Disclosure, Discrimination, and Identity among Working Professionals with Bipolar Disorder or Major Depression

2021 ◽  
Author(s):  
Marta Elliott ◽  
Jordan C. Reuter
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Major Depression ◽  
Three Dimensions ◽  
Full Potential ◽  
Identity Strategies ◽  
Status Inconsistency ◽  
The Status ◽  
How People Learn ◽  
Depth Interviews

This chapter presents the results of an analysis of in-depth interviews with a snowball sample of 45 people who identified as working professionals diagnosed with bipolar disorder or major depression. It explores three dimensions of their experience: disclosure versus concealment of their diagnosis on the job, exposure to discrimination in the workplace based on their mental illness diagnosis, and identity strategies they used to manage the status inconsistency between being a professional and having a mental illness diagnosis. The findings reveal how people learn to calculate when it is safe to disclose their diagnosis on the job, especially after experiencing discriminatory treatment such as being fired or demoted. They also indicate that applying for workplace modifications to accommodate symptoms of mental illness may be met with unprofessional and unsupportive reactions on the part of managers, Human Resources professionals, and coworkers, which could explain in part why so few participants in this sample sought them. When it comes to balancing inconsistent statuses, the findings demonstrate how people distance themselves from their mental illness identity in favor of the more prized status of working professional as a means of self-preservation. The chapter concludes with a call for sweeping changes in workplace culture to minimize fear and shame and maximize inclusion of people diagnosed with mental illness, allowing them to flourish in careers in which they may realize their full potential.

scholarly journals Association of severe mental illness with stroke outcomes and process-of-care quality indicators: nationwide cohort study

2021 ◽  
pp. 1-8
Author(s):  
Kelly Fleetwood ◽  
Sarah H. Wild ◽  
Daniel J. Smith ◽  
Stewart W. Mercer ◽  
Kirsty Licence ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Cohort Study ◽  
Major Depression ◽  
Severe Mental Illness ◽  
Quality Indicators ◽  
Care Quality ◽  
Process Of Care ◽  
Vascular Events ◽  
Stroke Outcomes

Background Severe mental illness (SMI) is associated with increased stroke risk, but little is known about how SMI relates to stroke prognosis and receipt of acute care. Aims To determine the association between SMI and stroke outcomes and receipt of process-of-care quality indicators (such as timely admission to stroke unit). Method We conducted a cohort study using routinely collected linked data-sets, including adults with a first hospital admission for stroke in Scotland during 1991–2014, with process-of-care quality indicator data available from 2010. We identified pre-existing schizophrenia, bipolar disorder and major depression from hospital records. We used logistic regression to evaluate 30-day, 1-year and 5-year mortality and receipt of process-of-care quality indicators by pre-existing SMI, adjusting for sociodemographic and clinical factors. We used Cox regression to evaluate further stroke and vascular events (stroke and myocardial infarction). Results Among 228 699 patients who had had a stroke, 1186 (0.5%), 859 (0.4%), 7308 (3.2%) had schizophrenia, bipolar disorder and major depression, respectively. Overall, median follow-up was 2.6 years. Compared with adults without a record of mental illness, 30-day mortality was higher for schizophrenia (adjusted odds ratio (aOR) = 1.33, 95% CI 1.16–1.52), bipolar disorder (aOR = 1.37, 95% CI 1.18–1.60) and major depression (aOR = 1.11, 95% CI 1.05–1.18). Each disorder was also associated with marked increased risk of 1-year and 5-year mortality and further stroke and vascular events. There were no clear differences in receipt of process-of-care quality indicators. Conclusions Pre-existing SMI was associated with higher risks of mortality and further vascular events. Urgent action is needed to better understand and address the reasons for these disparities.

