scholarly journals Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

2020 ◽  
Vol 29 ◽  
Author(s):  
Henry J. Whittle ◽  
William R. Wolfe ◽  
Lila A. Sheira ◽  
Edward A. Frongillo ◽  
Kartika Palar ◽  
...  
Keyword(s):  
Mental Health ◽  
Food Insecurity ◽  
Psychotropic Medication ◽  
Medication Use ◽  
The United States ◽  
Psychotropic Medications ◽  
Structural Factors ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Living With Hiv

Abstract Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. Methods We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). Results Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose–response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36–3.13) and 1.99 (p < 0.01; 95% CI = 1.26–3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16–3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19–0.96). Conclusions Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.

scholarly journals Correlates of Pain, Opioid Use, and Psychotropic Medications Among Older African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 785-786
Author(s):  
Sharon Cobb ◽  
Mohsen Bazargan ◽  
Shervin Assari
Keyword(s):  
Mental Health ◽  
African Americans ◽  
Psychotropic Medication ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Mental Health Crisis ◽  
Opioid Use ◽  
Health Crisis ◽  
Older African Americans

Abstract Unrecognized and undertreated pain among older African Americans (AAs) is well-documented. This study explored the link between social, behavioral, and health correlates of pain and psychotropic as well as opioid-based medications in a sample of underserved 740 AA older adults. Almost 16% and 17% of participants used at least one psychotropic and opioid-based medications, respectively. Of those who use opioid-based medications, 73% used opioids only, 28% used opioids and at least one psychotropic medication. Use of opioid or psychotropic medications were associated with increased polypharmacy. Multivariate analysis showed different types of pain are predictors of opioid use, however, depressive symptoms and level of pain were associated with use of psychotropic medication. Moreover, the relationship of pain and psychotropic medications warrants more study due to emerging mental health crisis. These findings underscore the need for optimal concurrent management of pain and mental health for older AAs with potential inappropriate medication use.

scholarly journals Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States

2019 ◽  
Vol 149 (2) ◽  
pp. 240-248 ◽  
Author(s):  
Emily L Tuthill ◽  
Lila A Sheira ◽  
Kartika Palar ◽  
Edward A Frongillo ◽  
Tracey E Wilson ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
At Risk ◽  
Depressive Symptoms ◽  
Food Insecurity ◽  
Well Being ◽  
The United States ◽  
Depression Score ◽  
Living With Hiv ◽  
Mental Well Being

Abstract Background Food insecurity and mental health negatively affect the lives of women in the United States. Participants in the Women's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time. Objective We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States. Methods We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States. Participants completed 6 semiannual assessments from 2013 to 2016 on food security (FS; high, marginal, low, and very low) and mental health (i.e., depressive symptoms and mental well-being). We used multiple regression analysis to estimate the association between these variables. Results Among 2551 participants, 44% were food insecure and 35% reported depressive symptoms indicative of probable depression. Current marginal, low, and very low FS were associated with 2.1-, 3.5-, and 5.5-point (all P < 0.001) higher depression scores, respectively. In models adjusting for both current and previous FS, previous marginal, low, and very low FS were associated with 0.2-, 0.93-, and 1.52-point higher scores, respectively (all P < 0.001). Women with very low FS at both time points (persistent food insecurity) had a 6.86-point higher depression score (P < 0.001). In the mental health models, there was a dose-response relation between current FS and worse mental health even when controlling for previous FS (all P < 0.001). Previous low FS was associated with worse mental health. These associations did not differ by HIV status. Conclusions Food insecurity placed women at risk of depression and poor mental well-being, but the risk was substantially higher for women experiencing persistent food insecurity. Future interventions to improve women's mental health call for multilevel components that include addressing food insecurity.

scholarly journals Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

2021 ◽  
pp. 003335492110186
Author(s):  
David H. Chae ◽  
Tiffany Yip ◽  
Connor D. Martz ◽  
Kara Chung ◽  
Jennifer A. Richeson ◽  
...  
Keyword(s):  
Mental Health ◽  
Asian American ◽  
Mental Health Problems ◽  
Black Americans ◽  
The United States ◽  
Racial Group ◽  
Depression And Anxiety ◽  
Linear Regression Models ◽  
Symptoms Of Depression ◽  
Increased Risk

