlation, reliability, and factor score difference in using a proxy instead of a target measure improved little when all other harmonization strategies were compared with a completely at-random strategy. However, for bifactor models, between-questionnaire specific factor correlation increased from 0.05-0.19 (random item harmonization) to 0.43-0.60 (expert-based 1:1 semantic harmonization) in BHRCS and HBN samples, respectively. Therefore, item harmonization strategies are relevant for specific factors from bifactor models and had little impact on p-factors and first-order correlated factors when the child behavior checklist (CBCL) and strengths and difficulties questionnaire (SDQ) were harmonized.


Assuntos
Transtornos Mentais , Psicopatologia , Criança , Feminino , Humanos , Adolescente , Masculino , Reprodutibilidade dos Testes , Psicometria , Saúde Mental , Inquéritos e Questionários , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia
19.
Int J Soc Psychiatry ; 70(1): 166-181, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37740657

RESUMO

INTRODUCTION: Social determinants of health (SDH) influence and modify the risk for mental health disorders. To our knowledge, no study has explored SDH in the context of mental health in Saudi Arabia (SA) using population-based data. This study investigated the association between several SDH and anxiety and mood disorders in SA. METHODS: We utilized data from the nationally-representative Saudi National Mental Health Survey (SNMHS) conducted in 2014 to 2016. This study examined associations between personal-level, socioeconomic, physical health, and family environment characteristics and anxiety and mood disorders. Participants were classified as having anxiety-only disorders, mood-only disorders, or comorbidity of both disorders. Multinomial logistic regression models were employed to examine the associations between SDH and anxiety and/or mood disorders, comparing them to participants who had not experienced these disorders. RESULTS: A total of 4,004 participants were included in this analysis; the lifetime prevalence of disorders was: anxiety only (18%), mood only (3.8%), and comorbidity of both (5.3%). Regression models indicated that females, young adults (26-35 years), individuals with a higher level of education, and those who were separated or widowed had higher odds of experiencing anxiety and/or mood disorders. Furthermore, there was a significant and direct association between having physical chronic conditions and all three categories of anxiety and mood disorders. Experiencing Adverse Childhood Events (ACEs) was also associated with a significant risk of developing anxiety and/or mood disorders, with the highest risk associated with physical or sexual abuse, followed by violence and neglect. CONCLUSION: This study underscores the correlation between several personal-level, socioeconomic, and environmental SDH and anxiety and mood disorders in SA. These findings provide a foundation for future analyses examining the intricate interplay between upstream and downstream SDH in SA. Such research can enhance local scientific knowledge, aid in planning for social services, and inform policy decisions and treatment strategies.


Assuntos
Transtornos Mentais , Transtornos do Humor , Feminino , Adulto Jovem , Humanos , Criança , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Determinantes Sociais da Saúde , Arábia Saudita/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Ansiedade , Inquéritos Epidemiológicos
20.
Occup Med (Lond) ; 73(9): 528-531, 2023 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-37967382

RESUMO

BACKGROUND: Unemployment is a structural inequality which raises the risk of premature deaths among people with mental illness. AIMS: This study examined whether UK National Health Service (NHS) patients with mental illness get support to find or keep a job because reducing unemployment rates can reduce the risk of premature mortality. METHODS: This study analysed recently released data from 54 NHS trusts which randomly sampled patients for a Care Quality Commission survey. This study assessed 11 001 working-age patients with mental illness, of whom 50% are long-term service users (6+ years). RESULTS: Perceived access to occupational support was poor with 46% of patients who wanted the support saying that they did not get help finding or returning to work. Perceived occupational support for physical co-morbidities needed improvement because 40% of patients with physical co-morbidities did not receive support for physical health needs. Twenty-five per cent said that medication side effects were not discussed, and 24% lacked medication follow-up although 87% of patients found medication beneficial to their mental health. Occupational support significantly benefited overall patient satisfaction to an equivalent extent as the main treatment (i.e. receiving medication and talking therapies), and it was a more consistent predictor of patient satisfaction than talking therapies. CONCLUSIONS: Improved access to schemes which reduce unemployment among NHS patients with mental illness is needed (e.g. individual placement and support programmes), although limited availability might be due to funding constraints. As well as addressing unemployment, occupational support should address other risk factors for premature mortality, for example, poverty, stigma, discrimination and social exclusion.


Assuntos
Transtornos Mentais , Medicina Estatal , Humanos , Criança , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Saúde Mental , Desemprego , Reabilitação Vocacional
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