scholarly journals Severe mental illness and mortality and coronary revascularisation following a myocardial infarction: a retrospective cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kelly Fleetwood ◽  
Sarah H. Wild ◽  
Daniel J. Smith ◽  
Stewart W. Mercer ◽  
Kirsty Licence ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Cohort Study ◽  
Major Depression ◽  
Severe Mental Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Sociodemographic Factors ◽  
Coronary Revascularisation

Abstract Background Severe mental illness (SMI), comprising schizophrenia, bipolar disorder and major depression, is associated with higher myocardial infarction (MI) mortality but lower coronary revascularisation rates. Previous studies have largely focused on schizophrenia, with limited information on bipolar disorder and major depression, long-term mortality or the effects of either sociodemographic factors or year of MI. We investigated the associations between SMI and MI prognosis and how these differed by age at MI, sex and year of MI. Methods We conducted a national retrospective cohort study, including adults with a hospitalised MI in Scotland between 1991 and 2014. We ascertained previous history of schizophrenia, bipolar disorder and major depression from psychiatric and general hospital admission records. We used logistic regression to obtain odds ratios adjusted for sociodemographic factors for 30-day, 1-year and 5-year mortality, comparing people with each SMI to a comparison group without a prior hospital record for any mental health condition. We used Cox regression to analyse coronary revascularisation within 30 days, risk of further MI and further vascular events (MI or stroke). We investigated associations for interaction with age at MI, sex and year of MI. Results Among 235,310 people with MI, 923 (0.4%) had schizophrenia, 642 (0.3%) had bipolar disorder and 6239 (2.7%) had major depression. SMI was associated with higher 30-day, 1-year and 5-year mortality and risk of further MI and stroke. Thirty-day mortality was higher for schizophrenia (OR 1.95, 95% CI 1.64–2.30), bipolar disorder (OR 1.53, 95% CI 1.26–1.86) and major depression (OR 1.31, 95% CI 1.23–1.40). Odds ratios for 1-year and 5-year mortality were larger for all three conditions. Revascularisation rates were lower in schizophrenia (HR 0.57, 95% CI 0.48–0.67), bipolar disorder (HR 0.69, 95% CI 0.56–0.85) and major depression (HR 0.78, 95% CI 0.73–0.83). Mortality and revascularisation disparities persisted from 1991 to 2014, with absolute mortality disparities more apparent for MIs that occurred around 70 years of age, the overall mean age of MI. Women with major depression had a greater reduction in revascularisation than men with major depression. Conclusions There are sustained SMI disparities in MI intervention and prognosis. There is an urgent need to understand and tackle the reasons for these disparities.

scholarly journals Acute myocardial infarction in several mental illness: a nationwide analysis of prevalence, management strategies and outcomes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Mohamed ◽  
M Rashid ◽  
S Farooq ◽  
N Siddiqui ◽  
P Parwani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Major Depression ◽  
Clinical Outcomes ◽  
Management Strategies ◽  
The United States ◽  
Increased Risk ◽  
Organic Psychoses ◽  
To Receive ◽  
Invasive Management