Objectives Experiences of vicarious racism—hearing about racism directed toward one’s racial group or racist acts committed against other racial group members—and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. Methods We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. Results Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]). Conclusions Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

HSR19-103: Burden of Self-Reported Mental Health Among Women With Cervical Cancer (CC) in the United States

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-103
Author(s):  
Chizoba Nwankwo ◽  
Michael J. Doane
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Propensity Score ◽  
Health Services ◽  
The United States ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
The Past ◽  
Patient Reported

Background: Globally, CC is the fourth most common cancer in women, with 569,847 new cases and 311,365 deaths from CC reported in 2018. Little is known about the burden of living with CC, especially related to mental health. This study examined patient-reported outcomes, including symptoms of depression and anxiety, amongst women with and without a diagnosis of CC. Methods: Data were aggregated from the 2016–2018 U.S. National Health and Wellness Surveys, a nationally representative, self-administered, internet-based survey of adults (N=247,484). Women who reported a physician-diagnosis of CC were matched 1:1 by propensity scores to a sample of women who did not report any cancer diagnoses. Propensity score matching was conducted using the following sociodemographic characteristics: age, race, possession of health insurance, smoking status, comorbidity status, body mass index, income, and year of survey completion. Bivariate analyses (ie, chi-square and t-tests) assessed differences in mental health outcomes between these 2 matched groups of female respondents. Outcomes included the following: (1) depressive severity via the Patient Health Questionnaire (PHQ-9), (2) suicidal ideation via the PHQ-9 (ie, thoughts of being better off dead on several days or more during the past 2 weeks), (3) anxiety severity via the Generalized Anxiety Disorder 7-Item Scale (GAD-7), and (4) healthcare resource use for mental health services (ie, visits to psychologists and psychiatrists during past 6 months). Results: Analyses of the propensity score matched sample of 1,044 women with a CC diagnosis versus 1,044 without a CC diagnosis showed that CC respondents reported significantly more severe scores of both depression (7.3 vs 6.0; P<.001) and anxiety (5.7 vs 4.7; P<.001). Although not statistically significant, a numerically greater proportion of CC respondents reported suicidal ideation during the past 2 weeks (19.0% vs 16.0%; P=.158). Respondents with CC were marginally more likely to visit a psychologist (8.6% vs 6.4%; P=.056) and were significantly more likely to visit a psychiatrist (8.6% vs 6.2%; P=.037) at least once during the prior 6 months than respondents without CC. Conclusions: CC is associated with mental health burden, including more severe symptoms of depression and anxiety as well as greater use of mental health services. This study highlights the likely impact of CC for both patients as well as the healthcare system

scholarly journals Rise in Use of Digital Mental Health Tools and Technologies in the United States During the COVID-19 Pandemic: Survey Study (Preprint)

2021 ◽  
Author(s):  
Dara H Sorkin ◽  
Emily A Janio ◽  
Elizabeth V Eikey ◽  
Margaret Schneider ◽  
Katelyn Davis ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Clinical Depression ◽  
Depression And Anxiety ◽  
Logistic Regression Models ◽  
Symptoms Of Depression ◽  
Time Point

