Integrating smartwatches in community mental health services for severe mental illness for detecting relapse and informing future intervention: A case series.

OBJECTIVE: This case series explored the integration of smartwatches in a community mental health service to support severe mental illness (SMI) management and intervention. We examined whether biometric data provided by smartwatches could help to predict relapse and inform treatment decisions. METHOD: Four Australian SMI outpatients of mixed diagnoses (age range = 19-24) were selected from a prior study. Clinicians accessed patients' biometric data (activity, sleep, heart rate, and electrodermal activity) through smartwatches. RESULTS: Changes in circadian rhythm and electrodermal activity preceded hospitalization in two cases. Additionally, smartwatch data was effectively used to guide targeted interventions, improving patient treatment outcomes. CONCLUSION: Integrating smartwatches in community mental health services offers promise as adjunct tools for SMI management. However, ethical considerations on data privacy and technology reliance require further evaluation. Additionally, as this is a small case series, randomized controlled trials with larger sample sizes are required to provide evidence for generalisability of results.

Outcomes for young people in out of home care accessing tiered mental health services in Sydney, Australia.

Young people in OOHC have complex mental health concerns, therefore the South Western Sydney Local Health District (SWSLHD) has trialled a tiered model of mental health care. Under this model the OOHC mental health team (OOHC-MHT) provides specialist tier four service delivery for those with the most severe, intense mental health needs. OOHC consumers with a reduced level of severity access services at a tier three centre-based iCAMHS. This study aims to understand the characteristics of young people in OOHC accessing different service provision options in Sydney, Australia. Sixty-six OOHC consumers 8-17 years accessing mental health services across SWSLHD from January 2020-December 2021 participated in the study. Group differences in OOHC-MHT and iCAMHS outcome measures were compared. HoNOSCA scores were significantly worse for OOHC-MHT than iCAMHS, indicating more severe psychopathology for OOHC-MHT at baseline. In OOHC-MHT, HoNOSCA decreased significantly from admission to discharge and scores on the CGAS increased significantly, indicating significant improvements in psychopathology and functioning. In the iCAMHS group scores on the HoNOSCA significantly decreased indicating improved psychopathology over this period. These findings support a tiered model of service delivery for OOHC consumers, with this tailored level of care resulting in significantly improved outcomes across a range of complexity.

General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis.

Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g = 0.48, 95% CI 0.35-0.60, p < 0.01) compared with control conditions. This effect was moderated by recovery stage (p < 0.01), study quality (p = 0.04), and dose (p = 0.04), but not CR approach (p = 0.63). Significant small to medium (g = 0.25-0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g = 0.27, 95% CI 0.04-0.51, p = 0.02) of CR persisted at follow-up (range 2-52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.

Activating Attachments Reduces Memories of Traumatic Images.

Emotional memories, and especially intrusive memories, are a common feature of many psychological disorders, and are overconsolidated by stress. Attachment theory posits that activation of mental representations of attachment figures can reduce stress and boost coping. This study tested the proposition that attachment activation would reduce consolidation of emotional and intrusive memories. Sixty-seven undergraduate students viewed subliminal presentations of traumatic and neutral images, which were preceded by subliminal presentations of either attachment-related images or non-attachment-related images; free recall and intrusive memories were assessed two days later. Participants with low avoidant attachment tendencies who received the attachment primes recalled fewer memories and reported fewer intrusions than those who received the non-attachment primes. Unexpectedly, those with high anxious attachment tendencies reported fewer memories. These findings generally accord with attachment theory, and suggest that consolidation of emotional memories can be moderated by activation of attachment representations.