Abstract Background Severe mental illness (SMI) is associated with an increased risk of cardiovascular disease and mortality. However, it is unclear whether SMI patients are just as likely to receive guideline-recommended therapy for AMI as those without mental illness. Purpose To examine national-level estimates of the prevalence, management strategies and in-hospital clinical outcomes of SMI patients presenting with AMI. Methods All AMI hospitalisations from the United States National Inpatient Sample were included, stratified by mental health status in to 5 groups: no-SMI, Schizophrenia, “Other non-organic psychoses” (ONOP), Bipolar Disorder and Major Depression. Multivariable logistic regression modelling was performed to examine the association between SMI subtypes and receipt of invasive management and subsequent in-hospital clinical outcomes, expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results Out of 6,968,777 AMI hospitalisations between 2004 and 2014, a total of 439,544 (6.5%) had an SMI diagnosis. The prevalence of SMI amongst the ACS population doubled over the study period (from 4.5% in 2004 to 9.5% in 2014), primarily due to an increase in Major Depression and Bipolar Disorder diagnoses. All SMI subtypes were less likely to receive coronary angiography and PCI, with the Schizophrenia group being at least odds of either procedure (aOR 0.46 95% CI 0.45, 0.48 and aOR 0.57 95% CI 0.55, 0.59, respectively). Although patients with Schizophrenia and ONOP experienced higher crude rates of in-hospital mortality and stroke compared to those without SMI, only Schizophrenia patients were associated with increased odds of mortality (aOR 1.10 95% CI 1.04, 1.16), while ONOP were the only group at increased odds of stroke (aOR 1.53 95% CI 1.42,1.65) following multivariate adjustment. Patients with ONOP were the only group associated with increased odds of in-hospital bleeding compared to those without SMI (aOR 1.11 95% CI 1.04,1.17). Conclusion Patients with SMI are less likely to receive invasive management for AMI, with women and schizophrenia diagnosis being the strongest predictors of conservative management. Schizophrenia and “other non-organic psychoses” are the only SMI subtypes associated with adverse clinical outcomes after AMI. A multidisciplinary approach between psychiatrists and cardiologists could improve outcomes of this high-risk population. Odds of management and clinical outcomes Funding Acknowledgement Type of funding source: None

scholarly journals Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring

2018 ◽  
Vol 10 (1) ◽  
pp. 100-107 ◽  
Author(s):  
A. Aylott ◽  
A. Zwicker ◽  
L. E. MacKenzie ◽  
J. Cumby ◽  
L. Propper ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Major Depression ◽  
Psychotic Symptoms ◽  
Same Sex ◽  
Mixed Effect ◽  
Increased Risk ◽  
Opposite Sex ◽  
Parent Of Origin ◽  
Origin Effects

AbstractChildren of parents with major mood and psychotic disorders are at increased risk of psychopathology, including psychotic symptoms. It has been suggested that the risk of psychosis may be more often transmitted from parent to opposite-sex offspring (e.g., from father to daughter) than to same-sex offspring (e.g., from father to son). To test whether sex-specific transmission extends to early manifestations of psychosis, we examined sex-specific contributions to psychotic symptoms among offspring of mothers and fathers with depression, bipolar disorder and schizophrenia. We assessed psychotic symptoms in 309 offspring (160 daughters and 149 sons) aged 8–24 years (mean=13.1, s.d.=4.3), of whom 113 had a mother with schizophrenia, bipolar disorder or major depression and 43 had a father with schizophrenia, bipolar disorder or major depression. In semi-structured interviews, 130 (42%) offspring had definite psychotic symptoms established and confirmed by psychiatrists on one or more assessments. We tested the effects of mental illness in parents on same-sex and opposite-sex offspring psychotic symptoms in mixed-effect logistic regression models. Psychotic symptoms were more prevalent among daughters of affected fathers and sons of affected mothers than among offspring of the same sex as their affected parent. Mental illness in the opposite-sex parent increased the odds of psychotic symptoms (odds ratio (OR)=2.65, 95% confidence interval (CI) 1.43–4.91, P=0.002), but mental illness in the same-sex parent did not have a significant effect on psychotic symptoms in offspring (OR=1.13, 95% CI 0.61–2.07, P=0.697). The opposite-sex-specific parent-of-origin effects may suggest X chromosome-linked genetic transmission or inherited chromosomal modifications in the etiology of psychotic symptoms.

