Achieving national HIV prevention goals: the case for addressing depression and other mental health comorbidities

AIDS ◽  
2021 ◽  
Vol 35 (12) ◽  
pp. 2035-2037
Author(s):  
Linda J. Koenig ◽  
Lela R. McKnight-Eily
Keyword(s):  
Mental Health ◽  
Hiv Prevention ◽  
Health Comorbidities

scholarly journals Integrating mental health into HIV prevention and care: a call to action

2021 ◽  
Vol 24 (S2) ◽  
Author(s):  
Robert H Remien ◽  
Vikram Patel ◽  
Dixon Chibanda ◽  
Melanie Amna Abas
Keyword(s):  
Mental Health ◽  
Hiv Prevention ◽  
Call To Action

Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: a narrative review

2021 ◽  
pp. 1-12
Author(s):  
Rachel Lees ◽  
Lindsey A. Hines ◽  
Deepak Cyril D'Souza ◽  
George Stothart ◽  
Marta Di Forti ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Decision Making ◽  
Treatment Compliance ◽  
Narrative Review ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Treatments ◽  
Health Comorbidities

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

scholarly journals Eleven-year multimorbidity burden among 637 255 people with and without type 2 diabetes: a population-based study using primary care and linked hospitalisation data

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033866
Author(s):  
Salwa S Zghebi ◽  
Douglas T Steinke ◽  
Martin K Rutter ◽  
Darren M Ashcroft
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Population Based ◽  
Mental Illnesses ◽  
Secondary Outcome ◽  
Clinical Practice Research Datalink ◽  
Physical And Mental Health ◽  
Health Comorbidities

ObjectivesTo compare the patterns of 18 physical and mental health comorbidities between people with recently diagnosed type 2 diabetes (T2D) and people without diabetes and how these change by age, gender and deprivation over time between 2004 and 2014. Also, to develop a metric to identify most prevalent comorbidities in people with T2D.DesignPopulation-based cohort study.SettingPrimary and secondary care, England, UK.Participants108 588 people with T2D and 528 667 comparators registered in 391 English general practices. Each patient with T2D aged ≥16 years between January 2004 and December 2014 registered in Clinical Practice Research Datalink GOLD practices was matched to up to five comparators without diabetes on age, gender and general practice.Primary and secondary outcome measuresPrevalence of 18 physical and mental health comorbidities in people with T2D and comparators categorised by age, gender and deprivation. Odds for association between T2D diagnosis and comorbidities versus comparators. A metric for comorbidities with prevalence of ≥5% and/or odds ≥2 in patients with T2D.ResultsOverall, 77% of patients with T2D had ≥1 comorbidity and all comorbidities were more prevalent in patients with T2D than in comparators. Across both groups, prevalence rates were higher in older people, women and those most socially deprived. Conditional logistic regression models fitted to estimate (OR, 95% CI) for association between T2D diagnosis and comorbidities showed that T2D diagnosis was significantly associated with higher odds for all conditions including myocardial infarction (OR 2.13, 95% CI 1.85 to 2.46); heart failure (OR 2.12, 1.84 to 2.43); depression (OR 1.75, 1.62 to 1.89), but non-significant for cancer (OR 1.12, 0.98 to 1.28). In addition to cardiovascular disease, the metric identified osteoarthritis, hypothyroidism, anxiety, schizophrenia and respiratory conditions as highly prevalent comorbidities in people with T2D.ConclusionsT2D diagnosis is associated with higher likelihood of experiencing other physical and mental illnesses. People with T2D are twice as likely to have cardiovascular disease as the general population. The findings highlight highly prevalent and under-reported comorbidities in people with T2D. These findings can inform future research and clinical guidelines and can have important implications on healthcare resource allocation and highlight the need for more holistic clinical care for people with recently diagnosed T2D.

A 'snap shot' of the health of homeless people in inner Sydney: St Vincent's Hospital

2011 ◽  
Vol 35 (1) ◽  
pp. 52 ◽  
Author(s):  
Caroline N. Chin ◽  
Kate Sullivan ◽  
Stephen F. Wilson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Health Services ◽  
Physical Health ◽  
Homeless People ◽  
Health Resources ◽  
Poor Health ◽  
Health Profile ◽  
The Poor ◽  
Health Comorbidities

Objectives. The poor health profile of people who are homeless results in a disproportionate use of health resources by these people. An in-hospital count of demographic and health data of homeless patients was conducted on two occasions at St Vincent’s Hospital in Sydney as an indicator of health resource utilisation for the Sydney region. Methods. Two in-hospital counts were conducted of homeless patients within the boundaries of St Vincent’s Hospital to coincide with the inaugural City of Sydney homeless street counts in winter 2008 and summer 2009. Data collected included level of homelessness, principal diagnosis, triage category, bed occupancy and linkages to services post hospital discharge. Results. Homeless patients at St Vincent’s utilised over four times the number of acute ward beds when compared with the state average. This corresponds to a high burden of mental health, substance use and physical health comorbidities in homeless people. There was high utilisation of mental health and drug and alcohol services by homeless people, and high levels of linkages with these services post-discharge. There were relatively low rates of linkage with general practitioner and ambulatory care services. Conclusion. Increasing knowledge of the health needs of the homeless community will assist in future planning and allocation of health services. What is known about the topic? The poor health status of people who are homeless has been previously noted in the USA, Canada and Scotland. What does this paper add? Homeless people living in Sydney also have a poor health profile and a disproportionate use of health resources when compared to people in the general population. What are the implications for practitioners? Health services for homeless people should be equipped to deal with mental health, substance use and physical health comorbidities.

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