Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

scholarly journals Implementation of stepped care for patients with chronic fatigue syndrome in community-based mental health care: outcomes at post-treatment and long-term follow-up

2019 ◽  
Vol 47 (5) ◽  
pp. 548-558 ◽  
Author(s):  
Anthonie Janse ◽  
Arno van Dam ◽  
Coby Pijpers ◽  
Jan F. Wiborg ◽  
Gijs Bleijenberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Fatigue ◽  
Post Treatment ◽  
Stepped Care ◽  
Community Based ◽  
Fatigue Syndrome ◽  
Specialist Centre ◽  
Long Term Follow Up

AbstractBackground:Cognitive behavioural therapy (CBT) is an evidence-based treatment for chronic fatigue syndrome (CFS). Stepped care for CFS, consisting of a minimal intervention followed by face-to-face CBT, was found efficacious when tested in a CFS specialist centre. Stepped care implemented in a community-based mental health centre (MHC) has not yet been evaluated.Aims:(1) To test the effectiveness of stepped care for CFS implemented in a MHC at post-treatment and at long-term follow-up; and (2) compare post-treatment outcomes of implemented stepped care with treatment outcomes of a CFS specialist centre.Method:An uncontrolled study was used to test effectiveness of stepped care implemented in a MHC (n = 123). The outcomes of implemented care were compared with the outcomes of specialist care reported in previous studies (n = 583). Data on outcomes from implemented stepped care were gathered at post-treatment and at long-term follow-up. Mixed models were used as method of analysis.Results:Fatigue decreased and physical functioning increased significantly following implemented stepped care (both p < .001). The follow-up was completed by 94 patients (78%) within 1–6 years after treatment. Treatment effects were sustained to follow-up. Patients in the MHC showed less improvement directly following stepped care compared with patients in a CFS specialist centre (p < .01).Conclusion:Implemented stepped care for CFS is effective with sustained treatment gains at long-term follow-up. There is room for improvement when compared with outcomes of a CFS specialist centre. Some suggestions are made on how to improve stepped care.

scholarly journals Readmission after discharge from a medium secure unit

2013 ◽  
Vol 37 (4) ◽  
pp. 124-129 ◽  
Author(s):  
Martin Clarke ◽  
Conor Duggan ◽  
Clive R. Hollin ◽  
Nick Huband ◽  
Lucy McCarthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Hospital ◽  
Psychiatric Hospitals ◽  
Patient Treatment ◽  
Multiple Sources ◽  
Long Term Follow Up ◽  
Secure Unit

Aims and methodWe examined readmission to psychiatric hospital of 550 patients discharged from one medium secure unit over 20 years. Multiple sources were used to obtain readmission data.ResultsReadmission was common, particularly to non-secure psychiatric hospitals. At least 339 patients (61.6%) were readmitted to any psychiatric hospital (mean follow-up 9.5 years), with over a third (37.6%) subsequently being readmitted to medium- or high-security or both. Of those discharged directly to the community, having previous in-patient treatment and a Mental Health Act classification of mental illness were associated with shorter time to first readmission.Clinical implicationsThe long-standing nature of disorders is evident in the high rates of readmission overall and the need for readmission to medium and high secure services, suggesting that these patients require long-term follow-up and support from mental health services.

scholarly journals The Woodlawn mental health studies: tracking children and families for long-term follow-up.

1978 ◽  
Vol 68 (2) ◽  
pp. 139-142 ◽  
Author(s):  
K C Agrawal ◽  
S G Kellam ◽  
Z E Klein ◽  
J Turner
Keyword(s):  
Mental Health ◽  
Children And Families ◽  
Long Term Follow Up ◽  
Health Studies

scholarly journals Long-Term Follow-Up of Cognition and Mental Health in Adult Phenylketonuria: A PKU-COBESO Study

2017 ◽  
Vol 47 (5) ◽  
pp. 486-497 ◽  
Author(s):  
Rianne Jahja ◽  
Francjan J. van Spronsen ◽  
Leo M. J. de Sonneville ◽  
Jaap J. van der Meere ◽  
Annet M. Bosch ◽  
...  
Keyword(s):  
Mental Health ◽  
Long Term Follow Up

Mastectomy versus breast conservation surgery: Mental health effects at long-term follow-up.