Adopting a mojo mindset: Training newspaper reporters in mobile journalism

Journalism ◽  
2021 ◽  
pp. 146488492199628
Author(s):  
Anja Salzmann ◽  
Frode Guribye ◽  
Astrid Gynnild
Keyword(s):  
Thematic Analysis ◽  
Participant Observation ◽  
Publishing House ◽  
Three Dimensions ◽  
Specific Training ◽  
New Production ◽  
Visual Storytelling ◽  
Training Course ◽  
News Organizations ◽  
Depth Interviews

Due to the visual turn in journalism and the emergence of mobile journalism, many newspaper journalists have had to change the way they work and learn to use new tools. To face these changes, traditional news organizations apply different strategies to increase staff competencies in using new production tools and creating innovative content in new formats. In this paper, we investigate how a specific training arrangement was experienced by a group of 40 print editors and journalists in a German regional publishing house. The journalists were introduced to audio-visual storytelling and reporting with smartphones in a 2-week training course. The training arrangements were studied using participant observation and in-depth interviews, followed by a thematic analysis of the data. The study indicates that for print journalists and editors, the transition from the print to the mojo mindset depends on three dimensions: (i) mastering mojo skills, (ii) adopting visual thinking and (iii) integrating ethical and legal awareness.

scholarly journals Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina Gillezeau ◽  
Wil Lieberman-Cribbin ◽  
Kristin Bevilacqua ◽  
Julio Ramos ◽  
Naomi Alpert ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
First Year ◽  
Convenience Sample ◽  
Student Sample ◽  
Medical Specialties ◽  
Residency Programs ◽  
Deferred Action ◽  
The Status ◽  
Depth Interviews

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

scholarly journals Blind spots in stigma research? Broadening our perspective on mental illness stigma by exploring ‘what matters most’ in modern Western societies

2021 ◽  
Vol 30 ◽  
Author(s):  
G. Schomerus ◽  
M. C. Angermeyer
Keyword(s):  
Mental Illness ◽  
Cultural Context ◽  
Value Orientations ◽  
Mental Illness Stigma ◽  
Full Potential ◽  
Qualitative Work ◽  
Conservative Values ◽  
Stigma Experiences ◽  
Blind Spots ◽  
What Matters

Abstract Aims The theory of ‘what matters most’ (WMM) has been developed to understand differences in mental illness stigma between cultures, postulating that stigma becomes most pervasive in situations that matter most in a specific cultural context. The rise of populism in Western societies demonstrates that also within one cultural context, different values ‘matter most’ to different groups. We expand the WMM framework to explore the spectrum of stigma manifestations within Western societies, relating it to both conservative/authoritarian and liberal/modern values. From our findings, we will develop hypotheses on how further research into value orientations and stigma might address potential blind spots in stigma research. Methods Based on a narrative review of the literature on mental illness stigma and value orientations, we apply the WMM framework to cultural mechanisms of stigma within modern Western societies. Results There are several studies showing an association between traditional, authoritarian, conservative values with stronger mental illness stigma, while studies examining the stigma within liberal, modern value orientations are scarce. We hypothesise on situations where encountering a person with mental illness could threaten liberal values and thus might provoke stigma among persons with such value orientations. For example, living with a person with mental illness could be seen as consuming energy and time, thereby jeopardising ‘self-actualisation’, the modern value of realising one's own full potential. As a result, a person highly valuing self-actualisation might try to avoid contact with persons with mental illness. Instances of potential ‘liberal stigma’ also include structural stigma or self-stigma, when, e.g. changing assumptions of what is considered ‘normal’ increase perceptions of being fundamentally different when experiencing mental illness. Conclusions ‘WMM’ appears to be a useful framework to direct research to potential blind spots within the field of stigma research. Looking at instances where liberal values conflict with dealing with a person with mental illness could provide a more comprehensive understanding of stigma experiences among persons with mental illness. However, for measuring stigma, tapping into liberal variations of mental illness stigma is methodologically challenging. Qualitative work could be the first step to elicit potential stigma experiences based on conflicts with liberal values.

scholarly journals Reply to “Replication of association of 3p21.1 with susceptibility to bipolar disorder but not major depression”

2010 ◽  
Vol 43 (1) ◽  
pp. 5-5 ◽  
Author(s):  
Francis J McMahon ◽  
Nirmala Akula ◽  
Sven Cichon ◽  
Sevilla D Detera-Wadleigh ◽  
Howard Edenberg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depression
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