BACKGROUND Accompanying the rising rates of reported mental distress during the COVID-19 pandemic has been a reported increase in the use of digital technologies to manage health generally, and mental health more specifically. OBJECTIVE The objective of this study was to systematically examine whether there was a COVID-19 pandemic–related increase in the self-reported use of digital mental health tools and other technologies to manage mental health. METHODS We analyzed results from a survey of 5907 individuals in the United States using Amazon Mechanical Turk (MTurk); the survey was administered during 4 week-long periods in 2020 and survey respondents were from all 50 states and Washington DC. The first set of analyses employed two different logistic regression models to estimate the likelihood of having symptoms indicative of clinical depression and anxiety, respectively, as a function of the rate of COVID-19 cases per 10 people and survey time point. The second set employed seven different logistic regression models to estimate the likelihood of using seven different types of digital mental health tools and other technologies to manage one’s mental health, as a function of symptoms indicative of clinical depression and anxiety, rate of COVID-19 cases per 10 people, and survey time point. These models also examined potential interactions between symptoms of clinical depression and anxiety, respectively, and rate of COVID-19 cases. All models controlled for respondent sociodemographic characteristics and state fixed effects. RESULTS Higher COVID-19 case rates were associated with a significantly greater likelihood of reporting symptoms of depression (odds ratio [OR] 2.06, 95% CI 1.27-3.35), but not anxiety (OR 1.21, 95% CI 0.77-1.88). Survey time point, a proxy for time, was associated with a greater likelihood of reporting clinically meaningful symptoms of depression and anxiety (OR 1.19, 95% CI 1.12-1.27 and OR 1.12, 95% CI 1.05-1.19, respectively). Reported symptoms of depression and anxiety were associated with a greater likelihood of using each type of technology. Higher COVID-19 case rates were associated with a significantly greater likelihood of using mental health forums, websites, or apps (OR 2.70, 95% CI 1.49-4.88), and other health forums, websites, or apps (OR 2.60, 95% CI 1.55-4.34). Time was associated with increased odds of reported use of mental health forums, websites, or apps (OR 1.20, 95% CI 1.11-1.30), phone-based or text-based crisis lines (OR 1.20, 95% CI 1.10-1.31), and online, computer, or console gaming/video gaming (OR 1.12, 95% CI 1.05-1.19). Interactions between COVID-19 case rate and mental health symptoms were not significantly associated with any of the technology types. CONCLUSIONS Findings suggested increased use of digital mental health tools and other technologies over time during the early stages of the COVID-19 pandemic. As such, additional effort is urgently needed to consider the quality of these products, either by ensuring users have access to evidence-based and evidence-informed technologies and/or by providing them with the skills to make informed decisions around their potential efficacy.

A fully automated conversational agent with artificial intelligence capabilities (Youper) for treating depression and anxiety: A nonrandomized feasibility trial (Preprint)

2019 ◽  
Author(s):  
Jose Hamilton Vargas ◽  
Thiago Antonio Marafon ◽  
Diego Fernando Couto ◽  
Ricardo Giglio ◽  
Marvin Yan ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Financial Incentives ◽  
Empirical Support ◽  
Digital Technologies ◽  
Feasibility Trial ◽  
Depression And Anxiety ◽  
Conversational Agents ◽  
Symptoms Of Depression ◽  
Viable Solution

BACKGROUND Mental health conditions, including depression and anxiety disorders, are significant global concerns. Many people with these conditions don't get the help they need because of the high costs of medical treatment and the stigma attached to seeking help. Digital technologies represent a viable solution to these challenges. However, these technologies are often characterized by relatively low adherence and their effectiveness largely remains empirical unverified. While digital technologies may represent a viable solution for this persisting problem, they often lack empirical support for their effectiveness and are characterized by relatively low adherence. Conversational agents using artificial intelligence capabilities have the potential to offer a cost-effective, low-stigma and engaging way of getting mental health care. OBJECTIVE The objective of this study was to evaluate the feasibility, acceptability, and effectiveness of Youper, a mobile application that utilizes a conversational interface and artificial intelligence capabilities to deliver cognitive behavioral therapy-based interventions to reduce symptoms of depression and anxiety in adults. METHODS 1,012 adults with symptoms of depression and anxiety participated in a real-world setting study, entirely remotely, unguided and with no financial incentives, over an 8-week period. Participants completed digital versions of the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7) at baseline, 2, 4, and 8 weeks. RESULTS After the eight-week study period, depression (PHQ-9) scores of participants decreased by 48% while anxiety (GAD-7) scores decreased by 43%. The RCI was outside 2 standard deviations for 93.0% of the individuals in the PHQ-9 assessment and 90.7% in the GAD-7 assessment. Participants were on average 24.79 years old (SD 7.61) and 77% female. On average, participants interacted with Youper 0.9 (SD 1.56) times per week. CONCLUSIONS Results suggest that Youper is a feasible, acceptable, and effective intervention for adults with depression and anxiety. CLINICALTRIAL Since this study involved a nonclinical population, it wasn't registered in a public trials registry.