1992 ◽  
Vol 11 (6) ◽  
pp. 349-354 ◽  
Author(s):  
Sandra M. Levy ◽  
Lathrop T. Haynes ◽  
Ronald B. Herberman ◽  
Jerry Lee ◽  
Sheila McFeeley ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Effects ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Conservation Surgery ◽  
Long Term Follow Up ◽  
Mental Health Effects

scholarly journals Psychotropic drugs in patients with Cushing’s disease before diagnosis and at long-term follow-up - a nationwide study

2021 ◽  
Author(s):  
Daniel Bengtsson ◽  
Oskar Ragnarsson ◽  
Katarina Berinder ◽  
Per Dahlqvist ◽  
Britt Edén Engström ◽  
...  
Keyword(s):  
Mental Health ◽  
Cushing’S Disease ◽  
Psychotropic Drugs ◽  
Psychiatric Morbidity ◽  
Cushing's Disease ◽  
Sustained Remission ◽  
Sleeping Pills ◽  
Long Term Follow Up

Abstract Context Psychiatric symptoms are common in Cushing’s disease (CD) and seem only partly reversible following treatment. Objective To investigate drug dispenses associated to psychiatric morbidity in CD patients before treatment and during long-term follow-up. Design Nationwide longitudinal register-based study. Setting University Hospitals in Sweden. Subjects CD patients diagnosed between 1990 and 2018 (N=372) were identified in the Swedish Pituitary Register. Longitudinal data was collected from 5 years before, at diagnosis and during follow-up. Four matched controls per patient were included. Cross-sectional subgroup analysis of 76 patients in sustained remission was also performed. Main outcome measures Data from the Swedish Prescribed Drug Register and the Patient Register. Results In the 5-year period before, and at diagnosis, use of antidepressants (OR 2.2[95%CI 1.3-3.7] and 2.3[1.6-3.5]), anxiolytics (2.9[1.6-5.3] and 3.9[2.3-6.6]) and sleeping pills (2.1[1.2-3.7] and 3.8[2.4-5.9]) was more common in CD than controls. ORs remained elevated at 5-year follow-up for antidepressants (2.4[1.5-3.9]) and sleeping pills (3.1[1.9-5.3]). Proportions of CD patients using antidepressants (26%) and sleeping pills (22%) were unchanged at diagnosis and 5-year follow-up, whereas drugs for hypertension and diabetes decreased. Patients in sustained remission for median 9.3 years (IQR 8.1-10.4) had higher use of antidepressants (OR 2.0[1.1-3.8]) and sleeping pills (2.4[1.3-4.7]), but not of drugs for hypertension. Conclusions Increased use of psychotropic drugs in CD was observed before diagnosis and remained elevated regardless of remission status, suggesting persisting negative effects on mental health. The study highlights the importance of early diagnosis of CD, and the need for long-term monitoring of mental health.

301: Prenatal omega-3 supplementation and risk of eczema among offspring at age 36 months: long-term follow-up of the mothers, omega-3, & mental health trial

2015 ◽  
Vol 212 (1) ◽  
pp. S162 ◽  
Author(s):  
Deborah Berman ◽  
Rachel Limb ◽  
Emily Somers ◽  
Chelsea Clinton ◽  
Vivian Romero ◽  
...  
Keyword(s):  
Mental Health ◽  
Omega 3 ◽  
Long Term Follow Up

Self and informant reports of mental health difficulties among adults with autism findings from a long-term follow-up study

Autism ◽  
2015 ◽  
Vol 19 (7) ◽  
pp. 832-841 ◽  
Author(s):  
Philippa Moss ◽  
Patricia Howlin ◽  
Sarah Savage ◽  
Patrick Bolton ◽  
Michael Rutter
Keyword(s):  
Mental Health ◽  
Adults With Autism ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Mental Health Difficulties
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