scholarly journals Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic

2021 ◽  
Vol 7 ◽  
pp. 237796082110242
Author(s):  
Anna E. Schierberl Scherr ◽  
Brian J. Ayotte ◽  
Marni B. Kellogg
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Online Survey ◽  
Psychological Symptoms ◽  
The United States ◽  
Direct Care ◽  
Behavioral Measure ◽  
Hierarchical Regression ◽  
Research Reporting ◽  
Symptoms Of Depression

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.

scholarly journals Association between food insecurity and access to a mental health professional: cross-sectional analysis of NHANES 2007–2014

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Camille Burruss ◽  
Marina Girgis ◽  
Karen Elizabeth Green ◽  
Lingyi Lu ◽  
Deepak Palakshappa
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Food Insecurity ◽  
Mental Health Professional ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The Past ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Abstract Background To determine if individuals with food insecurity (FI) were less likely to have seen a mental health professional (MHP) within the past year than individuals without FI. Methods This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 2007 and 2014. All participants 20 years of age or older were eligible for this study. We excluded participants who were pregnant, missing FI data, or missing data from the Patient Health Questionnaire (PHQ-9). The primary outcome was self-reported contact with a MHP in the past 12 months. We used multivariable logistic regression models to test the association between FI and contact with a MHP, controlling for all demographic and clinical covariates. Results Of the 19,789 participants, 13.9% were food insecure and 8.1% had major depressive disorder (MDD). In bivariate analysis, participants with FI were significantly more likely to have MDD (5.3% vs 2.8%, p < 0.0001) and to have been seen by a MHP in the preceding 12 months (14.0% vs 6.9%, p < 0.0001). In multivariable models, adults with FI had higher odds of having seen a MHP (OR = 1.32, CI: 1.07, 1.64). Conclusions This study demonstrates that individuals with FI were significantly more likely to have seen a MHP in the preceding 12 months compared to individuals without FI. Given the growing interest in addressing unmet social needs in healthcare settings, this data suggests that visits with MHPs may be a valuable opportunity to screen for and intervene on FI.

Improving psychotropic medication use among persons with dementia

2016 ◽  
Vol 28 (10) ◽  
pp. 1587-1588 ◽  
Author(s):  
Donovan T. Maust
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
Psychotropic Medication ◽  
Medication Use ◽  
The United States ◽  
Black Box ◽  
Community Settings ◽  
Limited Evidence

The use of psychotropic medication among persons with dementia (PWD) both in nursing home (Wetzels et al., 2011) and community settings (Maust et al., 2016) far exceeds what might be expected based on their limited evidence for benefit (Kales et al., 2015). This relatively high use persists despite years of evidence about the potential harms associated with their use in older adults generally and PWD in particular (e.g. Wang et al., 2001; Schneider et al., 2005). However, the solution to relatively high psychotropic use is not to end all psychotropic use, as there are individual patients for whom use of such medication is appropriate. For example, a policy that defines all antipsychotic use as inappropriate may simply lead to increased use of alternatives with even less evidence of benefit, as suggested by the response to antipsychotics’ black box warning in the United States (Kales et al., 2011).

Growing From Grief

2015 ◽  
Vol 73 (3) ◽  
pp. 203-230 ◽  
Author(s):  
Jessica Koblenz
Keyword(s):  
United States ◽  
The United States ◽  
Clinical Applications ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Bereaved Children ◽  
Loss Of A Parent

Currently, there are 2.5 million children in the United States who suffered the loss of a parent. Grieving children are more likely to experience symptoms of depression and anxiety compared with their nongrieving peers. Adults ( N = 19) who experienced a loss during childhood were interviewed to assess what was most helpful and most harmful in coping through the years following the death. The qualitative descriptions were coded and analysis of common themes determined. Five theoretical constructs were found: adjustment to catastrophe, support, therapy, continuing a connection with the deceased parent, and reinvestment. The findings have clinical applications for bereaved children, their families, and clinical programs targeting this population. The unique insights provide an emotionally salient expression of their experiences and provide a framework for how best to support this group.

Sign in / Sign up

Export Citation Format

Share Document